Multi-level Mechanisms of Emotion Regulation Strategy Selection in Adolescents

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Project Summary/Abstract Emotion regulation (ER) has emerged as a promising point of intervention given its robust association with the development, maintenance, and relapse of adolescent mood disorders. Current interventions focus on teaching adaptive ER strategies (e.g., reappraisal) based on the dominant assumption that ER dysfunction is caused by an incapacity to implement adaptive strategies to manage emotions. However, several studies challenge this ‘capacity account’ of ER dysfunction and they find that although patients can use adaptive ER strategies when instructed (i.e., intact capacity), they fail to use these strategies in daily life. This discrepancy between what one can do vs. chooses to do suggests that ER capacity may not be the problem and points to potential disruptions in ER strategy selection. A better understanding of how ER capacity and strategy selection contribute to ER dysfunction in adolescents is critical to developing more effective interventions. The current project will combine computational modeling of task behavior, ecological momentary assessment (EMA), and both lab-based and ambulatory psychophysiology to test the ER capacity account and investigate whether cognitive-affective factors related to avoidance disrupt ER strategy selection in adolescents (70 clinical; 30 healthy controls). Specific Aim 1 will use a multi-method laboratory task to empirically test the ER capacity account to determine whether adolescents with mood disorders revert to less effective ER strategies, even when capacity for adaptive ER is intact. Specific Aim 2 will identify whether biases in cognitive processes related to avoidance of aversive states and heighted affective reactivity predict failure to use adaptive ER strategies. Specific Aim 3 will utilize a 7-day EMA protocol with ambulatory psychophysiology to assess how cognitive-affective factors contribute to real-world ER strategy selection in daily life. Findings will provide preliminary data for a planned R01 application examining ER selection mechanisms as clinical predictors of psychiatric risk, course, and response, and a R61/R33 application to directly target ER strategy selection. Dr. LoPilato seeks to build upon her strong foundation in adolescent psychopathology in this K23 with a new emphasis on cognitive-affective processes that can be targeted with psychosocial intervention through training in the following domains: 1.) computational modeling of behavioral data; 2.) integration of lab-based and ambulatory psychophysiology with EMA methods; and 3.) clinical trial design. The Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine is an outstanding environment to engage this interdisciplinary training and clinical research. The mentoring team (Drs. Craighead, Treadway, Strauss) and consultants (Drs. Silk and Hartley) have extensive expertise in these training domains. The proposed research and training plan will prepare Dr. LoPilato to become a translational intervention researcher and establish an independent program of research integrating computational and ambulatory approaches to understand and target cognitive-affective mechanisms underlying adolescent ER dysfunction and mood disorders.