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.

项目摘要 精神病患者是严重的，使人衰弱的精神疾病，会给患者带来重大痛苦， 对我们的医疗保健系统面临重大挑战。鉴于很少有人在发作后实现康复 关于精神病障碍，人们对早期识别和预防精神病的兴趣越来越多。 精神病性疾病通常是前期阶段，其特征是功能下降和 微妙的衰减符号在几个月到几年的过程中逐渐恶化。这个时期 感兴趣的既是调查疾病发作过程的过程的窗口，又是 干预和预防。应力化功能模型仍然是起源的主要理论之一 精神病。但是，功能失调的HPA轴活动仅适度地增加应力反应性 预测CHR青年人的精神病转换，并没有导致预防突破。到 为了开发新的新目标以进行早期干预，目前的项目旨在检验中心假设 情绪调节异常（即使用策略来降低强度或频率的能力 负面情绪）是增加患有精神病的风险的脆弱因素。我们建议 通过GROSS的扩展过程对情绪调节进行全面评估 情绪调节的模型。这个模型提出，情绪调节涉及一系列阶段， 包括：识别（即检测情绪并确定是否调节），选择（即选择一个 策略）和实施（即执行选定的策略）。我们在成年人中的初步数据 精神分裂症（SZ）表明，这些阶段的每个阶段异常有助于状态波动 幻觉和妄想。当前的申请建议将这一发现扩展到50个CHR青年和50个 健康的控制措施，他们将完成由多模式电池组成的横断面评估 调节实验室任务（行为，电生理学，眼科跟踪，化学计量法）和6天的生态学 瞬时评估（EMA）将提交数学建模。这些数据将用于 完成以下特定目的：1）：评估应力掩盖性模型并检验以下假设。 在自主神经系统的异常之前，暂时衰减的精神病经历 反应性； 2）定义CHR青年的情绪调节阶段异常并确定主持人 每个阶段； 3）确定在情绪调节的每个阶段的异常是否都可以预测 精神病风险并确定情绪调节异常和压力反应的结合是否 将预测精神病的风险比单独的任何变量更重要。这项研究产生的发现将受益 通过确定可以是的特定情绪调节过程，可以提前识别和预防努力 针对社会心理干预措施。事实证明，这种干预措施有效治疗其他疾病， 但尚未在精神分裂症谱中评估以确定预防效率。