Neurocognitive Mechanisms of Pediatric Anxiety Disorders

描述（由申请人提供）：理由：儿童焦虑症非常普遍，并与不良的长期后果相关。这些疾病被认为受到潜在的认知和神经机制的影响，而这些机制尚未得到很好的理解。最近的研究表明，特定的神经认知模型与成人焦虑症有关；这样的数据在年轻人身上很少。目的：利用功能磁共振成像（fMRI）研究儿童焦虑症的神经认知机制。最初的研究集中在患有广泛性焦虑症（GAD）的青少年身上。长期计划是成为一名独立的研究者，并将研究扩展到其他儿科焦虑症。培训计划：候选人将接受以下方面的培训：1)与青少年焦虑症相关的发育和诊断问题，2)认知和情感神经科学研究及其在儿童焦虑症中的应用，3)功能磁共振成像研究设计和数据分析技术，以及4)临床研究的道德行为。培训内容包括：1)认知神经科学、功能磁共振成像和伦理学的正式课程；2)指导;3)多学科专家会诊；4)参加科学会议；5)补充职业发展活动的研究计划。研究计划：拟进行的研究旨在检验GAD的不确定性耐受模型，该模型假设GAD个体相对无法耐受不确定性，从而导致过度担忧和损害。第一项研究将使用决策任务作为对广泛性焦虑症青少年和对照组的不确定性耐受的行为测量。根据成人的研究结果，假设与对照组相比，广泛性焦虑症受试者在更不确定的条件下做出决定所需的时间要长得多。第二项研究将扩展不确定性不耐受模型，通过使用功能磁共振成像来测试广泛性焦虑症青少年和正常对照组在决策任务中的神经活动差异。预计与对照组相比，广泛性焦虑症受试者在更不确定的情况下，会在与决策和焦虑有关的旁边缘区表现出明显更大的激活。结果将为候选人未来的R01申请提供信息，以进一步研究将这一新的GAD理论视角与当前的神经认知方法联系起来，包括研究情绪识别和恐惧处理在儿童焦虑症中的作用。

DESCRIPTION (provided by applicant): Rationale: Pediatric anxiety disorders are highly prevalent and associated with adverse long-term consequences. These disorders are believed to be influenced by underlying cognitive and neural mechanisms which are not well understood. Recent studies suggest specific neurocognitive models associated with adult anxiety disorders; such data in young individuals are scant. Purpose: To develop expertise in the study of neurocognitive mechanisms in pediatric anxiety disorders using functional magnetic resonance imaging (fMRI). Initial studies focus on adolescents with generalized anxiety disorder (GAD). Long-term plans are to become an independent investigator and extend research to other pediatric anxiety disorders. Training Plan: The candidate will receive training in: 1) developmental and diagnostic issues relevant to anxiety disorders in youth, 2) cognitive and affective neuroscience research and its applications to pediatric anxiety disorders, 3) fMRI study design and data analytic techniques, and 4) the ethical conduct of clinical research. Training will include: 1) formal coursework in cognitive neuroscience, fMRI, and ethics; 2) mentoring; 3) consultation with multidisciplinary experts; 4) participation at scientific meetings; and 5) a research plan that complements career development activities. Research Plan: The proposed research aims to test the intolerance of uncertainty model of GAD, which postulates that GAD individuals are relatively unable to tolerate uncertainty, which leads to excessive worry and impairment. The first study will use a decision making task as a behavioral measure of intolerance of uncertainty in GAD adolescents and controls. Based on adult findings, it is hypothesized that compared to controls, GAD subjects will take significantly longer to make decisions under conditions of greater uncertainty. The second study will extend the intolerance of uncertainty model by using fMRI to test for differences between GAD adolescents and normal controls in neural activity during a decision making task. It is expected that compared to controls, GAD subjects will show significantly greater activation in paralimbic regions implicated in decision making and anxiety, during more uncertain conditions. Results will inform the candidate's future R01 application for further research linking this novel theoretical perspective on GAD to current neurocognitive approaches including those examining the role of emotion recognition and fear processing in pediatric anxiety disorders.