Affective Executive Functioning as a Mechanism of Mindfulness-Based Cognitive Therapy: A Pilot Randomized Controlled Trial

情感执行功能作为基于正念的认知治疗的机制：一项随机对照试验

• 批准号: 10370848
• 负责人: Morganne A Kraines
• 金额: $ 17.33万
• 依托单位: BUTLER HOSPITAL (PROVIDENCE, RI)
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2026-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10370848
• 关键词: Address; Adherence; Adult; Affect; Affective; Attention; Back; Behavior; Clinical Trials; Code; Cognition; Cognitive; Communities; Computers; Conscious; Data Analyses; Depressed mood; Disease; Educational workshop; Emotional; Environment; Executive Dysfunction; Financial Hardship; General Population; Goals; Grant; Health; Health education; Home; Hospitals; Impairment; Individual; Institution; Intervention; Knowledge; Literature; Major Depressive Disorder; Measures; Mental Depression; Mental Health; Mentors; Methods; Mind-Body Intervention; Mindfulness Training; Modeling; Monitor; Mood Disorders; National Center for Complementary and Integrative Health; Neurocognitive; Outcome; Participant; Patients; Personal Satisfaction; Process; Randomized; Randomized Controlled Trials; Reading; Relapse; Research; Research Ethics; Research Methodology; Research Personnel; Risk; Schedule; Services; Severities; Stimulus; Structure; System; Testing; Time; Training; Training Support; Treatment Protocols; Universities; Update; Work; arm; attentional bias; base; cognitive function; daily functioning; depressive symptoms; efficacious treatment; emotional stimulus; executive function; experience; improved; information processing; innovation; meetings; mental set; mindfulness; mindfulness based cognitive therapy; mindfulness intervention; novel; operation; prevent; programs; psychoeducational; recruit; reduce symptoms; research and development; resilience; skills; symposium; theories; training opportunity

PROJECT SUMMARY/ABSTRACT Mindfulness-Based Cognitive Therapy (MBCT) is an efficacious treatment for patients with symptoms of depression. However, the processes by which MBCT achieves its outcomes are not well understood. Drawing on literature on basic cognitive functioning and cognitive biases in depression, this K23 will use a randomized controlled trial to test the effect of MBCT vs. Health Education (HE) on affective inhibition (an important component of executive functioning (EF)), and a possible mechanism of action by which MBCT has an impact on depression symptoms. As a secondary aim, this project will also test the effect of MBCT vs. HE on affective updating and affective shifting (two remaining components of EF). In exploratory analyses, we will examine whether depression symptom severity covaries with change in affective EF (i.e., affective inhibition, shifting, and updating) overtime, and whether adherence to the treatment protocol predicts endpoint EF. To accomplish these goals, 76 adult participants with elevated depression symptoms will be recruited from the community and will be randomized to either an 8-week MBCT course at the Mindfulness Center at Brown University or an 8-week Psychoeducational Health Education Class (i.e., a control arm). Participants will complete validated computer-based tasks of affective EF at 5-assessments, 2 before, 2 during, and 1 after, the 8-week MBCT or HE programs. This project directly addresses NCCIH’s objective to advance the understanding of mechanisms through which mind and body approaches affect health, resilience and well-being. This project will directly address the candidate’s training goals of gaining clinical trials methods experience with mood disorders, expanding knowledge of mindfulness-based interventions (specifically MBCT), gain knowledge in neurocognitive assessment of individuals with depression symptoms, receive training in repeated longitudinal assessment, and further develop professional development, research ethics, and grants management skills. The candidate will complete a number of formal and informal activities (e.g., courses, workshops, conferences, directed readings, and regularly scheduled meetings with mentors) to meet the training goals. These training goals will assist the candidate to become a successful independent investigator examining cognitive mechanisms of mind-body interventions for depression and related disorders. The Mindfulness Center at Brown University and Butler Hospital are the ideal environments for this project, as they are leading institutions in clinical trials research and mindfulness-based interventions, with numerous opportunities for training and support services embedded within the systems.

项目总结/摘要 正念认知疗法（MBCT）是治疗抑郁症的有效方法。然而，MBCT实现其成果的过程并不清楚。根据有关抑郁症的基本认知功能和认知偏差的文献，K23将使用随机对照试验来测试MBCT与健康教育（HE）对情感抑制（执行功能（EF）的重要组成部分）的影响，以及MBCT对抑郁症症状产生影响的可能作用机制。作为次要目标，本项目还将测试MBCT与HE对情感更新和情感转移（EF的两个剩余组成部分）的影响。在探索性分析中，我们将检查抑郁症状的严重程度是否与情感EF的变化（即，情感抑制、转移和更新），以及是否依从治疗方案预测终点EF。为了实现这些目标，将从社区招募76名抑郁症状加重的成年参与者，并将随机分配到布朗大学正念中心为期8周的MBCT课程或为期8周的心理教育健康教育课程（即，控制臂）。受试者将在5次评估中完成经验证的基于计算机的情感EF任务，其中2次在8周MBCT或HE计划之前，2次在8周MBCT或HE计划期间，1次在8周MBCT或HE计划之后。该项目直接涉及NCCIH的目标，即促进对身心方法影响健康，复原力和福祉的机制的理解。该项目将直接解决候选人的培训目标，即获得情绪障碍的临床试验方法经验，扩大基于正念的干预措施（特别是MBCT）的知识，获得抑郁症状个体的神经认知评估知识，接受重复纵向评估培训，并进一步发展专业发展，研究道德和赠款管理技能。候选人将完成一些正式和非正式的活动（例如，课程、讲习班、会议、指导性阅读以及与导师定期安排的会议），以实现培训目标。这些培训目标将帮助候选人成为一名成功的独立调查员，研究抑郁症和相关疾病的身心干预的认知机制。布朗大学的正念中心和巴特勒医院是该项目的理想环境，因为它们是临床试验研究和正念干预的领先机构，系统中嵌入了大量培训和支持服务的机会。