Interpretation Bias Training in Depressed Adolescents: Effects and Mechanisms

描述（由申请人提供）：青少年是重度抑郁症（MDD）发作的高风险期;事实上，青少年MDD发作与更长和更严重的抑郁发作相关，这些抑郁发作通常难以治疗。因此，我们必须确定早发性MDD的相关因素，并制定更有效的早期干预方法。在试图阐明导致MDD发作和维持的因素时，研究人员集中于对信息的负偏差处理。抑郁症中最一致的认知偏见涉及对情感模糊信息的更多负面和更少正面的解释。重要的是，研究人员已经证明，不仅这些偏见在解释可以修改，但进一步，口译偏见培训（IBT）改善情绪调节，减少抑郁症状。然而，尽管有这些发现，我们对IBT这些积极作用的机制知之甚少。为了更全面地了解MDD中有偏见的认知功能，研究人员已经开始研究这种疾病中偏见的神经方面。在这种情况下，研究人员已经记录了功能，连接，和/或结构异常抑郁症的成年人在膝下和背侧前扣带（ACC），背侧前额叶皮层（PFC），杏仁核，情绪调节网络的所有组件。到目前为止，很少有研究探讨抑郁症儿童和青少年认知偏差的神经基础，或者改变抑郁症青少年认知偏差的影响。该项目的总体目标是：（1）评估旨在减少抑郁症青少年负面解释偏差的培训的认知，神经和临床效果;（2）检查神经和认知变化，介导IBT的积极临床效果。该项目的结果将增加我们对抑郁症青少年解释偏差的神经过程的理解，并有助于开发更有效的青少年MDD干预措施。

DESCRIPTION (provided by applicant): Adolescence is a period of high risk for the onset of Major Depressive Disorder (MDD); indeed, adolescent onset of MDD is associated with longer and more severe depressive episodes that are often refractory to treatment. Thus, it is imperative that we identify factors involved in early-onset MDD and develop more effective approaches to early intervention. In attempting to elucidate factors that contribute to the onset and maintenance of MDD, investigators have focused on negatively biased processing of information. The most consistent cognitive bias in depression involves more negative and less positive interpretations of emotionally ambiguous information. Importantly, investigators have shown not only that these biases in interpretation can be modified, but further, that Interpretatio Bias Training (IBT) improves emotion regulation and reduces depressive symptoms. Despite these findings, however, we know little about the mechanisms that underlie these positive effects of IBT. In an effort to gain a more comprehensive understanding of biased cognitive functioning in MDD, researchers have begun to examine neural aspects of biases in this disorder. In this context, investigators have documented abnormalities in function, connectivity, and/or structure in depressed adults in subgenual and dorsal anterior cingulate (ACC), dorsal prefrontal cortex (PFC), and amygdala, all components of emotion regulatory networks. To date, there is little research examining the neural foundations of cognitive biases in depressed children and adolescents or the effects of modifying these biases in depressed youth. The overarching goals of the proposed project are (1) to assess the cognitive, neural, and clinical effects of training designed to reduce negative interpretation biases in depressed adolescents; and (2) to examine neural and cognitive changes that mediate the positive clinical effects of IBT. Results of this project will increase our understanding of neural processes that underlie interpretation biases in depressed adolescents and contribute to the development of more effective interventions for MDD in adolescence.