Novel Behavioral Intervention to Target Social Reward Sensitivity and Attachment

社会关系是心理健康和幸福的基本决定因素。质量不佳 人际关系和社会隔离增加了对无数负面心理健康的脆弱性，并加剧了这种状况 结果(如焦虑、抑郁、自杀)，给个人和社会造成巨大代价。 尽管支持形成积极社会关系的生物行为过程很好- 如上所述，在将这些知识转化为发展机制信息方面存在着根本的差距 对精神疾病的干预。拟议的项目试图通过测试一种神经- 通过实验医学方法加强社会关系的中介途径。我们依靠的是 涉及正价系统(PVS)的研究，这是研究领域标准的核心维度 (RDoC)框架，作为促进社会联系和依恋的基本机制。在基础上建设 在我们最初的治疗开发工作中，我们将评估一种新的心理社会干预-社会干预的效果 方法培训-旨在提高PVS(社会方法动机和奖励)的组成部分 有焦虑或抑郁的寻求治疗的个人的响应性，或“社会回报敏感性”) 有社会功能障碍的。R61阶段：目标1将测试社交方法的假设 训练可以上调社会奖励敏感性(干预目标)，涉及神经，生理，行为， 和自我报告分析单位在n=60名患者随机分为两个治疗剂量之一，或不 干预控制条件。目标2将调查社交方法培训的最佳剂量，以最大限度地 与目标交战。目标3将建立进一步的心理测量支持(例如，重测可靠性) 目标交战的拟议措施。R33阶段：等待初步演示社交方法 培训调节社会奖励敏感性(R61-Aim 1)，R33阶段的目标1试图复制以下证据 通过比较随机接受最佳社交方法剂量的参与者来确定目标参与度 训练(n=50)或积极控制条件(压力管理训练；n=50)。Aim 2将检查 社会奖励敏感度的变化是否与频率和强度的提高有关 通过自我报告、社交网络调查和对现实世界的观察来评估社交关系 通过社交媒体获得的社交行为。通过这种方法，我们将获得前所未有的生态 确定干预对现实世界功能的影响的有效性，这是NIMH的高度优先事项 战略规划。我们还将探讨治疗后精神健康结果的变化。通过瞄准社交网络 探讨机制而不是无序症状，并将神经回路功能的变化与 现实世界社会关系的变化，我们将(1)加深对以下机制的理解 支持与他人的积极联系，以及(2)推进神经科学知情和有针对性的干预 有可能产生临床上有意义的结果，并产生可衡量的现实世界影响的方法。

Social relationships are fundamental determinants of psychological health and well-being. Poor quality relationships and social isolation heighten vulnerability to and exacerbate a myriad of negative mental health outcomes (e.g., anxiety, depression, suicide), which create substantial costs to the individual and society. Although the biobehavioral processes that support the formation of positive social relationships are well- delineated, a fundamental gap exists in translating that knowledge to develop mechanism-informed interventions for psychiatric conditions. The proposed project seeks to fill this gap by testing a neurally- mediated pathway for enhancing social connections through an experimental medicine approach. We draw on research implicating the positive valence system (PVS), a core dimension of the Research Domain Criteria (RDoC) framework, as a fundamental mechanism that promotes social affiliation and attachment. Building on our initial treatment development work, we will evaluate the effects of a novel psychosocial intervention – social approach training – designed to up-regulate components of the PVS (social approach motivation and reward responsiveness, or “social reward sensitivity”) in treatment-seeking individuals with anxiety or depression who present with social functioning impairments. R61 phase: Aim 1 will test the hypothesis that social approach training can up-regulate social reward sensitivity (intervention target) across neural, physiological, behavioral, and self-report units of analysis in n=60 patients randomized to one of two treatment doses, or a no intervention control condition. Aim 2 will investigate optimal dosing of social approach training to maximally engage the target. Aim 3 will establish further psychometric support (e.g., test-retest reliability) for the proposed measures of target engagement. R33 Phase: Pending initial demonstration that social approach training modulates social reward sensitivity (R61-Aim 1), Aim 1 of the R33 phase seeks to replicate evidence of target engagement by comparing participants randomized to receive the optimal dose of social approach training (n=50) or to an active control condition (stress management training; n=50). Aim 2 will examine whether changes in social reward sensitivity are associated with improvements in the frequency and strength of social connections assessed through self-report, social network surveys, and observation of real-world social behavior acquired through social media. Through this approach we will gain unprecedented ecological validity to ascertain the impact of the intervention on real-world functioning, a high priority of the NIMH Strategic Plan. We will also explore changes in mental health outcomes following treatment. By targeting social approach mechanisms rather than disorder-bound symptoms, and linking changes in neural circuit function to changes in real-world social connections, we will (1) deepen our understanding of the mechanisms that support positive connections with others, and (2) advance neuroscience-informed and targeted intervention approaches with the potential to yield clinically meaningful outcomes with measurable real-world impact.