Early Chronic Stress and Development of Depression: Mechanisms of Risk

描述（由申请人提供）：慢性应激性生活事件的经历是抑郁症发展的最受支持的风险因素之一;然而，对早期慢性应激和抑郁症之间的认知和生理机制知之甚少。先前的研究表明，长期处于压力下的青少年对悲伤的刺激表现出高度的注意力（即，有偏见的注意力），而在一个悲伤的情绪，可能会加强情绪的经验，并提高生理反应急性应激。抑郁症领域的研究表明，抑郁症患者对悲伤刺激也表现出高度的注意力，并经常对负面刺激进行持续性注意或沉思。此外，这些人表现出从急性应激源的生理恢复受损。到目前为止，这些多个研究领域之间的整合是缺乏的。目前尚不清楚一个人如何从情绪相关的偏见注意力和压力反应发展到长期的，强烈的抑郁情绪体验。同样未被探索的是，高度或持续的注意力是否有助于生理唤醒和随后的生理反应和恢复。 拟议的研究是一组新的研究，探索早期慢性压力的认知和生理后果，可能会导致抑郁症的风险，并测试这些领域之间相互作用的确切性质。具体而言，本研究的目的是：1）确定慢性应激青少年在悲伤情绪中对悲伤刺激是否表现出即时和长期的注意偏向，长期的注意偏向是否与反刍有关，以及注意偏向是否与增强的生理唤醒有关，2）测试信息处理异常是否因果地影响生理反应和恢复过程，以及3）是否长期处于压力中的青少年表现出即时和长期的注意力偏见，前瞻性地增加了患抑郁症的风险。我们将使用一个注意任务与任务无关的情绪面孔刺激和测量差异的反应时间的长期紧张和控制青少年不同的情绪刺激作为衡量偏见的注意。我们将使用血压监测仪和皮质醇测量来评估生理反应和恢复。 公共卫生相关性：抑郁症是世界范围内残疾的主要原因，大约20%的人口将在一生中的某个时候经历抑郁发作。风险因素和风险机制的隔离为制定有效的早期干预措施奠定了基础，这些干预措施可以在个人发展抑郁症之前实施，以有效减轻疾病的个人，经济和社会负担。

DESCRIPTION (provided by applicant): Experience of a chronic stressful life event is one of the most supported risk factors for development of depression; however, little is known about the cognitive and physiological mechanisms linking early chronic stress and depression. Previous research has shown that chronically stressed adolescents show heightened attention to sad stimuli (i.e., biased attention) while in a sad mood that may intensify the mood experience, and heightened physiological reactivity to acute stressors. Work in field of depression suggests that depressed individuals also show heightened attention to sad stimuli, and frequently engage in perseverative attention to negative stimuli, or rumination. Additionally, these individuals show impaired physiological recovery from acute stressors. To date, integration among these multiple domains of research is lacking. It remains unclear how an individual progresses from mood-related biased attention and stress reactivity to the prolonged, intense mood experience of depression. Also unexplored is whether heightened or perseverative attention contribute to physiological arousal and subsequent physiological reactivity and recovery. The proposed research is a novel set of studies exploring the cognitive and physiological consequences of early chronic stress that may confer risk for depression, and testing the precise nature of the interaction between these domains. Specifically, the aims of the research are 1) to determine if chronically stressed adolescents show immediate and prolonged attention biases to sad stimuli in a sad mood, whether prolonged attention bias is related to rumination, and whether attention biases are related to heightened physiological arousal, 2) to test whether information processing anomalies causally influence physiological reactivity and recovery processes, and 3) whether chronically stressed adolescents who show immediate and prolonged attention biases are at heightened risk for depression prospectively. We will use an attention task with task- irrelevant emotional face stimuli and measure differential reaction times of chronically stressed and control adolescents for different emotional stimuli as a measure of biased attention. We will use blood pressure monitors and cortisol measurements to assess physiological reactivity and recovery. PUBLIC HEALTH RELEVANCE: Depressive disorders are the leading cause of disability worldwide, and approximately 20% of the population will experience a depressive episode at some point in their life. Isolation of risk factors and mechanisms of risk lays the groundwork for development of effective early interventions that can be implemented before an individual develops depression, to effectively reduce the personal, economic, and social burden of the illness.