Positive Emotional Processing: Exploring Novel Treatment Targets in Social Phobia

社交焦虑症(SAD)是一种非常普遍和令人衰弱的疾病，其显著特征是 社会关系功能受损，生活质量下降。当前的治疗方法 因为SAD强调高度的负面情绪(焦虑和恐惧)，认知(全神贯注于 消极评价)，以回避行为为中心治疗对象。然而，这些治疗方法 从研究中剔除，表明SAD的特征也是基本调节失调 管理对积极刺激的反应和具有奖励潜力的情况的系统。虽然目前 SAD的现有治疗方法是有效的，许多人未能完全恢复并继续 在治疗后经历积极的社会功能障碍。这些不足之处值得注意。 鉴于积极的社会和情感体验是心理和身体健康的基础。 为了解决这一关键差距，拟议的项目将结合认知神经科学知识 使用功能神经成像的实验程序(认知偏差修正，CBM)？研究如何 为积极的社交线索修改内隐的方法倾向会影响行为、情感和大脑 对于积极的社会关系和福祉非常重要的机制。完成的工作由 申请人在K99阶段证明(1)接近/避免CBM程序可靠 修改隐含的接近倾向并影响后呼气时的积极社会功能指数， 和(2)CBM程序调节大脑中对情绪处理很重要的区域的功能。 在这些研究的基础上，这项建议的具体目标是：(1)审查简短的多场会议的影响 儿童积极情感和社会接近行为变化的循序渐进CBM程序研究 符合广泛性SAD诊断标准的个体；(2)检查社会心理障碍的神经关联 与健康对照组相比，GSAD患者的奖赏加工；以及(3)检查奖赏的功能变化 遵循循序渐进的CBM程序的神经官能学：该项目的目标是识别新的 可加强GSAD患者现有干预措施的治疗目标和方法。

Social anxiety disorder (SAD) is a highly prevalent and debilitating condition, marked by significant impairments in social relationship functioning and a diminished quality of life. Current treatment approaches for SAD emphasize heightened negative emotions (anxiety and fear), cognitions (preoccupation with negative evaluation), and avoidance behaviors as the central treatment targets. However, these treatments are removed from research suggesting that SAD is also characterized by a dysregulation of basic regulatory systems that govern responses to positive stimuli and situations with reward potential. Although currently available treatments for SAD are efficacious, many individuals fail to achieve full recovery and continue to experience impairments in positive social functioning following treatment. These deficiencies are notable given that positive social and emotional experiences are fundamental for psychological and physical wellbeing. To address this critical gap, the proposed project will combine a cognitive neuroscience-informed experimental procedure (cognitive bias modification, CBM)^with functioning neuroimaging to investigate how modifying implicit approach tendencies for positive social cues effects behavioral, affective, and brain mechanisms that are important for positive social relationships and well-being. Work accomplished by the applicant during the K99 phase demonstrated that (1) an approach/avoidance CBM procedure reliably modifies implicit approach tendencies and influences indices of positive social functioning in the latxiratory, and (2) CBM procedures modulate functioning in brain regions that are important for emotion processing. Building on these studies, the specific aims of this proposal are:. (1) To examine the effects of a brief multisession approach-positive CBM procedure on change in positive affect and social approach behaviors in individuals meeting diagnostic criteria for generalized SAD; (2) To examine the neural correlates of social reward processing in GSAD relative to healthy controls; and (3) To examine functional changes in reward neurodrcuitry following the approach-positive CBM procedure: The goal of this project is to identify novel treatment targets and approaches that can augment existing interventions in GSAD patients.