Tailored inhibitory control training to reverse EA-linked deficits in mid-life

 描述(由申请人提供)：人类的早期逆境(EA)是导致一系列有害的身心健康结果的主要因素，这些结果延伸到成年后，如抑郁和焦虑，肥胖和心脏病，以及过早死亡。除了显著降低个人幸福感和生活质量外，这些情况还消耗了联邦、州和社区组织的大量资源。电针对这些结果产生影响的机制越来越为人所知，其中包括与执行功能相关的神经认知通路。能够成功地针对、参与和改变这些机制中的一个或多个的功能的干预将是一种很有希望的方式，可以减轻电针对以后生活中有害后果的影响。这项拟议的研究聚焦于一种这样的途径--抑制控制缺陷(IC)--并在经历过电针的个体样本中测试干预措施的可行性和有效性，以增加该途径的功能。这种干预是基于一种神经知情的变化模型，该模型将IC缺陷指定为几种危及健康的行为(HRB)共同的潜在原因。这些IC缺陷在发育过程中出现，是一系列EA的结果，关键是，可以通过有针对性的干预在中年修复。我们实验室的研究证实了一种干预措施，可以提高IC的性能并改变其在年轻人中的潜在神经系统(Berkman，Kahn，&Merchant，2014)。在这里提出的这项研究计划的下一步是在经历过EA的中年个体样本中测试干预的有效性，以及我们的干预在多大程度上推广到该样本中普遍存在的HRB。第一个目的是测试在行为表现和神经功能方面与训练任务相似和不同的任务中，干预是否改变了IC系统。第二个目标是测试基础神经系统功能的改变是否中介了干预对绩效的影响，这两个目标将在两个手臂的单一随机对照试验(IC训练与主动控制)和IC绩效、IC神经系统和HRBS的岗位前测量的背景下实现。所有参与者(N=110)都来到实验室，对IC和HRB的行为/神经测量进行初步评估，以及其他测量。然后，参与者被随机分配到接受以人为中心的抑制控制(Pecic)训练或主动控制训练，每隔一天进行一次，为期3-4周。Pecic系统地将IC参与与酒精、烟草和/或高能量食物线索配对，这取决于每个参与者对这些领域中失控行为的报告。主动控制任务使用个性化线索和响应时间任务，但不涉及IC。最后，参与者返回实验室进行终点评估，在那里重复所有基线测量。这两个目标将在一系列分析中得到强有力的检验，这些分析比较了两组去抑制相关HRB从干预前到干预后的行为和神经变化。

 DESCRIPTION (provided by applicant): Early adversity (EA) in humans is a major contributing factor to a range of deleterious physical and mental health outcomes extending through adulthood such as depression and anxiety, obesity and heart disease, and premature death. In addition to detracting significantly from individual well-being and quality of life, these conditios also consume considerable resources from federal, state, and community organizations. The mechanisms through which EA exerts its effects on these outcomes are increasingly well understood, and include neurocognitive pathways related to executive function. An intervention that can successfully target, engage with, and alter the functioning of one or more of these mechanisms would be a promising way of mitigating the impact of EA on deleterious outcomes later in life. The proposed research focuses on one such pathway-deficits in inhibitory control (IC)-and tests the feasibility and efficacy of an intervention to increase functioning in that pathway in a sample of individuals who experienced EA. The intervention is grounded in a neurally informed model of change that specifies deficits in IC as an underlying causal factor common to several health-risking behaviors (HRBs). These IC deficits emerge during development as a result of a range of EA, and, critically, can be remediated in mid-life through targeted intervention. Research from our laboratory has validated an intervention that can increase IC performance and alter its underlying neural systems in young adults (Berkman, Kahn, & Merchant, 2014). The next step in this program of research, proposed here, is to test the efficacy of that intervention in a sample of mid-life individuals who have experienced EA and the extent to which our intervention generalizes to HRBs that are prevalent in that sample. The first Aim is to test whether the intervention alters the IC system in tasks both similar to and dissimilar from the training task in terms of both behavioral performance and neural functioning. The second Aim is to test whether alterations in the functioning of the underlying neural systems mediate the effect of the intervention on performance and The two Aims will be accomplished within the context of a single RCT with two arms (IC training vs. active control) and pre-post measurements of IC performance, IC neural systems, and HRBs. All participants (N = 110) come to the lab for an initial assessment of behavioral / neural measures of IC and HRBs, among other measures. Then, participants are randomly assigned to receive a Person-Centered Inhibitory Control (PeCIC) training or active control training, every other day for 3-4 weeks. The PeCIC systematically pairs IC engagement with alcohol, tobacco, and/or energy-dense food cues, depending on each participant's reports of disinhibited behavior in those domains. The active control task uses personalized cues and response time tasks but does not involve IC. Finally, participants return to the laboratory for an endpoint assessment where all baseline measures are repeated. The two Aims will be robustly tested in a series of analyses comparing the behavioral and neural change from pre- to post-intervention between the groups disinhibition-related HRBs.