For over 100 years, behavioral scientists have been concerned with the need to generalize learned behavior from a training environment to more relevant contexts (e.g., Thorndike &Woodworth, 1901;Skinner, 1938). Basic scientists continue to identify exciting novel approaches to transfer trained behavior into new environments. However, clinical scientists have been slow to translate these findings into new interventions for psychiatric populations. New approaches to generalizing adaptive behavior outside the clinic setting are needed that are not diagnosis specific, but instead target basic processes relevant across many psychiatric problems. Difficulties regulating negative emotions are common across many psychiatric disorders (e.g., mood, anxiety, eating, substance use disorders), and may be central to some of the most severe and difficult-to-treat populations (e.g., borderline personality disorder;BPD). In the present application, we will translate findings from basic behavioral science into a simple and brief method to reduce negative emotions outside of a lab/clinic setting. We propose to test the effects of habituation reminders (HRs) following emotional arousal to personally-relevant emotional stressors, as a method of reducing acute negative emotions in novel contexts inside and outside the laboratory. Grounded in modern learning theory and basic science, the primary aim of this application is to evaluate across three experiments whether novel auditory HRs: (a) can reduce acute negative emotions in novel contexts inside (Exp. 1) and outside the laboratory (Exp. 2-3) and (b) are feasible and acceptable as an adjunctive intervention (Exp. 3). Specifically, we will recruit 208 adult psychiatric outpatients who have severe difficulties with emotion regulation. In Exp. 1, 208 participants will be randomly assigned to receive the HR (n = 104) or no HR (n = 104) after habituating to emotional stressors during a Learning Phase, followed by a Testing Phase one week later in either the same or different context with either the HR or no HR. In Exp. 2, 104 participants from Exp. 1 will be randomly assigned to hear the HR or a sham reminder via an automated phone-based platform when acute negative emotions occur, over 1 week of 8x daily calls. In Exp. 3, 52 participants who received the HR during Learning and Testing Phases in Exp. 1 will be asked to use a study cellular phone to call into the automated system in order to hear the HR when acute negative emotions occur in their daily lives, during a 2-week period. Using the same participants from Exp. 1 in Exp. 2-3 will permit analyses of the effects of HRs in the lab on emotional arousal, valence, and HR effects outside the lab, within and across participants, and over time. Results from this project will be the first to provide evidence regarding the use of novel reminders of a habituation context as a method of generalizing emotion regulation from a lab/clinic setting into naturalistic settings. If successful, HRs could b used as an inexpensive and simple new adjunctive intervention to facilitate generalization of learning outside the therapeutic setting in behavioral treatments.

Public Health Relevance

In the next generation of behavioral treatments for psychiatric disorders, new approaches are needed as adjunctive tools to talk therapies that directly and immediately help patients outside the clinic setting in cost-effective and efficacious ways. Accordingly, the aim of this application is to translate findings from basic science to the development and evaluation of a new method used to transfer reductions in emotional arousal from inside to outside a controlled setting, across adults with a wide range of psychiatric disorders all characterized by difficulties with emotion regulation.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Adult Psychopathology and Disorders of Aging Study Section (APDA)
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Kozak, Michael J
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Duke University
Schools of Medicine
United States
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