Attention Training for Major Depressive Disorder

描述（由申请人提供）：重度抑郁症是一种常见的，复发性的和损害性的条件，预测未来的自杀企图，人际关系问题，失业，药物滥用和青少年犯罪。抑郁症的认知模型表明，有偏见的处理烦躁不安的信息有助于维护的障碍。尽管抑郁症的认知理论得到了实证支持，但所有以前的研究都是相关的。这是一个主要的限制。如果没有实验性地操纵有偏注意，就不可能排除注意偏误仅仅是MDD的一个后果，而在这种疾病的维持中没有因果关系。证明有偏见的注意力具有因果关系的作用，将提供重要的洞察维持MDD的过程。我们目前的初步数据表明，注意力训练可以显着减少成年人的抑郁症状。在这项初步工作的基础上，我们现在建议调查改变消极偏见的注意力是否会减少被诊断为重度抑郁症的个体的抑郁症状。目的1是确定是否修改选择性注意烦躁刺激减少抑郁症状在更大程度上比注意力训练控制诊断为MDD的成年人。目的二是探讨注意训练是否改变了情绪刺激注意加工的神经回路功能。目的3是测试注意力训练是否改善抑郁症维持中涉及的其他认知偏差，例如持续处理焦虑刺激和增强回忆情绪刺激。这将是第一个研究，以确定是否负偏的注意力有一个因果关系的作用，在抑郁症的成年人的抑郁症状的维持。它还将识别注意力训练后发生的神经和行为变化。这些发现可能会刺激治疗的发展，因为我们的项目将指出行为（即，负注意力偏差）和神经（例如，改善PFC功能）水平，维持MDD，并可通过心理或药理干预专门针对。因此，拟议中的研究应推进我们的知识的维护过程中，为MDD和提供具体的方向设计的治疗方案，这一严重的精神问题。 公共卫生相关性：该项目的总体目标是确定改变对焦虑信息的偏见是否会导致诊断为重度抑郁症（MDD）的成年人的症状改善。确定是否负偏注意有因果关系的作用，在维护MDD将推进我们的知识的维护过程中的MDD，并提供具体的方向设计治疗方案，这一严重的精神问题。

DESCRIPTION (provided by applicant): Major depressive disorder is a common, recurrent, and impairing condition that predicts future suicide attempts, interpersonal problems, unemployment, substance abuse, and delinquency. Cognitive models of depression suggest that biased processing of dysphoric information contributes to the maintenance of the disorder. Despite empirical support for cognitive theories of depression, all previous research has been correlational. This is a major limitation. Without experimentally manipulating biased attention, it is impossible to rule out that attentional bias is simply a consequence of MDD and has no causal role in the maintenance of the disorder. Demonstrating that biased attention has a causal role would provide important insight into the processes that maintain MDD. We present preliminary data that attention training can significantly reduce depressive symptoms among adults. Building on this preliminary work, we are now proposing to investigate whether changing negatively biased attention reduces depressive symptoms among individuals diagnosed with Major Depressive Disorder. Aim 1 is to determine whether modifying selective attention for dysphoric stimuli reduces depression symptoms to a greater extent than an attention training control among adults diagnosed with MDD. Aim 2 is to investigate whether attention training alters the function of neural circuitry involved in attentional processing of emotion stimuli. Aim 3 is to test whether attention training improves other cognitive biases implicated in depression maintenance, such as sustained processing of dysphoric stimuli and enhanced recall of emotion stimuli. This would be the first study to determine whether negatively biased attention has a causal role in the maintenance of depression symptoms among adults with MDD. It would also identify neural and behavioral changes that occur following attention training. Such discoveries could spur treatment development, as our project would point to specific mechanisms across behavioral (i.e., negative attention bias) and neural (e.g., improved PFC function) levels that maintain MDD and could be specifically targeted by psychological or pharmacological interventions. Thus, the proposed study should advance our knowledge of the maintenance processes for MDD and provide specific direction for the design of treatment programs for this serious psychiatric problem. PUBLIC HEALTH RELEVANCE: The overarching goal of this project is to determine whether altering biased attention for dysphoric information leads to symptom improvement among adults diagnosed with Major Depressive Disorder (MDD). Determining whether negatively biased attention has a causal role in the maintenance of MDD would advance our knowledge of the maintenance processes for MDD and provide specific direction for the design of treatment programs for this serious psychiatric problem.