Psychophysiological Response to Unpredictable Social Feedback: Relations with Social Anxiety and Real-World Functioning in Adolescence

摘要 社交焦虑（SA）困扰着超过13%的美国人口，并且是最普遍的精神疾病形式之一。 儿童和成人的疾病1，2. SA与学术、心理和行为方面的显著长期障碍相关， 职业和社会功能3，因此，SA是个人和公众的主要关注点 健康水平。SA的发病高峰期在妊娠期4，5，6，这使得这是一个关键的发展时期， 确定可能告知早期风险的核心基本机制。对负面评价的恐惧（FNE） 是SA 7，8中最有据可查且被广泛接受的核心组件之一。然而，近年来， 一个小的文献已经出现，表明不容忍的不确定性是一个强大的预测SA， FNE 9，10，11。越来越多的文献表明，有必要进一步研究对不确定性的敏感性， 的脆弱性，并强调需要将不可预测性纳入社会评价的调查。 尽管如此，只有一项研究直接调查了不可预测的社会评价反馈对 同行评级11，没有研究实验操纵和检查的影响，不可预测性 对社会威胁的神经或生理反应。在拟议的培训和研究补助金中，我们将开发 并利用一个新的任务，将直接测试我们的启发式模型的SA，强调不可预测性的作用 社会威胁是SA的核心要素。我们的新任务将检查的生理和神经相关的 预期可预测和不可预测的社会评价反馈的刺激处理。拟议 研究有三个具体目标：（1）利用一个新的任务来评估可预测和 青少年在多个测量领域的不可预测的社会评价（即，惊吓，事件- 相关电位（ERPs）和自我报告），（2）检查SA症状与基于实验室的 对不可预测的社会评价的预期措施;（3）获得生态瞬间的训练 评估（EMA），以探索我们基于实验室的敏感性措施之间的关系， 社会反馈和现实世界的功能和预期焦虑。最近有一百名青少年- 本研究将招募NIMH资助的纵向R 01。在哈卡克医生的指导下， 惊吓和头皮记录的ERP将在我们新颖的实验室任务中同时记录，而真实的- 将使用EMA在参与者的子样本（n = 50）中检查世界功能。目前的培训 我的建议将使我能够整合来自共同导师的培训，他们在情感研究方面具有专业知识。 使用心理生理学措施（Hajcak博士）和情感障碍模型， 发展人口（克莱因博士）。Hajcak博士提供的培训和指导相结合， 心理生理学方法和克莱因博士在发展心理病理学将推动我走向我的 成为一名发展临床心理生理学家。此外，专家将提供咨询， 对社会焦虑中不可预测性的敏感性的作用（Jarcho和Pine博士）， 发育样本中的心理生理学测量（Pine博士）和使用EMA的培训， 青少年人口（丝绸博士）。

Abstract Social anxiety (SA) afflicts over 13% of the U.S. population and is one of the most prevalent forms of mental illness in both children and adults1,2. SA is associated with significant long-term impairment in academic, occupational, and social functioning3, and as such, SA is a major concern at both the individual and public health levels. The onset of SA peaks during adolescence4,5,6, making this a critical developmental period for identifying core underlying mechanisms that may inform early risk. To date, fear of negative evaluation (FNE) is one of the most well-documented and widely accepted core components of SA7,8. However, in recent years, a small literature has emerged suggesting that intolerance of uncertainty is as strong a predictor of SA as FNE9,10,11. This growing literature signals the need for greater examination of sensitivity to uncertainty as a core vulnerability in SA, and highlights the need to integrate unpredictability into investigations of social evaluation. Despite this, only one study has directly investigated the impact of unpredictable social evaluative feedback on peer ratings11, and no study has experimentally manipulated and examined the impact of unpredictability on neural or physiological responding to social threat. In the proposed training and research grant, we will develop and utilize a novel task that will directly test our heuristic model of SA that highlights the role of unpredictability of social threat as a core element of SA. Our novel task will examine the physiological and neural correlates of stimulus processing in anticipation of predictable and unpredictable social evaluative feedback. The proposed study has three specific aims: (1) to leverage a novel task to assess anticipation of predictable and unpredictable social evaluation in adolescents across multiple domains of measurement (i.e., startle, event- related potentials (ERPs), and self-report), (2) to examine the association of SA symptoms with lab-based measures of anticipation of unpredictable social evaluation, and (3) to obtain training in ecological momentary assessment (EMA) to explore the relationship between our lab-based measures of sensitivity to unpredictable social feedback and real-world functioning and anticipatory anxiety. One hundred adolescents from a recently- NIMH-funded longitudinal R01 will be recruited for the study. Under the guidance of Dr. Hajcak, eye-blink startle and scalp-recorded ERPs will be simultaneously recorded during our novel lab-based task, and real- world functioning will be examined using EMA in a subsample of participants (n = 50). The current training proposal will allow me to integrate training from co-mentors who have expertise in the study of affective disorders using psychophysiological measures (Dr. Hajcak) and in models of affective disorders in developmental populations (Dr. Klein). The integration of training and mentorship received from Dr. Hajcak on psychophysiological methods and from Dr. Klein in developmental psychopathology will propel me towards my goal of becoming a developmental clinical psychophysiologist. Furthermore, experts will provide consultation in the role of sensitivity to unpredictability in social anxiety (Drs. Jarcho and Pine), collection of psychophysiological measures in developmental samples (Dr. Pine) and training in the use of EMA in adolescent populations (Dr. Silk).