Emotion Dysregulation in Adolescents at Risk for Depression: The Interpersonal Context

项目概要/摘要 重度抑郁症（MDD）是一种流行的、使人衰弱的精神疾病。有一个母亲 MDD是MDD的重要风险因素。抑郁症传播的一个核心过程是情绪 失调，这是由不规则的情绪反应和适应不良的情绪相结合的结果 调节（ER;以适应性方式改变一个人的情绪体验和表达的能力）。先前研究 已经表明，在对负面刺激的反应中，具有家族性MDD风险的青少年显示增加， 与负面影响相关的大脑区域的激活（NA;例如，杏仁核），并减少活动， 与认知控制相关的区域（例如，背外侧前额叶皮层[dlPFC]）。对于积极的刺激， 处于危险中的青少年在与奖励处理相关的区域中显示迟钝的反应（例如，腹侧纹状体）和 与认知控制相关的区域的激活增加。总之，这些发现支持了这样一种观点， 情绪失调是抑郁症的危险因素。相反，适应性ER可能作为一种保护因素。 因此，情绪失调是研究和干预的重要目标。先前的成像研究， 但生态有效性低。本研究将从两个方面解决这一局限性。一是 将重点关注人际环境，这是MDD风险的核心。为数不多的使用社会刺激的研究 只检查了对同伴反馈的反应，尽管有证据表明父母的反馈在MDD中至关重要。的 本研究将是第一个研究神经反应的母亲和同伴反馈使用 功能性磁共振成像（fMRI）。第二，我们将用经验采样补充功能磁共振成像 方法（ESM），一个高度生态有效的程序，涉及监测个人的日常生活。因此，在本发明中， 这项拟议的研究将独特地阐明神经反应与母亲的行为之间的联系。 以及同伴反馈和日常经验。我们将招募60名从未患过疾病的儿童（9-13岁）， 有（高风险）或无（低风险）既往MDD的母亲。参与者将完成一项功能磁共振成像任务， 对同伴和母亲反馈的反应。然后，我们将使用21天的ESM来评估他们的情绪， 对人际事件的反应和调节。我们假设（1）那些高（对低） 风险会对批评做出反应，与NA相关的大脑区域的激活程度更高，而与NA相关的区域的激活程度更低 与认知控制有关，而在对表扬的反应中，他们的大脑区域会显示出较少的激活， 与奖赏回路和认知控制相关区域的活动增加有关。(2)响应于 日常负性事件，高危青少年将经历更多的NA和使用更多的适应不良的ER， 适应性较低的ER;在应对积极事件时，高危青少年将经历较少的积极影响（PA） 多用适应不良ER，少用适应ER。(3)对反馈的神经反应将预测NA，PA， ER，和抑郁症状在日常生活中，并将（4）中度之间的人内关联 人际事件和影响。(5)性别将在分析中用作探索性调节因素。

Project Summary/Abstract Major Depressive Disorder (MDD) is a prevalent and debilitating psychiatric illness. Having a mother with MDD is a significant risk factor for MDD. A central process implicated in MDD transmission is emotion dysregulation, which results from a combination of irregular emotional reactions and maladaptive emotion regulation (ER; the ability to alter one’s emotional experience and expression in an adaptive way). Prior studies have shown that – in response to negative stimuli – adolescents with familial MDD risk display increased activation in brain regions associated with negative affect (NA; e.g., amygdala), and decreased activity in regions related to cognitive control (e.g., dorsolateral prefrontal cortex [dlPFC]). In response to positive stimuli, at-risk adolescents show blunted response in regions related to reward processing (e.g., ventral striatum) and increased activation in regions related to cognitive control. Together, these findings support the idea that emotion dysregulation is a risk factor for MDD. Conversely, adaptive ER may serve as a protective factor. Thus, emotion dysregulation is an important target for research and intervention. Prior imaging studies, however, suffer from low ecological validity. The present study will address this limitation in two ways. First, we will focus on interpersonal context, which is central to MDD risk. The few studies that used social stimuli examined only responses to peer feedback, despite the evidence that parental feedback is crucial in MDD. The present study will be the first to examine neural responses to both maternal and peer feedback using functional magnetic resonance imaging (fMRI). Second, we will complement fMRI with experience sampling methods (ESM), a highly ecologically valid procedure that involves monitoring individuals in daily life. Thus, the proposed study will uniquely shed light on the associations between neural responses to maternal and peer feedback and everyday experiences. We will recruit 60 never-disordered children (aged 9-13) of mothers with (high-risk) or without (low-risk) past MDD. Participants will complete an fMRI task assessing responses to peer and maternal feedback. Then, we will use ESM for 21 days to assess their emotional reactivity and regulation in response to interpersonal events. We hypothesize that (1) those at high (vs. low) risk will respond to criticism with greater activation in brain regions related to NA and less activation in regions related to cognitive control, whereas in response to praise, they will show less activation in brain regions related to reward circuitry and increased activity in regions related to cognitive control. (2) In response to everyday negative events, high-risk adolescents will experience more NA and use more maladaptive ER and less adaptive ER; in response to positive events, high-risk adolescents will experience less positive affect (PA) and use more maladaptive ER and less adaptive ER. (3) Neural responses to feedback will predict NA, PA, ER, and depressive symptoms in everyday life, and will (4) moderate within-person associations between interpersonal events and affect. (5) Gender will be used as an exploratory moderator across analyses.