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职业发展奖 (K23)，以支持她作为一名独立研究人员的发展，利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治疗时缺乏知识来指导他们。 Aupperle 博士的长期职业目标是利用有关大脑行为关系的知识来开发针对焦虑症的高度针对性的行为干预措施。更具体地说，目标是可以使用神经行为电池对个体患者进行评估，以确定使用哪些治疗模块来优化反应。拟议的研究将通过调查接近（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用于识别不太可能对基于暴露的广泛性焦虑症（GAD）治疗做出反应的个体，从而实现实现这一目标的第一步。该项目将使用 Aupperle 博士最近开发的一项任务，结合与接近和回避处理相关的其他任务和问卷，在仲裁接近和回避动机期间探测大脑和行为反应。 Aupperle 博士的职业目标以及该应用程序的具体研究目标的实现，需要与当前行为干预、治疗结果研究、神经影像方法和分析以及用于汇总多个级别的分析和建模纵向数据集的统计方法相关的专业知识。基于她之前的研究和临床培训，Aupperle 博士展示了功能神经影像学和当前焦虑心理干预方面的专业知识。拟议的培训计划将提供进一步的指导、课程作业和先进统计方法的实践经验，用于纵向和多层次分析、行为结果研究和多模式脑电图/功能磁共振成像神经影像（增加她研究的深度和临床普遍性）。 Aupperle 博士组建了一支独特的导师团队，能够提供所需的多元化专业知识。博士。 Martin Paulus（LIBR 科学总监兼主要导师）和 Jim Abelson 将提供整合神经生物学和临床/行为分析层面的专业知识。米歇尔·克拉斯克博士将带来她在焦虑行为干预的开发和研究方面的丰富经验。 LIBR 神经影像核心总监 Bodurka 博士将提供与同步脑电图/功能磁共振成像相关的指导。培训和相关研究将在 LIBR 进行，LIBR 是一家最先进的机构，致力于进行神经影像和遗传学研究，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.