Maintaining Mechanisms of Chronic Depression and Their Changeability
Condition: Major Depressive Disorder
MeSH terms: Depressive Disorder; Depressive Disorder, Major
Study type: Interventional

Summary: 
      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.
    

Detailed description: 
      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.
    

Intervention name(s): Brief Mindfulness Training; Resting Control Training
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Brief mindfulness training comprising of three weekly individual sessions and daily guided meditation home practice; Brief resting control training comprising of three weekly individual sessions and daily home practice consisting of resting periods
Other intervention name(s): Mindfulness Intervention; Resting Control
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Basic Science
Keywords: mindfulness; EEG; error-related negativity; late positive potential; long-range temporal correlations