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奖赏反应性降低与抑郁易感性:社会情境的考虑及干预意义。

Reduced reward responsiveness and depression vulnerability: Consideration of social contexts and implications for intervention.

机构信息

Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA.

出版信息

Psychophysiology. 2024 Jun;61(6):e14528. doi: 10.1111/psyp.14528. Epub 2024 Jan 23.

Abstract

Depression is a prevalent, heterogeneous, and debilitating disorder that often emerges in adolescence, and there is a need to better understand vulnerability processes to inform more targeted intervention efforts. Psychophysiological methods, like event-related potentials (ERPs), can offer unique insights into the cognitive and emotional processes underlying depression vulnerability. I review my and others' research examining ERP measures of reward responsiveness in youth depression and present a conceptual model of the development of low reward responsiveness, its role in depression vulnerability, and potential windows for targeted intervention. There is evidence that a blunted reward positivity (RewP) is observable in children at risk for depression, appears to be shaped in part by early social experiences, and predicts later depressive symptoms in combination with other risk factors like stress exposure. Further, a component consistent with RewP is reliably elicited in response to social acceptance feedback in computerized peer interaction tasks and demonstrates unique associations with social contextual factors and depressive symptoms, supporting the utility of developing psychophysiological tasks that may better capture youths' real-world experiences and social risk processes. In addition, I address the translational implications of clinical psychophysiological research and describe a series of studies showing that a reduced RewP predicts greater reductions in depressive symptoms with treatment but is not modifiable by current treatments like cognitive behavioral therapy. Finally, I describe our preliminary efforts to develop a positive emotion-focused intervention for the offspring of depressed mothers, informed by the RewP literature, and describe future directions for translating psychophysiological research to intervention and prevention.

摘要

抑郁症是一种普遍存在、异质且使人衰弱的障碍,通常在青少年时期出现,因此需要更好地了解易感性过程,以便为更有针对性的干预措施提供信息。心理生理学方法,如事件相关电位 (ERPs),可以为抑郁症易感性背后的认知和情绪过程提供独特的见解。我回顾了我和其他人研究检查青少年抑郁症中奖励反应的 ERP 测量,并提出了一个关于低奖励反应能力的发展的概念模型,及其在抑郁症易感性中的作用,以及潜在的干预目标窗口。有证据表明,在有抑郁风险的儿童中可以观察到奖励正波(RewP)减弱,它似乎部分是由早期的社会经验塑造的,并与其他风险因素(如压力暴露)一起预测后来的抑郁症状。此外,在计算机化的同伴互动任务中,对社会接纳反馈可靠地引出了与 RewP 一致的成分,并且与社会背景因素和抑郁症状有独特的关联,支持开发可能更好地捕捉青少年真实世界体验和社会风险过程的心理生理学任务的实用性。此外,我还讨论了临床心理生理学研究的转化意义,并描述了一系列研究,表明降低的 RewP 可以预测治疗后抑郁症状的更大减轻,但不能通过当前的治疗方法(如认知行为疗法)来改变。最后,我描述了我们根据 RewP 文献为抑郁母亲的子女开发积极情绪为重点的干预措施的初步努力,并描述了将心理生理学研究转化为干预和预防的未来方向。

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本文引用的文献

1
The effects of stress on reward responsiveness: a systematic review and preliminary meta-analysis of the event-related potential literature.
Cogn Affect Behav Neurosci. 2024 Feb;24(1):42-59. doi: 10.3758/s13415-023-01143-y. Epub 2023 Dec 13.
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6
Associations between parental conflict and social and monetary reward responsiveness in adolescents with clinical depression.
Res Child Adolesc Psychopathol. 2023 Jan;51(1):119-131. doi: 10.1007/s10802-022-00949-7. Epub 2022 Jul 19.
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Methods and metrics for EEG/ERP assessment of emotion and cognition in young children.
Dev Psychobiol. 2022 Sep;64(6):e22284. doi: 10.1002/dev.22284.
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Neural markers of emotion regulation difficulties moderate effects of COVID-19 stressors on adolescent depression.
Depress Anxiety. 2022 Jun;39(6):515-523. doi: 10.1002/da.23268. Epub 2022 May 23.

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