Stress Depression and Anxiety - An Integrative Psychobiological Investigation

描述（由申请人提供）：心境障碍和焦虑症是美国最常见的两类精神障碍，影响了相当多的人。特别是，重度抑郁症（MDD）和广泛性焦虑症（GAD）赋予显着的个人和社会成本;此外，MDD和GAD是高度共病。然而，令人惊讶的是，我们对这些疾病的独特和共同的心理生物学基础及其并发症的机制知之甚少。越来越多的研究表明，压力和痛苦，唤醒和调节的结构与我们对MDD和GAD的理解密切相关。然而，这是第一项研究，在一项单一研究中检查这些结构在单纯和共同发生的MDD和GAD个体中的作用。具体目标包括：（1）使用标准化实验室应激范式研究诊断为共同发生和非共同发生的MDD和GAD的个体的应激反应和调节;（2）检查这些个体日常生活中的应激过程;（3）比较基于实验室的评估与这些组内和组间的应激、反应和调节的经验抽样评估。为了实现这些目标，所有参与者将接受一个基线会议，包括症状严重程度，压力源，影响和影响调节的自我报告，然后是平衡实验室会议和为期一周的自然主义经验采样协议。在实验室会议期间，参与者的神经内分泌，自主神经和主观反应将被测量，因为他们经历了一个标准化的压力源任务中使用的独立文献抑郁症和焦虑症。在经验采样期间，参与者的昼夜皮质醇，压力源，消极和积极的影响，反刍和担心的报告将在他们的日常生活中进行测量。一个先进的，复杂的一组统计分析将进行测试理论驱动的假设组差异的平均水平和时间方差对这些措施，同时，这些结构之间的关键关联在每个组内的个人。额外的分析将检查压力，反应和调节措施方面的维度关系，抑郁症和焦虑症。该研究计划将为申请人提供新知识领域和新方法的培训，包括抑郁-焦虑相互作用的心理生物学，神经内分泌和经验采样数据的收集和解释，内分泌和自主数据的整合以及分层线性建模技术。本研究以一种新颖的综合方式解决了MDD和GAD的问题，这些发现将有助于阐明压力和反应的性质，以及与这些情绪障碍相关的反应和调节的困难。

DESCRIPTION (provided by applicant): Mood and anxiety disorders are the two most prevalent classes of mental disorder in the United States, affecting a significant number of individuals. In particular, Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) confer significant personal and societal costs; moreover, MDD and GAD are highly comorbid. Yet, we know surprisingly little about the unique and shared psychobiological underpinnings of these disorders and the mechanisms underlying their comorbidity. A growing body of research reveals that the constructs of stress and distress, and of arousal and regulation, are germane to our understanding of MDD and GAD. This is the first research, however, to examine these constructs in individuals with pure and co-occurring MDD and GAD within a single study. Specific objectives include: (1) investigating stress reactivity and regulation in individuals diagnosed with co-occurring and non-co-occurring MDD and GAD using a standardized laboratory stress paradigm; (2) examining stress processes in daily life in these same individuals; and (3) comparing laboratory-based assessment with experience sampling assessment of stress, reactivity, and regulation within and across these groups. To achieve these aims, all participants will undergo a baseline session that includes self-reports of symptom severity, stressors, affect, and affect regulation, followed by a counterbalanced experimental laboratory session and a one-week naturalistic experience sampling protocol. During the laboratory session, participants' neuroendocrine, autonomic, and subjective responses will be measured as they undergo a standardized stressor task used in the independent literatures on depression and anxiety. During the experience sampling period, participants' diurnal cortisol, reports of stressors, negative and positive affect, rumination, and worry will be measured in the context of their daily lives. An advanced, sophisticated set of statistical analyses will be conducted to test theoretically-driven hypotheses regarding group differences in mean levels and temporal variance on these measures, and simultaneously, key associations among these constructs in individuals within each group. Additional analyses will examine the stress, reactivity, and regulation measures with regard to their dimensional relations to depression and anxiety symptomatology. This research program will provide the applicant with training in new areas of knowledge and new methodologies, including the psychobiology of depression-anxiety interactions, the collection and interpretation of neuroendocrine and experience sampling data, the integration of endocrine and autonomic data, and hierarchical linear modeling techniques. This study addresses questions and issues surrounding MDD and GAD in a novel and integrated manner, and these findings will help to elucidate the nature of stress and reactivity, and the difficulties in reactivity and regulation associated with these emotional disorders.