The centre currently supports clinical research focusing on a set of inter-related core themes in affective disorders: basic processes and mechanisms; onset and vulnerability; treatment; and relapse prevention.
Basic processes and mechanisms
The clinical studies carried out in C2:AD are richly informed by basic science research that uses experimental psychology, brain imaging, psychopharmacology, endocrinology, psychophysiology, and descriptive and qualitative methods to investigate core mind and brain processes that underpin the affective disorders, as well as the dynamic social context in which they develop and occur. This work is carried out within basic science programmes in the C2:AD partner institutions including the Cognition, Emotion and Mental Health Programme at the MRC Cognition and Brain Sciences Unit, The Child and Adolescent Psychiatry Unit and other programmes in in the University of Cambridge Department of Psychiatry and The Behavioural and Clinical Neuroscience Institute (BCNI).
Affective Disorders Research Database
All partners within C2:AD are working together to create a list of people with experience of affective disorders who would like to be contacted about research studies that may be suitable for them. The overall aim of this database is to streamline the identification and recruitment process for research studies.
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Other current studies include:
A transdiagnostic approach to treating affective disorders.
We have developed a new psychological treatment for anxiety and mood problems; HARMONIC. Instead of focusing on any single diagnosis, HARMONIC combines the best treatment techniques into 10 modules, each of which targets problems common across the different mood and anxiety diagnoses (e.g., intense emotions, negative thinking, upsetting memories, distressing habits). We are currently completing a Phase II feasibility trial to determine the effectiveness of HARMONIC, compared to NHS treatment as usual, in improving symptoms for those with multiple diagnoses.
MemFlex – Relapse Prevention
We have developed a Memory Flexibility Programme which is designed to encourage helpful and flexible ways of relating to autobiographical memories. The purpose of this study is to compare MemFlex with a depression education workbook to establish whether MemFlex may improve depressive symptoms and reduce the likelihood of relapse. For more information contact: Caitlin.Hitchcock@mrc.cbu.ac.uk
Specialist Childhood Posttraumatic Stress Disorder (PTSD) Treatment Trials
The Childhood PTSD treatment stream is coordinated by Dr Richard Meiser-Stedman, and addresses the need for the development of acceptable, feasible and efficacious treatments for childhood posttraumatic stress. C2:AD currently supports two exploratory RCTs; PYCES and DECRYPT investigating our protocol of trauma-focused cognitive behavioural therapy – the Triple M model (CBT-3M) – in the treatment of childhood and adolescent PTSD.
PYCES stands for Parents and Young Children Under Extreme Stress and compares usual care against our CBT-3M protocol adapted for younger children aged 3-8 years old who have experienced or witnessed an extreme event and have developed PTSD following the event. Recruitment for this study is continuing until October 2017. For more information, please see the website: www.pyces.org
DECRYPT stands for Delivery of Cognitive therapy for Young People after Trauma and builds on PROSPECTS (see previous studies section). It is comparing usual care with out extended and modified version of CBT-3M for the treatment for PTSD in children and adolescents who have experienced multiple, repeated traumatic stressors, such as abuse or domestic/community violence. This project is running at multiple sites in the UK , for more information please email email@example.com
Online brain training for depression
We have tested this training programme in individuals with depression, which has shown to improve emotional and mental functioning in healthy individuals. We hope to find that individuals with depression will experience the same benefits. If this study proves to be effective, the training could be used to support individuals who suffer from depression, while they receive regular treatment or while they wait for a treatment intervention. For more information please contact firstname.lastname@example.org.
The ROOTS project is a longitudinal research study that has followed up more than 1000 Cambridgeshire teenagers since 2005 when they were 14. The project looks at genetic, hormonal, neural, psychological, and environmental factors and their interaction to understand aspects of adolescent life including the spectre of affective disorders.
C2:AD hosts a number of randomised controlled trials (RCTs) evaluating treatments for affective disorders in adults and young people. For example, narrative reprocessing therapy for adults with PTSD following discharge from intensive care is being compared with a wait list control group in the CANResT RCT which has now finished recruiting. The NIHR-funded IMPACT project is a multi-centre RCT comparing different complex interventions for depression in youth with embedded cognitive neuroscience studies to evaluate mechanisms of treatment effects.
C2AD has supported The Cambridge Specialist Depression Service (CSDS) in the pragmatic RCT of specialist services for treatment resistant depression compared to usual care funded by the Nottingham and Cambridge and Peterborough NIHR CLAHRCs.
The ASPECTS clinical trial looked at how we might support children and young people soon after a traumatic experience like a motor vehicle collision or assault. It was the first trial of its kind in the world. In particular, we looked at whether a psychological therapy called “cognitive therapy” would help children and young people feel better. The study’s main findings have now been published in the Journal of Child Psychology and Psychiatry – you can download the findings here: http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12673/full
Given the success of cognitive therapy with this population, we are now evaluating its efficacy with children and adolescents who have developed PTSD following exposure to multiple traumas, e.g. abuse, domestic violence. This is being led by Richard Meiser-Stedman at UEA (also a visiting scientist at the CBU in Cambridge), along with Tim Dalgleish (MRC CBU) and Patrick Smith (KCL).
PROSPECTS was a clinical case series investigating and extended and modified version of CBT-3M for the treatment of PTSD in children who have experienced multiple, repeated traumatic stressors, such as abuse or domestic/community violence. Results will be published shortly.
A core aim of the centre is to develop and evaluate preventative interventions for affective disorders in children and adults. For example, PREVENT is a large (N=420) definitive RCT based at the University of Exeter, in collaboration with C2:AD, that evaluated Mindfulness Based Cognitive Therapy, in comparison to continuation anti-depressant medication in the prevention of depressive relapse over a two year period.
We explored the impact of Memory Specificity training (MEST) on depressive symptoms. Those who experience depression often find it difficult to recall specific, detailed personal memories, and that this can be related to both current symptoms and experiencing symptoms in the future. This study compared group-format memory specificity training to support using education and discussion to determine how each of these group therapies impact depressive symptoms. Results will be published shortly.