Reducing Rumination in Depression: Mechanisms and Effects

减少抑郁症中的沉思：机制和效果

• 批准号: 8891982
• 负责人: IAN H GOTLIB
• 金额: $ 24.08万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-02-18 至 2017-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8891982
• 关键词: Affect; Affective; Anterior; Attention; Autonomic nervous system; Biological; Biological Process; Brain; Brain region; Chronic; Cognitive; Data; Depressed mood; Diagnosis; Disease; Distress; Dorsal; Emotional; Emotions; Exhibits; Future; Home environment; Individual; Investigation; Laboratories; Life; Link; Literature; Lobule; Maintenance; Major Depressive Disorder; Medial; Mediating; Mental Depression; Mental disorders; Methodology; Methods; Modification; Neurosecretory Systems; Parietal; Parietal Lobe; Participant; Population; Prefrontal Cortex; Process; Recovery; Recurrence; Research; Research Personnel; Rest; Short-Term Memory; Stimulus; Stress; Symptoms; Testing; Thinking; Time; Training; World Health Organization; base; cingulate cortex; cognitive process; cost; depressive symptoms; design; emotion regulation; experience; follow-up; improved; information processing; neuroimaging; neuromechanism; psychobiologic; psychologic; public health relevance; relating to nervous system; response; stressor; theories

 DESCRIPTION (provided by applicant): Major Depressive Disorder (MDD) is among the most prevalent and devastating of all psychiatric disorders, and is the single most burdensome disease worldwide. Consequently, it is imperative that we identify and examine the effects of altering mechanisms involved in the maintenance of MDD. In this context, investigators have documented that difficulty removing negative information from working memory is a core cognitive feature of MDD. Importantly, this cognitive difficulty is implicated in the persistence o both depressive symptoms and rumination, a style of thinking that hinders recovery from stress and exacerbates negative affect. To date, research linking difficulty removing negative information from working memory with rumination, the persistence of negative affect, and stress recovery in MDD has been limited by the use of correlational methodologies. Importantly, the Cognitive Bias Modification (CBM) literature underscores the viability of manipulating cognitive processes both to test causal relations and to identify mechanisms involved in the onset and maintenance of disorders. Therefore, a major aim of the proposed study is to build on established CBM methods to improve depressed individuals' ability to remove negative information (RNI) from working memory. We propose to examine the cognitive, affective, and biological effects of RNI training (Aim 1). In addition, we also propose to examine the neural mechanisms that underlie the beneficial effects of RNI training (Aim 2). To achieve these aims, 50 participants diagnosed with MDD will be assigned to receive either Real or Sham RNI training. All participants will complete pre-training laboratory-based and neuroimaging sessions, six at-home Real or Sham RNI training sessions, post-training laboratory-based and neuroimaging sessions, and a three-month follow-up assessment. We expect that, compared to Sham RNI training, Real RNI training will a) improve depressed participants' ability to remove negative information from working memory from pre- to post-training; b) decrease levels of rumination and depressive symptoms; and c) improve subsequent emotional and biological stress recovery. We further expect that RNI training will achieve its beneficial effects by decreasing brain activation from pre- to post-training in regions that subserve cognitive effort (dorsal anterior cingulate, posterior parietal lobe, and insular cortex), and by decreasing functional connectivity in regions posited to underlie rumination (subgenual anterior cingulate cortex and medial prefrontal cortex). The results of this study will increase our understanding of the relations among biases in working memory, rumination, and depressive symptoms, and will help to identify and elucidate specific mechanisms that contribute to the onset and maintenance of MDD.

 描述（由适用提供）：重度抑郁症（MDD）是所有精神疾病中最普遍，最毁灭性的，并且是全球范围内最腐烂的疾病。因此，我们必须确定并检查改变MDD涉及的机制的影响并检查。在这种情况下，研究人员已经记录，从工作记忆中删除负面信息是一种核心认知特征，这是一种重要的认知特征，这种认知困难在抑郁症状和反省的持久性中实现了，这种风格会阻碍压力和加剧负面影响。迄今为止，将难以从工作记忆中删除负面信息与反省，负面影响的持续性以及MDD的压力恢复的研究受到了相关方法的限制。重要的是，认知偏置修饰（CBM）文献强调了操纵认知过程以测试灾难性关系的可行性，并确定涉及疾病发作和维持的机制。因此，拟议研究的主要目的是建立在既定的CBM方法上，以提高抑郁症患者从工作记忆中删除负面信息（RNI）的能力。我们建议检查RNI培训的认知，情感和生物学效应（AIM 1）。此外，我们还建议研究RNI训练的有益作用的神经元机制（AIM 2）。为了实现这些目标，将分配50名被诊断为MDD的参与者接受真实或假RNI培训。所有参与者将完成训练前实验室和神经成像课程，六次在家的真实或假RNI培训课程，训练后实验室和神经成像课程以及三个月的随访评估。我们预计，与Sham RNI培训相比，真正的RNI培训将a）提高抑郁症参与者从训练前到训练后从工作记忆中删除负面信息的能力； b）降低反省水平和抑郁症状； c）改善随后的情绪和生物压力恢复。我们进一步期望RNI训练将通过减少从训练前到训练后的大脑激活来实现其有益作用，这些区域可以减少认知努力（背侧扣带回，后顶叶和岛状皮层），以及通过降低在底层反式的preex cortex corterex corterex cortront cortront cortront的区域的功能连接来降低功能连接。这项研究的结果将提高我们对工作记忆，反省和抑郁症状偏见之间关系的理解，并有助于识别和阐明有助于MDD发作和维持的特定机制。