Experimental studies on rumination and mindfulness: A multilevel approach using fMRI and ambulatory assessment in clinical and nonclinical samples

在第一个资助期（2010-2013），该项目利用功能磁共振成像（fMRI）研究了诱导注意焦点（反刍、正念）的功能连通性和神经相关性，以及自发性和诱导性注意焦点对抑郁症缓解患者和健康对照者日常生活中情绪、认知和内分泌过程的影响。在这种情况下，我们研究了两种测量水平（功能磁共振成像、动态评估、AA）的结果与它们对症状过程的预测价值之间的关系。通过整合这两种研究方法，我们的项目在反刍和正念研究领域追求一种全新的方法。在第二个资助期（2013-2016），我们的目标是研究在第一个资助期确定的基于AA和fmri的预测因子，研究它们预测患者长期症状过程和复发/复发风险的潜力，以及研究特定的基于正念的注意力训练对新样本患者神经和日常参数的干预效果。子研究1打算对研究1期间调查的抑郁症缓解患者（n=60）进行为期3年的结论性随访。在这个已经广泛表征的样本中，这允许对基于AA和fmri的变量的抑郁症相关改变的长期预测效果进行检查。除此之外，我们假设日常反刍的增加，更糟糕的情绪状态和对日常生活主观体验的皮质醇反应的降低将预示着更糟糕的症状过程和复发/复发的风险增加。我们还预计，在消极情绪和反刍诱导患者的默认模式网络（DMN）中发现的功能连接增加将预测三年期间的不利症状过程。最后，我们期望基线时的功能连接程度与症状过程之间的关系将通过基线时的日常反刍程度来调节。子研究2旨在调查为期四周的基于正念的注意力训练（n=35）与时间匹配的主动对照条件（渐进式肌肉放松，n=35）在一项随机实验干预研究中对DMN功能连通性以及日常生活中反刍、情绪过程和皮质醇活性的变化的短期影响。特别是，我们预计正念训练将导致DMN功能连接的更强下降，导致日常反刍的更大幅度减少，并导致自传体记忆特异性和习惯性正念的更大增加。最后，我们预计日常反刍的改善将调解干预对DMN功能连通性的影响。

During the first funding period (2010-2013), the project investigated functional connectivity and neural correlates of induced attention foci (rumination, mindfulness) using fMRI, and effects of spontaneous and induced attention foci on emotional, cognitive and endocrinological processes in daily life in remitted depressed patients and healthy controls. In this context, we examine the relationship between results of both measurement levels (fMRI, ambulatory assessment, AA) and their predictive value for the course of symptoms. By integrating both research approaches, our project pursues an as yet completely new approach in the area of rumination and mindfulness research. In the second funding period (2013-2016) we aim at investigating AA- and fMRI-based predictors identified during the first funding period with regard to their potential to predict the long-term symptom course and risk of relapse/recurrence in patients, as well as at investigating intervention effects of a specific mindfulness-based attention training on neural and everyday parameters in a new sample of patients.Substudy 1 intends to conduct a concluding three-year-follow-up of the remitted depressed patients (n=60) investigated in study period 1. This allows an examination of long-term predictive effects of depression-related alterations in AA- and fMRI-based variables for the longterm course of symptoms in this already extensively characterized sample. Amongst others, we assume that increased daily rumination, worse mood states and a decreased cortisol response towards subjective experiences in daily life will predict a worse course of symptoms and an increased risk of relapse/recurrence. We also expect that the increased functional connectivity identified within the Default Mode Network (DMN) in patients during negative mood and rumination induction will predict a disadvantageous course of symptoms over the three-year period. Finally, we expect that the relationship between degree of functional connectivity at baseline and the course of symptoms will be mediated by the degree of daily rumination at baseline.Substudy 2 aims to investigate the short-term effects of a four-week mindfulness-based attention training (n=35) compared to a time-matched active control condition (progressive muscle relaxation, n=35) in a randomised experimental intervention study on changes in functional connectivity of the DMN as well as rumination, emotional processes, and cortisol activity in daily life in a new sample of remitted recurrent depressed patients. In particular, we expect that the mindfulness training will lead to a stronger decrease in functional connectivity in the DMN, to a more substantial reduction in daily rumination, and to larger increases in autobiographical memory specificity and habitual mindfulness. Finally, we expect that improvements in daily rumination will mediate the effect of the intervention on functional connectivity in the DMN.