Attention Bias as an Etiologic Factor in Primary and Secondary Insomnia

描述（由申请人提供）：相对较少的研究已经进行，以确定失眠是什么，以及失眠如何可能赋予其他疾病状态的风险。缺乏研究可能部分是由于失眠表型缺乏客观标志物，这对于认知唤醒现象尤其如此。这个概念，虽然关键1）患者的经验，失眠和2）许多病因理论失眠，传统上是衡量只有自我报告。另一种方法可能是使用基于表现的注意力处理措施。实验'探测'任务，索引处理速度，已被有效地用于探索认知的作用，涉及广泛的心理和习惯障碍。到目前为止，三种类型的任务已经在失眠患者中进行了评估。这些研究成功地证明了精神生理障碍患者对语义和图形刺激的睡眠相关注意偏向现象。 拟定研究：本研究的目的是进一步探讨注意加工的关键组成部分，以期确定一个候选的失眠“标记”。为了实现这一点，将在4个组中评价认知唤醒的三个领域。这些领域是主观心理体验（自我报告），表现（注意力处理）和皮层活动（qEEG）。自我报告数据和面部肌电图也将用于索引唤醒的其他方面。四个受试者组为健康良好睡眠者、精神生理障碍患者和抑郁相关障碍患者（急性和缓解）。主要目标将是确定）在这三个认知领域中，群体差异的程度，2）对这种差异最关键的注意力组成过程，以及3）每种注意力测量（即诊断）的相对预测效用。

DESCRIPTION (provided by applicant): Relatively little research has been undertaken to determine what insomnia is and how insomnia may confer risk for other disease states. The lack of research may be due, in part, to the fact that the insomnia phenotype lacks objective markers, and that this is especially true for the phenomenon of cognitive arousal. This concept, while critical 1) to the patient's experience of insomnia and 2) for many etiologic theories about insomnia, is traditionally measured only by self-report. An alternative may be to use performance based measures of attentional processing. Experimental 'probe' tasks, indexing processing speed, have been used productively to explore the role of cognition in relation to wide range of psychological and habit disorders. To date, three types of task have been evaluated in patients with insomnia. These studies have successfully demonstrated the phenomenon of sleep-related attention bias, in patients with Psychophysiologic Insomnia, to semantic and pictorial stimuli. Proposed Study: The aim of the present study is to further explore the critical components of attentional processing with a view to identifying a candidate 'marker' for insomnia. In order to accomplish this, three domains of cognitive arousal will be evaluated in 4 groups. These domains are subjective mental experience (self report), performance (attentional processing) and cortical activity (qEEG). Self-report data and facial EMG will also be used to index other dimensions of arousal. The four subject groups will be Healthy Good Sleepers, patients with Psychophysiologic Insomnia and patients with Insomnia associated with Depression (acute and remitted). The primary goals will be to determine ) the extent to which the groups differ across these three cognitive domains, 2) the component processes of attention most critical to this differentiation and 3) the relative predictive utility of each of the attentional measures (viz. diagnosis).