Parent interpretation bias as a key mechanism of intergenerational transmission of anxiety

大约30%的儿童会经历焦虑症，使焦虑成为最常见的 美国儿童的心理健康问题。然而，很少有儿童接受治疗， 即使是我们最有效的焦虑治疗方法，也有多达一半的儿童需要额外的干预。 尽管父母焦虑在传递和维持儿童焦虑方面的作用已经确立，但缺乏 关于焦虑代际传递背后的特定父母机制的数据是一个关键的 阻碍了个性化治疗的新目标。根据NIMH的战略计划， 目的2.2了解终生精神疾病的危险因素和行为指标， 为了根据心理机制的知识确定新的干预目标，目前， 该提案侧重于解释偏见，即在模棱两可的情况下感知威胁的倾向。的 该项目的总体目标是实证检验代际的理论模型， 焦虑的传递集中在父母的解释偏差为根本原因。我们的具体目标是测试 父母解释偏差对（1）父母行为和（2）儿童解释偏差的理论影响， (3)评估潜在的调节者，以完善焦虑的代际传递理论， 未来的个性化干预。我们的中心假设是，父母的解释偏见会影响孩子 解释偏见通过其对适应不良，焦虑促进养育行为的影响，如 回避型应对的适应和模仿。为了验证这一假设，我们将随机抽取300名家长， 7-12岁的儿童完成为期四周的智能手机传递的解释偏差操纵 vs.一个自我评估的智能手机应用程序的条件。解释偏见干预教导父母 通过快速、重复的练习和纠正，以非威胁性的方式解释模棱两可的情况 反馈在完成随机分配的条件之前和之后， 自我报告和行为任务，旨在引起父母的焦虑促进行为， 根据他们对模糊情况的解释（演讲和拼图任务）。家长也将完成 生态瞬时评估（EMA）的养育行为，以捕捉影响的时间过程。 最后，我们将研究解释操纵对儿童解释偏差的下游影响 在访问前和访问后。我们将测试版主（例如，父母的焦虑和性别），以完善理论， 焦虑代际传递和为未来个性化干预提供信息。远景目标 这项工作的目的是为改善心理健康提供个性化的、以机制为重点的干预措施 焦虑的孩子和他们的父母的结果。未来的研究将把从中获得的知识 可以完全通过智能手机远程实施的可扩展治疗， 增加获得护理的机会。

Approximately 30% of children will experience an anxiety disorder, making anxiety the most common mental health problem among children in the United States. However, few children receive treatment and even our most effective anxiety treatments leave up to half of children in need of additional intervention. Despite the well-established role of parent anxiety in transmitting and maintaining child anxiety, the lack of data on specific parent mechanisms underlying the intergenerational transmission of anxiety is a critical barrier to informing novel targets of personalized treatments. Consistent with NIMH’s Strategic Plan, Objective 2.2 to understand risk factors and behavioral indicators of mental illness across the lifespan and to identify novel intervention targets based on knowledge of psychological mechanisms, the current proposal focuses on interpretation bias, the tendency to perceive threat in ambiguous situations. The overall objective of this project is to empirically test a theoretical model of the intergenerational transmission of anxiety focused on parent interpretation bias as a root cause. Our specific aims are to test theorized effects of parent interpretation bias on (1) parent behavior and (2) child interpretation bias and (3) evaluate potential moderators to refine theories of intergenerational transmission of anxiety and inform future personalized interventions. Our central hypothesis is that parent interpretation bias influences child interpretation bias through its effects on maladaptive, anxiety-promoting parenting behaviors, such as accommodation and modeling of avoidant coping. To test this hypothesis, we will randomize 300 parents of children ages 7-12 to complete four weeks of a smartphone delivered interpretation bias manipulation vs. a self-assessment smartphone app condition. The interpretation bias intervention teaches parents to interpret ambiguous situations in a non-threatening manner via quick, repeated practice and corrective feedback. Before and after completing their randomly assigned condition, parent-child dyads will complete self-report and behavioral tasks designed to elicit anxiety-promoting behaviors from parents depending upon their interpretation of the ambiguous situation (speech and puzzle tasks). Parents will also complete Ecological Momentary Assessment (EMA) of parenting behaviors to capture the time course of effects. Finally, we will examine downstream effects of the interpretation manipulation on child interpretation bias at pre- and post- visits. We will test moderators (e.g., parent anxiety and gender) to refine theories of intergenerational transmission of anxiety and inform future personalized interventions. The long-term goal of this work is to inform personalized, mechanism-focused interventions to improve mental health outcomes for anxious children and their parents. Future studies will translate knowledge gained from this project into a scalable treatment that can be implemented entirely remotely via smartphone thereby increasing access to care.