Attention Training's Impact on Biobehavioral Correlates of Behavioral Inhibition

描述（由申请人提供）：儿童早期气质，特别是行为抑制（BI），被视为儿童对新奇事物和威胁的生物反应倾向的表达。行为抑制儿童在同伴交往中有困难，在新的社会情境中表现出退缩。此外，BI儿童在青春期和成年后患焦虑症的风险增加。虽然研究已经帮助确定了最危险的儿童，由于极端的气质，环境风险因素或生物脆弱性，我们没有强有力的干预措施，可能有助于改善风险。事实上，一线或金标准干预措施，如认知行为疗法（CBT）的汇款率只有50%。成人文献表明，针对威胁的注意力偏差可能有助于减轻高危儿童的焦虑行为。这项工作建立在关注信息处理偏差的焦虑认知理论以及实证研究的基础上，这些研究表明，对威胁的注意偏差可能在焦虑的出现中发挥因果作用。事实上，最近的研究发现，注意力偏差修正（ABM）协议，训练注意力远离威胁减少焦虑症状，并改善个人对实验室压力源的反应。之前的研究已经表明，BI和焦虑之间存在许多生物行为上的相似之处，过去两年出现的新研究也发现BI儿童对威胁表现出注意力偏见。目前的研究将首次检查多周ABM方案对有焦虑气质风险的儿童的疗效。为了检查潜在ABM效应的呼吸，研究将评估基线和干预后BI和焦虑的生物行为相关性（结果）。这些标记包括事件相关电位（ERP）对注意力偏差的反应，注意力偏差的神经相关（通过功能磁共振成像），休息时的右额叶脑电图（EEG）不对称，与陌生的同龄人相遇时的社会行为，最后，父母和自我报告的焦虑情绪。将有三组9 - 12岁儿童参与：将接受主动ABM方案（BI-ABM）的BI儿童、接受注意力安慰剂（BI-安慰剂）的BI儿童和也将接受安慰剂（非BI-安慰剂）的非抑制儿童。我们预期两个BI组在基线时均将显示生物行为风险模式。然而，ABM后，我们预测BI-ABM组的风险将低于BI-安慰剂组，甚至可能与非BI-安慰剂组相当。如果成功，这项概念验证研究将为一种便携、高效、易于实施并可用于幼儿的新型干预措施提供证据。这将扩大我们减轻痛苦的能力，并扩大不同地理位置、社会经济地位和年龄的人获得治疗的机会。

DESCRIPTION (provided by applicant): Early childhood temperament, particularly behavioral inhibition (BI), is seen as an expression of a child's biologically based reaction tendencies to novelty and threat. Behaviorally inhibited children have difficulty with peer interactions and exhibit withdrawal in novel social situations. In addition, BI children are at increased risk for anxiety in adolescence and into young adulthood. While research has helped identify the most at-risk children, due to extreme temperament, environmental risk factors, or biological vulnerabilities, we do not have strong interventions that may help ameliorate risk. Indeed, front-line or gold-standard interventions such as cognitive-behavioral therapy (CBT) have remittance rates of only 50%. The adult literature suggests that targeting attention biases to threat may help lessen anxious behaviors in at-risk children. This work builds on cognitive theories of anxiety that focus on information processing biases as well as empirical research suggesting that attention biases to threat may play a causal role in the emergence of anxiety. Indeed, recent work has found that attention bias modification (ABM) protocols that train attention away from threat decrease anxious symptoms and improve an individual's response to a laboratory stressor. Previous work has shown numerous biobehavioral parallels between BI and anxiety, and new studies emerging in the last two years also find that BI children show attention biases to threat. The current study will for the first time examine the efficacy of a multi-week ABM protocol with children at temperamental risk for anxiety. To examine the breath of the potential ABM effect the study will assess biobehavioral correlates of BI and anxiety at baseline and after intervention (outcome). These markers include event-related potential (ERP) response to attention bias, the neural correlates (via fMRI) of attention bias, right frontal encephalogram (EEG) asymmetry at rest, social behavior in an encounter with an unfamiliar same-age, same-sex peer, and finally, parental- and self-report of anxious symptomotology. Three groups of 9 to 12-year-old children will participate: BI children who will undergo an active ABM protocol (BI-ABM), BI children undergoing an attention placebo (BI-Placebo) and non- inhibited children who will also experience a placebo (non-BI-Placebo). It is our expectation that both BI groups will display a biobehavioral pattern of risk at baseline. However, post-ABM we predict that the BI-ABM group will show less risk than their BI-Placebo counterparts and may even be comparable to the non-BI- Placebo group. If successful, this proof of concept study will provide evidence for a novel intervention that is portable, efficient, easily-implemented and can be used with very young children. This would broaden our ability to ameliorate suffering and broaden access to treatment across geographic location, socioeconomic status, and age.