Modeling Hedonic Processing and Anhedonia in Depression

描述（由申请人提供）：快感缺乏，或缺乏积极情绪，是抑郁症的一个重要组成部分，在诊断标准中以各种方式表现出来。所有形式的抑郁症都可能涉及对活动缺乏兴趣或乐趣，特别是当抑郁症患者与健康对照组相比时。忧郁性抑郁症特别需要额外的赤字，在情绪反应愉快的事件，与非典型抑郁症，其中情绪反应愉快的事件是存在的。与NIMH的战略目标1一致，本申请旨在以理论上连贯的方式评估快感缺乏，并解决抑郁症中的愿望，喜好和学习缺陷，旨在评估抑郁症中快感缺乏处理的各种任务。在每项任务中，将评估在愉快与中性条件下的眼动反射和神经肌电图幅度，作为积极情绪处理的指标。惊吓眨眼和皱眉肌肌电图的幅度将进行评估，以检查是否抑郁症患者也在他们的负性情绪水平不同，表明抑郁症的情绪背景不敏感。此外，在每个任务中将采用积极情绪的多种行为测量，以提供跨测量领域的快感缺乏综合评估。该项目还将证明抑郁性快感缺失的哪些成分和措施对临床干预有反应，哪些仍然受损，这表明它们可能作为抑郁症的内在表型。我们将招募健康对照组和抑郁症、非典型抑郁症或非亚型抑郁症患者。在完成心理诊断访谈和自我报告的特质和状态水平的享乐加工，参与者将完成三个平衡的任务。在一项任务中，他们将观看情绪图片并聆听情绪声音，沿着与每个刺激效价相关的线索，以提供对情绪反应的实验评估。他们的评级和身体对线索，图片和声音的反应将被记录下来，以评估他们喜欢实际刺激和想要这些刺激的程度（通过他们对线索的反应来衡量）。另外两项任务评估对愉快活动缺乏乐趣（喜欢）或兴趣（想要）。一个是衡量基于努力的工作的奖励，是对参与者在奖励活动中的享受（喜欢）和兴趣（想要）的实验性评估。另一个测试的是参与者在一项食欲评价性条件反射任务中学习愉快联想的能力，在这项任务中，中性词与高度愉快或中性的图片配对。我们将邀请相同的参与者在他们的第一次会议后三个月回到我们的实验室，以检查哪些快感缺失的过程和措施对临床改善（特别是在快感缺失症状中）有反应，以及哪些在缓解的抑郁参与者中仍然受损。后者是抑郁症内在表型的候选者，可用于识别有抑郁症风险的人，并在他们成为急性抑郁症之前进行主动干预。 公共卫生相关性：该项目将使用多种工具来衡量不同类型抑郁症的需求，喜好和学习。它将帮助我们理解抑郁症患者在体验积极情绪时遇到的各种问题。它还将显示，随着抑郁症患者病情好转，哪种积极情绪会增加，哪种保持较低。

DESCRIPTION (provided by applicant): Anhedonia, or the lack of positive emotion, is a critical component of depression that is represented in various ways in diagnostic criteria. All forms of depression may involve a lack of interest or pleasure in activities, particularly when depressed patients are contrasted against healthy controls. Melancholic depression specifically entails additional deficits in mood reactivity to pleasant events, in contrast to atypical depression, in which mood reactivity to pleasant events is present. Consistent with NIMH's Strategic Objective 1, this application seeks to assess anhedonia in a theoretically coherent way and address deficits in wanting, liking, and learning in depression, with tasks designed to assess the varieties of anhedonic processing in depression. In each task, postauricular reflex and zygomatic EMG magnitudes during pleasant vs. neutral conditions will be assessed as measures of positive emotional processing. Startle blink and corrugator EMG magnitudes will be assessed to examine whether depressed patients also differ in their levels of negative emotion, indicating an emotion context insensitivity in depression. Furthermore, multiple behavioral measures of positive emotion will be taken in each task to provide a comprehensive assessment of anhedonia across measurement domains. This project will also demonstrate which components and measures of depressive anhedonia are responsive to clinical intervention and which remain impaired, suggesting they may serve as endophenotypes for depression. We will recruit healthy controls and patients with melancholic, atypical, or non-subtyped depression. After completing psychodiagnostic interviews and self-reports of trait and state levels of hedonic processing, participants will complete three counterbalanced tasks. In one task, they will view emotional pictures and listen to emotional sounds, along with cues associated with each stimulus valence, to provide an experimental assessment of mood reactivity. Their ratings and bodies' reactions to the cues, pictures, and sounds will be recorded to assess their levels of liking the actual stimuli and wanting those stimuli (as measured by their reactions to the cues). Two additional tasks assess lack of pleasure (liking) or interest (wanting) in pleasant activities. One measures effort-based work for rewards and is an experimental assessment of participants' enjoyment (liking) and interest (wanting) during a rewarding activity. The other measures participants' ability to learn pleasant associations in an appetitive evaluative conditioning task, in which neutral words are paired with highly pleasant or neutral pictures. We will invite the same participants back to our laboratory three months after their initial session to examine which processes and measures of anhedonia are responsive to clinical improvement (particularly in anhedonic symptoms) and which remain impaired in remitted depressed participants. The latter make candidates for endophenotypes of depression, which can be used to identify people at risk for depression and intervene proactively before they become acutely depressed. PUBLIC HEALTH RELEVANCE: This project will use multiple tools to measure wanting, liking, and learning in different types of depression. It will help us understand the various kinds of problems that people with depression have in experiencing positive emotions. It will also show which kinds of positive emotions increase and which kinds stay low as people with depression get better.