Behavioral and fMRI correlates of late-life generalized anxiety disorder

描述(由申请人提供)：在临床焦虑的个体中，对环境中的负面线索的选择性关注可能会使情绪障碍的恶性循环永久化。注意力被过度的负面暗示俘获，引发焦虑情绪状态，进而强化负面信息的显着性。人们对注意力偏向在焦虑的老年人中的作用知之甚少，尽管人们承认有必要增加对晚年焦虑的研究。此外，有证据表明，在没有临床焦虑的老年人中，存在相反的偏见(倾向于积极的情感材料，而不是消极的情感材料)；然而，这些与年龄相关的情绪处理变化如何与焦虑相互作用目前尚不清楚。情绪Stroop(EStroop)任务要求快速识别消极、中性和积极情绪词的墨水颜色，但尚未被彻底测试为老年人注意偏差的指标。这项建议的具体目的有两个：1)测试eStroop反应时间是否区分焦虑和非焦虑的老年人；2)确定老年广泛性焦虑症(GAD)患者和年龄匹配的对照组eStroop的神经相关性。在研究1中，社区中的60名老年人将完成eStroop任务。我们将对反应时间数据进行分析，以检验这样一种预测，即在自我报告担忧的情况下，得分高的人会有选择地注意负面词语，而得分低的人会有选择地注意积极的词语。在研究2中，将分析最近在eStroop任务期间从40名老年人(28名寻求治疗的GAD患者，12名非焦虑对照组)收集的fMRI数据。分析将集中在与抑制控制(前额叶皮质区域)和情绪处理(杏仁核)有关的神经回路上，并将测试注意力偏向理论模型的预测。该项目将提供一项广泛应用于老年人样本研究的新数据，并将促进我们对研究不足的年龄组中正常和异常情绪处理的行为和神经相关性的理解。鉴于GAD是晚年最常见的精神疾病之一，而且对现有治疗的反应率相对较低，迫切需要对老年GAD的行为和神经机制有更好的了解。广泛性焦虑症是一种在老年人中普遍存在的致残疾病。这项研究将探索已被证明导致年轻人焦虑的注意力偏差是否与晚年焦虑同样相关，以及这些偏见背后可能存在的大脑活动模式。

DESCRIPTION (provided by applicant): In clinically anxious individuals, selective attention to negative cues in the environment may perpetuate a vicious cycle of emotional dysfunction. Attention is captured by negative cues to an inordinate degree, triggering anxious mood states which, in turn, reinforce the salience of negative information. Very little is known regarding the role of attentional biases in anxious older adults, despite the acknowledged need for an increase in research on late-life anxiety. Furthermore, there is evidence that in older adults without clinical anxiety, the opposite bias (toward positive, and away from negative, emotional material) is present; yet how these age-related changes in emotional processing interact with anxiety is currently unknown. The emotional Stroop (eStroop) task, which requires rapid identification of the ink color of negative, neutral, and positive emotional words, has yet to be thoroughly tested as an index of attentional bias in older adults. The specific aims of this proposal are twofold: 1) to test whether eStroop response times differentiate anxious and non-anxious older adults; and 2) to identify neural correlates of the eStroop in late-life generalized anxiety disorder (GAD) patients and age-matched controls. In Study 1, 60 older adults in the community will complete the eStroop task. Response time data will be analyzed to test the prediction that high scorers on a self-report measure of worry, but not low scorers, will selectively attend to negative words, while low scorers, but not high scorers, will selectively attend to positive words. In study 2, fMRI data recently collected from 40 older adults (28 treatment-seeking GAD patients, 12 non-anxious controls) during the eStroop task will be analyzed. Analyses will focus on the neural circuits implicated in inhibitory control (prefrontal cortex regions) and emotional processing (amygdala) and will test the predictions of a theoretical model of attentional bias. This project will provide novel data on the utility of a widely-used task for research with older adult samples and will advance our understanding of the behavioral and neural correlates of normal and abnormal emotional processing in an understudied age group. Given that GAD is one of the most prevalent psychiatric conditions in late life, and response rates to current therapies are relatively poor, an improved understanding of the behavioral and neural mechanisms of late-life GAD is urgently needed. Generalized anxiety disorder is a prevalent, disabling condition in the older adult population. This study will explore whether biases in attention that have been shown to contribute to anxiety in younger adults are equally relevant in late-life anxiety, and what patterns of brain activity may underlie these biases.