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Research in the CEMHP
Research within the CEMHP is guided by the MRC's framework for developing complex interventions and occupies a trajectory stretching from psychological theory, to basic cognitive neuroscience, to pre-clinical and proof-of-principal clinical research, and finally through to pilot, exploratory, definitive and pragmatic randomised clinical trials. This work is grounded within a transdiagnostic framework, taking the view that the greatest potential for understanding and treating affective disorder is to focus on maladaptive underlying psychological (and biological) processes that cross traditional diagnostic boundaries, rather than pursue diagnosis-led research. We use cognitive-experimental, psychophysiology, and neuroimaging methodologies in the laboratory and prospective longitudinal and clinical trial designs outside the laboratory.
Our basic and pre-clinical science is carried out at the CBSU. Our clinical research is carried out at the Cambridge Centre for Affective Disorders (C2:AD) co-directed by Tim Dalgleish and Prof. Ian Goodyer (Department of Psychiatry, University of Cambridge).
Psychological theory
CEMHP research is grounded in theoretical models that propose a translational and transdiagnostic approach to understanding affective disorders. For example, we have developed the Schematic Propositional Analogical Associative Representation System (SPAARS) model that focuses on basic emotion processes and how these go awry in clinical conditions (read more here). One example of the application of SPAARs is to account for the onset and maintenance of Post-Traumatic Stress Disorder (PTSD; read more here).
Fundamental Aspects of Cognitive-Affective Processing
Our basic research streams carried out at the CBSU currently focus on three core aspects of cognitive-emotional processing in healthy participants and those with affective disorders.
Regulation of emotional memories
Intrusive and distressing memories of past negative and traumatic experiences characterise the range of mood and anxiety disorders, including depression and PTSD, and are strongly implicated in the maintenance of disorder. Our ongoing studies focus on developing methods for controlling and regulating the content and intrusiveness of these emotional memories and on understanding how such control works; developing broader perspectives on memories across time, space and social context; and combating negative memory biases with systematic cognitive training. Two ongoing proof-of-principal clinical projects (led by Georgina Smith at the Haven, London, involving sexual assault and abuse victims, and by Emma Hill involving depressed individuals) combine these methods developed in the laboratory with existing clinical techniques to form a targeted intervention for patients for whom dysregulated distressing memories are a dominant clinical feature.
Emotion and emotion control
The core functional role of emotions is to enable rapid and targeted reconfiguration of behavioural, cognitive and biological systems in response to goal-relevant environmental contingencies. Mood and anxiety disorders are defined by maladaptive configuration of this emotion system allied with an impoverished capacity for emotion regulation. Our projects focus on the cognitive, behavioural and biological concomitants of affective states and their regulation in healthy participants and in patients with depression. Tim Dalgleish is a collaborator in two large scale cohort studies (the ROOTs project in 1500 teenagers and the CamCAN project on 700 18-88 year olds) with responsibility for the work streams investigating emotional reactivity and emotion regulation across the lifespan. These projects permit extensive investigation of relationships between emotion system function and other major neuro-cognitive domains in the context of negative mood. Work led by Dean Mobbs focuses more closely on human fear processing using novel virtual environment paradigms within fMRI to examine behaviour under threat and its neural substrates in healthy participants and those with PTSD. Work led by Barney Dunn focuses on positive affective states and their concomitants and involves development and piloting of a treatment intervention to augment cognitive and emotional components of positivity in depression.
Executive control in affective contexts
Emotional disorders such as PTSD and depression are characterised by deficits in executive control that seem particularly marked in the context of affectively-laden self-relevant information. In work led by Susanne Schweizer we are exploring the potential of working memory training using such emotional material to deliver transferable gains in affective processing across diverse cognitive domains. Ongoing studies focus on healthy participants and patient groups with depression and PTSD, and utilise behavioural and fMRI evaluation methods to examine the size of training and transfer effects and the brain systems that underlie them.
Clinical Research
Understanding MBCT
- Mindfulness based cognitive therapy (MBCT) has been found to be an effective relapse prevention programme for individuals with recurrent depression (read more here). Our current research programme is investigating how mindfulness might work, isolating components of mindfulness in the laboratory (read more here) and measuring change in key cognitive-affective processes in an ongoing treatment trial.
PTSD Interventions
- We are also evaluating the efficacy of CBT for Post-Traumatic Stress Disorder (PTSD) in both adults and children...read more
Cognitive Bias Modification and Perspective Broadening
- Another approach we are evaluating is to supplement existing cognitive-behavioural treatments using computerised training packages to modify underlying information processing biases ('cognitive bias modification') or to help individual's develop adaptive reappraisal strategies ('perspective broadening').