自动化认知调节策略及其训练对成年早期抑郁的干预：行为与脑的可塑性研究

Clinical depression is not only associated with depressed mood and loss of pleasure, but is also linked with negative thinking and social dysfunction. The clinical diagnosis of major depression has been shown to be most prevalent in young adulthood during lifelong development. To date, the cognitive and neural mechanisms of the young adulthood depression are undetermined, and the current psychotherapy necessitates patients' active cooperation and structured interaction between therapist and patient, thus leading to heavy economic cost and a high rate of drop-out. However, recent studies have shown that semantic priming of adaptive cognitive strategies and cognitive training are able to realize automatic emotion regulation, at little cost of cognitive resources. Thus, it is likely to cope with clinical depression by automatic application of cognitive strategies. Thus, this proposal plans to conduct the following four lines of research by using behavioral, EEG and fMRI approaches. 1, the cognitive and neural mechanism studies of early adulthood depression; 2), the intervention effects and brain plasticity of automatic cognitive strategies on the affective and social consequences of induced, subclinical depression during social rejection; 3), the intervention effects of automatic cognitive strategy training on the cognitive, affective and social profiles of clinical depression and the related brain plasticity; 4), the intervention effects of the combined training of automatic cognitive strategies on the comprehensive features of clinical depression and brain plasticity assessment. By these systematic studies, we target at clarifying the cognitive and neural mechanisms underlying the phenomenon of clinical depression prevalent in young adulthood, and lay methodological and practical basis for the effective and economical intervention of depressive affective disorders.

成年早期是临床抑郁的高发时期。临床抑郁不但伴随着抑郁心境与快乐缺失，也伴随着负面认知与社会功能失调。现有心理疗法以医患双方的结构化互动和长期配合为前提，治疗中断率高，资源经济性不足。近期研究表明通过语义启动及认知训练能实现认知调节策略的自动化使用，使简单有效的，无需费力的干预情绪成为了可能。为了揭示成年早期抑郁的成因并探索简单高效实施干预的方法，本项目拟采用行为、EEG与fMRI技术开展四个方面的研究: 一、成年早期抑郁现象的认知神经机制研究；二、自动化认知调节策略对社会拒绝所导致亚临床抑郁的影响及其认知神经机制；三、自动化认知调节策略的训练对抑郁患者认知、情感与社会功能失调的干预与大脑可塑性研究; 四、自动化认知调节策略的联合训练对临床抑郁核心特征的综合干预及大脑可塑性研究。通过上述系列研究，旨在探明成年早期抑郁的认知神经机理，为经济高效的实施临床抑郁干预提供方法选择与实践指导。

由于抑郁对认知资源的大量消耗，抑郁群体难以通过有意情绪调节实现抑郁症状的改善。基于此，本项目综合行为与调查、电生理与神经成像等技术，探讨无需费力的自动化情绪调节方法对成年早期抑郁的干预并揭示脑的可塑性。项目组以自动化目标启动与执行意图等技术为依托，系统探讨了1), 成年早期抑郁产生的认知机制与神经基础；2），自动化情绪调节方法对健康被试诱发性抑郁的干预及相关的神经可塑性；3），不同类型的自动化情绪调节方法对临床抑郁群体认知、情感与社会功能的干预及脑的可塑性研究。主要取得了如下结果：.1、就成长环境而言，低家庭社会经济地位与不利环境因素导致的社会支持资源的缺乏，进一步导致悲观特质水平的增高是成年早期抑郁产生的重要认知机制；另一方面，在众多习惯性情绪调节方式当中，认知重评能力的不足（认知灵活性下降）伴随着大脑静息状态下默认网络的长时记忆性增强，分别是成年早期抑郁产生的重要情绪调节机制与大脑神经基础；2、我们将自动化目标启动技术与适应性情绪调节方法相结合，揭示了基于执行意图的自动化认知重评调节诱发性抑郁的大脑功能链接机制；探索了基于情境选择的自动化情绪调节方法，揭示了自动化情绪调节起作用的范围及边界，为该方法的临床干预应用奠定了基础；3、通过系列实验揭示了只有无需费力的自动化情绪调节方法能有效干预抑郁群体的抑郁心境和负面认知，揭示了自动化情绪调节方法相比有意情绪调节方法更适合于抑郁群体的情绪调节和症状改善。项目组发表课题相关论文22篇，其中JCR-1区论文与国内权威期刊论文10篇；其中代表性成果最高影响因子10.02，代表性成果被Neurosci. Biobehav. Rev.编委撰写评论文章推荐阅读，被著名医学媒体《Medical Research.com》的专题采访，产生了重要学术影响和社会影响。