PDF(Pubmed)
Abstract：
UNASSIGNED: Rumination-focused cognitive behavioral therapy (RF-CBT) is designed to reduce depressive rumination or the habitual tendency to dwell on experiences in a repetitive, negative, passive, and global manner. RF-CBT uses functional analysis, experiential exercises, and repeated practice to identify and change the ruminative habit. This preregistered randomized clinical trial (NCT03859297, R61) is a preregistered replication of initial work. We hypothesized a concurrent reduction of both self-reported rumination and cross-network connectivity between the left posterior cingulate cortex and right inferior frontal and inferior temporal gyri.
UNASSIGNED: Seventy-six youths with a history of depression and elevated rumination were randomized to 10 to 14 sessions of RF-CBT (n = 39; 34 completers) or treatment as usual (n = 37; 28 completers). Intent-to-treat analyses assessed pre-post change in rumination response scale and in functional connectivity assessed using two 5 minute, 12 second runs of resting-state functional magnetic resonance imaging.
UNASSIGNED: We replicated previous findings: a significant reduction in rumination response scale and a reduction in left posterior cingulate cortex to right inferior frontal gyrus/inferior temporal gyrus connectivity in participants who received RF-CBT compared with those who received treatment as usual. Reductions were large (z change = 0.84; 0.73, respectively [ps < .05]).
UNASSIGNED: This adolescent clinical trial further demonstrates that depressive rumination is a brain-based mechanism that is modifiable via RF-CBT. Here, we replicated that RF-CBT reduces cross-network connectivity, a possible mechanism by which rumination becomes less frequent, intense, and automatic. This National Institute of Mental Health-funded fast-fail study continues to the R33 phase during which treatment-specific effects of RF-CBT will be compared with relaxation therapy.
UNASSIGNED: Seventy-six youths with a history of depression and elevated rumination were randomized to 10 to 14 sessions of RF-CBT (n = 39; 34 completers) or treatment as usual (n = 37; 28 completers). Intent-to-treat analyses assessed pre-post change in rumination response scale and in functional connectivity assessed using two 5 minute, 12 second runs of resting-state functional magnetic resonance imaging.
UNASSIGNED: We replicated previous findings: a significant reduction in rumination response scale and a reduction in left posterior cingulate cortex to right inferior frontal gyrus/inferior temporal gyrus connectivity in participants who received RF-CBT compared with those who received treatment as usual. Reductions were large (z change = 0.84; 0.73, respectively [ps < .05]).
UNASSIGNED: This adolescent clinical trial further demonstrates that depressive rumination is a brain-based mechanism that is modifiable via RF-CBT. Here, we replicated that RF-CBT reduces cross-network connectivity, a possible mechanism by which rumination becomes less frequent, intense, and automatic. This National Institute of Mental Health-funded fast-fail study continues to the R33 phase during which treatment-specific effects of RF-CBT will be compared with relaxation therapy.
摘要：
■以沉思为中心的认知行为疗法（RF-CBT）旨在减少抑郁沉思或惯常的习惯倾向，负,被动,和全球的方式。RF-CBT使用功能分析，体验式练习,并反复练习以识别和改变反思性习惯。这项预先注册的随机临床试验（NCT03859297，R61）是初始工作的预先注册复制。我们假设左后扣带回皮层与右下额叶和颞下回之间的自我报告的反思性和交叉网络连通性同时减少。
■76名有抑郁和反思性升高病史的年轻人被随机分配到10至14次RF-CBT（n=39；34名完成者）或照常治疗（n=37；28名完成者）。意向治疗分析评估了反省反应量表和功能连通性的前后变化，使用两个5分钟评估，静息状态功能磁共振成像的12秒运行。
■我们重复了以前的发现：与那些接受照常治疗的患者相比，接受RF-CBT的参与者的反思性反应量表显著降低，左后扣带皮质与右下额回/颞下回的连通性降低。减少很大(z变化=0.84;0.73,分别为[ps<.05])。
■这项青少年临床试验进一步证明，抑郁反思是一种基于大脑的机制，可通过RF-CBT进行修改。这里,我们复制了RF-CBT减少了跨网络连接，一种可能的机制，通过这种机制，沉思变得不那么频繁，激烈，和自动。这项由美国国家精神卫生研究所资助的快速失败研究持续到R33阶段，在此期间，RF-CBT的治疗特异性效果将与放松疗法进行比较。
■76名有抑郁和反思性升高病史的年轻人被随机分配到10至14次RF-CBT（n=39；34名完成者）或照常治疗（n=37；28名完成者）。意向治疗分析评估了反省反应量表和功能连通性的前后变化，使用两个5分钟评估，静息状态功能磁共振成像的12秒运行。
■我们重复了以前的发现：与那些接受照常治疗的患者相比，接受RF-CBT的参与者的反思性反应量表显著降低，左后扣带皮质与右下额回/颞下回的连通性降低。减少很大(z变化=0.84;0.73,分别为[ps<.05])。
■这项青少年临床试验进一步证明，抑郁反思是一种基于大脑的机制，可通过RF-CBT进行修改。这里,我们复制了RF-CBT减少了跨网络连接，一种可能的机制，通过这种机制，沉思变得不那么频繁，激烈，和自动。这项由美国国家精神卫生研究所资助的快速失败研究持续到R33阶段，在此期间，RF-CBT的治疗特异性效果将与放松疗法进行比较。
