Facial Affect Sensitivity Training for young children with CU traits.

项目总结 冷酷无情(CU)的特征(例如，缺乏内疚或悔恨，同理心低，情感浅薄)是 与成人精神变态的核心情感特征一致，是既定的风险 早期出现的、持续的和严重的青少年不当行为的因素。CU特征反映的是损伤 在已识别的神经认知机制中，干扰儿童社会化并预测较差 治疗结果，即使对破坏性行为进行了完善的治疗，因此呼吁 用于新的干预措施。那些试图解释那些患有 识别和恰当应对他人情绪困扰的CU特质都强调 情感敏感度方面的根本性缺陷，包括对 其他情绪暗示，特别是痛苦的信号(例如，恐惧、悲伤的面部表情)。 另一方面，高CU青少年对夸大的奖励反应表现出正常。我们坚称 对情绪困扰信号(恐惧和/或悲伤)的敏感性受损是机械性的 与儿童的CU特征有关，并通过直接通过 计算机化的自动反馈和激励系统，可以发挥下游效应 CU的特点。因此，我们提出了一种实验治疗学方法来开发和测试一种新的 CU特质的神经认知干预。拟议项目的第一阶段(R61)将 在一项初步随机对照试验(RCT；N=30)中证明，一种新的 神经认知干预(面部情感敏感性训练：FAST)可以使目标参与， Fas(主要通过求救表情的FER准确率衡量，其次通过 CU特征升高的儿童的眼睛凝视和神经活动增强)。我们将研究 个体生长速度和测试条件之间的斜率差异(FAST V对照)。目标 在FAST与非FAST的比较中，敬业度将定义为中等效果大小(d&>.40) 对主要目标(遇险火警)的治疗控制。我们还将致力于确定最佳 关于FER改善的治疗次数的剂量参数(例如，局部治疗的时间 起伏或衰减、变化量、最大变化发生时)以及参与者满意度 包括会话频率、时长和数量。在R33阶段，我们的目标是复制目标 与新的、更大的高CU样本接触，并评估可行性和初步 FAST的有效性，在RCT(N=50)的背景下，将FAST与有效的 控制条件(ACC；内隐眼睛凝视训练)，包括检查下游变化 CU的特点。如果快速干预提高了FER，降低了CU特征，那么早期的这种训练 童年可能有助于中断向反社会结果发展的级联。

PROJECT SUMMARY Callous-unemotional (CU) traits (e.g., lack of guilt or remorse, low empathy, shallow affect) are consistent with the core affective features of adult psychopathy and are an established risk factor for early emerging, persistent, and severe youth misconduct. CU traits reflect impairment in identified neurocognitive mechanisms that interfere with child socialization and predict poorer treatment outcomes, even with well-established treatments for disruptive behavior, and thus call for novel interventions. Prominent theories that attempt to account for the failure of those with CU traits to recognize, and respond appropriately to, others' emotional distress all emphasize fundamental deficits in affect sensitivity, including reduced attention toward and recognition of others emotional cues, particularly signals of distress (e.g., facial expressions of fear, sadness). On the other hand, high-CU youth show normal to exaggerated reward responsivity. We assert that impaired sensitivity for emotional distress cues (fear and/or sadness) is mechanistically linked to CU traits in children, and that by targeting facial affect sensitivity (FAS) directly via a computerized automated feedback and incentive system, we can exert downstream effects on CU traits. We thus propose an experimental therapeutics approach to develop and test a novel neurocognitive intervention for CU traits. The first phase (R61) of the proposed project will demonstrate, in a preliminary randomized controlled trial (RCT; N=30), that a new neurocognitive intervention (Facial Affect Sensitivity Training: FAST) can engage the target, FAS (measured primarily by FER accuracy for distress expressions, and secondarily by heightened eye gaze and neural activity) in children with elevated CU traits. We will examine individual growth rates and test slope differences between conditions (FAST v control). Target engagement will be defined as medium effect size (d > .40) in the comparison of FAST vs. no- treatment control on the primary target (distress FER). We will also aim to determine optimal dose parameters with regard to number of sessions for FER improvement (e.g., timing of local bump or decay, amount of change, when maximal change occurs), and participant satisfaction with session frequency, length, and number. In the R33 phase, we aim to replicate target engagement with a new, larger high-CU sample, and evaluate feasibility and preliminary efficacy of FAST, in the context of an RCT (N = 50) in which FAST is compared to an active control condition (ACC; implicit eye gaze training), including examining downstream change in CU traits. If the FAST intervention improves FER and reduces CU traits, such training in early childhood could help interrupt the developmental cascade toward antisocial outcomes.