An Ecological Momentary Assessment Study of Intolerance of Uncertainty: Linking Computational Measures with Clinical Factors

无法容忍不确定性的生态瞬时评估研究：将计算测量与临床因素联系起来

• 批准号: 10748537
• 负责人: Hannah Claire Broos
• 金额: $ 4.77万
• 依托单位: UNIVERSITY OF MIAMI CORAL GABLES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-16 至 2025-06-15
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10748537
• 关键词: Address; Adult; Affect; Affective; Anxiety; Anxiety Disorders; Behavior; Behavioral; Behavioral Model; Clinical; Clinical Research; Clinical assessments; Computer Models; Data; Decision Making; Development; Diagnostic; Distress; Divorce; Ecological momentary assessment; Fellowship; Goals; Individual; Individual Differences; Intervention; Investigation; Life; Link; Literature; Longitudinal Studies; Maintenance; Measurement; Measures; Mediating; Methodology; Methods; National Institute of Mental Health; Pathology; Patient Self-Report; Persons; Population; Prevention; Public Health; Quality of life; Research; Research Design; Research Domain Criteria; Research Personnel; Risk; Risk Estimate; Risk Factors; Sampling; Techniques; Time; Training; Uncertainty; anxiety symptoms; anxiety treatment; avoidance behavior; behavior measurement; behavioral response; comorbidity; cost; design; diagnostic criteria; economic cost; effective therapy; experience; functional disability; improved; innovation; meetings; modifiable risk; multimodality; negative affect; negative mood; novel; prevent; psychologic; response; treatment of anxiety disorders; virtual

PROJECT SUMMARY Anxiety disorders affect approximately 30% of the U.S. population1, with over 1 in 4 adults meeting diagnostic criteria for at least one lifetime anxiety disorder2. Anxiety disorders are a major public health burden3, as they are associated with a decreased quality of life4, substantial functional impairment5, and an enormous economic cost6,7. Despite these considerable ramifications, treatments for anxiety are only moderately effective8, highlighting the need to further identify and explore risk factors that may improve prevention and treatment efforts. Intolerance of uncertainty (IU) is one important risk factor implicated in the development of anxiety disorders9. Uncertainty permeates daily life and is generally found to be somewhat discomforting, though individuals differ greatly on the degree to which they tolerate uncertainty. Experiencing uncertainty as intolerable can elicit dysfunctional responses such as worry, negative mood, and avoidance behavior10,11, all of which are thought to contribute to the development of anxiety symptoms12. Importantly, research on how IU contributes to risk for anxiety is constrained by two main limitations. First, the definition of IU in the clinical literature is imprecise and may conflate two distinct components of uncertainty tolerance identified by the computational behavioral decision-making field. Further research using multimodal assessments is needed to integrate these distinct operationalizations of IU, in line with the NIMH RDoC Initiative which emphasizes the importance of considering multiple levels of analysis13. Second, there is virtually no research on IU using longitudinal, within-person designs, thus limiting our understanding of how IU influences affective and behavioral responses to real-life uncertainty. The proposed study will use novel methodologies to both address these conceptual limitations and expand research on how IU contributes to the development of anxiety over time. Specifically, this study will: a) compare clinical assessments of IU and behavioral measures derived from computational modeling, b) use ecological momentary assessment (EMA) to assess whether individual differences in clinical and behavioral IU predict daily negative affect and behavioral avoidance responses, and c) investigate whether daily affective and behavioral responses contribute to downstream anxiety symptoms. Results of this proposed study would advance the measurement of IU, providing a better understanding of how IU contributes to risk for anxiety and ultimately contributing to the development and refinement of treatments for anxiety disorders. This proposal has important implications for preventing and treating anxiety. Through this proposed study, the applicant will acquire additional training and experience in intensive longitudinal study design, advanced statistical techniques, and multimodal assessment methods, including computational modeling approaches. The experience gained through this fellowship will lay the groundwork for the applicant to become an independent researcher investigating the transdiagnostic risk factors of anxiety pathology, with the ultimate goal of identifying malleable targets for the development of more effective treatments for anxiety.

项目摘要 焦虑症影响大约30%的美国人口1，超过四分之一的成年人符合诊断标准。 至少有一种终生焦虑障碍的标准2.焦虑症是一个主要的公共卫生负担3，因为他们 与生活质量下降4、严重的功能障碍5和巨大的经济损失有关。 成本6.7。尽管有这些相当大的后果，治疗焦虑症的效果只有中等程度8， 强调需要进一步查明和探讨可能改善预防和治疗的风险因素 努力对不确定性的不耐受性（IU）是焦虑发展的一个重要危险因素 紊乱9.不确定性弥漫在日常生活中，通常会让人感到有些不安， 个体在容忍不确定性的程度上存在很大差异。体验不确定性， 无法忍受可能会引起功能失调的反应，如担心，消极情绪和回避行为10，11，所有 这被认为有助于焦虑症的发展12。重要的是，研究如何IU 导致焦虑的风险受到两个主要限制。首先，IU在临床中的定义 文献是不精确的，可能会混淆两个不同的组成部分，确定的不确定性公差 计算行为决策领域。需要使用多模式评估进行进一步研究， 根据NIMH RDoC倡议，整合IU的这些不同操作，该倡议强调 考虑多层次分析的重要性13.其次，几乎没有关于IU使用的研究 纵向，人内设计，从而限制了我们对IU如何影响情感和 对现实生活中不确定性的行为反应。拟议的研究将使用新的方法来解决 这些概念上的局限性，并扩大研究如何IU有助于焦虑的发展， 时间具体而言，本研究将：a）比较IU的临床评估和来自 计算模型，B）使用生态瞬时评估（EMA）来评估个体是否 临床和行为IU的差异预测日常负面影响和行为回避反应， c）调查日常情感和行为反应是否有助于下游焦虑症状。 这项拟议研究的结果将促进IU的测量，更好地了解如何 IU有助于焦虑的风险，并最终有助于治疗的发展和完善 治疗焦虑症这一建议对预防和治疗焦虑症具有重要意义。通过这个 建议的研究，申请人将获得额外的培训和密集的纵向研究经验 设计，先进的统计技术和多模式评估方法，包括计算 建模方法。通过该奖学金获得的经验将为申请人奠定基础 成为一名独立的研究人员，调查焦虑病理学的跨诊断风险因素， 最终目标是确定可延展的目标，以开发更有效的焦虑治疗方法。