Richard Zinbarg - US grants

This is a collaborative research effort of Northwestern University and the University of California, Los Angeles to evaluate common and specific risk factors for anxiety disorders and depression. Each site will work on a common protocol. We propose a prospective longitudinal study of 700 high school juniors, recruited in two cohorts over consecutive years at two high schools (Evanston and Santa Monica). Using a high-risk design, participants at high risk (according to Neuroticism cores) will be oversampled relative to medium and low risk groups. Their progression will be carefully tracked over the course of 8 to 10 assessments staggered over four to four and a half years of data collection. The participant sample will be geographically, ethnically, and socio-economically diverse. The proposal takes a comprehensive biopsychosocial approach to the conceptualization and measurement of risk factors, which include Neuroticism, depressogenic cognitive style, anxiety sensitivity, introversion and low positive affectivity, sociotropy and autonomy. Measures will include self report, parental report, as well as information processing tasks (modified Stroop, memory tasks), affective modulation of startle reactivity, and ambulatory cortisol assays. In addition, diathesis-stress interactions will be evaluated on the basis of contextual assessment of chronic and episodic life stress. Outcome will be measured in terms of symptoms and diagnosis of anxiety and depression. Various models of commonalities and specificities of risk and their interaction with stress will be tested using hierarchical logistic regression and structural equation modeling. The findings may further our conceptualization of emotional disorders and provide the platform for prevention research.

DESCRIPTION (provided by applicant): Our parent grant involves a comprehensive examination of common and specific risk factors for emotional disorders, with a rich array of measures of personality traits, life stress, symptom status and diagnostic status, assessed repeatedly over a 4-year interval, as well as other measures assessed only once in the first year cognitive biases (attentional bias, interpretive bias, and memory bias) and psychophysiological functioning (daily cortisol rhythms and fear potentiated startle). Our sample is comprised of 627 ethnically and socioeconomically diverse adolescents recruited during their junior year in high school. Using a high risk design, we overselected (60%) Ps who scored high on a measure of neuroticism to increase our power to identify risk factors for emotional disorders and allow evaluation of various models of commonalities and specificities of risk and their interaction with stress? We now propose to extend data collection for another 4 years, by which time most of our sample will be aged 23 to 25 years. By so doing, we will extend the goals of the parent grant in several ways. First, we will be able to study risk factors for emotional disorders whose average age of onset peaks after the original window of 16 20 years. Second, we will be better able to evaluate risk factors for course, severity and comorbidity among the emotional disorders. Third, by repeating risk measurement, we will be able to evaluate stability/plasticity in risk and its relationship to the onset, course, and comorbidity of emotional disorders. In addition, we propose several new directions. First, we propose to evaluate the relationship between genetic markers (DRD4, 5HTT and markers of coping) and emotional disorders, especially the interaction between genetic markers and indices of episodic and chronic life stress, and the hypothesized role of personality traits in mediating the associations between the genetic markers and emotional disorders. Also, we propose to evaluate potential candidate genetic markers of coping styles that have been hypothesized to decrease risk for emotional disorders. Second, we propose to evaluate personality pathology and its moderation of psychopathology over the period of transition into adulthood. We will also test whether attainment of developmental milestones associated with young adulthood and whether changes in normal personality traits common in young adulthood are predicted by earlier personality trait levels and emotional disorders and are predictors of later emotional disorders. Furthermore, we propose additional risk variables of early adversity, perceived control, coping style and rumination.

PROJECT SUMMARY Rates of anxiety and depression in youth are substantial, causing a major unmet need for effective interventions. Although some progress has been made in preventing these internalizing problems in adolescents, further research is needed that specifically targets theoretically and empirically supported risk processes. An important and salient risk factor found to increase the likelihood of anxiety and depression is negative affectivity ? a partially heritable trait propensity to experience and express more frequent, intense, and enduring aversive emotional states. The proposed randomized controlled prevention trial builds on our finding from our longitudinal study that elevated levels of negative affectivity during adolescence prospectively predicted internalizing disorders in early adulthood (Zinbarg et al., 2016); moreover, this relation was mediated by changes in momentary negative affect (mNA) measured with ecological momentary assessment (EMA) (Adam et al., 2018). The first phase (R61) of the proposed selective prevention trial will test whether an app-based, coach-supported mindfulness intervention as compared to an assessment-only control reduces momentary negative affect, measured with ecological momentary assessment (EMA), in 120 adolescents (age 12-16) at- risk based on their having high levels of trait negative affectivity. EMA will be used to measure average daily mood, (the ?Target?) collected six times a day across three days at pre-, mid-, and post- intervention. ?Target? engagement will be defined as a medium effect size (>.40) in the comparison of youth randomized to MBI versus control on the target ? momentary negative affect ? at post-test, adjusting for pre-test levels. We also will assess the dose-response relation by testing the association between number of sessions and exercises completed with changes in momentary negative affect and weekly mood ratings. In the second phase (R33), we will conduct a replication trial with a new sample of 360 at-risk (i.e., high trait negative affectivity) youths (ages 12-16) randomized to one of three conditions ? MBI, a nonspecific control, or an assessment-only control. Youth will be evaluated with regard to the target (i.e., mNA), internalizing symptoms and disorders, and functioning (e.g., social, academic) at baseline and post-intervention (R61 and R33), and at a 6-month follow-up (R33). Finally, in the R33 we will test if significant reductions in momentary negative affect are associated with improvements (or less worsening) in internalizing symptoms and fewer onsets of internalizing disorders.