A Precision Medicine Approach to Target Engagement for Emotion Regulation

Emotion dysregulation is a transdiagnostic maintenance factor involved in a wide array of costly and debilitating psychiatric disorders. Although numerous full-model behavioral health treatments have been designed to improve patients’ emotion regulation capacities, these treatments consist of multiple components, making it difficult to discern which are active mechanisms leading to reductions in negative emotion intensity. Further, it is unclear whether the delivery of these evidence-based components can be tailored to the individual patient. The proposed Mentored Patient-Oriented Research Career Development Award (K23) is a four-year plan to support the applicant’s long-term career goal of becoming a clinical scientist with expertise in (1) identifying active mechanisms of emotion regulation interventions for psychopathology, (2) tailoring these interventions to individual patients, and (3) developing scalable interventions for wide dissemination. The applicant’s training and career thus far are aligned with these long-term goals. Throughout his graduate work, he conducted studies testing emotion regulation mechanisms in transdiagnostic samples and used this information to explore for whom these mechanisms were most impactful. The immediate goals of the K23 award are for the applicant to become skilled at intensive longitudinal experimental designs to disaggregate between- from within-person mechanisms of change and enhance his proficiency in conducting and analyzing multimethod assessments of emotion regulation. This proposal uses a two-phase approach to address these goals. In line with an experimental therapeutics approach, the goal of Phase 1 is to compare the effects of teaching one or three emotion regulation skills on daily changes in negative emotion intensity among participants with elevated emotion dysregulation. The first goal of Phase 2 is to apply a personalization algorithm based on Phase 1 data to an independent sample to determine which baseline participant characteristics predict greater reductions in negative emotion intensity in each experimental condition. The second goal of Phase 2 is to compare the effects of teaching participants emotion regulation skill(s) according to their optimal or non-optimal delivery condition, based on the personalization algorithm. The training plan closely matches the proposed research and long-term goals, including (a) developing advanced understanding in statistical methods to test between- and within-person mechanisms of emotion regulation interventions, (b) gaining proficiency in applying novel personalization algorithms, and (c) enhancing expertise in the implementation and analysis of multimethod assessments of emotion regulation skills. The broader aim of this research and training is to address the need for more efficient, personalized, and scalable interventions for transdiagnostic psychiatric conditions, in line with the NIMH strategic plan. This study will answer important theoretical and practical questions about the efficacy of different emotion regulation mechanisms on clinical outcomes that may promote the development of more targeted and disseminable interventions.