Neural mechanisms of enhancing emotion regulation in bereaved spouses

项目总结/摘要 失去配偶是一个深刻的压力生活事件与显着增加发病率 和死亡率的风险。丧亲压力通常表现为情绪反应， 绝望、沮丧、内疚和其他抑郁症状。上述原因造成的严重痛苦 反应是非常普遍的，特别是在丧亲之痛的早期阶段（即，在最初的1-2年内）， 在日常生活活动中有明显的烦躁不安，通常持续更长时间（术后长达4年或更长时间）， 损失）。丧亲之痛也与低呼吸性窦性心律失常（RSA）有关，这是一种心理生理学疾病。 适应性心脏迷走神经张力的生物标志物和全因死亡率的强预测因子。情绪调节技巧 是心理干预促进丧偶配偶健康应对的理想目标。 尽管有明确的证据表明丧亲之痛的情绪压力与负面的健康结果有关， 现有的丧亲认知行为干预方法通常总体上无效; 涉及不同干预策略的培训，模糊了关于哪些策略最重要的知识， 有效;施加大量的时间/成本负担;并且--至关重要的是--通过神经生物学机制运作， 仍有待阐明。该提案的目的是使用实验医学方法， 评估基本的心理，心理生理学，和神经机制的基础上的一种新的认知 旨在改善心理结果的情绪调节干预（即，降低抑郁 症状和悲伤沉思）。认知重新评价（即修改 通过思考和评估情感信息的情感反应轨迹， 更适应的方式）是丧亲心理干预的一个非常有前途的目标。 重新评价可以通过两种主要策略来操作：心理距离（即评价一个人的能力）。 情绪刺激作为一个客观的，公正的观察者）和重新解释（即想象一个更好的结果 看起来似乎比最初更明显）。拟议的项目建立在有希望的初步工作的基础上， 研究一种新的五节认知疗法的有效性和潜在的神经生物学机制， 对丧偶配偶的重新评价干预。最近失去亲人的参与者（即约6个月 失去配偶后）将被随机分配接受疏远或重新解释方面的培训， 每1-3天进行一次会议，纵向收集情感，心理生理和功能 磁共振成像（fMRI）数据。拟议的研究旨在从机制上将 在一种新的情绪调节干预过程中， 在这个有压力的高危人群中实施之前。

Project Summary / Abstract The loss of a spouse is a profoundly stressful life event associated with significantly increased morbidity and mortality risk in bereaved spouses. Bereavement stress is often manifested in emotional reactions such as despair, dejection, guilt, and other symptoms of depression. Acute suffering stemming from the above reactions is highly prevalent, especially during the early stages of bereavement (i.e., within the first 1-2 years), with substantial dysphoria in everyday life activities often persisting even longer (up to 4 years or more post- loss). Bereavement is also associated with low respiratory sinus arrhythmia (RSA), a psychophysiological biomarker of adaptive cardiac vagal tone and a strong predictor of all-cause mortality. Emotion regulation skills represent an ideal target for psychological intervention to promote healthy coping in bereaved spouses. Despite clear evidence that the emotional stress of bereavement is associated with negative health outcomes, existing cognitive-behavioral intervention approaches for bereavement are frequently overall ineffective; involve training in disparate intervention strategies, obscuring knowledge about which strategies are most effective; impose substantial time/cost burdens; and—crucially—operate via neurobiological mechanisms that remain to be elucidated. The objective of this proposal is to use an experimental medicine approach to evaluate the basic psychological, psychophysiological, and neural mechanisms underlying a novel cognitive emotion regulation intervention aimed at improving psychological outcomes (i.e., reducing depressive symptoms and grief rumination) in bereaved spouses. Cognitive reappraisal (i.e. the ability to modify the trajectory of an emotional response by thinking about and appraising emotional information in an alternative, more adaptive way) represents a highly promising target for psychological intervention in bereavement. Reappraisal can be operationalized via two primary tactics: psychological distancing (i.e. appraising an emotional stimulus as an objective, impartial observer) and reinterpretation (i.e. imagining a better outcome than what initially seemed apparent). The proposed project builds upon promising preliminary work to investigate the effectiveness and underlying neurobiological mechanisms of a novel, five-session cognitive reappraisal intervention in bereaved spouses. Recently-bereaved participants (i.e. approximately 6 months post-spousal loss) will be randomly assigned to receive training in either distancing or reinterpretation, with five sessions occurring every 1-3 days, with longitudinal collection of affective, psychophysiological, and functional magnetic resonance imaging (fMRI) data. The proposed study aims to mechanistically relate changes in psychological, psychophysiological, and neural function during a novel emotion regulation intervention never before implemented in this stressed, high risk group.