Bottom-Up Mechanisms of Dysfunctional Self Evaluation in Depression

抑郁症自我评价功能失调的自下而上机制

• 批准号: 10377165
• 负责人: Jay C Fournier
• 金额: $ 27.91万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10377165
• 关键词: Bottom; Up; Mechanisms; Dysfunctional; Self

ABSTRACT Depression is the leading cause of disability worldwide, and despite the fact that several treatments have been developed, only a minority of patients (<40%) respond and sustain that response for a year, regardless of which treatment they receive. Sustained response rates beyond one year are lower still. Thus, there is a vital public health need to better target the enduring quality of depressive symptoms and to improve longer-term outcomes. Negative self-evaluations, a core characteristic of depressive illness, appear to contribute to the enduring nature of depression. Negative self-evaluations are not only linked directly to the persistence of depressive symptoms, but for many, negative self-evaluations persist even after otherwise effective treatments, increasing the risk of relapse. Although much is known about the cognitive deficits and negative information processing biases in memory and attention among adults with depression, very little is known about the specific disruptions in information processing and brain function that cause depressed adults to make overly negative self-evaluations either during or following episodes of depression. We argue that we can substantially improve longer-term outcomes by identifying the underlying pathology that leads to these negative self-evaluations so that better targeted and more enduring treatments can be developed. Building on our preliminary data, and the work of others, the goal of this short-term project is to provide the first test of a novel hypothesis about the neural mechanisms that lead to dysfunctional self-evaluations in current and remitted depressed adults and to begin to examine the real-world consequences of that pathology for future symptoms and functioning. To test our hypotheses, we will evaluate behavioral and neuroimaging markers of abnormal processing during self- evaluation in 30 currently depressed, 30 remitted depressed, and 30 healthy adults. Participants will complete baseline clinical and functional magnetic resonance imaging (fMRI) assessments, as well as three weeklong daily diary protocols (over the span of four months) that will assess symptoms, self-evaluations in daily life, and real-world functioning. The project will examine processes leading to the abnormal engagement of the autobiographical memory (Aim 1) and social-cognitive (Aim 2) networks among depressed adults when evaluating self-relevant material, and it will examine whether abnormalities in brain function during self- evaluation prospectively predict psychiatric symptoms and poorer interpersonal and work functioning in daily life (Exploratory Aim). The aims of the project match well with the strategic goals of the National Institute of Mental Health, and the results of this study have the potential to lead to new, brain-based treatment strategies to target the identified mechanisms underlying negative self-evaluations to improve longer-term outcomes.

抽象的 抑郁症是全球残疾的主要原因，尽管有几种治疗方法 开发，只有少数患者（<40％）反应并维持这种反应一年，无论如何 他们接受的治疗。超过一年的持续回应率仍然较低。因此，有一个重要的公众 健康需要更好地针对抑郁症状的持久质量并改善长期结局。 负面的自我评估是抑郁疾病的核心特征，似乎有助于持久的性质 抑郁症。负自我评估不仅与抑郁症状的持续性直接相关，而且 但是对于许多人来说，即使经过有效的治疗，负面的自我评估仍然存在，从而增加了 复发。尽管对认知缺陷和负面信息处理偏见有很多了解 成年人的记忆和注意力，对特定干扰知之甚少 信息处理和大脑功能会导致沮丧的成年人产生过度负面的自我评估 抑郁症发作或之后。我们认为我们可以实质上改善长期 通过识别导致这些负面自我评估的潜在病理来取得的结果，以便更好 可以开发有针对性和更多持久的治疗方法。以我们的初步数据为基础 其他人，这个短期项目的目的是提供有关神经的新假设的首次检验 导致当前和减弱成年人的自我评估功能失调的机制，并开始 检查该病理学对未来症状和功能的现实后果。测试我们的 假设，我们将评估自我过程中异常处理的行为和神经影像学标记 当前30名抑郁症，30个抑郁症和30名健康成年人的评估。参与者将完成 基线临床和功能磁共振成像（fMRI）评估以及三个星期 每日日记协议（在四个月的时间范围内）将评估症状，日常生活中的自我评估以及 现实世界功能。该项目将研究导致异常参与的过程 自传记忆（AIM 1）和社会认知（AIM 2）网络在沮丧的成年人中 评估自相关的材料，它将检查自我期间大脑功能异常 评估预测精神病症状，人际交往和工作功能较差 （探索目的）。该项目的目的与国家心理研究所的战略目标非常吻合 健康，这项研究的结果有可能导致新的，基于大脑的治疗策略 负面自我评估以改善长期结局的确定机制。