Mechanisms Underlying Emotion Regulation Abnormalities in Youth at Clinical High-Risk for Psychosis

临床精神病高危青少年情绪调节异常的机制

• 批准号: 10011943
• 负责人: GREGORY P STRAUSS
• 金额: $ 18.88万
• 依托单位: UNIVERSITY OF GEORGIA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-09 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10011943
• 关键词: Adult; Area; Attenuated; Autonomic nervous system; Awareness; Behavior; Clinical; Cognitive; Computer Models; Cues; Data; Delusions; Disease; Early Intervention; Early identification; Ecological momentary assessment; Electrophysiology (science); Emotional; Emotions; Evaluation; Frequencies; Functional disorder; Funding; Hallucinations; Healthcare Systems; Individual; Intervention; Knowledge; Laboratories; Maintenance; Mental disorders; Modeling; Onset of illness; Patients; Pattern; Phase; Prevention; Process; Psychophysiology; Psychotic Disorders; Randomized Clinical Trials; Recovery; Regulation; Research Design; Risk; Schizophrenia; Self Efficacy; Series; Stress; Surveys; Symptoms; Testing; Update; Visual attention; Work; Youth; base; biological adaptation to stress; design; emotion regulation; experience; follow-up; functional decline; high risk; hypothalamic-pituitary-adrenal axis; interest; lens; mathematical model; multimodality; negative affect; novel; novel strategies; prospective; psychosocial; response; stress reactivity; theories; visual tracking

Project Summary Psychotic disorders are serious and debilitating mental illnesses that incur substantial suffering for patients and present major challenges to our health care system. Given that few individuals achieve recovery after the onset of a psychotic disorder, there is increasing interest in the early identification and prevention of psychosis. Psychotic disorders are typically preceded by a prodromal phase characterized by functional decline and subtle attenuated symptoms that progressively worsen over the course of several months to years. This period is of interest both as a window for investigating processes involved in disease onset and as a potential point of intervention and prevention. The stress-vulnerability model remains one of the leading theories on the origins of psychosis. However, dysfunctional HPA axis activity and heightened stress reactivity alone only modestly predicts conversion to psychosis among CHR youth and has not led to breakthroughs in prevention. To develop novel targets for early intervention, the current project aims to test the central hypothesis that abnormalities in emotion regulation (i.e., the ability to use strategies to decrease the intensity or frequency of negative emotion) are a vulnerability factor that increases risk for developing a psychotic disorder. We propose to conduct a comprehensive evaluation of emotion regulation through the lens of Gross’ extended process model of emotion regulation. This model proposes that emotion regulation involves a series of stages, including: identification (i.e., detecting emotion and determining whether to regulate), selection (i.e., choosing a strategy), and implementation (i.e., executing the selected strategy). Our preliminary data in adults with schizophrenia (SZ) indicates that abnormalities at each of these stages contribute to state fluctuations in hallucinations and delusions. The current application proposes to extend this finding to 50 CHR youth and 50 healthy controls who will complete a cross-sectional evaluation consisting of a multimodal battery of emotion regulation laboratory tasks (behavior, electrophysiology, eye tracking, pupillometry) and 6 days of ecological momentary assessment (EMA) that will be submitted to mathematical modeling. This data will be used to complete the following specific aims: 1): To evaluate the stress-vulnerability model and test the hypothesis that attenuated psychotic experiences are temporally preceded by abnormalities in autonomic nervous system reactivity; 2) To define which stages of emotion regulation are abnormal in CHR youth and identify moderators of each stage; 3) To identify whether abnormalities at each of the stages of emotion regulation are predictive of psychosis risk and determine whether the combination of emotion regulation abnormalities and stress reactivity will predict psychosis risk more so than either variable alone. Findings resulting from this study will benefit early identification and prevention efforts by identifying specific emotion regulation processes that can be targeted in psychosocial interventions. Such interventions have proven effective for treating other disorders, but have not yet been evaluated in the schizophrenia-spectrum to determine efficacy for prevention.

项目概要 精神障碍是严重且使人衰弱的精神疾病，给患者和患者带来巨大痛苦 给我们的医疗保健系统带来了重大挑战。鉴于很少有人在发病后康复 随着精神病的发生，人们对精神病的早期识别和预防越来越感兴趣。 精神病性障碍之前通常有一个前驱期，其特征是功能衰退和 微妙的减弱症状，在几个月到几年的时间内逐渐恶化。这个时期 既可以作为研究疾病发作过程的窗口，也可以作为潜在的研究点 干预和预防。压力-脆弱性模型仍然是起源的主要理论之一 精神病。然而，仅功能失调的 HPA 轴活动和应激反应性升高只是适度的 预测 CHR 青年人会转化为精神病，但并未在预防方面取得突破。到 制定早期干预的新目标，当前项目旨在测试以下中心假设： 情绪调节异常（即使用策略降低情绪强度或频率的能力） 负面情绪）是增加患精神障碍风险的脆弱因素。我们建议 通过格罗斯扩展过程的视角对情绪调节进行综合评价 情绪调节模型。该模型提出情绪调节涉及一系列阶段， 包括：识别（即检测情绪并决定是否调节）、选择（即选择一个 战略）和实施（即执行选定的战略）。我们在成人中的初步数据 精神分裂症（SZ）表明，每个阶段的异常都会导致精神分裂症的状态波动。 幻觉和妄想。当前的申请建议将这一发现扩展到 50 名 CHR 青少年和 50 名 健康对照者将完成由多模式情绪组成的横断面评估 调节实验室任务（行为、电生理学、眼动追踪、瞳孔测量）和 6 天的生态 将提交数学建模的瞬时评估（EMA）。该数据将用于 完成以下具体目标： 1): 评估压力脆弱性模型并检验以下假设： 减弱的精神病体验暂时先于自主神经系统的异常 反应性； 2) 明确CHR青少年情绪调节的哪些阶段是异常的并确定调节因素 每个阶段； 3）确定情绪调节各个阶段的异常是否可以预测 精神病风险并确定是否结合情绪调节异常和应激反应 比单独使用任一变量更能预测精神病风险。这项研究的结果将受益 通过识别特定的情绪调节过程进行早期识别和预防工作 心理社会干预的目标。事实证明，此类干预措施可有效治疗其他疾病， 但尚未在精神分裂症谱系中进行评估以确定预防效果。