Major Depressive Disorder Clinical Trial
Official title:
Maintaining Mechanisms of Chronic Depression and Their Changeability: the Role of Discrepancy-based Processing
Despite considerable progress in the understanding of depression, the treatment of those who have entered a chronic course of the disorder still represents a major challenge. In order to develop more effective interventions it is important to learn more about maintaining mechanisms and the ways in which these can be addressed. Recent research has outlined aberrations in neurophysiological parameters that may serve as risk factors underlying tendencies to engage in maladaptive responses to negative mood, and that may be particularly pronounced in patients with chronic depression. Initial evidence suggests that such deficits may not be easily amenable through established treatments. The current study investigated whether mental training using mindfulness mediation, as compared to an active control training, could alter these parameters in chronically depressed patients.
Persistent engagement in maladaptive patterns of thinking is a hallmark of depression. In
those who suffer from a chronic course of the disorders, tendencies towards engagement in
such patterns of thinking are likely to have become habitual and automatic in nature. Recent
research has begun to elucidate potential cognitive and neurophysiological bases of such
persistence. There is evidence that depressed patients show significant deficits in
performance monitoring (Weinberg, Dieterich, & Riesel, 2015). Research on error-related
negativity (ERN), a signal that occurs briefly after commission of an error, has reported
significant aberrations in depressed suggesting deficits at the early stages of processing
discrepancies. Deficits in ERN have been suggested to serve as an endophenotype for
depression and psychopathology more generally (Manoach & Agam, 2013). Preliminary findings
suggest that deficits remain even when symptoms are reduced following established
treatments. Similarly, there is evidence for increased tendencies to elaborate negative
information as evidenced by stronger late positive potentials (LPP; Auerbach, Stanton,
Proudfit, & Pizzagalli, 2015) and an increased rigidity of spontaneous activity of the brain
during rest as indicated by increased long-range temporal correlations of spontaneous brain
oscillations (LRTC; Bornas et al., 2013).
Interventions using mental training may be particularly suited to address these aberrations.
Indeed even brief training in mindfulness has been found to have significant neuroplastic
effects (Tang et al., 2010) The aim of the current study was therefore to investigate the
effects of a brief intervention using training in mindfulness meditation on the above listed
parameters. Chronically depressed patients were randomly allocated to receive either a
two-week mindfulness training or a resting control training. EEG was measured before and
after the intervention along with self-reports of current symptoms and
resilience/vulnerability factors. We expected the mindfulness training to have significantly
stronger effects on ERN, LPP, and LRTC than the resting control training.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Basic Science
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