Behavioral Adaptation to Negative Social Cues in Depressed Patients According to Personal History of Suicide Attempt- COMPASS (COMPASS)

Behavioral Adaptation to Negative Social Cues in Depressed Patients According to Personal History of Suicide Attempt

Social interactions are part of daily life. To decide to interact with someone or not is a routine for humans. To ensure the quality of interpersonal relationships, emotional cues must be taken into account to adapt optimally the investigator's behavior.

Difficulties in interpersonal relationships often trigger suicidal behavior. Suicide attempters are characterized by an impaired decision - making associated with difficulties in familial relationships.

To date, little data on emotional recognition and social decision- making in clinical population is available.

The study aims to compare behavioral response to negative social cues in 82 depressed patients according to their history of suicide attempt using a computerized neuropsychological task.

Study Overview

• Status: Terminated
• Conditions: Depression; History of Suicide Attempt
• Intervention / Treatment: Other: Waiting room task

Detailed Description

To identify the nature of the mechanisms involved in social decisions, Mennella and coll. have developed a computerized task (waiting room task) in which the participant is asked to avoid or to approach individuals expressing negative emotional expressions, in this case: anger or fear. In practice, participants have to choose between two chairs to sit in a waiting room in which subjects expressing a neutral face or negative emotions are present. To make this choice they must press a specific keyboard button. In addition to that, in order to evaluate motivation, some of the trials are reversed, meaning that the choice made by the participant will result in the opposite result.

Using this task they have shown that: (1) anger is associated with more avoidance behavior than fear, (2) this behavior is goal- directed and, (3) the higher the level of impulsivity of the subjects, the less able they are to adapt their responses.

The proposed study will use this neuropsychological assessment, the waiting room task, to evaluate if depressed patients would avoid or approach individuals expressing negative facial emotions. The main objective is to compare behavioral adaptation to anger vs neutral cues among depressed patients with and without history of suicide attempt.

The study also aims to :

1. compare behavioral response to fear vs. neutral and anger vs. fear in depressed patients according to suicidal history ;
2. assess the modulation of behavioral adaptation by history of childhood maltreatment, level of impulsivity, anxiodepression and anhedonia;
3. correlate behavioral adaptation to negative cues (anger and fear) with decision-making performances using the Iowa Gambling Task.

The hypothesis is that depressed patients with a history of suicide attempt will exhibit anger specific hyper-responsiveness resulting in an increased avoidance behavior compared to subjects without suicidal history. It is expected that depressed suicide attempters will not have a different emotional reactivity compared to patients without suicidal history for another negative emotion, namely fear.

To that purpose, 82 depressed patients will be recruited in the study. Half of them will have a history of suicide attempt (suicide attempters) while the other half will have none (affective controls). Their participation will consist of an unique visit.

• Study Type: Interventional
• Enrollment (Actual): 66
• Phase: Not Applicable

Contacts and Locations

Study Locations

• France
  • Montpellier, France, 34295
    • Uhmontpellier

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Being between 18 and 65 years old
• Meeting the DSM-5 criteria for a current major depressive disorder
• For suicidal patients : having a lifetime history of suicide attempt
• For affective controls : having no personal history of suicide attempt
• Being able to understand the nature, purpose and methodology of the study
• Having signed the informed consent
• Being affiliated to a social security system

Exclusion Criteria:

• Current depressive episode with psychotic characteristics
• Mental retardation or sever medical co-morbidity
• Lifetime Diagnosis of schizophrenia or schizoaffective disorder
• Current manic or hypomanic episode
• Sensory or cognitive disability
• Pregnant or breastfeeding woman
• Deprivation of liberty (by judicial or administrative decision)
• Protection by law (guardianship or curatorship)
• Exclusion period in relation to another protocol
• Inability to understand, speak and write French

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Depressed patients with history of suicide attempt; Depressed patients with a lifetime history of suicide attempt will be evaluated regarding their behavioral adaptation toward negative social cues.	Other: Waiting room task; The waiting room task consists in a computerized neuropsychological task in which the participant is asked to freely choose a chair to sit in a waiting room. In a row of four chairs, the two in the middle are occupied by two males or females. One of the two subjects sitting either has a neutral face, or express a negative emotion (fear or anger). To make their decision, participants must press the "S" keyboard button to go left or the "L" keyboard button to go right in a time limit of 1500 milliseconds. One third of the time, the cursor moves in the opposite direction to that requested by the participant. For example, if the subject presses "S", the cursor moves to the right instead of to the left. Those reverse trials are used to evaluate their motivation to correct the movement of the cursor. The participant will repeat the task 360 times for the assessment to be completed.
Experimental: Depressed patients without any history of suicide attempt; Depressed patients without history of suicide attempt will be evaluated regarding their behavioral adaptation toward negative social cues.	Other: Waiting room task; The waiting room task consists in a computerized neuropsychological task in which the participant is asked to freely choose a chair to sit in a waiting room. In a row of four chairs, the two in the middle are occupied by two males or females. One of the two subjects sitting either has a neutral face, or express a negative emotion (fear or anger). To make their decision, participants must press the "S" keyboard button to go left or the "L" keyboard button to go right in a time limit of 1500 milliseconds. One third of the time, the cursor moves in the opposite direction to that requested by the participant. For example, if the subject presses "S", the cursor moves to the right instead of to the left. Those reverse trials are used to evaluate their motivation to correct the movement of the cursor. The participant will repeat the task 360 times for the assessment to be completed.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Motivation to avoid anger during the emotional task	Calculation of the proportion of avoidance vs. approach choices from people expressing anger	At inclusion

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in the proportion of avoidant choices in reverse trials compared to normal trials	Computerized calculation of the proportion of avoidance choices in reverse trials and comparison to the proportion calculated in normal trials.	At inclusion
Reaction time before clicking	Computerized measurement of reaction time before clicking to make the avoidant or approach choice	At inclusion
Reaction time between first and second choices in reverse tests	Computerized measurement of reaction time between the first choice and the second choice during the reverse condition	At inclusion
Iowa Gambling Test score	Decision- making impairment assessment with the Iowa Gambling Task. In this task participants are asked to choose between four piles of cards allowing them to earn or lose money. - Among those piles, two are advantageous (little gain and little loss) while the other two are disadvantageous (bigger gain but bigger loss). The goal is to earn as much money as possible. Persistence to choose the disadvantageous piles is interpreted to reflect impulsivity.	At inclusion

Collaborators and Investigators

• Sponsor: University Hospital, Montpellier
• Collaborators: INSERM U960 - Cognitive Neuroscience Laboratory - Paris, France

Study record dates

Study Major Dates

• Study Start (Actual): April 9, 2019
• Primary Completion (Actual): April 10, 2021
• Study Completion (Actual): October 10, 2021

Study Registration Dates

• First Submitted: March 29, 2019
• First Submitted That Met QC Criteria: April 1, 2019
• First Posted (Actual): April 2, 2019

Study Record Updates

• Last Update Posted (Actual): January 5, 2022
• Last Update Submitted That Met QC Criteria: December 14, 2021
• Last Verified: December 1, 2021

More Information

Terms related to this study

• Keywords: Depression; Neuropsychology; Social interaction; Suicide attempt; Decision- making; Implicit Emotional processing
• Additional Relevant MeSH Terms: Behavioral Symptoms; Self-Injurious Behavior; Depression; Suicide; Suicide, Attempted
• Other Study ID Numbers: RECHMPL19_0024

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No