Stress Sensitivity and Reward Responsivity in Depression

Study Overview
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Brief Summary
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The goal of this project is to learn more about the different ways in which people process information that is stressful and rewarding, and how abnormalities in these two processes are related to depression.

Detailed Description
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Participants will participate in two 3-hour sessions separated by a week at Providence Care, Mental Health Services, and a third, 1.5-hour session at the Queen's MRI Facility. At the first session participants will complete a packet of questionnaires about their mood and take part in an interview about their mood, medications, drug use, and any other symptoms, as well as an interview about their relationships with their parents and any experiences of abuse. At the second session participants will participate in a stress test, which involves giving a speech to a panel. The investigators will also collect saliva samples to look at stress hormones. Participants will also complete a task on the computer that involves looking at cartoon faces and making decisions about them. At the third session, the investigators take images of of participant's brain using a magnetic resonance scanner. Participants are invited to participate in a 6-month follow-up for this study, which would involve the same procedure as outline above.

Official Title
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Stress Sensitivity and Reward Responsivity: An Integration of Two Endophenotypes in Major Depression

Conditions
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Depressed

Participation Criteria
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Eligibility Criteria
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For Depressed Participants: Inclusion Criteria: Outpatients aged 18-65 Currently suffering from unipolar depression Fluency in English, sufficient to complete the interviews and self-report questionnaires Exclusion Criteria: Clinical diagnosis of bipolar disorder, psychotic disorders, current alcohol/substance dependence, or significant medical comorbidity Treatment-resistant (defined as failing more than 3 trials of anti-depressant medication) History of neurological insult (e.g., concussion), neurological disease, seizure disorder Smokers Pregnant women Endocrine disorders High suicidal risk, defined by clinician judgement For Healthy Control Participants: Inclusion Criteria: Adults aged 18-65 No history of Axis I disorders according to DSM-IV-TR criteria, as determined by the SCID No first-degree relatives diagnosed with bipolar disorder Fluency in English, sufficient to complete the interviews and self-report questionnaires Exclusion Criteria: History of neurological insult (e.g., concussion), neurological disease, seizure disorder Smokers Pregnant women Endocrine disorders

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Depressed Participants<br>No intervention | |
| Healthy Control Participants<br>No intervention | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Stress Sensitivity: Salivary Hormone and Stress Challenge Test (TSST) | Participants are required to give a speech and an arithmetic test in front of a panel. Saliva samples are collected at 8 points throughout the test. | 2 hours after beginning of Time B Appointment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mood and Anxiety Symptom Questionnaire (MASQ) | Self-report scale of general distress (GD), anhedonic depression (AD), and anxious arousal (AA) symptoms | Administered at first baseline appointment and covers past 2 weeks | 
| Reward Responsivity: Probabilistic Reward Task | Computerized task that requires participants to choose between two stimuli and develop a response bias to the more frequently rewarded stimulus. | Administered at second baseline appointment | 
| Snaith Hamilton Pleasure Scale (SHAPS and SHAPS-C) | Self-report of anhedonia symptoms | Administered at first baseline appointment and covers past 2 weeks prior to interview |