Neural mechanisms of enhancing emotion regulation in bereaved spouses

项目摘要/摘要 失去配偶是一件压力很大的生活事件，与发病率显著增加有关 以及丧偶的死亡风险。丧失亲人的压力通常表现在情绪反应上，例如 绝望、沮丧、内疚和其他抑郁症状。因上述原因引起的急性痛苦 反应非常普遍，特别是在丧失亲人的早期阶段(即在最初的1-2年内)， 日常生活中有大量烦躁不安的活动，通常持续时间更长(长达4年或更长时间后) 损失)。丧亲也与下呼吸性窦性心律失常(RSA)有关，RSA是一种心理生理学疾病 适应性心脏迷走神经张力的生物标志物和全因死亡率的强烈预测因子。情绪调节技巧 是心理干预促进丧偶健康应对的理想目标。 尽管有明确的证据表明，丧失亲人的情绪压力与负面的健康后果有关， 现有的对丧亲的认知-行为干预方法往往总体上无效； 涉及不同干预策略的培训，模糊了关于哪些策略是最重要的知识 有效；施加巨大的时间/成本负担；以及--关键是--通过以下神经生物学机制运作 仍有待阐明。这项提案的目标是使用一种实验医学方法来 评估新认知的基本心理、心理生理学和神经机制 旨在改善心理结果(即减少抑郁)的情绪调节干预 症状和悲痛反省)丧偶。认知重新评估(即修改 通过思考和评估替代方案中的情绪信息来确定情绪反应的轨迹， 更适应的方式)是丧亲心理干预的一个非常有希望的目标。 重新评估可以通过两种主要策略来实现：心理疏远(即评估 作为客观、公正的观察者的情感刺激)和重新解释(即想象更好的结果 比最初看起来明显的)。拟议的项目建立在承诺开展以下前期工作的基础上 研究一种新的五次认知训练的有效性和潜在的神经生物学机制 对丧偶的重新评估干预。最近失去亲人的参与者(即大约6个月 )将被随机分配接受疏远或重新口译方面的培训，共5人 每1-3天举行一次会议，纵向收集情感、心理生理和功能方面的信息 磁共振成像(FMRI)数据。这项拟议的研究旨在机械地将 一种新的情绪调节干预中的心理、心理生理和神经功能 在这一压力较大的高危人群中实施之前。

Project Summary / Abstract The loss of a spouse is a profoundly stressful life event associated with significantly increased morbidity and mortality risk in bereaved spouses. Bereavement stress is often manifested in emotional reactions such as despair, dejection, guilt, and other symptoms of depression. Acute suffering stemming from the above reactions is highly prevalent, especially during the early stages of bereavement (i.e., within the first 1-2 years), with substantial dysphoria in everyday life activities often persisting even longer (up to 4 years or more post- loss). Bereavement is also associated with low respiratory sinus arrhythmia (RSA), a psychophysiological biomarker of adaptive cardiac vagal tone and a strong predictor of all-cause mortality. Emotion regulation skills represent an ideal target for psychological intervention to promote healthy coping in bereaved spouses. Despite clear evidence that the emotional stress of bereavement is associated with negative health outcomes, existing cognitive-behavioral intervention approaches for bereavement are frequently overall ineffective; involve training in disparate intervention strategies, obscuring knowledge about which strategies are most effective; impose substantial time/cost burdens; and—crucially—operate via neurobiological mechanisms that remain to be elucidated. The objective of this proposal is to use an experimental medicine approach to evaluate the basic psychological, psychophysiological, and neural mechanisms underlying a novel cognitive emotion regulation intervention aimed at improving psychological outcomes (i.e., reducing depressive symptoms and grief rumination) in bereaved spouses. Cognitive reappraisal (i.e. the ability to modify the trajectory of an emotional response by thinking about and appraising emotional information in an alternative, more adaptive way) represents a highly promising target for psychological intervention in bereavement. Reappraisal can be operationalized via two primary tactics: psychological distancing (i.e. appraising an emotional stimulus as an objective, impartial observer) and reinterpretation (i.e. imagining a better outcome than what initially seemed apparent). The proposed project builds upon promising preliminary work to investigate the effectiveness and underlying neurobiological mechanisms of a novel, five-session cognitive reappraisal intervention in bereaved spouses. Recently-bereaved participants (i.e. approximately 6 months post-spousal loss) will be randomly assigned to receive training in either distancing or reinterpretation, with five sessions occurring every 1-3 days, with longitudinal collection of affective, psychophysiological, and functional magnetic resonance imaging (fMRI) data. The proposed study aims to mechanistically relate changes in psychological, psychophysiological, and neural function during a novel emotion regulation intervention never before implemented in this stressed, high risk group.