Approach-Avoidance Conflict-a multi-level predictor for exposure therapy response

 描述(由申请人提供)：Robin Aupperle博士正在申请以患者为导向的导师职业发展奖(K23)，以支持她作为一名独立研究人员的发展，使用神经科学方法为焦虑症的行为治疗提供信息。目前，临床医生和患者在决定是否开始治疗或如何修改手动治疗以优化个体化治疗时，几乎没有什么知识来指导他们。Aupperle博士的长期职业目标是利用有关大脑-行为关系的知识，开发针对焦虑症的高针对性行为干预措施。更具体地说，目标是可以使用神经行为电池对单个患者进行评估，以确定使用哪些治疗模块来优化反应。这项拟议的研究将通过调查方法(即奖励)和回避(即威胁)动机的水平，或仲裁这些动机的能力是否可以用来识别不太可能对基于暴露的广泛性焦虑症(GAD)治疗有反应的个体，从而完成朝着这一目标迈出的第一步。这个项目将使用Aupperle博士最近开发的一项任务，以探索在接近和回避动机的仲裁期间的大脑和行为反应，以及与接近和避免处理相关的其他任务和问卷。要实现Aupperle博士的职业目标和这项应用的具体研究目标，需要与当前行为干预、治疗结果研究、神经成像方法和分析相关的专业知识，以及用于汇总多个层次的分析和对纵向数据集进行建模的统计方法。基于她之前的研究和临床培训，奥珀尔博士在功能神经成像和目前的焦虑心理干预方面表现出了专业知识。拟议的培训计划将在纵向和多水平分析、行为结果研究和多模式EEG/fMRI神经成像的高级统计方法方面提供进一步的指导、课程安排和实践经验(增加她研究的深度和临床可推广性)。奥珀尔博士组建了一支导师团队，他们非常适合提供所需的多样化专业知识。Martin Paulus博士(LIBR科学总监和首席导师)和Jim Abelson博士将提供跨神经生物学和临床/行为层面的分析集成的专业知识。米歇尔·克拉斯克博士将带来她在焦虑行为干预开发和研究方面的丰富经验。LIBR神经成像核心总监博杜尔卡博士将提供与同步EEG/fMRI成像相关的指导。培训和相关研究将在LIBR进行，这是一个致力于进行神经成像和遗传学研究的最先进的研究所，旨在开发更有效的神经精神疾病治疗方法。

 DESCRIPTION (provided by applicant): Dr. Robin Aupperle is applying for the Mentored Patient-Oriented Career Development Award (K23) to support her development as an independent researcher using neuroscientific methods to inform the behavioral treatment of anxiety disorders. Clinicians and patients currently have little knowledge to guide them when deciding whether or not to embark on therapy or how to modify manualized therapy to optimize individual treatment. Dr. Aupperle's long-term career goal is to use knowledge regarding brain-behavior relationships to develop highly targeted behavioral interventions for anxiety disorders. More specifically, the aim would be that an individual patient could be assessed using a neurobehavioral battery to determine which therapy modules to use for optimizing response. The proposed research will accomplish the first steps towards this goal by investigating whether levels of approach (i.e., reward) and avoidance (i.e., threat) motivations, or the ability to arbitate these motivations can be used to identify individuals unlikely to respond to exposure-based therapy for generalized anxiety disorder (GAD). This project will use a task Dr. Aupperle recently developed to probe brain and behavior responses during the arbitration of approach and avoidance motivations in combination with other tasks and questionnaires relevant to approach and avoidance processing. The achievement of Dr. Aupperle's career goals, and the specific research objectives of this application, requires expertise related to current behavioral interventions, treatment outcome research, neuroimaging methods and analyses, and statistical methods for aggregating across multiple levels of analyses and modeling longitudinal datasets. Based on her prior research and clinical training, Dr. Aupperle has demonstrated expertise in functional neuroimaging and current psychological interventions for anxiety. The proposed training plan will provide further mentorship, coursework, and hands-on experience in advanced statistical methods for longitudinal and multilevel analyses, behavioral outcome research, and multimodal EEG/fMRI neuroimaging (increasing the depth and clinical generalizability of her research). Dr. Aupperle has assembled a team of mentors uniquely suited to provide the required diversity of expertise. Drs. Martin Paulus (LIBR Scientific Director and primary mentor) and Jim Abelson will provide expertise for integrating across neurobiological and clinical/behavioral levels of analyses. Dr. Michelle Craske will bring her extensive experience related to the development and investigation of behavioral interventions for anxiety. Dr. Bodurka, LIBR Neuroimaging Core Director, will provide mentorship related to simultaneous EEG/fMRI imaging. The training, and associated research, will take place at LIBR, a state-of-the-art institute dedicated to conducting neuroimaging and genetics research aimed at developing more effective treatments for neuropsychiatric disorders.