Identification of neural indices of distress tolerance using fMRI

描述（由申请人提供）：证据表明，痛苦不耐受，或一个人在经历情感痛苦时无法坚持目标导向的活动，提供了避免情感痛苦的行为代理，并表明在禁欲尝试的早期阶段保持禁欲和治疗的能力。尽管实用程序的行为措施的痛苦不容忍在确定个人的风险，不良的物质使用的结果，这条线的工作还没有被利用在一个评估范式，能够确定与痛苦不容忍的神经过程。虽然先前的研究已经确定了涉及复发过程的关键神经结构，包括前额叶和边缘系统区域，但迄今为止还没有将这些区域整合到一个评估范式中，该评估范式可以捕获一个人在不进行回避行为的情况下容忍痛苦的能力。因此，本研究的具体目标将允许桥接的情感和认知神经科学与临床和行为心理学的科学家在利用功能磁共振成像的一个有效的痛苦不容忍的范例，以确定负责痛苦不容忍的关键神经生物学指标。痛苦不容忍范式为这一研究领域提供了一种经过经验验证的创新方法，因为它（1）在目标导向活动的背景下消除实时痛苦，而不是回忆以前的痛苦事件或观看痛苦图片，（2）反复证明了与许多“现实世界”药物滥用结果的关系，也许最重要的是，（3）允许在实验过程中研究一个人对痛苦的行为反应（即退出任务）。具体地，本申请的主要目的是识别与避免情感困扰相关联的神经过程（即，在30名健康的非药物使用和30名可卡因依赖的成年人进入住宅物质滥用治疗（总n = 60）的样本中，这些神经过程在解释痛苦不耐受和可卡因依赖之间的关系的影响。

DESCRIPTION (provided by applicant): Evidence indicates that distress intolerance, or one's inability to persist in goal directed activity while experiencing affective distress, provides a behavioral proxy of avoidance of affective distress, and is indicative of the ability to remain abstinent and in treatment during the early stages of an abstinence attempt. Despite the utility of the behavioral measures of distress intolerance in identifying individuals at risk for poor substance use outcomes, this line of work has yet to be utilized in an assessment paradigm capable of identifying the neural processes associated with distress intolerance. Although previous studies have identified key neural structures implicated in the relapse process including prefrontal and limbic regions, none to date have integrated these areas in an assessment paradigm that captures one's ability to tolerate distress without engaging in avoidance behavior. The specific aims of this study will thus allow for the bridging of scientists within affective and cognitive neuroscience with clinical and behavioral psychology in the utilization of a well validated distress intolerance paradigm in fMRI to identify key neurobiological indices responsible for distress intolerance. The distress intolerance paradigm provides an empirically validated and innovative approach to this line of research because it (1) elicits real-time distress in the context of goal directed activity as opposed to recalling a previously distressing event or viewing distressing pictures, (2) has repeatedly demonstrated a relationship with a number of "real-world" substance abuse outcomes, and perhaps most importantly, (3) allows for the study of one's behavioral response to distress (i.e. quitting the task) during the experimental procedure. Specifically, the primary aims of the current application are to identify the neural processes associated with the avoidance of affective distress (i.e., distress intolerance) in a sample of 30 healthy non-drug using and 30 cocaine dependent adults entering residential substance abuse treatment (Total n = 60), and the influence of these neural processes in explaining the relationship between distress intolerance and cocaine dependence.