Intrusive negative cognitions are key transdiagnostic features of many psychiatric disorders, are difficult to treat, and predict poor outcomes in conventional and neurobehavioral interventions. Here, we evaluate the extent to which a novel intervention capitalizing on a preserved neurocircuitry for attending to evolutionarily salient somatosensory stimuli can be used to train attentional mechanisms to override otherwise pre-potent negative cognitions. The R21 period will involve intervention refinement and mechanistic evaluation of mechanism; N=35 individuals with high levels of intrusive negative cognitions and dysphoria will be assessed pre/post intervention. The R33 phase will involve mechanistic comparison to control conditions and psychometric evaluation; N=60 individuals with high levels of intrusive negative cognitions and associated dysphoria will undergo either an active intervention involving directed attention to graduated decreasing degrees of physical sensation (N=40) or a non-graduated control condition (N=40). Mechanisms of attentional focus on non-emotional and emotional stimuli will be assessed via neuroimaging in these individuals before and after the intervention along with 20 healthy control participants who will be assessed a twice. Success will suggest a new intervention pathway for a traditionally treatment-resistant dimension of psychopathology.
Summary Intrusive negative thinking styles such as rumination are typical of many psychiatric disorders, are difficult to treat, and predict poor treatment outcome. We propose to evaluate a new intervention for negative thinking that capitalizes and builds on the preserved ability to attend to physical sensation. We will examine changes in brain mechanisms and symptoms.
