Targeting Ruminative Thinking in Adolescents at Risk for Depressive Relapse: Rumination-Focused Cognitive Behavior Therapy in a Pilot Randomized Controlled Trial with Resting State fMRI.
Targeting Ruminative Thinking in Adolescents at Risk for Depressive Relapse: Rumination-Focused Cognitive Behavior Therapy in a Pilot Randomized Controlled Trial with Resting State fMRI.
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DOI：
10.1371/journal.pone.0163952
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Langenecker SA
中科院分区：
文献类型：
--
作者：
Jacobs RH;Watkins ER;Peters AT;Feldhaus CG;Barba A;Carbray J;Langenecker SA
这项初步随机对照试验旨在研究反刍集中认知行为疗法（RFCBT）是否能减少有抑郁症（MDD）病史的青少年中的反刍和残留抑郁症状，这些青少年有复发的风险。我们还研究了这些症状的变化是否与后扣带皮层（PCC）功能连接的变化有关，PCC是默认模式网络（DMN）中的关键节点。33名青少年（12-18岁）被随机分配到8周的RFCBT或仅评估（AO）对照组。22名青少年成功完成了干预前后的fMRI扫描。青少年从诊所和社区招募，符合至少一次MDD既往发作的标准，目前处于完全或部分缓解状态。一名独立评估员在八周的干预前后采访了父母和孩子。左侧PCC（-5，-50，36）种子用于探测DMN的静息状态功能连接。接受RFCBT的青少年表现出减少的反刍（F =-2.76，df = 112，p < .01，95%CI [-4.72，-0.80]）和自我报告的抑郁症（F =-2.58，df = 113，p < .01，95%CI [-4.21，-0.94]）。接受RFCBT的青少年也表现出左侧PCC与右侧额下回（IFG）和双侧颞下回（ITG）之间的连接显著减少。连通性的变化程度与自我报告抑郁和反刍的变化相关。这些数据表明，反刍可以减少超过8周，这种减少与平行减少残余抑郁症状和减少功能连接的左PCC与认知控制节点。这些变化可能会提高脆弱青年在向成年过渡期间保持健康的能力。试用注册：ClinicalTrials.gov NCT 01905267
This pilot randomized control trial was designed to examine whether Rumination-Focused Cognitive Behavior Therapy (RFCBT) reduces rumination and residual depressive symptoms among adolescents with a history of Major Depressive Disorder (MDD) who are at risk for relapse. We also examined whether these changes in symptoms were associated with changes in functional connectivity of the posterior cingulate cortex (PCC), a key node in the default mode network (DMN). Thirty-three adolescents (ages 12–18) were randomized to eight weeks of RFCBT or an assessment only (AO) control. Twenty two adolescents successfully completed fMRI scans pre- and post-intervention. Adolescents were recruited from the clinic and community and met criteria for at least one previous episode of MDD and were currently in full or partial remission. An Independent Evaluator interviewed parent and child before and after the eight-week intervention. The left PCC (-5, -50, 36) seed was used to probe resting state functional connectivity of the DMN. Adolescents who received RFCBT demonstrated reduced rumination (F = -2.76, df = 112, p < .01, 95% CI [-4.72,-0.80]) and self-report depression across eight weeks (F = -2.58, df = 113, p < .01, 95% CI [-4.21, -0.94]). Youth who received RFCBT also demonstrated significant decreases in connectivity between the left PCC and the right inferior frontal gyrus (IFG) and bilateral inferior temporal gyri (ITG). Degree of change in connectivity was correlated with changes in self-report depression and rumination. These data suggest that rumination can be reduced over eight weeks and that this reduction is associated with parallel decreases in residual depressive symptoms and decreased functional connectivity of the left PCC with cognitive control nodes. These changes may enhance the ability of vulnerable youth to stay well during the transition to adulthood. Trial Registration: ClinicalTrials.gov NCT01905267
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影响因子：
5.7
作者：
Di X;Biswal BB
通讯作者：
Biswal BB
DOI：
10.3969/j.issn.1002-0829.2014.04.004
发表时间：
2014-08
期刊：
Shanghai archives of psychiatry
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