■行为激活是抑郁症的循证治疗方法。理论上的考虑表明,治疗反应取决于强化学习机制。然而,哪些强化学习机制参与并介导行为激活的治疗效果,仍然只是部分理解,并且没有程序来衡量这种机制。
■进行一项试点研究,以检查通过任务或自我报告测量的强化学习过程是否与对行为激活的治疗反应有关。
■试点研究招募了13名患有重度抑郁症的门诊患者(12名完成者),从2018年7月到2019年2月,在BA进行了为期9周的试验。精神病学评估,之前获得了决策测试和自我报告的奖励经验和预期,治疗期间和之后。使用强化学习模型分析任务和自我报告数据。通过线性混合效应模型,推断参数与抑郁严重程度的度量相关。
■通过任务中的特定决策过程来捕获治疗不同阶段的治疗效果。在专注于积极追求奖励的几周里,在那些表现出巴甫洛夫食欲影响增加的个体中,治疗效果更为明显。在专注于避免惩罚的几周内,在那些显示巴甫洛夫回避增加的个体中,治疗反应更为明显。根据正式的RL规则,自我报告的加固预期发生了变化。学习遵循RL规则的程度与快感缺失的变化有关。
■在这项试点研究中,任务和自我报告衍生的强化学习措施都捕获了对行为激活的治疗反应的个体差异。嗜好和厌恶的巴甫洛夫反射过程似乎是通过单独的心理治疗干预来调节的。调制强度与对特定干预措施的反应密切相关。自我报告的强化预期变化也与治疗反应有关。
■设定目标:参与GO/No-Go主动学习,#NCT03538535,http://www.临床试验.gov.
UNASSIGNED: Behavioral activation is an evidence-based treatment for depression. Theoretical considerations suggest that treatment response depends on reinforcement learning mechanisms. However, which reinforcement learning mechanisms are engaged by and mediate the therapeutic effect of behavioral activation remains only partially understood, and there are no procedures to measure such mechanisms.
UNASSIGNED: To perform a pilot study to examine whether reinforcement learning processes measured through tasks or self-report are related to treatment response to behavioral activation.
UNASSIGNED: The pilot study enrolled 13 outpatients (12 completers) with major depressive disorder, from July of 2018 through February of 2019, into a nine-week trial with BA. Psychiatric evaluations, decision-making tests and self-reported reward experience and anticipations were acquired before, during and after the treatment. Task and self-report data were analysed by using reinforcement-learning models. Inferred parameters were related to measures of depression severity through linear mixed effects models.
UNASSIGNED: Treatment effects during different phases of the therapy were captured by specific decision-making processes in the task. During the weeks focusing on the active pursuit of reward, treatment effects were more pronounced amongst those individuals who showed an increase in Pavlovian appetitive influence. During the weeks focusing on the avoidance of punishments, treatment responses were more pronounced in those individuals who showed an increase in Pavlovian avoidance. Self-reported anticipation of reinforcement changed according to formal RL rules. Individual differences in the extent to which learning followed RL rules related to changes in anhedonia.
UNASSIGNED: In this pilot study both task- and self-report-derived measures of reinforcement learning captured individual differences in treatment response to behavioral activation. Appetitive and aversive Pavlovian reflexive processes appeared to be modulated by separate psychotherapeutic interventions, and the modulation strength covaried with response to specific interventions. Self-reported changes in reinforcement expectations are also related to treatment response.
UNASSIGNED: Set Your Goal: Engaging in GO/No-Go Active Learning, #NCT03538535, http://www.clinicaltrials.gov.