Cognitive Reappraisal in Adolescents With Major Depression
Condition: Major Depressive Disorder
MeSH terms: Depression; Depressive Disorder; Depressive Disorder, Major
Study type: Interventional

Summary: 
      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.

      In this study, MD adolescents will be randomly assigned to a group that receives a task-based
      training in CR or to a control training group. It will be examined whether the task-based CR
      training is superior to the control training with regard to improvements in negative affect,
      perceived stress in daily life and depressive symptoms. Moreover, during the four training
      sessions, the event-related potential "Late Positive Potential" (LPP) will be recorded to
      assess neurophysiological indices of CR processes and gaze fixations on emotional areas
      within negative pictures and affective responses to pictures will be collected to identify
      mechanisms underlying training effects.This study 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 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.
    


Intervention name(s): Cognitive Reappraisal Training; Control Training
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The training procedure is adapted from a study by Denny & Ochsner (2014). Before the task, participants are instructed that they will be presented pictures and that these pictures will be preceded by a condition specific cue signaling the appropriate strategy during picture viewing. Participants are instructed to indicate their affective response to the image on a rating scale. The task involves 4 conditions: 1) Negative-decrease: participants are asked to view negative pictures and to decrease their affective response by reappraising the negative event. 2) Negative-attend/ 3) Neutral-attend/ 4) Positive-attend: participants are asked to view pictures and to respond naturally to them without trying to alter their affective response. The training task will be repeated over 4 training sessions.; The task in the control group is implemented to account for unspecific effects and is as similar as possible to the CR task except that it involves no negative-decrease (i.e., no reappraisal) condition. Instead, the control task only involves the three attend conditions (negative- attend, neutral-attend, positive-attend).
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: This study is designed as a short-term randomized controlled, participant-blind clinical trial including two groups of adolescents with MD. MD participants will be randomly assigned to a group that receives task-based training in CR or to a control training. Randomisation will be performed by a statistician, stratifying for age (14 years and younger and 15 years and older) and sex.
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Emotion Regulation Training; LPP; Adolescence; Major Depression; Eye-tracking; Cognitive Reappraisal; Event-related Potentials