# Ambulatory Monitoring of Threat Dysregulation in Adolescents at Risk for Psychosis

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2020 · $659,676

## Abstract

PROJECT ABSTRACT
The proposed study seeks to examine the role of physiological threat dysregulation (TD) as a contributor to
social impairment and psychotic-like experiences in youth at-risk for psychosis, and further examine the extent
to which faulty cognitive and affective threat responses play a role in partially mediating this relationship.
Although the “diathesis-stress model” is a well-established framework for the onset of psychosis and other
forms of psychopathology, the exact mechanism as it applies to psychosis remains unclear. This is an important
mechanism to examine because TD can generate chronic fear and arousal, states which interfere with social
relationships and healthy development. The proposed study will address this gap in the literature by
comprehensively examining physiological TD, including the function of the Hypothalamic-Pituitary-Adrenal
(HPA) axis and the Autonomic Nervous System (ANS). The current proposal uses multiple methods, including
laboratory assessments, ecological momentary assessment (EMA), and ambulatory psychophysiology, to
examine the link between TD and outcomes in the laboratory and in daily life. This proposal will utilize a
longitudinal design to examine how TD is associated with the persistence or worsening of social impairment
and psychotic-like experiences over 1 year. Given that the post-pubertal adolescent developmental stage is a
sensitive period for the development of psychotic disorders, we propose to recruit a post-pubertal (age 14-17)
sample of adolescents at clinical high-risk for psychosis (CHR; n = 105) and a group of age- and sex-matched
controls (n = 70). Multi-method assessments will include 3 laboratory visits (Baseline, 6 months, and 1 year
later) with clinical assessments and evaluation of TD before, during, and after a social threat induction task.
Visits will be followed by 2 weeks of at-home EMA to investigate real-time ANS threat response (via cardiac
wearable device), social impairment, stress, and psychotic-like experiences (via smartphone self-report). The
proposed study would be novel in that it will to pair EMA with cutting-edge, ambulatory cardiovascular
psychophysiology assessment. Thus, this proposal would unite established in vitro (laboratory) assessments of
key variables with novel in vivo (EMA) assessments, the latter of which have high ecological and clinical
validity. The aims of the project match well with the strategic goals of the National Institute of Mental Health
(NIMH); in particular, Strategies 2 and 3. The proposed conceptual model is highly relevant to the NIMH
Research Domain Criteria (RDoC) domains of the sustained and acute threat systems, as well as the “social
processes” domain; thus, this research should have relevance to the study of psychopathology across diagnostic
boundaries. The proposed award should 1) provide precision to investigation of a theoretical model of TD and
its impacts on social impairment and psychotic-like experiences, 2) contri...

## Key facts

- **NIH application ID:** 10049429
- **Project number:** 1R01MH121386-01A1
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** LESLIE E HORTON
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $659,676
- **Award type:** 1
- **Project period:** 2020-07-01 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10049429

## Citation

> US National Institutes of Health, RePORTER application 10049429, Ambulatory Monitoring of Threat Dysregulation in Adolescents at Risk for Psychosis (1R01MH121386-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10049429. Licensed CC0.

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