Modification of Threat Interpretation Bias to Reduce Anxiety in Neurodegenerative Movement Disorders

项目摘要：拟议的K23奖将准备博士杰西吉布森，博士，注册护士，AGPCNP-BC 成为一名独立的研究者，开发神经精神症状管理的干预措施， 神经退行性疾病吉布森博士的临床和研究经验提供了一个基础， 亨廷顿病（HD）神经精神症状的识别、测量和影响， 帕金森病（PD）。拟议的研究计划将使吉布森博士准备采取下一步行动， 在独立的临床试验中研究这些症状的治疗方法。焦虑症状非常严重 在HD和PD中普遍存在，对患者和护理人员造成重大负担。不幸的是， 如何治疗这些症状的证据专家建议使用心理干预来治疗 HD和PD的焦虑症状，但很少有严格的研究来支持这些建议。 解释偏差的认知偏差修正（CBM-I）范式通过以下方式解决负面解释偏差： 培训参与者以更良性的方式（重新）解释模棱两可的，潜在的威胁情况， 焦虑思维更灵活。我们的初步工作证明了基于网络的建立信任措施的可行性， 人口，并确定需要调整CBM-I计划，以满足个人的需求与运动 紊乱我们目前的目标是确定基于网络的认知偏差修正是否 解释偏差（CBM-I）干预可以降低PD和HD患者的焦虑。因此，我们的目标是：1）收集 利益攸关方的观点，2）制定一个基于网络的建立信任措施-I干预措施， 神经退行性运动障碍（MindTrails-Movement），然后3）评估目标参与， MindTrails-Movement减少HD患者解释偏倚和焦虑症状的初步疗效， 警局实现这些目标，并使吉布森博士成为制定干预措施的国家领导人 对于神经退行性疾病的神经精神症状管理，她将与专家合作， 由Bethany Teachman博士领导的指导团队，包括共同导师Madaline Harrison博士，Carol Manning，Jeanne Alhusen，and Guofen Yan.培训经验将支持吉布森博士的职业生涯 发展目标：1）培养使用以人为本的设计开发行为干预的技能; 2） 发展临床试验设计和实施的专业知识; 3）建立先进的机制知识 维持情绪和焦虑障碍; 4）发展领导力和grananonymous技能，并建立 合作，以准备作为一个独立的护士科学家成功的职业生涯。弗吉尼亚大学 提供了理想的环境，以实现这些研究和职业发展目标，作为一个世界的家- 类护理学校，亨廷顿病卓越中心，美国帕金森病协会 高级研究中心，以及焦虑，认知和治疗计划（PACT）实验室-所有这些都是 对这个提案的成功至关重要

PROJECT SUMMARY: The proposed K23 award will prepare Dr. Jessie Gibson, PhD, RN, AGPCNP-BC to become an independent investigator developing interventions for neuropsychiatric symptom management in neurodegenerative disease. Dr. Gibson’s clinical and research experiences have provided a foundation in identification, measurement, and effects of neuropsychiatric symptoms in Huntington’s disease (HD) and Parkinson’s disease (PD). The proposed research plan will prepare Dr. Gibson to take the next steps toward investigating treatment for these symptoms in independent clinical trials. Anxiety symptoms are extremely prevalent in HD and PD, causing significant burden for patients and caregivers. Unfortunately, there is limited evidence for how to treat these symptoms. Experts recommend use of psychological interventions to treat anxiety symptoms in HD and PD, but there have been few rigorous studies to support these recommendations. Cognitive bias modification for interpretation bias (CBM-I) paradigms address negative interpretation biases by training participants to (re)interpret ambiguous, potentially threatening situations in more benign ways to make anxious thinking more flexible. Our preliminary work has demonstrated feasibility of web-based CBM-I in this population and identified the need to adapt CBM-I programs to meet the needs of individuals with movement disorders. Our current objective is to determine whether a web-based cognitive bias modification for interpretation bias (CBM-I) intervention can reduce anxiety in PD and HD. Thus, we aim to: 1) gather stakeholder perspectives and 2) develop a web-based CBM-I intervention tailored to individuals with neurodegenerative movement disorders (MindTrails-Movement), then 3) evaluate target engagement and preliminary efficacy of MindTrails-Movement for reducing interpretation bias and anxiety symptoms in HD and PD. To carry out these aims and prepare Dr. Gibson to become a national leader in developing interventions for neuropsychiatric symptom management in neurodegenerative disease, she will work with an expert mentoring team led by Dr. Bethany Teachman, and including co-mentors Drs. Madaline Harrison, Carol Manning, Jeanne Alhusen, and Guofen Yan. Training experiences will support Dr. Gibson’s career development goals to: 1) cultivate skills to develop behavioral interventions using human-centered design; 2) develop expertise in clinical trial design and implementation; 3) establish advanced knowledge of mechanisms that maintain mood and anxiety disorders; and 4) develop leadership and grantsmanship skills and establish collaborations to prepare for a successful career as an independent nurse scientist. University of Virginia provides the ideal environment to achieve these research and career development goals, as home to a world- class nursing school, Huntington’s Disease Center of Excellence, American Parkinson’s Disease Association Advanced Center for Research, and the Program for Anxiety, Cognition and Treatment (PACT) lab- all of which are critical to the success of this proposal.