Modeling Hedonic Processing and Anhedonia in Depression

描述(申请人提供)：快感缺乏，或缺乏积极的情绪，是抑郁症的一个关键组成部分，在诊断标准中以各种方式表现出来。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进行对比时。与非典型抑郁症形成鲜明对比的是，忧郁型抑郁症会导致对愉快事件的情绪反应性出现额外的缺陷。与NIMH的战略目标1一致，这款应用程序寻求以理论上一致的方式评估快感缺乏症，并解决抑郁症患者在想要、喜欢和学习方面的缺陷，任务旨在评估抑郁症患者快感障碍的各种处理方式。在每项任务中，在愉快和中性条件下，耳后反射和颧肌电信号的大小将被评估为积极情绪处理的测量。惊恐眨眼和皱纹肌电的大小将被评估，以检查抑郁症患者的负面情绪水平是否也不同，这表明抑郁症患者对情绪环境不敏感。此外，在每个任务中将采取积极情绪的多个行为测量，以提供跨测量领域的快感缺失的综合评估。该项目还将展示抑郁性快感缺乏的哪些成分和措施对临床干预有反应，哪些仍然受损，表明它们可能是抑郁症的内在表型。我们将招募健康对照和抑郁症、非典型抑郁症或非亚型抑郁症患者。在完成心理诊断访谈和对特征和享乐加工状态水平的自我报告后，参与者将完成三个平衡任务。在一项任务中，他们将观看情绪图片和听情绪声音，以及与每个刺激价相关的线索，以提供对情绪反应性的实验性评估。他们的评分和身体对线索、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(根据他们对线索的反应来衡量)。另外两个任务评估的是对愉快的活动缺乏愉悦(喜欢)或兴趣(想要)。一种衡量基于努力的工作以获得回报，是对参与者在奖励活动中的享受(喜欢)和兴趣(想要)进行的实验性评估。另一项是测量参与者在食欲评价条件反射任务中学习愉快联想的能力，在这项任务中，中性词语与高度愉悦或中性的图片配对。我们将邀请相同的参与者在他们最初的会议三个月后回到我们的实验室，检查哪些快感缺乏的过程和措施对临床改善(特别是快感症状)有反应，哪些在缓解的抑郁症参与者中仍然受损。后者使抑郁症的内表型成为候选对象，这种表型可以用来识别抑郁症的风险人群，并在他们变得严重抑郁之前进行主动干预。 公共卫生相关性：该项目将使用多种工具来衡量不同类型抑郁症的愿望、喜好和学习情况。它将帮助我们了解抑郁症患者在体验积极情绪方面存在的各种问题。它还将显示，随着抑郁症患者的好转，哪些积极情绪会增加，哪些会保持低迷。

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.