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May 02, 2018
Part of Rising Star
Clinically significant anxiety affects 20% of preschool-aged children and increases risk for persistent anxiety problems throughout the lifespan. The persistence of anxiety into adulthood may be due, in part, to disruptions of brain processes supporting effortful control, as this pathophysiological signature is evident across development. Targeting effortful control early in development could therefore help reduce the burden of anxiety in youth and promote trajectories towards health and away from chronic illness. To date however, treatments have not been developed to specifically target this brain mechanism, which may explain why 31-51% of anxious youth remain symptomatic following a trial of existing empirically-supported therapy.
The central premise of the study is that neuroscientifically-derived information can facilitate more mechanistically-plausible, precise, and effective treatments for early childhood anxiety. The study focuses specifically on the characteristic pattern of insufficient capacity for effortful control (EC) in young children with clinically significant anxiety problems. Insufficient capacity for EC reflects failures of frontal brain regions (e.g., dorsolateral prefrontal cortex and anterior cingulate cortex) to adaptively regulate behavior and emotion. Neural substrates of EC can be easily measured using a non-invasive neurophysiological measure, namely the error-related negativity (ERN). Research from our labs and others have found that anxiety in young children is associated with reduced ERN, confirming insufficient capacity for EC in early development. Importantly, reduced ERN shows associations with behavioral deficits in EC (selective attention, response inhibition), but also with excessive fear behaviors (avoidance of fear-provoking stimuli) that are characteristic of anxious youth. Moreover, smaller ERN relates to larger fear potentiated startle (FPS), a neurophysiological marker of fear reactivity, consistent with the inverse association between top-down control and bottom-up fear processes believed to underlie anxiety. Thus, targeting EC could have beneficial effects on neural mechanisms and behavioral expressions of EC and fear in anxious youth.
Hypotheses: EC training will 1) increase ERN and proximal EC behavior and 2) decrease FPS, proximal fear behavior and more distal measures of clinically expressed anxiety.
Building from cognitive training, early childhood intervention and anxiety treatment literatures, we have developed an EC training intervention styled as a child-friendly, interactive “camp”. EC camp is comprised of short exercises that teach selective attention, response inhibition, and set shifting skills to groups of 4-6 anxious children over several sessions.
The primary goal is to test neural target engagement; that is, the extent to which EC camp a) increases ERN and b) decreases FPS. Secondary goals will be to explore associations between changes in neurophysiological targets (ERN and FPS), anxiety-relevant behaviors (EC, Fear) and anxiety symptom severity.
|Number of Subjects||17|