Psychophysiology, 2023, 60(S1):S17. [Presented at the 63^rd Annual Meeting of the Society of Psychophysiological Research (SPR), September 27 - 30, 2023.]

Targeting Mechanisms of Emotion Regulation During Cognitive Behavior Therapy in Depression: Preliminary Findings Linking Mindfulness, Treatment Response, and ERPs to Emotionally-Arousing Stimuli

Jürgen Kayser^1,2, Yifan Gao², Tayler Wilson³, Rocco Rinaldi-Rose³, Christopher Aceto³, Steven D. Hollon⁴, Gerard E. Bruder¹, Ronit Kishon^1,3

¹Columbia University, Department of Psychiatry, New York, NY, USA; ²New York State Psychiatric Institute, Division of Translational Epidemiology, New York, NY, USA; ³New York State Psychiatric Institute, Depression Evaluation Service, New York, NY, USA; ⁴Vanderbilt University, Department of Psychology, Nashville, TN, USA

Abstract

We aimed to elucidate the neurobiological mechanisms by which change occurs during cognitive behavior therapy (CBT) for major depressive disorder (MDD). Emotion regulation is deemed critical for CBT success. Event-related potentials (ERPs) to salient affective pictures reflect different stages of emotion processing (stimulus-driven categorization to cognitive appraisal). MDD is characterized by blunted ERPs to emotionally-arousing stimuli. We examined if these stages are moderated by treatment response and/or meta-cognitive processes of self-observation, such as mindfulness. Using an emotional hemifield paradigm with negative/neutral pictures, 72-channel ERPs were recorded from 39 depressed patients before and after cognitive-behavioral or nonspecific-supportive therapy. Reference-free current source density (CSD) transformations of ERPs were quantified by temporal principal components analysis, confirming three distinct stages of emotion processing (negative-greater-than-neutral): early N2 sink, P3 source, and late centroparietal (CP) source. Mixed-effects models (MLMs) provided continuous estimates of treatment response (symptoms) and mindfulness change (time-by-score=slope). These slopes were used as predictors in MLMs evaluating each CSD-PCA component. Symptom and mindfulness slopes were 1) inversely correlated, and 2) interacted with emotional effects in a complex fashion, involving treatment arm and testing session. Findings are consistent with hypothesized differences in top-down regulation of bottom-up emotion processing that are linked to MDD treatment response.

Key Words: depression; cognitive behavioral therapy (CBT); treatment response; event-related potential (ERP); current source density (CSD); principal components analysis (PCA); mindfulness