Interpretation Bias Training in Depressed Adolescents: Effects and Mechanisms

描述（由申请人提供）：青春期是重度抑郁症（MDD）发病的高风险时期；事实上，青春期MDD的发病与更长的、更严重的抑郁发作有关，而这些抑郁发作往往难以治疗。因此，我们必须确定早发性重度抑郁症的相关因素，并开发更有效的早期干预方法。在试图阐明导致重度抑郁症发病和维持的因素时，研究人员将注意力集中在消极偏见的信息处理上。抑郁症中最一致的认知偏差包括对情感模糊信息的更多消极和更少积极的解释。重要的是，研究人员已经表明，这些解释偏差不仅可以修改，而且进一步表明，解释偏差训练（IBT）可以改善情绪调节并减少抑郁症状。然而，尽管有这些发现，我们对IBT这些积极作用的机制知之甚少。为了更全面地了解重度抑郁症中的偏见认知功能，研究人员已经开始研究这种疾病中偏见的神经方面。在此背景下，研究人员已经记录了抑郁症成年人亚属和背前扣带（ACC）、背前额叶皮层（PFC）和杏仁核的功能、连通性和/或结构异常，这些都是情绪调节网络的组成部分。到目前为止，很少有研究检查抑郁儿童和青少年认知偏差的神经基础，或者改变这些偏见对抑郁青少年的影响。该项目的总体目标是：(1)评估旨在减少抑郁青少年负面解释偏见的训练的认知、神经和临床效果；(2)研究介导IBT积极临床效应的神经和认知变化。这个项目的结果将增加我们对青少年抑郁症解释偏差的神经过程的理解，并有助于开发更有效的青少年重度抑郁症干预措施。

DESCRIPTION (provided by applicant): Adolescence is a period of high risk for the onset of Major Depressive Disorder (MDD); indeed, adolescent onset of MDD is associated with longer and more severe depressive episodes that are often refractory to treatment. Thus, it is imperative that we identify factors involved in early-onset MDD and develop more effective approaches to early intervention. In attempting to elucidate factors that contribute to the onset and maintenance of MDD, investigators have focused on negatively biased processing of information. The most consistent cognitive bias in depression involves more negative and less positive interpretations of emotionally ambiguous information. Importantly, investigators have shown not only that these biases in interpretation can be modified, but further, that Interpretatio Bias Training (IBT) improves emotion regulation and reduces depressive symptoms. Despite these findings, however, we know little about the mechanisms that underlie these positive effects of IBT. In an effort to gain a more comprehensive understanding of biased cognitive functioning in MDD, researchers have begun to examine neural aspects of biases in this disorder. In this context, investigators have documented abnormalities in function, connectivity, and/or structure in depressed adults in subgenual and dorsal anterior cingulate (ACC), dorsal prefrontal cortex (PFC), and amygdala, all components of emotion regulatory networks. To date, there is little research examining the neural foundations of cognitive biases in depressed children and adolescents or the effects of modifying these biases in depressed youth. The overarching goals of the proposed project are (1) to assess the cognitive, neural, and clinical effects of training designed to reduce negative interpretation biases in depressed adolescents; and (2) to examine neural and cognitive changes that mediate the positive clinical effects of IBT. Results of this project will increase our understanding of neural processes that underlie interpretation biases in depressed adolescents and contribute to the development of more effective interventions for MDD in adolescence.