Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany.
Department of Biostatistics, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany.
Behav Res Ther. 2023 Sep;168:104383. doi: 10.1016/j.brat.2023.104383. Epub 2023 Aug 2.
In Major Depressive Disorder, first evidence shows heightened mood-reactivity toward daily events. Related longitudinal studies in remitted patients with recurrent major depression are lacking. Long-term changes in such short-term within-person associations can be analysed via measurement burst designs. Two bursts, separated by approximately 4.4 years, consisted of a baseline session and an Ambulatory Assessment (burst-1: 3 days, burst-2: 5 days). Via smartphone, 54 initially remitted patients with recurrent major depression indicated their negative and positive affect, rumination, self-acceptance, and the occurrence of negative and positive daily events ten times and collected saliva cortisol samples five times per day. In bursts with higher depression levels, patients showed blunted negative affect- and cortisol-reactivity and stronger decreases in positive affect and self-acceptance toward negative daily events, as well as stronger increases in self-acceptance following positive daily events. However, patients with higher depression levels demonstrated stronger ruminative stress-reactivity within bursts. Furthermore, patients with higher depression levels showed an increase of affective stress-reactivity over bursts, such that negative affect more strongly increased and positive affect more strongly decreased following negative daily events over bursts. Following positive daily events, patients with higher depression levels showed stronger decreases in negative affect within bursts and a decrease of self-acceptance-reactivity over bursts. To conclude, measurement burst designs enable to examine intraindividual variability and change of micro-level processes, and possible moderators thereof, potentially providing prognostic information for the course of recurrent major depression.
在重度抑郁症中，首先有证据表明患者对日常事件的情绪反应更为强烈。但缺乏针对复发性重度抑郁症缓解期患者的相关纵向研究。可以通过测量爆发设计来分析这种短期个体内关联的长期变化。两个爆发期之间相隔约 4.4 年，包括基线期和动态评估期（爆发期 1：持续 3 天，爆发期 2：持续 5 天）。通过智能手机，54 名最初缓解但有反复发作的重度抑郁症患者每天 10 次记录他们的消极和积极情绪、反刍、自我接纳以及消极和积极日常事件的发生情况，并采集 5 次唾液皮质醇样本。在抑郁水平较高的爆发期中，患者对消极情绪和皮质醇的反应较为迟钝，对消极日常事件的积极情绪和自我接纳的下降幅度更大，对积极日常事件的自我接纳的增强幅度也更大。然而，在爆发期中，抑郁水平较高的患者表现出更强的反刍压力反应性。此外，抑郁水平较高的患者在爆发期内表现出更强的情感压力反应性，即负性日常事件后消极情绪更强地增加，正性日常事件后积极情绪更强地减少。而对于积极的日常事件，抑郁水平较高的患者在爆发期内的消极情绪下降幅度更大，且在爆发期内自我接纳反应性降低。总之，测量爆发设计能够检验个体内的可变性和微观过程的变化，以及其可能的调节因素，为复发性重度抑郁症的病程提供预后信息。
