Neural Mechanisms Underlying MBSR and CBT in Patients/J.Gross

情绪失调被认为是许多医学和精神病学的核心机制 精神错乱。特别是，情绪调节失调被认为在身体和情绪上起着至关重要的作用 对疼痛的反应。越来越多的基础研究开始阐明神经关联和 情绪失调和疼痛感知的行为后遗症。与此同时，越来越多的 临床研究支持选定的心理社会干预措施对疼痛的疗效。然而，几乎没有什么是 知道这些治疗是如何调节对疼痛的情绪反应的。拟议的研究将直接 通过研究两种截然不同的心理社会治疗模式--认知--来解决这一知识差距 行为疗法(CBT)和基于正念的减压(MBSR)-影响两种特定形式的 CLBP患者的情绪调节--认知调节(CR)和注意力调节(AR)。背部疼痛 影响高达85%的人的一生；高达5%的成年人经历严重的和令人衰弱的影响 CLBP的。慢性支气管炎与巨大的疾病负担有关：它的复发率很高，而且 与精神障碍并存，包括重度抑郁(MOD)、药物滥用和焦虑 精神错乱。尽管CLBP是功能性残疾和痛苦的主要原因，但心理社会 治疗可以减少这种痛苦，但人们对此还没有很好的理解。我们的总体方法是使用行为和神经 RCT背景下情绪调节的测量，以检验CBT和CBT的不同影响 MBSR对慢性阻塞性肺疾病患者疼痛症状和幸福感的影响(目标1)，以区分CR和AR的变化 与CBT和MBSR(目标2)相关，并确定CR和AR是否中介治疗结果 (目标3)。这个翻译研究项目的广泛的、长期的目标是提供经验基础 为CLBP提炼和/或集成CBT和MBSR的特定组件，并加强我们的 了解特定的情绪调节过程在CLBP中的作用，以及其他医学和 精神障碍。

Emotion dysregulation is thought to be a core mechanism underlying many medical and psychiatric disorders. In particular, emotion dysregulation is believed to play a crucial role in physical and emotional responses to pain. A growing body of basic research is beginning to illuminate the neural correlates and behavioral sequelae of emotion dysregulation and perception of pain. Concurrently, a growing body of clinical research supports the efficacy of selected psychosocial interventions for pain. However, little is known about how these treatments modulate emotional reactivity to pain. The proposed study will directly address this knowledge gap by examining how two, distinct psychosocial treatment modalities-Cognitive- Behavioral Therapy (CBT) and Mindfulness-Based Stress Reduction (MBSR)-impact two specific forms of emotion regulation-cognitive regulation (CR) and attention regulation (AR)-in patients with CLBP. Back pain affects up to 85% of people over their lives; up to 5% of all adults experience severe and debilitating effects of CLBP. CLBP is associated with a huge disease burden: it has a high rate of recurrence and is highly comorbid with psychiatric disorders, including major depression (MOD), substance abuse, and anxiety disorders. Although CLBP is a major cause of functional disability and suffering, how psychosocial treatments reduce that suffering is not well understood. Our overall approach is to use behavioral and neural measures of emotion regulation in the context of an RCT to examine the differential impacts of CBT versus MBSR on pain symptoms and well-being in patients with CLBP (Aim 1), to differential changes in CR and AR related to CBT versus MBSR (Aim 2), and to determine whether CR and AR mediate treatment outcome (Aim 3). The broad, long-term objective of this translational research program is to provide an empirical basis for refining and/or integrating specific components of CBT and MBSR for CLBP and strengthen our understanding of the role specific emotion regulation processes play in CLBP, as well as other medical and psychiatric disorders.