奖赏反应性降低与抑郁易感性:考虑社会环境和干预的影响。

Psychophysiology Pub Date : 2024-06-01 Epub Date: 2024-01-23 DOI:10.1111/psyp.14528
Autumn Kujawa
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引用次数: 0

摘要

抑郁症是一种普遍、异质性和使人衰弱的疾病,通常在青少年时期出现,因此有必要更好地了解抑郁症的易感性过程,以提供更有针对性的干预措施。心理生理学方法,如事件相关电位(ERPs),可以为了解抑郁症脆弱性的认知和情感过程提供独特的见解。我将回顾自己和其他人对青少年抑郁症奖赏反应性的ERP测量方法的研究,并提出一个关于低奖赏反应性的发展、其在抑郁症易感性中的作用以及针对性干预的潜在窗口的概念模型。有证据表明,在有抑郁风险的儿童身上可以观察到奖赏积极性(RewP)减弱的现象,这种现象似乎部分是由早期社会经历形成的,并与其他风险因素(如压力暴露)相结合,预示着日后抑郁症状的出现。此外,在计算机化的同伴互动任务中,对社会接纳反馈的反应会可靠地激发出与 RewP 一致的成分,并显示出与社会环境因素和抑郁症状的独特关联,这支持了开发心理生理学任务的实用性,该任务可以更好地捕捉青少年的真实世界经历和社会风险过程。此外,我还探讨了临床心理生理学研究的转化意义,并介绍了一系列研究,这些研究表明,RewP 的降低预示着抑郁症状在治疗后会有更大程度的缓解,但目前的治疗方法(如认知行为疗法)却无法改变这一现象。最后,我介绍了我们根据RewP文献,为抑郁母亲的后代开发以积极情绪为重点的干预措施的初步工作,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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Reduced reward responsiveness and depression vulnerability: Consideration of social contexts and implications for intervention.

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.

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