Physiological Markers of Stress Generation and Affect Reactivity in Depression

 描述（由申请人提供）：重度抑郁症（MDD）是最常见的精神疾病之一，与重大的个人和社会成本相关[1]。鉴于MDD发病率和复发率很高，需要进行研究以更好地了解导致抑郁症易感性的生物心理社会机制。虽然现有的研究已经评估了各种生理，情感和环境的风险因素，抑郁症，以前的工作已经评估了孤立的风险因素，而不考虑这些过程之间的动态关系，赋予抑郁症的风险。该建议旨在评估抑郁症高危人群中日常压力源发生的生理标志物和对压力源的情感反应，MDD发作和复发的可变和潜在脆弱性。该项目旨在1）评估生理反应作为未来MDD风险的lat青少年日常压力产生和对压力源的情感反应的预测因子，2）检查日常压力产生作为连接生理反应和日常情感反应以及随后的抑郁症状的机制，和3）探索性别差异在这些过程中的贡献者妇女更容易受到MDD使用多个单元的分析。考虑到青春期后期是MDD首次发作和复发率较高的时期[2]，以及压力性生活事件显著增加，拟议研究的参与者将是有重度或阈下抑郁症病史的本科生，这是未来MDD发作风险的重要群体[3]。参与者将完成对实验室诱导的应激挑战的心理生理反应性（通过呼吸性窦性心律失常和射血前期）的基线评估，以及自我报告的抑郁症状和前六周发生的生活事件（随后进行生活事件访谈）。参与者将完成为期两周的每日日记评估（14个日记），评估生活压力源以及对压力源的积极和消极影响，允许对压力和影响的变化进行具体（受试者内）测量。在一个月后的随访评估中，参与者将再次完成生活事件问卷和访谈，并测量抑郁症状。符合NIMH战略目标（2.3），这项多方法，微观纵向研究提出评估生理，环境和情感过程之间的关系，在抑郁症的脆弱性测量使用多个单元的分析，这有可能阐明这些脆弱性赋予抑郁症风险的机制，以更好地识别风险个体，并为新的个性化预防提供信息。和抑郁症的干预项目。

 DESCRIPTION (provided by applicant): Major depressive disorder (MDD) is one of the most common mental disorders and is associated with significant personal and societal costs [1]. Given the high rates of MDD onset and recurrence, research is needed to better understand the bio-psychosocial mechanisms that contribute vulnerability to depression. Although existing research has evaluated various physiological, affective, and environmental risk factors for MDD, much prior work has evaluated risk factors in isolation without considering the dynamic relationships among these processes in conferring risk for depression. This proposal seeks to evaluate physiological markers of the occurrence of daily stressors and affective reactivity to stressors, mutable and potent vulnerabilities for MDD onset and recurrence, among individuals at high risk for depression. The proposed project is designed to 1) evaluate physiological re-activities as predictors of daily stress generation and affective reactivity to stressors among lat adolescents at risk for future MDD, 2) examine daily stress generation as a mechanism linking physiological re-activities and daily affective reactivity, as well as subsequent depressive symptoms, and 3) explore sex differences in these processes as contributors to women's greater vulnerability to MDD using multiple units of analysis. Given that late adolescence is a period in which there are high rates of first onset and recurrence of MDD [2], as well as significant increases in stressful life events, participants in the proposed study will be undergraduate students with a history of major or sub-threshold depression, an important group at risk for future episodes of MDD [3]. Participants will complete a baseline evaluation of psychophysiological reactivity (via respiratory sinus arrhythmia and pre-ejection period) to a laboratory-induced stress challenge, as well as self-report symptoms of depression and life events that occurred in the prior six weeks (followed by a life events interview). Participants the will complete daily diary assessments for two weeks (14 diaries) evaluating life stressors and positive and negative affect in response to stressors, allowing for idiographic (within-subject) measurement of variations in stress and affect. At a follow-up assessment one month later, participants again will complete the life events questionnaire and interview, and measure of depressive symptoms. Consistent with the NIMH Strategic Objectives (2.3), this multi-method, micro-longitudinal study proposes to evaluate the relationships among physiological, environmental, and affective processes in vulnerability to depression measured using multiple units of analysis, which has the potential to elucidate the mechanisms through which these vulnerabilities confer risk for depression to better identify individuals at risk and inform novel nd personalized prevention and intervention programs for depression.