Behavioral and fMRI correlates of late-life generalized anxiety disorder

描述（由申请人提供）：在临床焦虑的个体中，对环境中的负面线索的选择性关注可能会使情绪功能障碍的恶性循环永久化。注意力被负面线索过度地吸引，引发焦虑情绪状态，反过来又加强了负面信息的显著性。关于注意力偏差在焦虑的老年人中的作用知之甚少，尽管人们承认需要增加对晚年焦虑的研究。此外，有证据表明，在没有临床焦虑的老年人中，存在相反的偏见（朝向积极的，远离消极的情绪材料）;然而，这些与年龄相关的情绪处理变化如何与焦虑相互作用目前尚不清楚。情绪Stroop（eStroop）任务需要快速识别消极、中性和积极情绪词的墨水颜色，但作为老年人注意力偏差的指标还有待于彻底测试。该提案的具体目的有两个：1）测试eStroop反应时间是否区分焦虑和非焦虑老年人; 2）确定晚年广泛性焦虑症（GAD）患者和年龄匹配对照组中eStroop的神经相关性。在研究1中，社区中的60名老年人将完成eStroop任务。反应时间数据将进行分析，以测试的预测，高分的自我报告措施的担心，但不是低分，将选择性地参加负面的话，而低分，但不是高分，将选择性地参加积极的话。在研究2中，将分析最近从40名老年人（28名寻求治疗的GAD患者，12名非焦虑对照）在eStroop任务中收集的fMRI数据。分析将集中在抑制控制（前额叶皮层区域）和情绪处理（杏仁核）涉及的神经回路，并将测试注意力偏差的理论模型的预测。该项目将提供新的数据，广泛使用的任务，研究与老年人样本的效用，并将促进我们的理解的行为和神经相关的正常和异常的情绪处理在一个未充分研究的年龄组。鉴于广泛性焦虑症是晚年最普遍的精神疾病之一，目前治疗的反应率相对较低，迫切需要进一步了解晚年广泛性焦虑症的行为和神经机制。广泛性焦虑症是一种普遍的，致残的条件，在老年人的人口。这项研究将探讨已被证明有助于年轻人焦虑的注意力偏见是否与晚年焦虑同样相关，以及大脑活动的模式可能是这些偏见的基础。

DESCRIPTION (provided by applicant): In clinically anxious individuals, selective attention to negative cues in the environment may perpetuate a vicious cycle of emotional dysfunction. Attention is captured by negative cues to an inordinate degree, triggering anxious mood states which, in turn, reinforce the salience of negative information. Very little is known regarding the role of attentional biases in anxious older adults, despite the acknowledged need for an increase in research on late-life anxiety. Furthermore, there is evidence that in older adults without clinical anxiety, the opposite bias (toward positive, and away from negative, emotional material) is present; yet how these age-related changes in emotional processing interact with anxiety is currently unknown. The emotional Stroop (eStroop) task, which requires rapid identification of the ink color of negative, neutral, and positive emotional words, has yet to be thoroughly tested as an index of attentional bias in older adults. The specific aims of this proposal are twofold: 1) to test whether eStroop response times differentiate anxious and non-anxious older adults; and 2) to identify neural correlates of the eStroop in late-life generalized anxiety disorder (GAD) patients and age-matched controls. In Study 1, 60 older adults in the community will complete the eStroop task. Response time data will be analyzed to test the prediction that high scorers on a self-report measure of worry, but not low scorers, will selectively attend to negative words, while low scorers, but not high scorers, will selectively attend to positive words. In study 2, fMRI data recently collected from 40 older adults (28 treatment-seeking GAD patients, 12 non-anxious controls) during the eStroop task will be analyzed. Analyses will focus on the neural circuits implicated in inhibitory control (prefrontal cortex regions) and emotional processing (amygdala) and will test the predictions of a theoretical model of attentional bias. This project will provide novel data on the utility of a widely-used task for research with older adult samples and will advance our understanding of the behavioral and neural correlates of normal and abnormal emotional processing in an understudied age group. Given that GAD is one of the most prevalent psychiatric conditions in late life, and response rates to current therapies are relatively poor, an improved understanding of the behavioral and neural mechanisms of late-life GAD is urgently needed. Generalized anxiety disorder is a prevalent, disabling condition in the older adult population. This study will explore whether biases in attention that have been shown to contribute to anxiety in younger adults are equally relevant in late-life anxiety, and what patterns of brain activity may underlie these biases.