Can social support figures enhance fear extinction in patients with social anxiety?

项目总结/摘要 据估计，大约三分之一的美国成年人将受到与恐惧有关的疾病的影响， 他们一生的历程这些障碍，包括诊断，如广泛性焦虑症，社交 焦虑症或创伤后应激障碍的特征是破坏性的恐惧， 对健康和福祉造成长期有害后果。即使是最成功的 迄今为止的治疗，暴露疗法（一套程序，采用恐惧消退过程，以减少恐惧） 效果有限，治疗期间的不适导致脱落和复发仍然是常见的 发生。因此，研究增加暴露疗法治疗和改善恐惧的方法， 减少战略对于改善患有与恐惧有关的疾病的个人的福祉至关重要。 最近的研究表明，社会支持可能是这样一种方法，表明， 社会支持提醒增强了健康成年人恐惧的消除，并减少了恐惧的获得。 这些发现是出乎意料的，因为它们与目前认为所有安全性信号（包括 社会支持人士，在减少恐惧干预期间是有害的。因此，虽然目前的观点认为， 这些线索减少灭绝并增强获得，社会支持提醒实际上增强了灭绝 减少收购。这种差异可能是由于社会支持在人类中的重要作用 生存;特别是，进化来加强社会联系的神经生物学机制似乎 与支持恐惧学习的系统重叠，使社会支持成为减少恐惧的独特力量。 这些先前的发现暗示了一种令人兴奋的可能性，即社会支持可能在 改善患有恐惧相关疾病的个体的结果。特别是社会支持的存在 提醒（例如，图片）可能会增加暴露疗法治疗，提高灭绝的结果， 丰富策略，以防止有发展破坏性恐惧风险的个人获得恐惧。虽然 社会支持的减少恐惧的效果已经在健康的成年人身上得到了证明，这些效果从来没有 在患有恐惧相关疾病的成年人中进行了测试。因此，拟议的研究将是第一个探讨是否 社会支持1）增强恐惧消退和2）减少社交焦虑症成年人的恐惧获得 (SAD)健康的对照。在第一项研究中，我们将测试是否存在社会支持形象（与。 微笑的陌生人图像）导致被诊断为SAD的参与者（n=60，30名女性）的灭绝增强 健康对照组（n=60，30名女性）。在第二项研究中，我们将测试是否存在社会 支持图像（与微笑的陌生人图像相比）减少了SAD参与者的获取（n=60，30名女性） 健康对照组（n=60，30名女性）。这项工作将确定是否减少恐惧的影响，社会 支持范围从健康成年人扩展到那些患有恐惧相关疾病的人， 廉价的方法来加强目前的恐惧减少治疗和减弱新的恐惧的形成。

Project Summary/Abstract It is estimated that roughly one third of adults in the US will be affected by a fear-related disorder over the course of their lifetime. These disorders, including diagnoses such as generalized anxiety disorder, social anxiety disorder, or post-traumatic stress disorder, are marked by disruptive fears that can interfere with daily life and have harmful long-term consequences on health and well-being. Yet, even the most successful treatment to date, exposure therapy (a set of procedures that employs fear extinction processes to reduce fear) has limited effects, with discomfort during therapy leading to drop-out and relapse remaining a common occurrence. Thus, investigation of methods to augment exposure therapy treatments and improve fear reduction strategies is critical for improving the well-being of individuals with fear-related disorders. Recent work has revealed that social support may represent one such method, demonstrating that social support reminders enhance the extinction of fear and reduce the acquisition of fear in healthy adults. These findings are unexpected, as they are in direct contrast with current views that all safety signals, including social support figures, are harmful during fear-reduction interventions. Thus, while current views would suggest that these cues reduce extinction and enhance acquisition, social support reminders in fact enhance extinction and reduce acquisition. This divergence may be explained by the crucial role of social support in human survival; specifically, the neurobiological mechanisms that have evolved to reinforce social bonds appear to overlap with the systems that support fear learning, making social support uniquely poised to reduce fear. These previous findings hint at the exciting possibility that social support may play an important role in improving outcomes for individuals with fear-related disorders. In particular, the presence of social support reminders (e.g., pictures) may augment exposure therapy treatments, enhancing extinction outcomes, and enrich strategies to prevent fear acquisition in individuals at risk for developing disruptive fears. However, while the fear-reducing effects of social support have been demonstrated in healthy adults, these effects have never been tested in adults with fear-related disorders. Thus, the proposed studies will be the first to explore whether social support 1) enhances fear extinction and 2) reduces fear acquisition in adults with social anxiety disorder (SAD) and healthy controls. In the first study, we will test whether the presence of a social support image (vs. smiling stranger image) leads to enhanced extinction in participants diagnosed with SAD (n=60, 30 females) and healthy controls (n=60, 30 females). In the second study, we will test whether the presence of a social support image (vs. smiling stranger image) reduces acquisition in participants with SAD (n=60, 30 females) and healthy controls (n=60, 30 females). This work will establish whether the fear-reducing effects of social support extend beyond healthy adults to those with fear-related disorders, potentially shedding light on simple, inexpensive ways to augment current fear reduction treatments and attenuate the formation of new fears.