Remitted Depression Research Articles

Evaluation of a web-based information platform on youth depression and mental health in parents of adolescents with a history of depression

Research shows the important role of parents’ mental health literacy in detecting depressive symptoms and supporting their children to seek professional help. Improving mental health literacy in parents has recently gained even greater importance due to the negative impact of the COVID-19 pandemic on children and adolescents’ mental health. The aim of the present experimental pre-post-follow-up study was to examine knowledge change after the reception of contents from an innovative web-based platform (www.ich-bin-alles.de/eltern) containing evidence-based information on youth depression and mental health in parents of adolescents with a history of depression. A second aim was to assess evaluation of the layout and the acceptance of the platform. N = 33 parents of adolescents with a history of depression (either current or remitted depression) were presented different content domains of the website. Participants’ knowledge about depression was assessed at pre- and post-intervention, and at a four week follow-up. Moreover, parents evaluated the acceptance and the layout of the website. The trial was preregistered at clinicaltrials.gov (NCT05335564). The results showed a significant increase in total knowledge from pre to post, which remained stable over the course of four weeks. Explorative analyses showed that sociodemographic variables did not influence the extent of knowledge gain. Acceptance rates were high and evaluations of the website’s layout were positive. The findings show that the web-based information portal is a promising and appealing means to increase parental knowledge on youth depression. Low-threshold psychoeducational approaches like websites are particularly relevant in times of crisis and increased prevalence rates of depressive symptoms and disorders (ehealth). These results are an important basis for future studies as well as approaches that aim to impart knowledge about mental disorders like youth depression via web-based means. Furthermore, they bear implications for policy decisions concerning mental health education and campaigns.

Estradiol effects on an emotional interference task in adolescents with current and remitted depression

Attentional biases to emotional stimuli are thought to reflect vulnerability for mood disorder onset and maintenance. This study examined the association between the endogenous sex hormone estradiol and emotional attentional biases in adolescent females with either current or remitted depression. Three groups of participants (mean age ± SD) completed the Emotional Interrupt Task: 1) 20 adolescent females (15.1 ± 1.83 years) currently diagnosed with Major Depressive Disorder (MDD), 2) 16 adolescent females (16.4 ± 1.31 years) who had experienced at least one episode of MDD in their lifetime but currently met criteria for MDD in remission, and 3) 30 adolescent female (15.4 ± 1.83 years) healthy controls. Attentional interference (AI) scores were calculated as differences in target response reaction time between trials with emotional facial expressions versus neutral facial expressions. Estradiol levels were assayed by Salimetrics LLC using saliva samples collected within 30 min of waking on assessment days. Robust multiple regression with product terms evaluated estradiol's main effect on AI scores, as well as hypothesized estradiol × diagnostic group interactions. Although neither mean estradiol levels nor mean AI scores in the current-MDD and remitted-MDD groups differed from controls, the relationship between estradiol and overall AI score differed between control adolescents and the remitted-MDD group. Specifically, the remitted-MDD adolescents performed worse (i.e., showed greater attentional interference) when they had higher estradiol; no significant relationship existed in the current-MDD group. Because this finding was driven by angry and not happy stimuli, it appears higher estradiol levels were associated with greater susceptibility to the attention-capturing effects of negatively-valenced emotional content in girls at risk for MDD from prior history.

P276. Estradiol Effects on an Emotional Interference Task in Adolescents With Current and Remitted Major Depression

Attentional biases to emotional stimuli are thought to reflect vulnerability for mood disorder onset and maintenance. This study examined the influence of the endogenous sex hormone estradiol on emotional attentional bias in adolescent females with either current or remitted depression.

Distinct patterns of posterior default mode network‐medial temporal lobe connectivity in mild cognitive impairment and subjective cognitive decline

AbstractBackgroundOlder adults with subjective cognitive decline (SCD) show alterations in functional connectivity of the posterior default mode network (DMN), but both increases and decreases have been reported, suggesting that changes in connectivity may be nonlinear across the AD spectrum. Alternatively, the variable findings may be attributable to heterogeneity within SCD samples. Specifically, studies of SCD exclude individuals with current depression, but history of past remitted depression is not typically ascertained. This is problematic because emerging evidence suggests that state‐independent aberrations in neural networks, including within posterior DMN, persist following recovery from depression. In the current study, we compared posterior DMN connectivity using resting state functional magnetic resonance imaging (rs‐fMRI) amongst SCD, mild cognitive impairment (MCI) or cognitively unimpaired (CU) older adults free of current or remitted depression.MethodParticipants were 58 older adults who were screened via psychiatric/medical assessment for current or past history of depression and neurological conditions, and consisted of 21 SCD [12F, mean age 70.6(SD5.5)] defined as perception of memory decline with concern or worry and normal neuropsychological (NP) test scores, 12 MCI [4F, mean age 73(SD6.8)] defined as subjective cognitive complaints with functional independence and impaired performance on >=2 NP tests, and 25 CU [15F, mean age 71.8(SD7.2)] based on normal NP scores and absence of subjective memory decline with worry. Rs‐fMRI was acquired using gradient‐echo EPI BOLD at 3T and processed using CONN toolbox. Seed analysis using a posterior cingulate cortex (PCC) seed (x=‐6, y=‐52, z=40) was performed. Hippocampus and parahippocampal gyrus were target regions‐of‐interest. Multivariate ANOVA was used to examine group differences in PCC connectivity followed by post hoc comparisons using Dunnett’s test.ResultGroups differed in PCC connectivity with the right hippocampus [F(2, 55)=3.74, P=.03] and left posterior parahippocampal gyrus [F(2, 55)=3.35, P=.042]. Relative to CU, PCC‐right hippocampal connectivity was reduced in MCI (P=.028), while PCC‐left parahippocampal connectivity was found in SCD (P=.024).ConclusionDisruptions in posterior DMN connectivity were observed in SCD and MCI that were not attributable to current or remitted depression. The distinct patterns of posterior DMN disruption are consistent with putative non‐linear changes in neural network connectivity with AD progression.

Improved emotion regulation in depression following cognitive remediation: A randomized controlled trial

ObjectiveExecutive functions (EFs) play a key role in emotion regulation and, related to this, depression. Cognitive remediation (CR) targeting EFs, such as Goal Management Training (GMT) and computerized cognitive training (CCT), may reduce maladaptive emotion regulation. However, the clinical potential of GMT in the context of depression and emotion regulation remains to be tested. Hence, the primary aim of the present study was to compare effects of GMT with CCT on symptoms of emotion dysregulation. MethodThe paper reports the effects of a preregistered randomized controlled trial. Sixty-three participants (18–60yrs) with active or remitted depression and EF complaints were randomized to nine sessions of GMT (n = 35) or CCT (n = 28). All were assessed at baseline, post-intervention, and at 6-month follow-up. The Ruminative Response Scale and the Difficulties in Emotion Regulation Scale were employed to assess emotion regulation. ResultsBoth groups improved following the intervention on emotion regulation domains after controlling for intention-to-treat, including brooding rumination and on items reflecting non-accepting reactions to distress. Relative to CCT, the GMT-group demonstrated increased clarity of emotional responses in the per protocol analysis. ConclusionsOur findings demonstrate the potential of GMT and CCT in reducing maladaptive emotion regulation in depression.

Is a Negative Attentional Bias in Individuals with Autism Spectrum Disorder Explained by Comorbid Depression? An Eye-Tracking Study

Heightened attention towards negative information is characteristic of depression. Evidence is emerging for a negative attentional bias in Autism spectrum disorder (ASD), perhaps driven by the high comorbidity between ASD and depression. We investigated whether ASD is characterised by a negative attentional bias and whether this can be explained by comorbid (sub) clinical depression. Participants (n = 116) with current (CD) or remitted depression (RD) and/or ASD, and 64 controls viewed positively and negatively valenced (non-)social pictures. Groups were compared on three components of visual attention using linear mixed models. Both CD individuals with and without ASD, but not remitted depressed and never-depressed ASD individuals showed a negative bias, suggesting that negative attentional bias might be a depressive state-specific marker for depression in ASD.

Irregular sleep-wake patterns in older adults with current or remitted depression

Background: Disturbed sleep and irregular sleep-wake patterns have been associated with poor outcomes in older adults. Sleep regularity however has not been studied in a sample with current or remitted major depression.Methods: 138 participants (63.8±8.6 years; n=27 current major depression, n=64 remitted, and n=47 healthy controls) were monitored using wrist-worn actigraphy. The Sleep Regularity Index (SRI), sleep-wake fragmentation and stability, sleep onset and offset timing, number of awakenings and measures from cosinor analysis were computed.Results: Compared with controls, older adults with current depression had lower SRI (p < 0.01), lower relative amplitude (p < 0.05), and higher activity during sleeping and post-midnight hours (p < 0.05). Older adults with remitted depression displayed lower activity during the day (p < 0.05), showed reduced average activity and lower amplitude than controls. Total sleep time, sleep timing, and number of awakenings did not differ between groups. All groups differed significantly in self-reported sleep quality and depression severity.Limitations: Longitudinal studies which examine how sleep-wake patterns change based on depressive episode recency, severity and how medications may influence these patterns are needed.Conclusions: Older adults with current or remitted major depression do not differ from controls on traditional sleep metrics but do report poor quality sleep and show differences in sleep regularity and rest-activity patterns. Reducing the risk of poor outcomes in both groups may be aided by interventions that help promote sleep regularity and increased activity.

Suicidal ideation and suicide attempts: associations with sleep duration, insomnia, and inflammation.

Sleep disturbance has been consistently identified as an independent contributor to suicide risk. Inflammation has emerged as a potential mechanism linked to both sleep disturbance and suicide risk. This study tested associations between sleep duration, insomnia, and inflammation on suicidal ideation (SI) and history of a suicide attempt (SA). Participants included 2329 adults with current or remitted depression and/or anxiety enrolled in the Netherlands Study of Depression and Anxiety. Sleep duration, insomnia, past week SI, and SA were assessed with self-report measures. Plasma levels of C-reactive protein, interleukin-6, and tumor necrosis factor-α were obtained. Short sleep duration (⩽6 h) compared to normal sleep duration (7-9 h) was associated with reporting a prior SA, adjusting for covariates [adjusted odds ratio (AOR) 1.68, 95% CI 1.13-2.51]. A higher likelihood of SI during the past week was observed for participants with long sleep duration (⩾10 h) compared to normal sleep duration (AOR 2.22, 95% CI 1.02-4.82), more insomnia symptoms (AOR 1.44, 95% CI 1.14-1.83), and higher IL-6 (AOR 1.31, 95% CI 1.02-1.68). Mediation analyses indicated that the association between long sleep duration and SI was partially explained by IL-6 (AOR 1.02, 95% CI 1.00-1.05). These findings from a large sample of adults with depression and/or anxiety provide evidence that both short and long sleep duration, insomnia symptoms, and IL-6 are associated with the indicators of suicide risk. Furthermore, the association between long sleep duration and SI may operate through IL-6.

Affect fluctuations examined with ecological momentary assessment in patients with current or remitted depression and anxiety disorders.

There is increasing interest in day-to-day affect fluctuations of patients with depressive and anxiety disorders. Few studies have compared repeated assessments of positive affect (PA) and negative affect (NA) across diagnostic groups, and fluctuation patterns were not uniformly defined. The aim of this study is to compare affect fluctuations in patients with a current episode of depressive or anxiety disorder, in remitted patients and in controls, using affect instability as a core concept but also describing other measures of variability and adjusting for possible confounders. Ecological momentary assessment (EMA) data were obtained from 365 participants of the Netherlands Study of Depression and Anxiety with current (n = 95), remitted (n = 178) or no (n = 92) DSM-IV defined depression/anxiety disorder. For 2 weeks, five times per day, participants filled-out items on PA and NA. Affect instability was calculated as the root mean square of successive differences (RMSSD). Tests on group differences in RMSSD, within-person variance, and autocorrelation were performed, controlling for mean affect levels. Current depression/anxiety patients had the highest affect instability in both PA and NA, followed by remitters and then controls. Instability differences between groups remained significant when controlling for mean affect levels, but differences between current and remitted were no longer significant. Patients with a current disorder have higher instability of NA and PA than remitted patients and controls. Especially with regard to NA, this could be interpreted as patients with a current disorder being more sensitive to internal and external stressors and having suboptimal affect regulation.

Persistent Intrinsic Functional Network Connectivity Alterations in Middle-Aged and Older Women With Remitted Depression.

BackgroundIn younger adults, residual alterations in functional neural networks persist during remitted depression. However, there are fewer data for midlife and older adults at risk of recurrence. Such residual network alterations may contribute to vulnerability to recurrence. This study examined intrinsic network functional connectivity in midlife and older women with remitted depression.MethodsA total of 69 women (24 with a history of depression, 45 with no psychiatric history) over 50 years of age completed 3T fMRI with resting-state acquisition. Participants with remitted depression met DSM-IV-TR criteria for an episode in the last 10 years but not the prior year. Whole-brain seed-to-voxel resting-state functional connectivity analyses examined the default mode network (DMN), executive control network (ECN), and salience network (SN), plus bilateral hippocampal seeds. All analyses were adjusted for age and used cluster-level correction for multiple comparisons with FDR < 0.05 and a height threshold of p < 0.001, uncorrected.ResultsWomen with a history of depression exhibited decreased functional connectivity between the SN (right insula seed) and ECN regions, specifically the left superior frontal gyrus. They also exhibited increased functional connectivity between the left hippocampus and the left postcentral gyrus. We did not observe any group differences in functional connectivity for DMN or ECN seeds.ConclusionsRemitted depression in women is associated with connectivity differences between the SN and ECN and between the hippocampus and the postcentral gyrus, a region involved in interoception. Further work is needed to determine whether these findings are related to functional alterations or are predictive of recurrence.

State-independent and -dependent structural alterations in limbic-cortical regions in patients with current and remitted depression

BackgroundThe high recurrence of major depressive disorder (MDD) may derive from underlying state-independent structural alterations. MethodsFirst-episode drug-naïve currently depressed (cMDD) patients (N = 97), remitted depressed (RD) patients (N = 72), and healthy controls (HCs, N = 100) underwent structural magnetic resonance imaging (MRI). Group differences in cortical thickness (CT), surface area (SA), and local gyrification index (lGI) were analyzed in FreeSurfer. ResultsBoth groups of depressed patients had significantly decreased CT, relative to HCs, in the left precentral gyrus and significantly increased lGI values in the left superior frontal gyrus (SFG) indicative of state-independent alterations. Relative to HCs, the cMDD group had decreased CT of the SFG, caudal middle frontal gyrus (MFG), posterior cingulate cortex (PCC), and lateral occipital regions as well as increased SA or lGI of the superior temporal gyrus, precuneus, and pericalcarine, whereas the RD group had increased SA or lGI of the SFG, caudal MFG, and supramarginal gyrus; these alterations appeared to be state-dependent. SA or lGI values of the fusiform gyrus, inferior temporal gyrus, and superior parietal lobule differed between the cMDD and RD groups, consistent with state-dependent alterations. Beck depression inventory scores correlated with CT or lGI values of the caudal MFG, lateral occipital cortex in depressed patients. LimitationsThe structural features of several subcortical limbic regions were not analyzed. ConclusionsLeft precentral gyrus CT and left SFG gyrification alterations may represent state-independent alterations in MDD.

New avenues in brain stimulation treatments for major depression: Efficacy, acceptability, and translation of novel treatments into clinical practice

In current perspectives on non-invasive brain stimulation techniques for mental disorders novel stimulation techniques, modalities, and increasingly also combinations with other treatment approaches play a key role. The limited efficacy and often unfavourable side effect profile of antidepressant medications—currently the most frequently used approach to treat depression—calls for additional treatment options. Several new nonpharmacological treatment alternatives have been proposed. However, the translation of these alternatives into treatment practice has been proceeding at a slower rate. The present symposium is therefore organized around three central aims: – to present results of the comparative efficacy and acceptability of non-invasive brain stimulation techniques for the treatment of major depressive disorder and bipolar depression and; – to provide insights regarding the difficulty of translating cutting edge research findings into clinical practice. For instance, transcranial magnetic stimulation (TMS) has been found to be efficacious in treatment of depression, and yet its availability in Europe remains limited. We will discuss potential means for improving the availability of TMS at the European level and how the characteristics (e.g. high treatment resistance) of patients enrolled in randomized controlled trials may affect efficacy estimates; – we will discuss the use of cognitive training to improve cognitive functions in depression and a rationale to combine it with non-invasive brain stimulation. Depression leads to persistent cognitive impairments in up to 50% of patients, resulting in problems in everyday life. To date it is unknown which factors determine the persistence of cognitive problems and there is no state-of-the-art treatment in either acute or remitted depression.

F76. Persistent Intrinsic Functional Network Connectivity Alterations in Middle-Aged and Older Women With Remitted Depression

F76. Persistent Intrinsic Functional Network Connectivity Alterations in Middle-Aged and Older Women With Remitted Depression

Orbito-frontal cortex mechanism of inhibition of return in current and remitted depression.

Deficient inhibition of return (IOR) for emotional materials is an important cognitive biomarker of depression. However, its neural mechanism and role in depression remission remain largely unknown. Using functional magnetic resonance imaging (fMRI), this study observed the neural foundation of inhibition of return in individuals with current (n = 30) and remitted (n = 27) depression and in healthy controls (n = 33), by using a cue-target task. The results showed that individuals with remitted depression (RMD) possessed a nonavoidant attention model for sad faces, which indicated a cue validity and was correlated with enhanced task- and resting-state activation and function connectivity in orbitofrontal cortex (OFC). The patients with major depressive disorder (MDD), in contrast, displayed an IOR effect for all faces, which indicated a strategy of attention avoidance due to the high cognitive burden in the cue-target task, and was correlated with decreased resting-state activation and function connectivity in OFC. Moreover, the hippocampus, a less-known cortex in IOR, showed a contrary model, that is, lower activation in depression remission and higher task- and resting-state activation in depressive episodes. The results suggest the OFC mechanism of the IOR effect in remitted depression and the hippocampus mechanism of the IOR effect in depressive episodes, which offer potential biomarkers for the clinical treatment of depression.

P.3.001 - Depression is associated with increased insulin resistance: a meta-analysis

Background Depression has been linked to an increased incidence of clinical comorbidity, such as diabetes mellitus (DM) [1]. Moreover, a bidirectional relationship between depression and DM has been described, with depressive symptoms being predictive of poor glycemic control in type 2 DM and DM increasing the incidence of depression [2]. To date, increased levels of insulin, indicating metabolic alterations, have been described in schizophrenia and bipolar disorder [3,4]. However, the presence of increased levels of insulin in depression remains unclear. The aim of this study is to verify if peripheral insulin levels are altered in acute or remitted depression compared to healthy controls. We also seek to determine whether there are changes on insulin levels after clinical resolution of an index depressive episode following antidepressant treatment. Methods A systematic search for all eligible peer-reviewed articles was conducted using Medline, the Cochrane Library and Scopus according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA Statement). No language, year or country restrictions were used. The last search was performed in August of 2016. We included studies assessing serum or plasma fasting insulin in adults with depression alongside a control group of healthy volunteers. Two reviewers performed the study selection and data extraction. We identified 8,769 studies, of which thirty-eight fulfilled inclusion criteria. We carried out three between-group meta-analyses examining differences in serum or plasma insulin levels between healthy controls and: a) adult subjects with acute depression with psychiatric medication, b) adult subjects with acute depression without psychiatric medication and c) adult subjects with remitted depression with psychiatric medications. We also conducted a within-group meta-analysis comparing changes on insulin levels before and after treatment of an index depressive episode with antidepressants. Standardized mean difference estimates in insulin levels were calculated for all meta-analyses. Sensitivity analyses and meta-regressions according to mood state and psychiatric medication status were also performed. As the analyses showed that the studies were heterogeneous, effect size results from different studies were pooled according to the inverse variance method accounting for random effects. Results Thirty-eight studies were included, providing data on 31,763 participants. Of all the participants, 7,142 were subjects with depression and 24,623 were healthy controls. Insulin levels were moderately increased in subjects with acute depression compared with healthy controls, both in patients treated with psychiatric medication (g=0.38, 95% CI 0.17 to 0.59, p Conclusions Our findings show that insulin levels are increased in acute depression and normal in remission. These results highlight a potential use of insulin as a biomarker of disease activity in depression. Further studies are warranted.

Treatment of Cognitive Impairment Using a Computer Program in Patients with Depression in Remission

The patient with depressive disorder presents a cognitive impairment which does not disappear despite the fact that the depression is considered to be in remission. This study aims to assess the impact of training in the improvement of cognitive functions of patients with remitted depression (RD). Captain’s Log Computerized Cognitive-Training Program (CLCT) was used as a cognitive trainer in a group of patients with RD and with Selective serotonin reuptake inhibitors (SSRI) as treatment; another group with RD was treated uniquely with SSRI. The treatment intervention’s impact was evaluated using the Hamilton Rating Scales for Anxiety and Depression, the Wechsler Adult Intelligence Scale (WAIS-III), and the Integrated Program of Neuropsychological Examination-Revised Barcelona Test. CLCT was used in college students with RD, twice a week, for six months. Patients from both groups decreased depressive and anxious symptoms, however, patients who received CLCT substantially increased their intellectual performance; changes in the psychometric analysis of the Barcelona Test were consistent with the ones presented in WAIS-III. CLCT application is associated with an improvement of cognitive functions in patients with RD.

Safety of Flibanserin in Women Treated With Antidepressants: A Randomized, Placebo-Controlled Study

BackgroundDepression is often associated with sexual dysfunction, and pharmacologic treatment for hypoactive sexual desire disorder can be considered in women receiving treatment for depression. AimTo evaluate the safety of flibanserin in women treated for depression with selective serotonin reuptake inhibitors or serotonin and norepinephrine reuptake inhibitors. MethodsIn this double-blinded, randomized, placebo-controlled trial, women with remitted or mild depression treated with selective serotonin reuptake inhibitors or serotonin and norepinephrine reuptake inhibitors who were not postmenopausal and were experiencing symptoms of hypoactive sexual desire disorder (ie, decreased sexual desire and related distress) received flibanserin 50 mg at bedtime (qhs) for 2 weeks and up-titrated to 100 mg qhs, flibanserin 100 mg qhs for the entire treatment period, or placebo for up to 12 weeks. OutcomesSafety assessment included adverse events and symptoms of depression and anxiety. Results73 patients were randomly assigned to flibanserin (both dose groups combined) and 38 to placebo. The sponsor terminated the study early at discontinuation of the development of flibanserin. Treatment duration was at least 8 weeks for 84.9% and 94.7% of patients in the flibanserin and placebo groups, respectively. The most common adverse events (incidence ≥ 2% in the flibanserin group and higher than that in the placebo group) included dry mouth (5.5% for flibanserin vs 2.6% for placebo), insomnia (5.5% vs 2.6%), back pain (4.1% vs 2.6%), and dizziness (4.1% vs 0.0%). There were no serious adverse events and no instances of suicidal ideation or behavior. The proportions of patients with symptom worsening in the flibanserin and placebo groups, respectively, were 6.9% and 21.6% for depression and 1.4% and 2.7% for anxiety. Remission of depression at study end point, as measured by the Quick Inventory of Depressive Symptomatology–Self Report, was experienced by 19.4% of flibanserin-treated patients and 10.8% of patients receiving placebo; remission of anxiety based on the Beck Anxiety Inventory was noted in 16.4% and 2.7% of patients, respectively. Clinical ImplicationsThe results of this study support the safety of flibanserin in premenopausal women being treated with a serotonergic antidepressant. No increased risks were observed when adding flibanserin to a stable selective serotonin reuptake inhibitor or serotonin and norepinephrine reuptake inhibitor treatment regimen. Strengths and LimitationsThis was a well-designed, randomized, placebo-controlled trial. The primary limitation was the early study discontinuation by the sponsor, which decreased the sample size and duration of treatment. ConclusionIn this small trial, flibanserin 100 mg qhs was generally safe and well tolerated in premenopausal women with mild or remitted depression taking a serotonergic antidepressant.Clayton AH, Croft HA, Yuan J, et al. Safety of Flibanserin in Women Treated With Antidepressants: A Randomized, Placebo-Controlled Study. J Sex Med 2018;15:43–51.

Depression and Substance Use: Towards the Development of an Emotion Regulation Model of Stigma Coping

ABSTRACTThe comorbidity between depression and substance use problems is well-documented, yet little research has investigated how stigma associated with one's depression might relate to alcohol and drug use. The current study examined the association between depression-related stigma and substance use coping and considered the role of emotion dysregulation (i.e., difficulty in monitoring, evaluating, and modulating one's emotional reactions) as a mechanism underlying this association. A sample of individuals who self-identified as having current or remitted depression (N = 218) completed self-report measures of depression-related stigma, emotion dysregulation, and tendency to rely on alcohol or drugs to cope with psychological distress. Depression-related stigma was positively associated with emotion dysregulation, which was in turn associated with a greater tendency to engage in substance use coping. These findings provide initial support for the role of stigma as a contributor to maladaptive coping responses, such as substance use, among people living with depression. Further, they underscored the potential utility of targeting emotion dysregulation in stigma coping and substance abuse prevention intervention efforts.

Deficient manipulation of working memory in remitted depressed individuals: Behavioral and electrophysiological evidence.

The study aimed to examine whether remitted depressed (RMD) individuals show a dysfunction of valence-dependent manipulation and its neurophysiological correlates. Event-related potentials were conducted on 25 individuals with remitted depression and 27 controls during a working memory manipulation task. The sorting costs and the P3b and slow wave (SW) amplitudes were analyzed. Compared to the control subjects, the RMD individuals revealed higher sorting costs, particularly when they were shown negative targets. The control individuals exhibited reduced P3b and SW amplitudes in response to the backward negative pictures, whereas the RMD participants exhibited increased central-parietal and lateral P3b and SW amplitudes in the backward condition. Both groups exhibited overall decreased P3b and SW amplitudes in response to the backward positive pictures. RMD individuals are associated with a deficient manipulation for negative material and an unimpaired manipulation for positive material. This study extends current knowledge that deficits in cognitive control persist after the remission of depressive symptoms.

Internet-delivered cognitive control training as a preventive intervention for remitted depressed patients: Evidence from a double-blind randomized controlled trial study.

Cognitive control impairments may place remitted depressed (RMD) patients at increased risk for developing future depressive symptomatology by disrupting emotion regulation processes. Research has shown that directly targeting cognitive control has beneficial effects on high trait ruminators and clinically depressed patients. The current study tested whether internet-delivered cognitive control training (CCT) can be used as an intervention to increase resilience to depression in RMD patients. Effects of CCT were assessed using a double-blind randomized controlled design. RMD patients performed 10 sessions of a working memory-based CCT (N = 34) or a low cognitive load training (N = 34; active control condition) over a period of 14 days. Assessments took place prior to training, immediately following 2 weeks of training, and at 3 months follow-up. Brooding and depressive symptomatology were selected as primary outcome measures, alternative indicators for emotion regulation and residual symptomatology were selected as secondary outcome measures, along with indicators of functioning. Compared to an active control condition, CCT demonstrated beneficial effects on a cognitive transfer task, brooding, depressive symptomatology, residual complaints, self-reported use of general maladaptive emotion regulation strategies, and resilience after controlling for intention to treat. Furthermore, completers of the CCT reported a reduction in experienced disability and cognitive complaints. However, no beneficial effects were found for self-reported use of adaptive emotion regulation strategies. These findings demonstrate the effectiveness of CCT as an intervention to reduce cognitive vulnerability, residual symptomatology, and foster resilience following recovery from depression. CCT thus holds potential as a preventive intervention for RMD patients. (PsycINFO Database Record