Major Depressive Disorder (MDD) is one of the most common psychiatric illnesses, and is associated with substantial personal and societal costs. Difficulty removing negative information from working memory is a core cognitive feature of MDD. A growing body of research indicates that this cognitive difficulty is associated with the persistence of depressive symptoms and, in the face of negative events, with the tendency to repetitively ruminate about the negative aspects of such events. Rumination, in turn, is associated with impaired recovery from stress, both emotionally and biologically, which further contributes to symptom persistence. To date, research linking difficulty removing negative information from working memory with rumination, symptom persistence, and stress recovery has been limited by the use of correlational methodologies. Therefore, a major aim of the proposed study is to use established Cognitive Bias Modification methods to experimentally manipulate individuals' ability to remove negative information (RNI) from working memory. We propose to test the effects of RNI training on cognition, levels of rumination and depression, and emotional and biological recovery from stress. To achieve these aims, participants diagnosed with MDD will complete a laboratory- based pre-training session (Session 1), six at-home training sessions, and a second laboratory-based post- training session (Session 2). In Session 1, participants will complete a structured clinical interview, self-report measures of baseline rumination and depressive symptoms, and two computer-based cognitive tasks - one of which explicitly assesses their ability to remove negative information from working memory. Participants then will be randomly assigned to either Real RNI training or to a Sham RNI training condition. They will be taught how to perform the training tasks and will be provided with a laptop on which they will complete the training at home daily for the next six days. On the seventh day, participants will return to the laboratory for the post- training Session 2, during which they will complete the self-report measures and computer-based cognitive tasks that they completed in Session 1. In addition, participants will be exposed to a psychosocial stressor, during which we will measure stress-induced state rumination and assess psychological and biological recovery from the stressor. Compared to Sham RNI training, we expect that Real RNI training will a) increase participants' ability to remove negative information from working memory; b) decrease levels of depressive and ruminative symptoms from baseline; and c) decrease levels of stress-induced rumination, which we posit will, in turn, improve subsequent emotional and biological stress recovery. The results of this study will not only increase our understanding of the relations among cognition, rumination, and stress recovery, but will also provide insight into a novel and innovative treatment approach that has the potential to decrease rumination and improve psychological and biological responses to stress in MDD. Thus, we anticipate that the current study will contribute to both cognitive models of depression and clinical intervention efforts.

Public Health Relevance

Major Depressive Disorder (MDD) is associated with enormous personal and societal costs; it is the leading cause of disability worldwide, and is a significant risk factor for substance abuse, physical health problems, and other emotional disorders. In the proposed study we will examine the clinical and biological effects of training depressed individuals to remove negative information from working memory. Findings from the proposed study will increase our understanding of cognitive and biological mechanisms underlying MDD and will offer a novel and innovative treatment approach for this debilitating disorder.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Postdoctoral Individual National Research Service Award (F32)
Project #
5F32MH102013-03
Application #
8899367
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Chavez, Mark
Project Start
2013-09-01
Project End
2016-08-31
Budget Start
2015-09-01
Budget End
2016-08-31
Support Year
3
Fiscal Year
2015
Total Cost
Indirect Cost
Name
Stanford University
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94304
LeMoult, Joelle; Colich, Natalie; Joormann, Jutta et al. (2018) Interpretation Bias Training in Depressed Adolescents: Near- and Far-Transfer Effects. J Abnorm Child Psychol 46:159-167
King, Lucy S; Colich, Natalie L; LeMoult, Joelle et al. (2017) The impact of the severity of early life stress on diurnal cortisol: The role of puberty. Psychoneuroendocrinology 77:68-74
Kircanski, Katharina; LeMoult, Joelle; Ordaz, Sarah et al. (2017) Investigating the nature of co-occurring depression and anxiety: Comparing diagnostic and dimensional research approaches. J Affect Disord 216:123-135
Ordaz, Sarah J; LeMoult, Joelle; Colich, Natalie L et al. (2017) Ruminative brooding is associated with salience network coherence in early pubertal youth. Soc Cogn Affect Neurosci 12:298-310
LeMoult, Joelle; Kircanski, Katharina; Prasad, Gautam et al. (2017) Negative Self-Referential Processing Predicts the Recurrence of Major Depressive Episodes. Clin Psychol Sci 5:174-181
Foland-Ross, Lara C; Behzadian, Negin; LeMoult, Joelle et al. (2016) Concordant Patterns of Brain Structure in Mothers with Recurrent Depression and Their Never-Depressed Daughters. Dev Neurosci 38:115-23
LeMoult, Joelle; Joormann, Jutta; Kircanski, Katharina et al. (2016) Attentional bias training in girls at risk for depression. J Child Psychol Psychiatry 57:1326-1333
LeMoult, Joelle; Chen, Michael C; Foland-Ross, Lara C et al. (2015) Concordance of mother-daughter diurnal cortisol production: Understanding the intergenerational transmission of risk for depression. Biol Psychol 108:98-104
LeMoult, Joelle; Colich, Natalie L; Sherdell, Lindsey et al. (2015) Influence of menarche on the relation between diurnal cortisol production and ventral striatum activity during reward anticipation. Soc Cogn Affect Neurosci 10:1244-50
LeMoult, Joelle; Ordaz, Sarah J; Kircanski, Katharina et al. (2015) Predicting first onset of depression in young girls: Interaction of diurnal cortisol and negative life events. J Abnorm Psychol 124:850-9