Improving Depression Outcome by Enhancing Memory for Cognitive Therapy

描述(申请人提供)：严重抑郁障碍(MDD)是世界上最普遍的精神障碍之一，也是导致残疾的主要原因。现有的治疗方法不能完全恢复。在改善结果方面取得的进展必须包括安全、强大、廉价和简单的创新(以便快速有效地传播)。这项拟议的研究试图测试一项这样的创新。我们寻求通过改善对认知治疗(CT)会议内容的记忆来改善结果。CT是治疗MDD最有前景的方法之一，但仍有改进的空间。我们认为，在CT中加入记忆增强策略可能会改善MDD的预后，因为：(A)MDD通常以记忆障碍为特征，(B)有证据表明记忆障碍是可改变的，(C)CT通常涉及情绪激活，(D)情绪可能损害或偏见记忆，以及(E)有证据表明，对治疗内容的记忆力较差。瞄准。为了评估增加一种新的策略是否会改善MDD的治疗结果，该策略源于记忆文献，旨在增强对CT会议内容的记忆。认知支持包括支持情景记忆的编码和提取阶段的一系列特定程序。这是假设的CT+认知支持，相对于通常的CT-AS，将与改善抑郁结局有关，在治疗结束和治疗结束后6个月。研究计划。第一阶段包括一个迭代的过程，通过测试患有MDD的成年人(n=8)的治疗来开发和完善认知支持干预。在第二阶段，将对48名患有MDD的成年人进行小型可行性随机对照试验，他们将被随机分为：(A)CT+认知支持组(n=24)或(B)CT照常组(n=24)。结果测量将在基线、治疗结束和治疗后6个月进行。长期目标。如果结果是积极的，将对公共卫生产生重大影响，因为简单、廉价的记忆增强策略可以很容易地作为标准功能包括在所有针对广泛精神疾病的心理社会治疗中。作为实现这一目标的第一步，这项研究将提供必要的试点数据，以准备一项更大规模的干预研究，重点是通过改善对MDD治疗过程内容的记忆来改善结果。

DESCRIPTION (provided by applicant): Major depressive disorder (MDD) is one of the most prevalent psychiatric disorders and a leading cause of disability worldwide. Existing therapies fail to produce complete recovery. Progress toward improving outcome must include innovations that are safe, powerful, inexpensive and simple (for fast and effective dissemination). The proposed research seeks to test one such innovation. We seek to improve outcome by improving memory for the content of cognitive therapy (CT) sessions. CT is one of the most promising approaches to the treatment of MDD, yet there is room for improvement. We believe that adding memory enhancing strategies to CT may improve MDD outcome because: (a) MDD is often characterized by memory impairment, (b) there is evidence that the memory impairment is modifiable, (c) CT typically entails the activation of emotion, (d) emotion can impair or bias memory and (e) there is evidence that memory for the content of therapy sessions is poor. Aim. To evaluate if the addition of a novel strategy, derived from the memory literature and designed to enhance memory for the content of CT sessions, will improve treatment outcome for MDD. Cognitive support involves a series of specific procedures that support the encoding and retrieval stages of an episodic memory. It is hypothesized that CT+Cognitive Support, relative to CT-as-usual, will be associated with improved depression outcome at the end of treatment and 6 months after the completion of treatment. Research Plan. Phase 1 involves an iterative process of developing and refining the cognitive support intervention by testing the treatment with adults with MDD (n = 8). In Phase 2, a small pilot feasibility RCT will be conducted on adults with MDD (n = 48) who will be randomized to either: (a) CT+Cognitive Support (n = 24) or (b) CT-as-usual (n = 24). Outcome measures will be taken at baseline, end of treatment, and 6 months after treatment. Long-term objective. The outcomes, if positive, will have major public health implications because simple, inexpensive memory enhancing strategies can be readily included as a standard feature in all psychosocial treatments for a broad range of mental illness. As a first step toward achieving this goal, this research will provide the pilot data needed to prepare a larger scale intervention study focused on improving outcomes by improving memory for the content of therapy sessions in MDD.