Testing the Efficiency of a Psychological Treatment for the Rehabilitation of Action Cognition in Depression

Brief Summary

Detailed Description

Major depressive disorder is a highly prevalent and chronic disorder incurring significant costs to society. Although several treatments are recommended for the treatment of major depressive disorder, the high rate of recurrence suggests the need for constant improvement in the treatments for depression. Cognitive deficits following depressive episodes are possible targets to improve existing treatments. Cognitive symptoms are residual symptoms and often interfere with the ability of individuals with depression to solve life problems. Building on the idea that action cognition and motor imagery deficits are more stable in depressed individuals a rehabilitation-type of motor imagery training was developed. It is based on principles of rehabilitation of motor imagery (used in sport as in the field of neurorehabilitation), for individuals with neurological conditions. It does integrate a forward modeling of action and motor imagery, remote kinematics (Kinect) and embodied cognition account. This new intervention proved efficient in clinical work. There are several steps to the intervention. In the first session, the therapist explains the intervention and teaches a dynamic simulation routine. Then, the patient undergoes Kinect training for 10 minutes followed by an actfulness exercise focusing on feelings of movement that focuses on sensations of movement and dynamic imagining of a planned activity. In the second session, patients are thought to restructure action memories. The intervention is based on the scaffolding of two well-known interventions: mindfulness meditation-movement meditations and memory restructuring. Deficient action simulations are rehabilitated by: (a) partial movements (alternating covert with dynamic-partial movements simulations in response to stimuli); (b) linguistic supports (training in gerundival perceptions, e.g., recognize and naming a stimuli by actions, e.g., a door to open), (c) enhanced perceptual and affective simulations and (d) episodic memory support (participants have to form future memories of action cores-last sequence of movement before the perception of desired environmental change, correct them by experience and remember at the end of the day). Thus, it is a rehearsal training including combined actual and mental practice with augmentation of the motor component of simulations in thinking by enhancing gestures, language and episodic memory as controls of simulation, and is applied to promote the use of motor simulations in everyday life.

Primary Outcomes

Secondary Outcomes

• Change from baseline in anxiety symptoms using the Generalized Anxiety Disorder 7-item(Baseline; Intervention Week 8)
• Change from baseline in depressive symptoms using the Patient Health Questionnaire 9(Baseline; Intervention Week 1; Intervention Week 2; Intervention Week 3; Intervention Week 4; Intervention Week 5; Intervention Week 6; Intervention Week 7; Intervention Week 8; 3 months post-intervention)
• Change from baseline in anhedonia symptoms using the Snaith-Hamilton Pleasure Scale(Baseline; Intervention Week 8; 3 months post-intervention)
• Change from baseline in the health and disability level using The WHO Disability Assessment Schedule 12-item(Baseline; Intervention Week 8; 3 months post-intervention)
• Change from baseline in the diagnosis of depression assessed using the Structured Clinical Interview for DSM-5 Disorders -- Clinician Version(Baseline; Intervention Week 8)
• Changes from baseline in apathy level using Motivational Apathy Index(Baseline; Intervention Week 8; 3 months post-intervention)
• Change from baseline in the behavioral activation level using The Behavioral Activation for Depression Scale - Short Form(Baseline; Intervention Week 6; Intervention Week 8)
• Change from baseline in Backward digit span task(Baseline; Intervention Week 6 Intervention Week 8)
• Change from baseline in verb fluency task(Baseline; Intervention Week 6; Intervention Week 8)
• Change from baseline in The Movement Imagery Questionnaire-3(Baseline; Intervention Week 6)
• Scores for adverse and unwanted effects of the experimental intervention(Week 8)
• Change from baseline in the motor imagery is assessed at baseline using the Vividness of Motor Imagery Questionnaire-2(Baseline; Intervention Week 6)
• Change from baseline in affect and behaviour monitoring scale(Baseline; Intervention Week 1; Intervention Week 2; Intervention Week 3; Intervention Week 4; Intervention Week 5; Intervention Week 6; Intervention Week 7; Intervention Week 8; 3 months post-intervention)
• Change from baseline in the Environmental and Reward Observation Scale(Baseline; Intervention Week 6)
• Change from baseline in the rumination style scale(Baseline; Intervention Week 6)
• Change from baseline in verbal fluency task(Baseline; Intervention Week 6; Intervention Week 8)
• Acceptability ratings(Week 8)