Modeling Hedonic Processing and Anhedonia in Depression

抑郁症中的享乐加工和快感缺乏建模

• 批准号: 8244297
• 负责人: STEPHEN D BENNING
• 金额: $ 23.04万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-02-02 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8244297
• 关键词: Address; Anhedonia; Atypical depressive disorder; Back; Behavioral; Biological; Biological Markers; Blinking; Chemosensitization; Clinical; Clinical assessments; Conscious; Cues; Depressed mood; Diagnosis; Diagnostic; Disease; Emotional; Emotions; Event; Exhibits; Failure; Individual; Intervention; Interview; Laboratories; Learning; Link; Measurement; Measures; Melancholic Depression; Mental Depression; Modeling; Moods; Participant; Patient Self-Report; Patients; Pattern; Pharmacotherapy; Process; Process Measure; Psychophysiology; Reaction; Recruitment Activity; Reflex action; Rewards; Risk; Smiling; Stimulus; Sum; Symptoms; Testing; Work; base; behavior measurement; conditioning; depressive symptoms; design; endophenotype; experience; hedonic; improved; interest; pleasure; positive emotional state; sound; tool; trait

DESCRIPTION (provided by applicant): Anhedonia, or the lack of positive emotion, is a critical component of depression that is represented in various ways in diagnostic criteria. All forms of depression may involve a lack of interest or pleasure in activities, particularly when depressed patients are contrasted against healthy controls. Melancholic depression specifically entails additional deficits in mood reactivity to pleasant events, in contrast to atypical depression, in which mood reactivity to pleasant events is present. Consistent with NIMH's Strategic Objective 1, this application seeks to assess anhedonia in a theoretically coherent way and address deficits in wanting, liking, and learning in depression, with tasks designed to assess the varieties of anhedonic processing in depression. In each task, postauricular reflex and zygomatic EMG magnitudes during pleasant vs. neutral conditions will be assessed as measures of positive emotional processing. Startle blink and corrugator EMG magnitudes will be assessed to examine whether depressed patients also differ in their levels of negative emotion, indicating an emotion context insensitivity in depression. Furthermore, multiple behavioral measures of positive emotion will be taken in each task to provide a comprehensive assessment of anhedonia across measurement domains. This project will also demonstrate which components and measures of depressive anhedonia are responsive to clinical intervention and which remain impaired, suggesting they may serve as endophenotypes for depression. We will recruit healthy controls and patients with melancholic, atypical, or non-subtyped depression. After completing psychodiagnostic interviews and self-reports of trait and state levels of hedonic processing, participants will complete three counterbalanced tasks. In one task, they will view emotional pictures and listen to emotional sounds, along with cues associated with each stimulus valence, to provide an experimental assessment of mood reactivity. Their ratings and bodies' reactions to the cues, pictures, and sounds will be recorded to assess their levels of liking the actual stimuli and wanting those stimuli (as measured by their reactions to the cues). Two additional tasks assess lack of pleasure (liking) or interest (wanting) in pleasant activities. One measures effort-based work for rewards and is an experimental assessment of participants' enjoyment (liking) and interest (wanting) during a rewarding activity. The other measures participants' ability to learn pleasant associations in an appetitive evaluative conditioning task, in which neutral words are paired with highly pleasant or neutral pictures. We will invite the same participants back to our laboratory three months after their initial session to examine which processes and measures of anhedonia are responsive to clinical improvement (particularly in anhedonic symptoms) and which remain impaired in remitted depressed participants. The latter make candidates for endophenotypes of depression, which can be used to identify people at risk for depression and intervene proactively before they become acutely depressed. PUBLIC HEALTH RELEVANCE: This project will use multiple tools to measure wanting, liking, and learning in different types of depression. It will help us understand the various kinds of problems that people with depression have in experiencing positive emotions. It will also show which kinds of positive emotions increase and which kinds stay low as people with depression get better.

描述（由申请人提供）：快感缺乏，或缺乏积极情绪，是抑郁症的一个关键组成部分，在诊断标准中以多种方式表现出来。所有形式的抑郁症都可能涉及对活动缺乏兴趣或乐趣，特别是当抑郁症患者与健康对照组形成对比时。与非典型抑郁症相比，忧郁性抑郁症特别会导致对愉快事件的情绪反应出现额外的缺陷，而非典型抑郁症则存在对愉快事件的情绪反应。与 NIMH 的战略目标 1 一致，该应用程序旨在以理论上连贯的方式评估快感缺失，并解决抑郁症中的想要、喜欢和学习方面的缺陷，其任务旨在评估抑郁症中快感缺失处理的多样性。在每项任务中，愉快与中性条件下的耳后反射和颧肌电图幅度将被评估为积极情绪处理的措施。将评估惊跳眨眼和皱眉肌电图幅度，以检查抑郁症患者的负面情绪水平是否也存在差异，表明抑郁症患者对情绪背景不敏感。此外，每项任务都将采取多种积极情绪的行为测量，以提供跨测量领域的快感缺失的全面评估。该项目还将证明抑郁症快感缺乏的哪些成分和测量对临床干预有反应，哪些仍然受损，表明它们可能作为抑郁症的内表型。我们将招募健康对照者和患有忧郁症、非典型或非亚型抑郁症的患者。在完成心理诊断访谈以及享乐处理特征和状态水平的自我报告后，参与者将完成三项平衡任务。在一项任务中，他们将观看情感图片并聆听情感声音，以及与每种刺激效价相关的线索，以提供情绪反应性的实验评估。他们的评分和身体对提示、图片和声音的反应将被记录下来，以评估他们喜欢实际刺激和想要这些刺激的程度（通过他们对提示的反应来衡量）。另外两项任务评估对愉快活动的乐趣（喜欢）或兴趣（想要）的缺乏。一种衡量基于努力的工作的奖励，是对参与者在奖励活动期间的享受（喜欢）和兴趣（想要）的实验评估。另一种方法衡量参与者在食欲评价调节任务中学习愉快联想的能力，其中中性词语与高度愉快或中性的图片配对。我们将邀请相同的参与者在初次治疗三个月后回到我们的实验室，以检查哪些快感缺乏过程和测量对临床改善（特别是快感缺乏症状）有反应，哪些在缓解抑郁症的参与者中仍然受到损害。后者是抑郁症内表型的候选者，可用于识别有抑郁风险的人，并在他们变得严重抑郁之前主动干预。 公共健康相关性：该项目将使用多种工具来衡量不同类型抑郁症的需求、喜好和学习。它将帮助我们了解抑郁症患者在体验积极情绪时遇到的各种问题。它还将显示随着抑郁症患者的好转，哪些积极情绪会增加，哪些积极情绪会保持低水平。