School of Experimental Psychology, University of Bristol, Bristol, UK.
National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK.
Psychol Med. 2021 May;51(7):1211-1219. doi: 10.1017/S0033291719004124. Epub 2020 Feb 17.
There is demand for new, effective and scalable treatments for depression, and development of new forms of cognitive bias modification (CBM) of negative emotional processing biases has been suggested as possible interventions to meet this need.
We report two double blind RCTs, in which volunteers with high levels of depressive symptoms (Beck Depression Inventory ii (BDI-ii) > 14) completed a brief course of emotion recognition training (a novel form of CBM using faces) or sham training. In Study 1 (N = 36), participants completed a post-training emotion recognition task whilst undergoing functional magnetic resonance imaging to investigate neural correlates of CBM. In Study 2 (N = 190), measures of mood were assessed post-training, and at 2-week and 6-week follow-up.
In both studies, CBM resulted in an initial change in emotion recognition bias, which (in Study 2) persisted for 6 weeks after the end of training. In Study 1, CBM resulted in increases neural activation to happy faces, with this effect driven by an increase in neural activity in the medial prefrontal cortex and bilateral amygdala. In Study 2, CBM did not lead to a reduction in depressive symptoms on the BDI-ii, or on related measures of mood, motivation and persistence, or depressive interpretation bias at either 2 or 6-week follow-ups.
CBM of emotion recognition has effects on neural activity that are similar in some respects to those induced by Selective Serotonin Reuptake Inhibitors (SSRI) administration (Study 1), but we find no evidence that this had any later effect on self-reported mood in an analogue sample of non-clinical volunteers with low mood (Study 2).
目前需要新的、有效的、可扩展的治疗抑郁症的方法,而开发新形式的认知偏差修正(CBM)来修正负面情绪处理偏差已被认为是满足这一需求的可能干预措施。
我们报告了两项双盲 RCT 研究,其中高抑郁症状水平的志愿者(贝克抑郁量表二项式(BDI-ii)>14)完成了一项简短的情绪识别训练(一种使用面孔的新型 CBM 形式)或假训练。在研究 1(N=36)中,参与者在进行功能磁共振成像(fMRI)以研究 CBM 的神经相关性时,完成了一项训练后情绪识别任务。在研究 2(N=190)中,在训练后、2 周和 6 周随访时评估了情绪测量结果。
在两项研究中,CBM 导致了情绪识别偏差的初始变化,而这种变化(在研究 2 中)在训练结束后持续了 6 周。在研究 1 中,CBM 导致了对快乐面孔的神经激活增加,这种效应是由内侧前额叶皮层和双侧杏仁核的神经活动增加驱动的。在研究 2 中,CBM 并没有导致 BDI-ii 上的抑郁症状减少,也没有导致 2 周或 6 周随访时的情绪、动机和坚持相关测量或抑郁解释偏差减少。
情绪识别的 CBM 在某些方面对神经活动的影响与选择性 5-羟色胺再摄取抑制剂(SSRI)给药(研究 1)相似,但我们没有发现任何证据表明,在情绪低落的非临床志愿者模拟样本中,这种方法在 2 周或 6 周随访时对自我报告的情绪有任何后续影响(研究 2)。