Neurobehavioral Mechanisms of Emotion Regulation in Depression across the Adult Lifespan

摘要 在面对压力时，调节情绪反应的能力对于保持情绪健康至关重要。 在使用寿命内累积的不良事件。虽然有些情绪调节能力被认为是 在健康的老年人中保持甚至改善，这种有益的成熟效应被以下因素所调节： 抑郁症和神经认知的个体差异，导致残疾，发病率和损失， 生活质量进入老年。额叶边缘回路功能障碍是年轻人和老年人的标志， 重度抑郁症（MDD），而激活和这些电路的组件之间的连接 预测治疗反应。这种干扰影响核心认知过程，包括认知控制和 注意力偏差，影响情绪调节能力，尽管尚不清楚他们对 抑郁症的影响在成年人的一生中各不相同。此外，MDD患者不太能够利用 帮助老年人科普逆境的补偿性资源，如社会支持，面对年龄- 相关的神经认知能力下降。考虑到美国老年人口的预计增长， 因此，必须制定有效的干预措施， 与晚年抑郁症相关的调节缺陷，并开始确定神经认知预测因子， 增加抑郁症状。研究小组的初步证据表明， 调节策略如重新评价和分散注意力的有效性随年龄和抑郁状态而变化。 然而，迫切需要一种全面、综合的方法来研究情绪调节 使用链接大脑回路完整性、认知功能、社会支持和临床症状的策略， 研究这些关系是如何随着年龄变化的。这项研究的中心假设是， 年龄、诊断状态、神经认知功能和社会支持将不同程度地影响重新评价， 注意力分散效能，以及它们对策略使用的综合影响将预测1年时的抑郁症状 扫描后。这项拟议中的研究有望在成熟的变化如何有助于 有意识地减少抑郁成年人的负面影响。共200名成年人按年龄分层 从35岁到75岁，有和没有MDD将接受结构和基于任务的功能神经成像。我们 将测试两种不同情绪调节策略在成功方面的年龄和诊断特异性差异， 减少实验诱导的负面影响，识别与成功使用 使用结构和功能磁共振成像进行重新评估和分散注意力，并测试情绪 调节作为未来抑郁症症状严重程度的预测因子。结果将用于更好地针对情绪 根据患者的年龄和诊断状态进行调节干预。

ABSTRACT The ability to regulate one’s emotional responses is critical for maintaining emotional health in the face of adverse events that cumulate over the lifespan. Although some emotion regulation abilities are thought to be maintained or even improve in healthy older adults, such beneficial maturation effects are moderated by individual differences in depression and neurocognition that contribute to disability, morbidity, and loss of quality of life into old age. Frontolimbic circuit dysfunction is a hallmark of both younger and older adults with major depressive disorder (MDD), while both activation in and connectivity among components of these circuits predicts treatment response. Such disruptions impact core cognitive processes, including cognitive control and attentional biasing, that influence emotion regulation ability, although it is unknown how their susceptibility to depressive influences varies across the adult lifespan. Moreover, MDD patients are less able to utilize compensatory resources that help older adults cope with adversity, such as social support, in the face of age- associated neurocognitive decline. Given the projected growth of the elderly population in the U.S. and the associated burden on the public health system, it is imperative to develop effective interventions to target regulatory deficits associated with depression in late life and to begin to identify neurocognitive predictors of increasing depressive symptoms. Preliminary evidence from the study team demonstrates that the effectiveness of regulatory strategies such as reappraisal and distraction vary with age and depressive status. However, there is a pressing need for a comprehensive, integrative approach to study emotion regulation strategy use that links brain circuitry integrity, cognitive function, social support, and clinical symptoms, and investigates how these relationships change with age. The central hypothesis of the proposed study is that age, diagnostic status, neurocognitive functioning, and social support will differentially impact reappraisal and distraction efficacy, and that their combined effect on strategy use will predict depressive symptoms at 1 year post-scan. The proposed study is expected to yield new insights in how maturational changes contribute to the conscious ability to reduce negative affect in depressed adults. A total of 200 adults in stratified age groups from 35 to 75 years with and without MDD will undergo structural and task-based functional neuroimaging. We will test age- and diagnosis-specific differences in the success of two different emotion regulation strategies in reducing experimentally induced negative affect, identify brain regions associated with successful use of reappraisal and distraction using structural and functional magnetic resonance imaging, and test emotion regulation as a predictor of future depression symptom severity. Results will be used to better target emotion regulation interventions based on a patient’s age and diagnostic status.