Physiological Markers of Stress Generation and Affect Reactivity in Depression

 描述(由申请人提供)：严重抑郁障碍(MDD)是最常见的精神障碍之一，与巨大的个人和社会成本相关[1]。鉴于MDD的发病和复发率很高，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。尽管现有的研究已经评估了MDD的各种生理、情感和环境风险因素，但许多先前的工作都是孤立地评估风险因素，而没有考虑这些过程之间的动态关系，从而导致抑郁的风险。这项建议旨在评估日常应激源的发生和对应激源的情感反应性的生理标记物，以及在抑郁症高危人群中发生MDD和复发的可变和潜在的易感性。这项拟议的项目旨在1)评估生理反应作为未来MDD风险青少年日常应激产生和对应激源的情感反应的预测因子，2)检查日常应激产生作为连接生理反应和日常情感反应以及随后抑郁症状的机制，以及3)使用多个分析单位探索这些过程中的性别差异作为女性更容易患MDD的因素。考虑到青春期后期是MDD初发率和复发率较高的时期[2]，以及应激性生活事件的显著增加，拟议研究的参与者将是有严重或亚临界性抑郁症病史的本科生，这是未来MDD发作的一个重要群体[3]。参与者将完成对实验室诱导的压力挑战的心理生理学反应的基线评估(通过呼吸窦性心律失常和射血前阶段)，以及自我报告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篇日记)，评估生活压力源以及对应激源的积极和消极情绪，允许具体(在受试者内)测量压力和情绪的变化。在一个月后的后续评估中，参与者将再次完成生活事件问卷和访谈，并测量抑郁症状。与NIMH战略目标(2.3)一致，这项多方法的微观纵向研究建议使用多个分析单位来评估易患抑郁症的生理、环境和情感过程之间的关系，这可能有助于阐明这些脆弱性赋予抑郁症风险的机制，以更好地识别处于危险中的个人，并为抑郁症提供新的和个性化的预防和干预方案。

 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.