Interplay between stress and rumination in predicting depression: An EMA study

描述（由申请人提供）：重度抑郁症（MDD）是最常见的精神障碍，与重大的个人，社会和经济成本相关。不幸的是，对抑郁症的病理生理学缺乏了解，阻碍了对许多患者有效治疗的发展。为了解决这些未满足的需求，更好地了解抑郁症发病和维持的神经认知机制是必要的。虽然大量的研究已经研究了特质反刍作为抑郁症认知脆弱性的作用，但相对较少关注反刍在状态水平上实时发挥作用的方式。考虑到自我报告特质测量可能会受到回顾性回忆偏差的影响，研究反刍是至关重要的，因为它在不同的背景下自然发生，以最好地理解这种认知脆弱性可能导致抑郁风险的机制。这项建议旨在采用生态瞬时评估（EMA）技术，以更好地了解反刍思维在应对压力生活事件中的作用，作为抑郁症状发展的脆弱性。据推测，反刍可能会增加编码的负面生活事件，改善随后的回忆，这些信息，因此有助于进一步抑郁的影响。本研究的第二个目的是在没有近端压力源的情况下，研究自我关注的沉思思维作为抑郁症的额外预测因素。MDD的首次发作通常发生在成年早期，特别是在大学期间，这是一个新的和增加的压力源的时期。因此，拟议中的研究的目的是调查的方式，其中国家级的反刍，无论是在存在和不存在的近端生活压力，可能有助于抑郁症的风险年龄的大学生之间的抑郁症状的发展。参与者将在第1天实验室访视时完成一系列自我报告问卷，包括特质水平反刍和抑郁症状的测量。第1天访视后，受试者将完成为期7天的手机EMA部分，其中受试者每天4次（第2-8天）记录其当前的负面生活事件、反刍和情绪体验。在一周的缓冲期以减少近因效应之后，参与者将返回实验室以完成经历的所有负面生活事件的偶然自由回忆任务，以及完成反刍和抑郁症状的后续特质测量（第15天）。拟议的研究将采用强大的统计测试，以确定模式，抑郁症状的发展与反刍，无论是在直接响应压力或在没有近端压力。从这些国家级数据中得出的结论旨在为针对特定认知模式的更有针对性的治疗和干预提供信息，这些认知模式可能会导致抑郁症状的发生。

DESCRIPTION (provided by applicant): Major depressive disorder (MDD) is the most common mental disorder, associated with major personal, societal, and economic costs. Unfortunately, a poor understanding of the pathophysiology of depression has impeded the development of effective treatments for many patients. To address these unmet needs, a better understanding of the neurocognitive mechanisms implicated in the onset and maintenance of depressive illness is necessary. Although a wealth of research has examined the role of trait rumination as a cognitive vulnerability for depression, comparatively little attention has been given to the ways in which rumination functions in real-time at the state level. Given that self-report trait measures can fall prey to retrospective recall biases, it is crucial to examine rumination as it occurs naturally in varied contexts to best understand the mechanisms through which this cognitive vulnerability may confer risk for depression. This proposal seeks to employ ecological momentary assessment (EMA) techniques to better understand the role of ruminative thought in response to stressful life events as a vulnerability for the development of depressive symptoms. It is hypothesized that rumination may increase encoding of negative life events, improve subsequent recall of this information, and therefore contribute to further depressed affect. A secondary aim of this research is to examine self-focused ruminative thought in the absence of proximal stressors as an additional predictor of depression. First onset of MDD often occurs during early adulthood and especially during college, a period of novel and increased stressors. Therefore, the proposed study aims to investigate the ways in which state-level rumination, both in the presence and absence of proximal life stress, may contribute to the development of depressive symptoms among undergraduates at an age of risk for depression. Participants will complete a battery of self-report questionnaires at the Day 1 lab visit, includin measures of trait-level rumination and depressive symptoms. Following the Day 1 visit, they will complete a 7 day cell phone EMA component in which they record their current experience of negative life events, rumination, and mood 4 times a day (Days 2-8). Following a one week buffer period to lessen recency effects, the participant will return to the lab to complete an incidental free recall task of all negative life events experienced as well as to complete follow-u trait measures of rumination and depressive symptoms (Day 15). The proposed study will employ powerful statistical tests in order to identify patterns in which depressive symptoms develop in relation to rumination, either in direct response to stress or in the absence of proximal stress. Conclusions derived from this state-level data aim to inform more tailored treatments and interventions that target specific cognitive patterns that may confer risk for the development of depressive symptoms.