Interplay between stress and rumination in predicting depression: An EMA study

描述(由申请人提供)：重度抑郁障碍(MDD)是最常见的精神障碍，与重大的个人、社会和经济代价有关。不幸的是，对抑郁症的病理生理学缺乏了解，阻碍了许多患者有效治疗的发展。为了解决这些未得到满足的需求，有必要更好地了解抑郁症的发病和维持所涉及的神经认知机制。虽然大量的研究已经检验了特质反省作为抑郁症的认知脆弱性的作用，但相对较少的关注在国家层面上反省如何实时发挥作用。鉴于自我报告特质测量可能成为追溯性回忆偏差的牺牲品，至关重要的是考察沉思，因为它在不同的背景下自然发生，以最好地理解这种认知弱点可能导致抑郁风险的机制。这项建议寻求使用生态瞬时评估(EMA)技术来更好地理解反思性思维在应对应激性生活事件时作为抑郁症状发展的脆弱性所起的作用。据推测，沉思可能会增加对负面生活事件的编码，改善随后对这些信息的回忆，从而导致进一步的抑郁情绪。这项研究的第二个目的是检验在没有近端应激源的情况下，自我聚焦的反思性思维作为抑郁的另一个预测因素。首次发病的MDD通常发生在成年早期，特别是在大学期间，这是一个新的和增加的压力源时期。因此，这项拟议的研究旨在调查在存在和不存在近端生活压力的情况下，国家层面的反省可能如何促进处于抑郁风险年龄的大学生抑郁症状的发展。参与者将在第一天的实验室访问中完成一系列自我报告问卷，包括特质层面的沉思和抑郁症状的测量。在第一天的访问之后，他们将完成一项为期7天的手机EMA部分，在其中他们每天4次(第2-8天)记录他们目前的负面生活事件、沉思和情绪体验。在为期一周的缓冲期以减轻近期影响之后，参与者将返回实验室，完成对所有经历的负面生活事件的附带自由回忆任务，并完成对沉思和抑郁症状的后续测量(第15天)。这项拟议的研究将采用强大的统计检验，以确定抑郁症状与沉思有关的模式，无论是在对压力的直接反应中，还是在没有压力的情况下。从州一级数据得出的结论旨在为更多针对特定认知模式的量身定制的治疗和干预提供信息，这些认知模式可能会增加抑郁症状的发展风险。

DESCRIPTION (provided by applicant): Major depressive disorder (MDD) is the most common mental disorder, associated with major personal, societal, and economic costs. Unfortunately, a poor understanding of the pathophysiology of depression has impeded the development of effective treatments for many patients. To address these unmet needs, a better understanding of the neurocognitive mechanisms implicated in the onset and maintenance of depressive illness is necessary. Although a wealth of research has examined the role of trait rumination as a cognitive vulnerability for depression, comparatively little attention has been given to the ways in which rumination functions in real-time at the state level. Given that self-report trait measures can fall prey to retrospective recall biases, it is crucial to examine rumination as it occurs naturally in varied contexts to best understand the mechanisms through which this cognitive vulnerability may confer risk for depression. This proposal seeks to employ ecological momentary assessment (EMA) techniques to better understand the role of ruminative thought in response to stressful life events as a vulnerability for the development of depressive symptoms. It is hypothesized that rumination may increase encoding of negative life events, improve subsequent recall of this information, and therefore contribute to further depressed affect. A secondary aim of this research is to examine self-focused ruminative thought in the absence of proximal stressors as an additional predictor of depression. First onset of MDD often occurs during early adulthood and especially during college, a period of novel and increased stressors. Therefore, the proposed study aims to investigate the ways in which state-level rumination, both in the presence and absence of proximal life stress, may contribute to the development of depressive symptoms among undergraduates at an age of risk for depression. Participants will complete a battery of self-report questionnaires at the Day 1 lab visit, includin measures of trait-level rumination and depressive symptoms. Following the Day 1 visit, they will complete a 7 day cell phone EMA component in which they record their current experience of negative life events, rumination, and mood 4 times a day (Days 2-8). Following a one week buffer period to lessen recency effects, the participant will return to the lab to complete an incidental free recall task of all negative life events experienced as well as to complete follow-u trait measures of rumination and depressive symptoms (Day 15). The proposed study will employ powerful statistical tests in order to identify patterns in which depressive symptoms develop in relation to rumination, either in direct response to stress or in the absence of proximal stress. Conclusions derived from this state-level data aim to inform more tailored treatments and interventions that target specific cognitive patterns that may confer risk for the development of depressive symptoms.