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Translating Language-Emotion Interactions in Exposure Therapy

暴露疗法中语言-情感相互作用的转化

基本信息

批准号：
7787488
负责人：
Katharina Kircanski
金额：
$ 0.65万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-03-09 至 2010-06-08
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7787488
关键词：
Affect Affective Amygdaloid structure Animal Experimentation Anxiety Anxiety Disorders Attenuated Basic Behavioral Science Basic Science Behavior Therapy Behavioral Cognition Cognitive Effectiveness Emotional Emotions Exposure to Extinction (Psychology)Fright Galvanic Skin Response Goals Health Heart Rate Human Label Language Learning Maintenance Measures Methods Modality Neurosciences Participant Pathway interactions Patient Self-Report Patients Phobic anxiety disorder Physiological Pilot Projects Prefrontal Cortex Process Psychophysiology Relative (related person)Reporting Research Sampling Spiders Stimulus Testing Translating Translations base clinically relevant distraction improved indexing innovation novel strategies public health relevance relating to nervous system response self reported behavior theories tool translational approach

项目摘要

DESCRIPTION (provided by applicant): The broad goal of this research is to translate advances made in the basic science of language-emotion interactions to innovations and improvements in exposure therapy for phobias and other anxiety disorders. The most common behavioral treatment for anxiety disorders entails repeated exposure to feared stimuli. Despite demonstrations of its effectiveness, exposure therapy is not full-proof, in that it does not benefit every patient and may fail to reduce fear responding for many reasons. Akin to extinction, exposure therapy is presumed to evoke inhibitory learning rather than a complete erasure of original fear learning, as indicated by human and animal research inducing return of fear following fear extinction/exposure therapy. As such, it is critical to evaluate novel strategies to enhance the access to or retrievability of inhibitory learning at re-test and maintain long-term fear reduction. Advances in basic behavioral science and neuroscience suggest that controlled verbal processing may be one way to enhance inhibitory learning in exposure. Two specific types of verbalization, labeling and reappraisal, have been shown to activate regions of the prefrontal cortex that then attenuate automatic affective processes associated with the amygdala and autonomic activation. Thus, an inhibitory pathway involving verbalization may enhance inhibitory processes in exposure therapy and more effectively attenuate fear responding across clinically-relevant indices. To this end,a study is proposed to evaluate these methods of verbalization during exposure within a spider-fearful sample. First, the study aims to evaluate whether two verbalization conditions (labeling, reappraisal) using variable encoding reduce fear responding relative to an exposure-alone condition and a distraction condition, from baseline to immediate re-test and one-week re-test, across autonomic (heart rate, skin conductance), self- report (affect, cognitions), and behavioral (approach distance) indices of fear responding. Second, the study aims to evaluate whether reappraisal more comprehensively reduces fear responding than labeling across these indices. Third, the study aims to evaluate whether verbalization at re-test reduces fear responding relative to exposure-alone at re-test, and is necessary for longer maintenance of fear reduction. PUBLIC HEALTH RELEVANCE: This study aims to hasten the translation of basic science discoveries regarding language-emotion interactions to more effective behavioral treatments for phobias and other anxiety disorders. The methods and findings could have a significant impact by providing new tools to clinicians and patients that directly incorporate verbal processing in exposure therapy. This research also has implications for understanding of fear and anxiety processes and ways in which verbalization improves long-term health.

描述（由申请人提供）：本研究的总体目标是将语言-情感互动基础科学的进展转化为恐惧症和其他焦虑障碍的暴露疗法的创新和改进。对焦虑症最常见的行为治疗是反复暴露于令人恐惧的刺激。尽管暴露疗法的有效性得到了证明，但它并不是完全可靠的，因为它并不是对每个病人都有好处，而且由于许多原因，它可能无法减少恐惧反应。与“消失”类似，暴露疗法被认为是唤起抑制性学习，而不是完全消除原始的恐惧学习，正如人类和动物研究表明的那样，在恐惧消失/暴露疗法后会诱发恐惧的回归。因此，评估新的策略以提高复试时抑制学习的可获得性和可检索性，并保持长期的恐惧减少是至关重要的。基础行为科学和神经科学的进展表明，控制言语加工可能是增强暴露条件下抑制性学习的一种方式。有两种特定类型的语言表达，标记和重新评价，已经被证明可以激活前额皮质区域，然后减弱与杏仁核和自主神经激活相关的自动情感过程。因此，涉及语言表达的抑制途径可能会增强暴露治疗中的抑制过程，并更有效地减弱临床相关指标的恐惧反应。为此，提出了一项研究，以评估这些方法的语言表达期间暴露在一个蜘蛛恐惧的样本。首先，本研究旨在通过自主神经（心率、皮肤电导）、自我报告（情感、认知）和行为（接近距离）指标，从基线到即时重测和一周重测，评估两种语言化条件（标记、重新评价）相对于单独暴露条件和分心条件是否减少恐惧反应。其次，本研究旨在评估重新评估是否比在这些指标上贴标签更全面地减少了恐惧反应。第三，本研究旨在评估复试时言语化是否相对于单独暴露降低了复试时的恐惧反应，以及是否有必要延长恐惧减少的维持时间。公共卫生相关性：本研究旨在加速将语言-情感相互作用的基础科学发现转化为对恐惧症和其他焦虑障碍的更有效的行为治疗。这些方法和发现可以为临床医生和患者提供新的工具，直接将语言处理纳入暴露疗法，从而产生重大影响。这项研究也对理解恐惧和焦虑的过程以及语言化改善长期健康的方式有启示。