Cognitive reappraisal in adolescents with major depression: from neurobiological mechanisms to intervention

• Applicant: Privatdozentin Dr. Ellen Greimel
• Subject Area: Personality Psychology, Clinical and Medical Psychology, Methodology ; Clinical Psychiatry, Psychotherapy, Child and Adolescent Psychiatry
• Term: from 2018 to 2022
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 399482529

Major depression (MD) is common during adolescence and associated with significant morbidity and mortality. One important factor for the development and maintenance of adolescent MD are disturbances in emotion regulation, including deficits in cognitive reappraisal (CR). CR is a particularly effective emotion regulation strategy that aims at reinterpreting emotional events to modify affective responses. Adolescents with MD apply this strategy less often than their healthy peers and show disturbances in brain activation patterns underlying CR. However, at the neurobiological level, it is still unknown whether deficits arise at early or late stages of the reappraisal process. Event-related potential studies are needed to tackle this question, but are missing to date in adolescent MD. Moreover, it remains an open question whether a focused training in CR might be a promising intervention to normalize disturbed neurobiological processes along with depressive symptoms in adolescents suffering from MD. To address these basic and clinical research questions, the project proposal combines the investigation of neurobiological mechanisms of CR in adolescents with MD (compared to healthy adolescents) and the investigation of the effects of a short-term CR training in a pilot randomized controlled clinical trial.In Study 1, adolescents with MD and a control group will perform a well-established CR task to assess the ability to down-regulate negative affect to negative pictures. During the task, early and late time windows of the event-related potential “Late Positive Potential” (LPP) will be recorded to assess neurophysiological indices of CR processes. In addition, gaze fixations on emotional areas within negative pictures and behavioral indices of CR (affective responses to pictures) will be assessed. In Study 2, MD adolescents will be randomly assigned to a group that receives a task-based training in CR or to a control training group. Before (pre) and after the training (post), assessments of negative mood will be conducted. During the sessions, the LPP, gaze fixations on emotional areas within negative pictures and affective responses to pictures will be collected to identify mechanisms underlying training effects.Study 1 will be an essential step towards an improved understanding of emotion regulation deficits in adolescent MD. The results of this study will substantially inform models of MD and can also prove helpful for the early diagnosis of adolescent MD. Study 2 will provide first evidence for the efficacy of a short-time training that has previously shown to be effective in healthy individuals. Moreover, the study will identify neurobiological mechanisms that predict training effects. The results of this pilot investigation will lay the ground for a clinical trial to investigate whether a CR training added to an established intervention improves treatment effects for adolescent MD.

• DFG Programme: Research Grants
• International Connection: Netherlands
• Co-Investigators: Professor Dr. Frans J. Oort; Professor Dr. Gerd Schulte-Körne; Dr. Martin Schulte-Rüther