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 抑郁症是全世界残疾的主要原因，尽管事实上已经有多种治疗方法 发展后，只有少数患者（<40%）有反应并维持该反应一年，无论哪种 他们接受的治疗。超过一年的持续响应率更低。因此，存在着至关重要的公众 健康需要更好地针对抑郁症状的持久质量并改善长期结果。 消极的自我评价是抑郁症的核心特征，似乎有助于其持久性 抑郁症。消极的自我评价不仅与抑郁症状的持续存在直接相关， 但对许多人来说，即使经过其他有效的治疗，负面的自我评价仍然存在，从而增加了患病的风险 复发。尽管人们对认知缺陷和负面信息处理偏差了解很多 对于患有抑郁症的成年人的记忆和注意力的具体破坏知之甚少 信息处理和大脑功能导致抑郁的成年人做出过度消极的自我评价 在抑郁症发作期间或之后。我们认为，从长远来看，我们可以大幅改善 通过识别导致这些负面自我评价的潜在病理学，以便更好地评估结果 可以开发出有针对性的、更持久的治疗方法。以我们的初步数据和工作为基础 其他人，这个短期项目的目标是提供对关于神经网络的新假设的第一次测试 导致当前和缓解的抑郁症成年人自我评价功能失调的机制，并开始 检查该病理学对未来症状和功能的现实后果。来测试我们的 假设，我们将评估自我处理期间异常处理的行为和神经影像标记 对 30 名目前患有抑郁症的成年人、30 名已缓解抑郁症的成年人和 30 名健康成年人进行了评估。参与者将完成 基线临床和功能磁共振成像 (fMRI) 评估，以及为期三周的评估 每日日记方案（超过四个月）将评估症状、日常生活中的自我评估，以及 现实世界的运作。该项目将检查导致异常参与的流程 抑郁症成年人的自传体记忆（目标 1）和社会认知（目标 2）网络 评估自我相关材料，并将检查自我相关期间大脑功能是否异常 评估前瞻性地预测精神症状以及日常生活中较差的人际关系和工作功能 （探索性目标）。该项目的目标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 已确定的负面自我评价背后的机制，以改善长期结果。