Emotion Regulation in Distress Disorders: Elucidating the Role of Cognitive Processes and Person-Situation Fit in the Laboratory and Daily Life

应激障碍中的情绪调节：阐明认知过程和人境适应性在实验室和日常生活中的作用

• 批准号: 10056639
• 负责人: Kristin Gainey
• 金额: $ 50.56万
• 依托单位: UNIVERSITY OF WESTERN AUSTRALIA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-12 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10056639
• 关键词: Emotion; Regulation; Distress; Disorders; Elucidating

ABSTRACT: Major depression and generalized anxiety disorder, conceptualized jointly as distress disorders, are prevalent conditions with considerable public health burden and comparatively lower response to treatment. Distress disorders share numerous features that serve to maintain and worsen these conditions, including heightened negative emotions, deficits in emotion regulation (ER), and elevated perseverative negative thinking (PNT). Importantly, effective ER is associated with better psychological functioning and better physiological recovery from stress, and it is a target in distress disorders interventions. Effective ER depends upon intact emotional awareness and contextual sensitivity, which facilitate flexibly enacting ER strategies to match one's characteristics and the current situation. A critical barrier to improving interventions for distress disorders is a lack of knowledge regarding the specific predictors of effective ER, especially when assessing performance under optimal conditions measured in the lab (ER capacity) and naturalistic, spontaneous ER use in daily life (ER tendency). The goal of this application is to evaluate how cognitive and situational factors contribute to effective ER capacity and ER tendency, and to examine how ER capacity and tendency work synergistically to predict long-term distress symptoms and functioning. An integrative model of ER specifically suited to the distress disorders that incorporates PNT will be tested in the laboratory and in daily life, with findings linked to prospective assessments of distress symptoms and functioning to isolate elements of effective ER most relevant to clinical outcomes. The proposed study will be comprised of 300 adults, oversampling for elevated PNT, with a multi-method design. Participants will complete a lab assessment that incorporates behavioral, cardiovascular physiological, and clinical interview measures, followed by a 10-day ecological momentary assessment study examining predictors of ER in daily life. To better capture negative emotions as they occur, reports in daily life will be physiologically-triggered with algorithms that detect psychological stress. Effective ER will be operationalized in multiple ways in the lab and in daily life, using self-reported changes in affect, physiological indices, and perceived ER success. The associations of effective ER and its predictors will then be examined in relation to the trajectory of distress symptoms and functioning at 6-month and 12-month follow-up assessments. Additionally, an exploratory aim is to create predictive models from a multifaceted battery of theoretically motivated variables that may impact real-life ER and subsequent clinical outcomes, by using machine learning to build a clinically-relevant framework for how person-level, situation-level, and ER strategy use interact to predict optimal ER. This project is consistent with NIMH strategic objectives and the RDoC framework due to the dimensional approach to psychopathology and multiple units of analysis. Overall, this project contributes to the long-term goal of identifying and refining targets for personalized interventions, by more precisely isolating key mechanisms of effective ER for specific individuals and the contexts they encounter in their daily lives.

摘要：重度抑郁症和广泛性焦虑症，统称为痛苦障碍， 是一种普遍存在的疾病，具有相当大的公共卫生负担，而且对治疗的反应相对较低。 应激障碍有许多共同的特征，这些特征有助于维持和恶化这些状况，包括 负面情绪加剧、情绪调节 (ER) 缺陷以及持续性负面思维增多 （PNT）。重要的是，有效的 ER 与更好的心理功能和更好的生理功能相关。 从压力中恢复，这是应激障碍干预的目标。有效的 ER 取决于完整的 情绪意识和情境敏感性，有助于灵活制定 ER 策略来匹配自己的情况 特点和现状。改善痛苦障碍干预措施的一个关键障碍是 缺乏关于有效 ER 的具体预测因素的知识，尤其是在评估绩效时 在实验室测量的最佳条件下（ER 容量）以及日常生活中自然、自发的 ER 使用 （ER 趋势）。该应用程序的目标是评估认知和情境因素如何影响 有效的 ER 能力和 ER 趋势，并研究 ER 能力和趋势如何协同作用 预测长期痛苦症状和功能。特别适合的 ER 综合模型 包含 PNT 的应激障碍将在实验室和日常生活中进行测试，结果与 对痛苦症状和功能进行前瞻性评估，以隔离最相关的有效 ER 要素 到临床结果。拟议的研究将由 300 名成年人组成，针对升高的 PNT 进行过采样，其中 多方法设计。参与者将完成一项实验室评估，其中包括行为、心血管 生理和临床访谈测量，然后进行为期 10 天的生态瞬时评估研究 检查日常生活中 ER 的预测因素。为了更好地捕捉日常生活中出现的负面情绪 将通过检测心理压力的算法在生理上触发。有效的急诊室将是 利用自我报告的情感、生理变化，在实验室和日常生活中以多种方式进行操作 指数和感知 ER 成功。然后将检查有效 ER 及其预测因子的关联 与 6 个月和 12 个月随访评估中痛苦症状和功能轨迹的关系。 此外，一个探索性的目标是从多方面的理论上创建预测模型 通过使用机器学习，可能影响现实生活中的 ER 和随后的临床结果的动机变量 建立一个临床相关框架，用于说明个人层面、情况层面和 ER 策略如何相互作用 预测最佳 ER。该项目符合 NIMH 战略目标和 RDoC 框架，因为 精神病理学的维度方法和多分析单位。总体而言，该项目有助于 通过更精确地隔离关键因素来确定和完善个性化干预目标的长期目标 针对特定个人及其日常生活中遇到的情况的有效 ER 机制。