Despite substantial progress in the treatment of adolescent depression, 50% will relapse within two years. One predictor of depressive relapse is repetitive negative thinking about the past (i.e., rumination). The Candidate will extend her background in the developmental psychopathology and treatment of adolescent Major Depressive Disorder (MDD) to examine the neural networks supporting rumination and further contextualize these findings to the real-world using ecological momentary assessment (EMA). This will develop her mechanistic understanding and expertise in the course and effective prevention of depressive relapse. The Candidate will learn to: 1) modulate illness mechanisms at the level of the brain by developing a novel, developmentally appropriate, multilevel fMRI task (Training Aim (TA) 1), 2) capture real-world vulnerabilities in developmental context using the methodology of EMA (TA2), and 3) dimensionally link multilevel fMRI data to real-world EMA u s i n g advanced modeling statistics (TA3). In line with these training aims, the Candidate's short-term career goal is to understand the neural signature of rumination when induced (full experimental control), when oscillating more naturally during the resting state, and during sporadic functional Momentary Assessment (FMA; intermittent) for the full spectrum of Parametric Rumination Induction as a Mood Endophenotype (PRIME). This Mentored Patient Oriented Career Development Award will allow the Candidate to advance the cognitive neuroscience of adolescent depression with the long-term career goal of developing just in time interventions for rumination in addition to other targets that increase risk for depressive relapse The University of Illinois at Chicago (UIC) is the ideal setting for the candidate's research with ongoing development of local resources such as an independent research-dedicated 3T scanner and one of only 21 nationwide National Network of Depression Centers (NNDC). Mentor Scott Langenecker is an expert in the cognitive and affective neuroscience of mood disorders across the adult lifespan and has an established expertise in task development and mechanistic approaches for studying depression. Co-Mentor Robin Mermelstein is an expert in adolescent development and in the use of EMA.
The Specific Aims afford an excellent opportunity for the Candidate to learn the necessary skills to propel her to independence. Twenty-eight youth (ages 14-16) with a history of MDD who are currently remitted and at risk for depressive relapse (RDR) and 28 matched healthy controls (HCs) will complete PRIME and EMA.
Specific Aim 1 addresses TA 1 by affording the Candidate the opportunity to modulate illness mechanisms across the spectrum of PRIME from controlled to naturalistic.
Specific Aim 2 supports TA2 through the application of EMA methods to assess the real-world context for rumination and cognitive control, allowing the Candidate to move her research out of the clinic and lab for the first time in her career. TA 3 is met through Specific Aim 3 by allowing the Candidate to learn novel statistical methods for linking EMA of rumination and cognitive control to neural network function in the lab. Clinical relevance is aided by following RDR and HC youth longitudinally for one year to verify clinical course. This cohort will provide critical preliminar data for a planned R01 examining developmental mechanisms in RDR and whether these mechanisms can be directly targeted through novel interventions. Executing the complimentary specific and training aims will promote long-term career goals of the Candidate and establish her independent expertise in identifying neural and behavioral targets in the course of developmental psychopathologies.
Approximately half of youth who are effectively treated for depression will relapse over the subsequent two years. The proposed study seeks to better understand how thought patterns such as rumination can be observed in both behavior and brain network functioning to establish how these patterns increase risk for relapse among this vulnerable population.
