An Integrated Chronobiological-Cognitive Approach to Seasonal Affective Disorder

季节性情感障碍的综合时间生物学认知方法

• 批准号: 8403422
• 负责人: Jennifer Nicole Mahon
• 金额: $ 3.58万
• 依托单位: UNIVERSITY OF VERMONT & ST AGRIC COLLEGE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-12-31 至 2013-12-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8403422
• 关键词: Accounting; Adult; Affect; American; Attitude; Behavioral; Behavioral Model; Belief; Biological; Circadian Rhythms; Clinical; Clinical Investigator; Cognition; Cognitive; Collaborations; DSM-IV; Depressed mood; Development; Discipline; Disease susceptibility; Endogenous depression; Exhibits; Future; Individual; Intervention; Laboratories; Light; Link; Literature; Longitudinal Studies; Major Depressive Disorder; Measures; Melatonin; Mental Depression; Mental Health; Modeling; Mood Disorders; National Research Service Awards; Participant; Patients; Pattern; Phase; Photoperiod; Phototherapy; Predisposition; Prevention; Public Health; Recurrence; Relative (related person); Research; Research Personnel; Research Training; Risk Factors; Seasonal Affective Disorder; Severities; Sleep; Symptoms; Syndrome; Testing; Time; Training; Visit; Wrist; actigraphy; career; circadian pacemaker; depressive symptoms; experience; falls; improved; longitudinal design; novel; prospective; psychologic; research study; response; single episode major depressive disorder; stem; theories; treatment strategy

DESCRIPTION (provided by applicant): The proposed NRSA project will be part of a research training plan to prepare the P.I. for a career as a clinical investigator of the chronobiological and psychological mechanisms of mental health. This NRSA project will be the first study to integrate theory and expertise from leading chronobiological and cognitive-behavioral SAD researchers to test an integrative model of seasonal affective disorder (SAD). This study will use a prospective, longitudinal design to clarify the etiological underpinnings of SAD in a test of Rohan's integrative cognitive-behavioral model of SAD by (1) comparing the vulnerabilities between SAD patients and never-depressed matched controls at summer and winter, and (2) testing the relative and combined contributions of the chronobiological and cognitive vulnerabilities in predicting winter depression severity in patients and controls. The measures selected for the cognitive vulnerability are established measures of cognitive vulnerability to Nonseasonal depression that have research to support their relevance to SAD: brooding rumination; cognitive reactivity, and a measure of the SAD- specific seasonal cognitions proposed in Rohan's model. The chronobiological vulnerability will be measured as seasonal change in Phase Angle Difference (PAD): the difference in timing between circadian phase (as marked by the Dim Light Melatonin Onset) and the averaged midpoint of sleep (as recorded by wrist actigraphy) for each participant. To test between-group effects and the longitudinal prediction of winter depression severity, all measures will be completed once in the summer when the SAD patients are relatively asymptomatic, and once in the winter when the SAD patients are experiencing a Major depressive Episode, per DSM-IV-TR criteria. The summer cognitive measures and a seasonal change in PAD will be utilized as statistical predictors of winter depression severity in a longitudinal linear mixed model analysis. To control for baseline depression severity, depression severity measures will be obtained at both the summer and winter laboratory visits, with the summer measure will be entered into the analysis as a control variable. These cognitive and chronobiological predictors will be examined for unique and interactive effects on winter depression severity. As a collaboration of the leading disciplines in SAD research, this study represents the first test of an integrative etiological model of SAD recurrence. An integrative etiological model holds clinical implications for the treatment of SAD. Specifically results may inform whether new treatment strategies, i.e. the development of novel intervention strategies targeting these vulnerabilities and/or utilization of a treatment hierarchy, are warranted to reduce annual SAD recurrence.

描述（由申请人提供）：拟议的NRSA项目将是一个研究培训计划的一部分，该计划将使私家侦探成为心理健康的时间生物学和心理机制的临床研究者。这个NRSA项目将是第一个整合来自领先的时间生物学和认知行为SAD研究人员的理论和专业知识的研究，以测试季节性情感障碍（SAD）的综合模型。本研究将采用前瞻性、纵向设计来阐明SAD的病因学基础，通过测试Rohan的SAD综合认知-行为模型(1)比较SAD患者和从未抑郁的匹配对照组在夏季和冬季的脆弱性，以及(2)测试时间生物学和认知脆弱性在预测患者和对照组冬季抑郁严重程度方面的相对和综合贡献。认知易感性所选择的测量方法是对非季节性抑郁的认知易感性的既定测量方法，这些方法有研究支持它们与SAD的相关性：沉思反刍；认知反应，以及在Rohan的模型中提出的SAD特定季节性认知的测量。时间生物学脆弱性将通过相位角差（PAD）的季节性变化来测量：每个参与者的昼夜节律阶段（由昏暗的褪黑激素开始标记）和平均睡眠中点（由手腕活动记录仪记录）之间的时间差异。为了检验组间效应和冬季抑郁严重程度的纵向预测，根据DSM-IV-TR标准，所有测量将在夏季SAD患者相对无症状时完成一次，在冬季SAD患者经历重度抑郁发作时完成一次。在纵向线性混合模型分析中，夏季认知测量和PAD的季节性变化将用作冬季抑郁症严重程度的统计预测因子。为了控制基线抑郁严重程度，将在夏季和冬季实验室访问时获得抑郁严重程度测量值，夏季测量值将作为控制变量输入分析。这些认知和时间生物学的预测因素将被检查对冬季抑郁症严重程度的独特和相互作用的影响。作为SAD研究领先学科的合作，这项研究代表了SAD复发的综合病因学模型的首次测试。一个综合的病因模型对SAD的治疗具有临床意义。具体而言，研究结果可能会告知新的治疗策略，即针对这些弱点开发新的干预策略和/或利用治疗层次，是否有必要减少SAD的年度复发。