Behavioral and fMRI correlates of late-life generalized anxiety disorder

描述（由申请人提供）：在临床焦虑的个体中，对环境中消极线索的选择性注意可能会使情绪功能障碍的恶性循环持续下去。注意力被消极的线索捕获到一个不合理的程度，引发焦虑的情绪状态，反过来，强化了消极信息的显著性。尽管人们承认需要增加对晚年焦虑的研究，但关于注意力偏差在焦虑的老年人中的作用，我们所知甚少。此外，有证据表明，在没有临床焦虑的老年人中，存在相反的偏见（倾向于积极的，远离消极的情绪材料）；然而，这些与年龄相关的情绪处理变化是如何与焦虑相互作用的，目前尚不清楚。情感斯特鲁普（eStroop）任务要求快速识别消极、中性和积极情绪词汇的墨水颜色，作为老年人注意偏差的指标，这项任务尚未得到彻底的测试。本研究的具体目的有两个：1)测试eStroop反应时间是否能区分焦虑和非焦虑的老年人；2)确定老年广泛性焦虑障碍（GAD）患者和年龄匹配对照中eStroop的神经相关性。在研究1中，60名社区老年人将完成eStroop任务。研究人员将分析反应时间数据，以检验这样一种预测：在焦虑自我报告中，得分高的人（而不是得分低的人）会选择性地关注消极词汇，而得分低的人（而不是得分高的人）会选择性地关注积极词汇。在研究2中，将分析最近收集的40名老年人（28名寻求治疗的广泛性焦虑症患者，12名非焦虑对照组）在eStroop任务期间的fMRI数据。分析将集中在涉及抑制控制（前额皮质区域）和情绪处理（杏仁核）的神经回路上，并将测试注意偏差理论模型的预测。该项目将为老年人样本研究中广泛使用的任务的效用提供新的数据，并将促进我们对未充分研究的年龄组中正常和异常情绪处理的行为和神经相关性的理解。鉴于广泛性焦虑症是最常见的老年精神疾病之一，而目前治疗的反应率相对较低，迫切需要提高对老年广泛性焦虑症的行为和神经机制的理解。广泛性焦虑症是一种在老年人中普遍存在的致残疾病。这项研究将探讨注意力偏差是否会导致年轻人的焦虑，是否与晚年焦虑同样相关，以及大脑活动的哪些模式可能是这些偏见的基础。

DESCRIPTION (provided by applicant): In clinically anxious individuals, selective attention to negative cues in the environment may perpetuate a vicious cycle of emotional dysfunction. Attention is captured by negative cues to an inordinate degree, triggering anxious mood states which, in turn, reinforce the salience of negative information. Very little is known regarding the role of attentional biases in anxious older adults, despite the acknowledged need for an increase in research on late-life anxiety. Furthermore, there is evidence that in older adults without clinical anxiety, the opposite bias (toward positive, and away from negative, emotional material) is present; yet how these age-related changes in emotional processing interact with anxiety is currently unknown. The emotional Stroop (eStroop) task, which requires rapid identification of the ink color of negative, neutral, and positive emotional words, has yet to be thoroughly tested as an index of attentional bias in older adults. The specific aims of this proposal are twofold: 1) to test whether eStroop response times differentiate anxious and non-anxious older adults; and 2) to identify neural correlates of the eStroop in late-life generalized anxiety disorder (GAD) patients and age-matched controls. In Study 1, 60 older adults in the community will complete the eStroop task. Response time data will be analyzed to test the prediction that high scorers on a self-report measure of worry, but not low scorers, will selectively attend to negative words, while low scorers, but not high scorers, will selectively attend to positive words. In study 2, fMRI data recently collected from 40 older adults (28 treatment-seeking GAD patients, 12 non-anxious controls) during the eStroop task will be analyzed. Analyses will focus on the neural circuits implicated in inhibitory control (prefrontal cortex regions) and emotional processing (amygdala) and will test the predictions of a theoretical model of attentional bias. This project will provide novel data on the utility of a widely-used task for research with older adult samples and will advance our understanding of the behavioral and neural correlates of normal and abnormal emotional processing in an understudied age group. Given that GAD is one of the most prevalent psychiatric conditions in late life, and response rates to current therapies are relatively poor, an improved understanding of the behavioral and neural mechanisms of late-life GAD is urgently needed. Generalized anxiety disorder is a prevalent, disabling condition in the older adult population. This study will explore whether biases in attention that have been shown to contribute to anxiety in younger adults are equally relevant in late-life anxiety, and what patterns of brain activity may underlie these biases.