POSITIVE EMOTIONAL PROCESSING: EXPLORING NOVEL TREATMENT TARGETS IN SOCIAL PHOBIA - DESCRIPTION (provided by applicant): The current proposal is for a NIMH Pathway to Independence Award (K99/R00) designed to strengthen and expand the candidate's expertise in translational research in the area of anxiety disorders. Career Development Plan: The candidate possesses a strong background in basic experimental psychopathology and treatment outcome research in anxiety. A consistent theme running throughout the candidate's research is the application of basic concepts and experimental procedures in social cognition to study the factors hypothesized to bias the processing and assimilation of positive social information in individuals with generalized social anxiety disorder (GSAD). The goal of these experimental studies is to provide novel insights into ways of addressing treatment refractory cases with GSAD. His long-term career objectives are to remain in academia as a treatment-oriented clinical scientist with the requisite skills that will ensure his success as a productive member of an interdisciplinary research team. The candidate recognizes the importance of expanding his existing skill set, particularly in information processing and neurobiological approaches to examine basic mechanisms and treatment response in anxiety. Accordingly, the career development plan will take advantage of cross-site mentorship from leading experts at the vanguard of research studying the cognitive-affective (Dr. Nader Amir, San Diego State University) and neurobiological bases of pathological anxiety and fear (Dr. Murray Stein, University of California, San Diego; Dr. Martin Paulus, UCSD). These researchers direct active programs of translational clinical research that will provide the candidate with rich hands-on training in the context of ongoing projects. The candidate will also complete formal coursework and intensive seminars in neuroimaging, biostatistics, and the ethical conduct of research. Environment: The long-standing and highly successful collaborative history between the SDSU Department of Psychology and UCSD Department of Psychiatry provides the strong and well-established institutional infrastructure that will promote the successful execution of the proposed training plan. The candidate will benefit from the unique opportunity to witness the successful merging of a traditional psychology department with a research-oriented psychiatry department, a context that will provide an in vivo opportunitiy to function as part of a trans-disciplinary research team. The exceptional academic reputation, available mentorship and consultation of internationally recognized leaders in the field, and collaborative interdisciplinary environment of SDSU and UCSD unite to create a training environment that is ideally suited to promote the candidate's career development and transition to independence. Research plan: GSAD is a common and debilitating condition, marked by significant impairments in social relationship functioning and an overall diminished quality of life (e.g., Alden & Taylor, 2004, 2010; Stein & Stein, 2008). Contemporary treatment approaches for anxiety disorders, including GSAD, are grounded in fear-based models of extinction learning (see Craske et al., 2008; McNally, 2007). As a result, these treatments have been removed from research pointing to a dysregulation of basic regulatory systems involved in the processing of positive social and emotional information in GSAD (see Kashdan, 2007 for a review). Indeed, despite the efficacy of existing treatments in reducing symptoms of social anxiety and avoidance (e.g., Hofmann & Smits, 2008; Rodebaugh et al., 2004; Stein & Stein, 2008), many individuals with GSAD remain residually symptomatic and continue to experience significant disruptions in domains of positive social functioning following treatment (Eng et al., 2005). These deficiencies are notable given that positive social and emotional experiences are consistently shown to have a beneficial impact on psychological and physical health outcomes (e.g., Folkman & Moskowitz, 2000; Lyubomirsky et al., 2005). In contrast, limited social ties and social isolation are associated with increased morbidity and risk of mortality (e.g., Cacioppo et al., 2003; House et al., 1988), which positions GSAD as a significant public health concern. Thus, to bridge the gap between basic findings in social cognition and affective neuroscience and existing treatments for SAD, the candidate proposes a series of studies designed to elucidate the cognitive, affective, and neurobiological substrates of aberrant positive emotional responsiveness in GSAD. The goal of these studies is to identify novel targets for the development of experimental procedures designed to modify deficits in positive social emotional processing in GSAD (R phase). The long-term goal of this research is to develop interventions that can augment existing treatment approaches in the service of enhancing treatment response and positive social functioning in refractory GSAD patients.
