Biobehavioral mechanisms of smartphone-based cognitive emotion regulation training for unpaid primary caregivers of persons with Alzheimer's Disease

项目总结/摘要 阿尔茨海默病（AD）和阿尔茨海默病相关痴呆（ADRD）不仅是一种严重的疾病， 他们也给病人带来了巨大的情感、身体和经济负担， 家人照顾者为被诊断患有AD的亲人提供护理的压力，通常跨越几年， 与抑郁风险升高和整体健康状况较差有关。现有的认知和行为 ADRD无报酬主要照顾者的干预方法通过生物行为机制运作， 仍有待澄清。此外，现有的干预措施针对许多组成部分和战略 同时，使推论的有效性，特别是战略难以得出，并涉及 时间/成本负担。情绪调节技能是心理干预的理想目标 促进ADRD照顾者的健康应对。这项拟议中的研究试图使用一种实验性药物， 方法来测试一种新的，相对简短的，有针对性的，可扩展的， 完全基于智能手机的认知情绪调节干预，旨在改善心理 结果（即，减少感知压力，照顾者负担和抑郁症状） 主要照顾者以及检查照顾者干预对护理生活质量的潜在益处 受惠人士认知再评价（Cognitive reassessment），通过思考改变情绪反应轨迹的能力 以另一种更适应的方式来了解和评估情感信息）代表了一种高度 对ADRD照顾者进行心理干预的有希望的目标。重新评估可以通过以下两个途径来实现 主要策略：心理距离（即评估情绪刺激作为一个客观，公正， 观察者）和重新解释（即，想象一个比最初看起来更好的结果）。的 拟议的项目建立在有希望的初步工作，以调查的功效和基础 在这一人群中进行为期一周的新型认知再评价干预的生物行为机制， 在2周、4周和3个月时进行随访评估。ADRD无报酬的主要照顾者将随机 被分配接受距离、重新解释或无规则自然历史控制方面的培训 条件，与自我报告的积极和消极的影响，远程生态瞬间评估- 收集的心理生理健康相关的生物标志物（即，心率变异性数据测量使用 基于智能手机的光电体积描记法）和健康相关的问卷报告。拟定研究 目的是将心理和心理生理功能的变化与 在一种从未实施过的新型情绪调节干预期间的健康相关行为结果 在这个有压力的高危人群中

Project Summary / Abstract Alzheimer’s Disease (AD) and Alzheimer's Disease-Related Dementias (ADRD) not only exact a heavy toll on patients, they also impose an enormous emotional, physical, and financial burden on unpaid, often family, caregivers. The strain of providing care for a loved one diagnosed with AD, often across several years, is associated with elevated depression risk and poorer overall health. Existing cognitive and behavioral intervention approaches for ADRD unpaid primary caregivers operate via biobehavioral mechanisms that remain to be clarified. In addition, existing interventions target many components and strategies simultaneously, making inferences about the effectiveness of particular strategies difficult to draw, and involve substantial time/cost burdens. Emotion regulation skills represent an ideal target for psychological intervention to promote healthy coping in ADRD caregivers. The proposed research seeks to use an experimental medicine approach to test the efficacy and biobehavioral mechanisms of a novel, relatively brief, targeted, scalable, entirely smartphone-based cognitive emotion regulation intervention aimed at improving psychological outcomes (i.e., reducing perceived stress, caregiver burden, and depressive symptoms) in ADRD unpaid primary caregivers as well as examine potential benefits of the caregiver intervention on quality of life in care recipients. Cognitive reappraisal (i.e., the ability to modify the trajectory of an emotional response by thinking about and appraising emotional information in an alternative, more adaptive way) represents a highly promising target for psychological intervention in ADRD caregivers. Reappraisal can be operationalized via two primary tactics: psychological distancing (i.e. appraising an emotional stimulus as an objective, impartial observer) and reinterpretation (i.e., imagining a better outcome than what initially seemed apparent). The proposed project builds upon promising preliminary work to investigate the efficacy and underlying biobehavioral mechanisms of a novel, one-week cognitive reappraisal intervention in this population, with follow-up assessments at 2 weeks, 4 weeks, and 3 months. ADRD unpaid primary caregivers will be randomly assigned to receive training in either distancing, reinterpretation, or a no regulation natural history control condition, with ecological momentary assessments of self-reported positive and negative affect, remotely- collected psychophysiological health-related biomarkers (i.e., heart rate variability data measured using smartphone-based photoplethysmography), and health-related questionnaire reports. The proposed study aims to mechanistically relate changes in psychological and psychophysiological function to prediction of health-relevant behavioral outcomes during a novel emotion regulation intervention never before implemented in this stressed, high risk group.