Attention Bias as an Etiologic Factor in Primary and Secondary Insomnia

描述(由申请人提供)：在确定失眠是什么以及失眠如何可能给其他疾病状态带来风险方面，进行的研究相对较少。缺乏研究的部分原因可能是失眠表型缺乏客观标志，尤其是认知唤醒现象。这一概念虽然对1)失眠患者的经历和2)许多关于失眠的病因理论是关键的，但传统上只能通过自我报告来衡量。一种替代方法可能是使用基于表现的注意力处理测量。实验性的“探测”任务，即索引处理速度，已经被有效地用来探索认知在广泛的心理和习惯障碍中的作用。到目前为止，已经对失眠患者进行了三种类型的任务评估。这些研究已经成功地证明了心理生理性失眠症患者对语义和图片刺激存在与睡眠相关的注意偏差现象。 建议的研究：本研究的目的是进一步探索注意力处理的关键组成部分，以期确定失眠的候选“标记”。为了做到这一点，认知唤醒的三个领域将被分成四组进行评估。这些领域是主观心理体验(自我报告)、表现(注意加工)和大脑皮质活动(QEEG)。自我报告数据和面部肌电也将被用来索引唤醒的其他维度。这四个受试组将是健康的良好睡眠者，精神生理性失眠症患者和与抑郁症相关的失眠症患者(急性和缓解)。主要的目标将是确定)这三个认知领域的群体差异的程度，2)对这种差异最关键的注意成分过程，以及3)每种注意测量的相对预测性(即。诊断)。

DESCRIPTION (provided by applicant): Relatively little research has been undertaken to determine what insomnia is and how insomnia may confer risk for other disease states. The lack of research may be due, in part, to the fact that the insomnia phenotype lacks objective markers, and that this is especially true for the phenomenon of cognitive arousal. This concept, while critical 1) to the patient's experience of insomnia and 2) for many etiologic theories about insomnia, is traditionally measured only by self-report. An alternative may be to use performance based measures of attentional processing. Experimental 'probe' tasks, indexing processing speed, have been used productively to explore the role of cognition in relation to wide range of psychological and habit disorders. To date, three types of task have been evaluated in patients with insomnia. These studies have successfully demonstrated the phenomenon of sleep-related attention bias, in patients with Psychophysiologic Insomnia, to semantic and pictorial stimuli. Proposed Study: The aim of the present study is to further explore the critical components of attentional processing with a view to identifying a candidate 'marker' for insomnia. In order to accomplish this, three domains of cognitive arousal will be evaluated in 4 groups. These domains are subjective mental experience (self report), performance (attentional processing) and cortical activity (qEEG). Self-report data and facial EMG will also be used to index other dimensions of arousal. The four subject groups will be Healthy Good Sleepers, patients with Psychophysiologic Insomnia and patients with Insomnia associated with Depression (acute and remitted). The primary goals will be to determine ) the extent to which the groups differ across these three cognitive domains, 2) the component processes of attention most critical to this differentiation and 3) the relative predictive utility of each of the attentional measures (viz. diagnosis).