Differential Extinction of Specific Types of Posttraumatic Emotional Reactivity

描述（由申请人提供）：我的总体职业目标是成为一名学术背景下的临床科学家，我的工作重点是理解与创伤事件相关的情绪反应的范围，以及它们对创伤后应激反应的自然和促进恢复的影响。基于这一目标，我正在寻求以下方面的培训：1)使用复杂的方法和分析技术，包括与创伤相关的实验室情感激发和评估；2)运用实验精神病理学方法了解创伤后后遗症，包括PTSD；3)将这些证据应用于针对创伤后问题的治疗和预防项目的发展和完善。拟议的以实验室为基础的研究是实现这些目标的关键一步，它为我提供了丰富的背景，使我能够检查能够为量身定制的循证干预措施的发展提供信息的机制。因此，这项拟议的研究利用复杂的实验室程序来比较反复接触性侵犯相关线索时厌恶和恐惧情绪反应的下降率。具体来说，92名性侵犯妇女将完成一项基于实验室的评估，评估她们对反复暴露于个性化脚本驱动的图像程序的厌恶和恐惧情绪反应。在暴露于以厌恶和恐惧为中心的性侵犯剧本以及中性剧本（对照组）之后，将测量情绪反应的变化。参与者将被随机分配到四组（2个实验组，2个对照组），他们将反复接触以厌恶和恐惧为重点的性侵犯剧本（实验组）或中性剧本（对照组）。具体研究假设如下：1)总体而言，反复暴露于性侵犯线索比暴露于恐惧线索更容易消除基于厌恶的反应；2)反复暴露于以厌恶为中心的性侵犯线索比暴露于以恐惧为中心的线索更容易消除基于厌恶的反应；3)反复暴露于以恐惧为中心的性侵犯线索比暴露于以厌恶为中心的线索更容易消除基于恐惧的反应。以暴露为基础的程序被整合到最完善的预防方案和治疗性侵犯造成的创伤后压力，然而，有相当一部分接受这种干预的人似乎没有受益，而且对干预反应良好的人通常报告残留症状。因此，本项目旨在了解可能影响基于暴露的干预措施结果的具体过程和机制，以进一步减轻创伤后应激障碍带来的广泛的公共卫生负担。

DESCRIPTION (provided by applicant): Based on my overarching career goal of becoming a clinical scientist in an academic setting with a program of work focused on understanding the range of emotional reactions associated with traumatic events and their affect on both natural and facilitated recovery from posttraumatic stress reactions, I am seeking training in 1) the use of sophisticated methodological and analytic techniques involving trauma-relevant laboratory elicitation and assessment of emotion; 2) the use of experimental psychopathology methods to understand posttraumatic sequelae, including PTSD; and 3) the application of this evidence to the development and refinement of both treatment and prevention programs targeting problematic posttraumatic outcomes. The proposed laboratory-based study represents a key step in the service of these aims by providing a rich context for me to examine mechanisms that can inform the development of tailored, evidence-based interventions. As such, the proposed study utilizes sophisticated laboratory-based procedures to compare rates of decline in the emotional reactivity of disgust and fear in response to repeated exposure to sexual assault-related cues. Specifically, 92 sexually assaulted women will complete a laboratory-based assessment of disgust- and fear-based emotional reactivity in response to repeated exposures to an individualized script-driven imagery procedure. Change in emotional reactivity will be measured following exposure to disgust- and fear- focused sexual assault scripts as well as neutral scripts (control groups). Participants will be randomly assigned to one of four groups (2 experimental, 2 control) where they will receive repeated exposure to disgust-focused and fear-focused sexual assault scripts (experimental groups) or neutral scripts (control groups). Specific study hypotheses are as follows: 1) overall, repeated exposure to sexual assault cues will result in less extinction of disgust-based reactivity compared to fear-based reactivity, 2) repeated exposure to disgust-focused sexual assault cues, compared to exposure to fear-focused cues, will result in greater extinction of disgust-based reactivity, and 3) Repeated exposure to fear-focused sexual assault cues, compared to exposure to disgust- focused cues, will result in greater extinction of fear-based reactivity. Exposure-based procedures are integrated into the most well-established prevention programs and treatments for posttraumatic stress resulting from sexual assault, yet a significant minority of people receiving such interventions do not appear to benefit and people responding well to interventions commonly report residual symptoms . Accordingly, this project aims to understand specific processes and mechanisms that likely affect outcomes of exposure-based interventions to advance efforts to further alleviate the extensive public health burden introduced by PTSD. PUBLIC HEALTH RELEVANCE: While leading scholars in the area of sexual assault have long suggested that emotions other than fear are likely to be impact interventions for posttraumatic problems, the current project incorporates one of the first controlled laboratory investigations of this hypothesis by investigating the effects of exposure to sexual assault- relevant cues on disgust- and fear-based reactivity. Findings from this study will lay the foundation for an investigation of effects of specifically targeting disgust-based reactivity in the treatment of sexual assault- related PTSD. This project is both significant and clinically important in that it seeks to better understand specific processes and mechanisms that likely affect outcomes of exposure-based interventions in an effort to enhance interventions designed to alleviate the extensive public health burden introduced by PTSD.