Dynamic Functional Network Biomarkers of Emotion Regulation Flexibility in Internalizing Disorders
openNIMH - National Institute of Mental Health
Project Summary/Abstract. Close to 20% of Americans suffer from internalizing disorders like depression,
anxiety, and posttraumatic stress in their lifetime (National Center for Health Statistics, 2023). These conditions
disproportionally affect young adults, and prevalence rates have risen 30% in the past five years (Santomauro
et al., 2021). Moreover, there is considerable comorbidity across internalizing disorders and heterogeneity within
disorders (Price et al., 2019; Spinhoven et al., 2014), highlighting the need to identify transdiagnostic biomarkers
for effective screening and treatment. Deficits in emotion regulation (ER) is a hallmark risk factor for
internalizing disorders (Aldao et al., 2010, 2016). Specifically, low flexibility in ER strategy use – the inability
to use a large and varied repertoire of strategies flexibility according to contextual demands – has been linked
to internalizing disorders transdiagnostically (Wen et al., 2021, 2024, 2025). However, the neurobiological
mechanisms by which flexibility in ER influences internalizing disorders remain largely unclear. Elucidating such
mechanisms is a critical step to advancing effective, targeted clinical interventions.
In this K99/R00, three aims are proposed to examine the mechanism of ER flexibility in internalizing
disorder etiology. In the K99 phase, a large-scale longitudinal dataset (PI: Craske) containing resting state fMRI
data and self-reported ER from young adults with varying levels of internalizing disorder severity will be analyzed.
Dynamic co-activation pattern analysis will be used to identify functional brain network dynamics (e.g., transitions
between the salience, default mode, and central executive networks), and examine associations with ER
flexibility as assessed by an innovative, validated index of ER flexibility developed by the Candidate (Wen et al.,
2021, 2024; Aim 1). These functional brain network dynamics will then be evaluated in relation to broad symptom
dimensions underlying internalizing disorders transdiagnostically (Aim 2). In the R00 phase, new data will be
collected for individuals with clinical levels of internalizing symptom severity. Variables include internalizing
symptoms, ER flexibility, functional network dynamics, stress, and cognitive control that is theorized to underlie
ER (LeMoult & Gotlib, 2019). Path analyses will be conducted to compare two models with hypothesized
neurobiological pathways by which ER flexibility influences broad internalizing symptom dimensions (Aim 3).
This proposed K99 training will be conducted with Dr. Michelle Craske (primary mentor) and Dr. Lucina
Uddin (co-mentor) at UCLA, with guidance from an advisory committee of experts in neuroimaging and
psychopathology research. This environment will help the Candidate achieve the career development goal of
acquiring of new skillsets in functional neuroimaging and knowledge in functional brain dynamics. The proposed
training will provide the Candidate with intellectual and technical training needed to launch an independent
research program at a top academic institution studying the neurobiological mechanisms by which emotional
processes influence the etiology for internalizing disorders broadly.
Up to $118K
health research