Stress Depression and Anxiety - An Integrative Psychobiological Investigation

描述（由申请人提供）：情绪障碍和焦虑症是美国最常见的两种精神障碍，影响了相当数量的个体。特别是，重度抑郁症（MDD）和广泛性焦虑症（GAD）给个人和社会带来了巨大的代价；此外，重度抑郁症和广泛性焦虑症是高度共病的。然而，令人惊讶的是，我们对这些疾病的独特和共同的心理生物学基础以及其合并症的机制知之甚少。越来越多的研究表明，压力和痛苦的结构，以及觉醒和调节，与我们对重度抑郁症和广泛性焦虑症的理解密切相关。然而，这是第一次在单一研究中对纯重度抑郁症和广泛性焦虑症患者的这些结构进行研究。具体目标包括：(1)使用标准化的实验室压力范式研究诊断为共发和非共发MDD和GAD的个体的应激反应和调节；(2)检查这些人日常生活中的压力过程；(3)比较基于实验室的评估与经验抽样评估对这些群体内部和群体之间的压力、反应性和调节的影响。为了实现这些目标，所有参与者都将经历一个基线会议，包括症状严重程度、压力源、影响和影响调节的自我报告，随后是一个平衡的实验实验室会议和一个为期一周的自然体验抽样协议。在实验过程中，参与者的神经内分泌、自主神经和主观反应将被测量，因为他们接受了一个标准化的压力源任务，该任务用于抑郁和焦虑的独立文献。在经验抽样期间，参与者的日常皮质醇、压力源报告、消极和积极影响、反思和担忧将在他们的日常生活中进行测量。将进行一套先进的、复杂的统计分析，以检验理论驱动的假设，这些假设涉及这些措施的平均水平和时间方差的组差异，同时，在每个组内的个体中，这些结构之间的关键关联。额外的分析将检查压力、反应性和调节措施，考虑到它们与抑郁和焦虑症状的维度关系。该研究项目将为申请人提供新领域知识和新方法的培训，包括抑郁-焦虑相互作用的心理生物学，神经内分泌和经验采样数据的收集和解释，内分泌和自主数据的整合，以及层次线性建模技术。本研究以一种新颖和综合的方式解决了围绕MDD和GAD的问题和问题，这些发现将有助于阐明压力和反应性的本质，以及与这些情绪障碍相关的反应性和调节的困难。

DESCRIPTION (provided by applicant): Mood and anxiety disorders are the two most prevalent classes of mental disorder in the United States, affecting a significant number of individuals. In particular, Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) confer significant personal and societal costs; moreover, MDD and GAD are highly comorbid. Yet, we know surprisingly little about the unique and shared psychobiological underpinnings of these disorders and the mechanisms underlying their comorbidity. A growing body of research reveals that the constructs of stress and distress, and of arousal and regulation, are germane to our understanding of MDD and GAD. This is the first research, however, to examine these constructs in individuals with pure and co-occurring MDD and GAD within a single study. Specific objectives include: (1) investigating stress reactivity and regulation in individuals diagnosed with co-occurring and non-co-occurring MDD and GAD using a standardized laboratory stress paradigm; (2) examining stress processes in daily life in these same individuals; and (3) comparing laboratory-based assessment with experience sampling assessment of stress, reactivity, and regulation within and across these groups. To achieve these aims, all participants will undergo a baseline session that includes self-reports of symptom severity, stressors, affect, and affect regulation, followed by a counterbalanced experimental laboratory session and a one-week naturalistic experience sampling protocol. During the laboratory session, participants' neuroendocrine, autonomic, and subjective responses will be measured as they undergo a standardized stressor task used in the independent literatures on depression and anxiety. During the experience sampling period, participants' diurnal cortisol, reports of stressors, negative and positive affect, rumination, and worry will be measured in the context of their daily lives. An advanced, sophisticated set of statistical analyses will be conducted to test theoretically-driven hypotheses regarding group differences in mean levels and temporal variance on these measures, and simultaneously, key associations among these constructs in individuals within each group. Additional analyses will examine the stress, reactivity, and regulation measures with regard to their dimensional relations to depression and anxiety symptomatology. This research program will provide the applicant with training in new areas of knowledge and new methodologies, including the psychobiology of depression-anxiety interactions, the collection and interpretation of neuroendocrine and experience sampling data, the integration of endocrine and autonomic data, and hierarchical linear modeling techniques. This study addresses questions and issues surrounding MDD and GAD in a novel and integrated manner, and these findings will help to elucidate the nature of stress and reactivity, and the difficulties in reactivity and regulation associated with these emotional disorders.