Training cognitive control over emotional material in working memory: effects on the frequency of using rumination and its impact on daily mood in depressed patients

抑郁症是一种非常普遍的精神障碍，具有巨大的个人和社会负担。尽管有效的心理治疗和药物治疗，复发率仍然很高。研究得最好的抑郁发作和复发的危险因素之一是沉思。大量的研究已经证明了反刍对抑郁情绪和其他抑郁症状的负面影响，然而，减少反刍的有效治疗方法仍然缺失。一些研究人员假设，反刍的倾向与认知控制功能的损伤有关。具体来说，反刍已被证明与从工作记忆中去除负面材料的能力下降有关。因此，训练抑郁症患者从工作记忆中去除负面材料，并检验这种训练对反刍和情绪的影响，将是一件有趣的事情。迄今为止，很少有研究调查认知控制训练对反刍的影响。虽然一些结果是有希望的，但结论受到重要的方法学局限性的限制，例如样本量很小，使用非临床样本，缺乏主动控制条件，或使用中性刺激。因此，本项目的目的是研究更新工作记忆中的情绪材料的训练是否会影响临床抑郁症参与者在日常生活中使用反刍的频率以及反刍对情绪的影响。为此，参与者将被随机分配到10个计算机认知控制训练或有效安慰剂条件下。每天的反刍和情绪将在训练前后进行评估，并在三个月的随访中进行评估。重要的是，本项目将使用动态评估来评估训练对反刍的影响，以及在自然环境下情绪和反刍之间的动态关系。在工作记忆中更新情绪材料的能力的变化将在训练前后进行评估。研究认知控制训练对反刍的影响将是进一步提高我们对反刍潜在机制的认识的重要一步。与该领域的其他研究一起，这可能最终有助于治疗抑郁症复发的最突出的危险因素之一。

Depression is a highly prevalent mental disorder with immense personal and societal burden. Despite effective psychotherapeutic and pharmacological treatments, relapse rates remain high. One of the best researched risk factor for the onset and recurrence of depressive episodes is rumination. A large body of research has demonstrated the negative consequences of rumination on depressed mood and other symptoms of depression, however, effective treatments for reducing rumination are still missing. Several researchers have postulated that the tendency to ruminate is associated with impairments in cognitive control functions. Specifically, rumination has been demonstrated to be associated with a reduced ability to remove negative material from working memory. It will thus be intriguing to train depressed individuals in removing negative material from working memory and to examine the effects of such training on rumination and mood. To date, few studies have investigated the effects of cognitive control trainings on rumination. Although some results are promising, conclusions have been restricted by important methodological limitations, such as very small sample sizes, use of non-clinical samples, lack of an active control condition, or use of neutral stimuli. Thus, the aim of the present project is to examine whether training to update emotional material in working memory will have an effect on the frequency of using rumination as well as on the impact of rumination on mood in the daily lives of clinically depressed participants. For this purpose, participants will be randomly assigned to 10 sessions of either computerized cognitive control training or an active placebo condition. Daily rumination and mood will be assessed pre- and post-training, as well as at three-month follow-up. Importantly, the present project will use ambulatory assessment to assess the effects of training on rumination and on the dynamics between mood and rumination in a naturalistic setting. Changes in the ability to update emotional material in working memory will be assessed pre- and post-training. Examining the effects of a cognitive control training on rumination will be an important further step for improving our knowledge about the underlying mechanisms of rumination. Together with other studies in this field, this may ultimately contribute to treating one of the most prominent risk factors for depression relapse.