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An Approach-Avoidance, Computational Framework for Predicting Behavioral Therapy Outcome in Anxiety and Depression

Award Number: R01MH123691
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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An Approach-Avoidance, Computational Framework for Predicting Behavioral Therapy Outcome in Anxiety and Depression - PROJECT SUMMARY Depression and anxiety disorders are highly comorbid and rank in the top ten causes of years lived with disability. Current gold-standard treatments are effective but do not work as well as we would like, with less than 50% experiencing long-lasting improvements. Two gold-standard behavioral interventions for depression and anxiety include behavioral activation, focused on enhancing approach behavior towards meaningful and reinforcing activities, and exposure-based therapy, focused on decreasing avoidance and challenging negative expectations through exposure to anxiety-provoking cues or situations. While these interventions have divergent approach versus avoidance treatment targets, there is currently little knowledge to guide clinical decision-making, i.e., to inform which strategies should be provided in the frequent case of comorbid anxiety and depression symptoms. Approach-avoidance decision-making paradigms focus on assessing neural and behavioral responses when faced with potential rewards and threats, tapping into processes though to be important for both anxiety and depression as well as behavioral activation and exposure-based therapy. For this study, we will recruit individuals reporting both anxiety and depression symptoms and randomize them to one of three different psychotherapeutic interventions delivered in a group setting, including (1) behavioral activation, (2) exposure-based therapy, and a non-specific therapy approach (3) supportive therapy. Participants will complete clinical, self-report, behavioral, and functional magnetic resonance imaging (fMRI) assessments before and after therapy. Clinical symptoms will also be assessed three and six months following therapy completion. We will use a computational approach to model the different factors that may influence one’s behavior during approach-avoidance decision-making, including drives to avoid threat versus approach reward and confidence versus uncertainty in one’s decisions. This project will accomplish the following aims (1) Determine how changes in brain and behavior responses during approach-avoidance conflict relate to changes in mental health symptoms with the different therapy approaches, (2) Determine the degree to which baseline brain and behavior responses during approach-avoidance conflict predict response to the different therapy approaches, above and beyond the influence of demographics and baseline symptom severity. Results will have enhance our understanding of how different psychotherapy approaches (behavioral activation, exposure-based therapy) may impact brain responses and decisions when faces with potential reward versus threat and approach versus avoidance drives. In addition, results will have important implications concerning the potential for a more personalized approach to psychotherapy, enhancing knowledge of which types of therapy strategies may be most beneficial for which individuals.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $465,943 )
2024	2024	LAUREATE INSTITUTE FOR BRAIN RESEARCH, LLC	6655 S YALE AVE	TULSA	OK	74136	TULSA	USA	Mental Health Research Grants	000	5	8/9/2024	NON-COMPETING CONTINUATION	$465,943
														Subtotal = $465,943

Issue Date FY: 2023 ( Subtotal = $530,141 )
2023	2023	LAUREATE INSTITUTE FOR BRAIN RESEARCH	6655 S YALE AVE	TULSA	OK	74136	TULSA	USA	Mental Health Research Grants	000	4	7/12/2023	NON-COMPETING CONTINUATION	$530,141
														Subtotal = $530,141

Issue Date FY: 2022 ( Subtotal = $537,279 )
2022	2022	LAUREATE INSTITUTE FOR BRAIN RESEARCH, INC.	6655 S YALE AVE	TULSA	OK	74136	TULSA	USA	Mental Health Research Grants	000	3	6/22/2022	NON-COMPETING CONTINUATION	$537,279
														Subtotal = $537,279

Issue Date FY: 2021 ( Subtotal = $544,497 )
2021	2021	LAUREATE INSTITUTE FOR BRAIN RESEARCH, INC.	6655 S YALE AVE	TULSA	OK	74136	TULSA	USA	Mental Health Research Grants	000	2	6/7/2021	NON-COMPETING CONTINUATION	$544,497
														Subtotal = $544,497

Issue Date FY: 2020 ( Subtotal = $511,699 )
2020	2020	LAUREATE INSTITUTE FOR BRAIN RESEARCH, INC.	6655 S YALE AVE	TULSA	OK	74136	TULSA	USA	Mental Health Research Grants	000	1	6/22/2020	NEW	$511,699
														Subtotal = $511,699

Grand Total All Awards = $2,589,559

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An Approach-Avoidance, Computational Framework for Predicting Behavioral Therapy Outcome in Anxiety and Depression

Award Number: R01MH123691

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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