Is ?the idle mind the devil?s playground?? It depends on where the wandering mind goes. If it is busy reflecting on recent activity, consolidating recent material into long term memories, and envisioning the future, then these thought patterns may be highly adaptive, allowing us to learn from the past and plan for the future. But when the mind turns to the dark side and rumination takes over, these thought patterns are maladaptive. Rumination involves recursive negative thinking focused on causes and consequences rather than solutions. It cuts across diagnostic boundaries: it is both a cause and consequence of major depressive disorder (MDD) and is related to hallucinations and delusions in schizophrenia (SZ). It affects cognitive and emotional responses, yet it can be treated with mindfulness-based therapies. Mindfulness-meditation is a type of behavioral therapy that focuses on cultivating present focused attention, is a stress-reduction intervention that targets rumination, and improves many medical and psychiatric conditions: Trait mindfulness is associated with less distress from auditory hallucinations and fewer residual depressive symptoms. It is the practice of attending to present moment experiences and allowing emotions and thoughts to come and go without judgment, thereby avoiding a downward spiral into rumination. Compared to simple mind wandering, a brief mindfulness induction recruits an attention network including parietal and . prefrontal structures while mind wandering only recruits the default mode network (DMN) Based on data from the last funding period, we know that activation of the DMN affects both basic sensory and semantic processing in SZ. We propose to extend this by focusing specifically on rumination and adding patients with depression. We ask how rumination affects basic sensory, cognitive and emotional responses, and if mindfulness can rescue these functions, across diagnoses and the wellness spectrum. We will acquire simultaneous EEG and fMRI data from veterans with depression and schizophrenia and mentally healthy veterans to assess early sensory responses, context updating, and responses to emotional images. Understanding how rumination affects engagement with the environment is the first step towards assessing its far-reaching cognitive and emotional costs, which cut across traditional diagnostic boundaries. Understanding how mindfulness restores information processing will increase our understanding of how, and for whom, it works. We predict rumination inductions will prevent the brain from fully processing a spectrum of external events, and mindfulness inductions will restore these abilities. We predict trait rumination and mindfulness will modulate the effects in all groups, with exaggerated effects in those with depression or schizophrenia. The outcome variables will be EEG-based event related potentials (ERPs) and fMRI, and their integration. Symptom severity, trait rumination, and trait mindfulness will be considered in the analyses.
Aim 1 : Simple effects of rumination inductions on fMRI connectivity. We will compare the effects of rumination and mindfulness inductions on the connectivity between DMN and rumination-sensitive brain regions. Compared to mindfulness inductions, we predict rumination will increase this connectivity, with greater effects in depressed and schizophrenia patients than in healthy controls.
Aim 2 : Carry-over effects of mindfulness inductions on ERPs and fMRI and their integration. We predict the effects of 30-second mindfulness inductions will persist into the subsequent visual oddball task, thereby augmenting sensory, attention, and emotional ERP components and fMRI activation in sensory, cognitive and emotional networks, compared to rumination inductions. We will explore the covariance between fMRI and ERP data fusion methods as we have done previously.
Aim 3 : Effects of trait rumination and mindfulness. We will assess the relationship between neural data and trait rumination, mindfulness, and symptom severity in all groups.

Public Health Relevance

The VA provides health care to over half a million Veterans with depression or psychosis, with about half having a diagnosis of schizophrenia. In 2000, the total cost of patient care for Veterans suffering from these mental illnesses was $4.2B. While approximately 7% had depression, by 2008, 17.4% of Iraq and Afghanistan veterans seeking VA care were diagnosed with depression. Not surprisingly, this contributed to the ~$1B annual increase needed to care for depressed veterans from 2000-2008. The idle mind allows us to reflect on the past and prepare for the future, but when it turns to the dark side, rumination takes over. Rumination is related to many psychiatric symptoms (e.g., depression and psychosis) that benefit from mindfulness meditation. How does rumination affect sensory, cognitive, and emotional responses and how does mindfulness restores them? This study will provide insights into the negative and positive neural mechanisms underlying rumination and mindfulness.

Agency
National Institute of Health (NIH)
Institute
Veterans Affairs (VA)
Type
Non-HHS Research Projects (I01)
Project #
5I01CX000497-06
Application #
9678214
Study Section
Mental Health and Behavioral Science B (MHBB)
Project Start
2011-07-01
Project End
2022-03-31
Budget Start
2019-04-01
Budget End
2020-03-31
Support Year
6
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Veterans Affairs Medical Center San Francisco
Department
Type
DUNS #
078763885
City
San Francisco
State
CA
Country
United States
Zip Code
94121
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Ford, Judith M (2017) Current Approaches to Studying Hallucinations: Overcoming Barriers to Progress. Schizophr Bull 43:21-23
Ford, Judith M (2016) Studying auditory verbal hallucinations using the RDoC framework. Psychophysiology 53:298-304
Oestreich, Lena K L; Mifsud, Nathan G; Ford, Judith M et al. (2015) Subnormal sensory attenuation to self-generated speech in schizotypy: Electrophysiological evidence for a 'continuum of psychosis'. Int J Psychophysiol 97:131-8
Meerwijk, Esther L; Ford, Judith M; Weiss, Sandra J (2015) Resting-state EEG delta power is associated with psychological pain in adults with a history of depression. Biol Psychol 105:106-14
Hay, Rachel A; Roach, Brian J; Srihari, Vinod H et al. (2015) Equivalent mismatch negativity deficits across deviant types in early illness schizophrenia-spectrum patients. Biol Psychol 105:130-7
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Ford, Judith M; Dierks, Thomas; Fisher, Derek J et al. (2012) Neurophysiological studies of auditory verbal hallucinations. Schizophr Bull 38:715-23