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Depression: HELP
Articles by Jay C. Fournier
Based on 10 articles published since 2010
(Why 10 articles?)

Between 2010 and 2020, J. C. Fournier wrote the following 10 articles about Depression.
+ Citations + Abstracts
1 Article Decoupling Personality and Acute Psychiatric Symptoms in a Depressed Sample and a Community Sample. 2019

Fournier, Jay C / Wright, Aidan / Tackett, Jennifer L / Uliaszek, Amanda / Pilkonis, Paul A / Manuck, Stephen B / Bagby, R Michael. ·Department of Psychiatry, University of Pittsburgh School of Medicine. · Department of Psychology, University of Pittsburgh. · Department of Psychology, Northwestern University. · Department of Psychology, University of Toronto Scarborough. · Department of Psychiatry, University of Toronto. ·Clin Psychol Sci · Pubmed #31595211.

ABSTRACT: The association between depression and neuroticism is complex, but due to the difficulty in assessing neuroticism during mood episodes, the mechanisms underlying this relationship remain poorly understood. In this study, we sought to decompose neuroticism into finer-grained elements that were uncorrelated with psychiatric symptoms and to examine the incremental validity of those elements in explaining deficits in interpersonal functioning. A bifactor model with one general factor and six specific factors fit the data well in both a depressed (

2 Article Personalized prediction of antidepressant v. placebo response: evidence from the EMBARC study. 2019

Webb, Christian A / Trivedi, Madhukar H / Cohen, Zachary D / Dillon, Daniel G / Fournier, Jay C / Goer, Franziska / Fava, Maurizio / McGrath, Patrick J / Weissman, Myrna / Parsey, Ramin / Adams, Phil / Trombello, Joseph M / Cooper, Crystal / Deldin, Patricia / Oquendo, Maria A / McInnis, Melvin G / Huys, Quentin / Bruder, Gerard / Kurian, Benji T / Jha, Manish / DeRubeis, Robert J / Pizzagalli, Diego A. ·Harvard Medical School - McLean Hospital,Boston, MA,USA. · University of Texas, Southwestern Medical Center,Dallas, TX,USA. · University of Pennsylvania,Philadelphia, PA,USA. · University of Pittsburgh School of Medicine,Pittsburgh, PA,USA. · Harvard Medical School, Massachusetts General Hospital,Boston, MA,USA. · New York State Psychiatric Institute & Department of Psychiatry,College of Physicians and Surgeons of Columbia University,New York, NY,USA. · Stony Brook University,Stony Brook, NY,USA. · University of Michigan,Ann Arbor, MI,USA. · University of Zurich,Zurich,Switzerland. ·Psychol Med · Pubmed #29962359.

ABSTRACT: BACKGROUND: Major depressive disorder (MDD) is a highly heterogeneous condition in terms of symptom presentation and, likely, underlying pathophysiology. Accordingly, it is possible that only certain individuals with MDD are well-suited to antidepressants. A potentially fruitful approach to parsing this heterogeneity is to focus on promising endophenotypes of depression, such as neuroticism, anhedonia, and cognitive control deficits. METHODS: Within an 8-week multisite trial of sertraline v. placebo for depressed adults (n = 216), we examined whether the combination of machine learning with a Personalized Advantage Index (PAI) can generate individualized treatment recommendations on the basis of endophenotype profiles coupled with clinical and demographic characteristics. RESULTS: Five pre-treatment variables moderated treatment response. Higher depression severity and neuroticism, older age, less impairment in cognitive control, and being employed were each associated with better outcomes to sertraline than placebo. Across 1000 iterations of a 10-fold cross-validation, the PAI model predicted that 31% of the sample would exhibit a clinically meaningful advantage [post-treatment Hamilton Rating Scale for Depression (HRSD) difference ⩾3] with sertraline relative to placebo. Although there were no overall outcome differences between treatment groups (d = 0.15), those identified as optimally suited to sertraline at pre-treatment had better week 8 HRSD scores if randomized to sertraline (10.7) than placebo (14.7) (d = 0.58). CONCLUSIONS: A subset of MDD patients optimally suited to sertraline can be identified on the basis of pre-treatment characteristics. This model must be tested prospectively before it can be used to inform treatment selection. However, findings demonstrate the potential to improve individual outcomes through algorithm-guided treatment recommendations.

3 Article Neural correlates of autobiographical problem-solving deficits associated with rumination in depression. 2017

Jones, Neil P / Fournier, Jay C / Stone, Lindsey B. ·Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara St., Pittsburgh, PA 15216, USA. Electronic address: jonesnp@upmc.edu. · Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara St., Pittsburgh, PA 15216, USA. ·J Affect Disord · Pubmed #28477499.

ABSTRACT: BACKGROUND: Analytical rumination can be characterized as negative thoughts focused on searching for answers to personal problems. Failure to think concretely during autobiographical problem-solving (APS) is hypothesized to drive the inability of ruminators to generate effective solutions. Clarifying the brain correlates underlying APS deficits in depressed ruminators may identify novel biological targets for treatment. METHOD: Forty participants (22 unmedicated depressed and 18 never-depressed adults) ranging in rumination engaged in APS and negative self-referential processing (NSP) of negative trait adjectives during fMRI. We contrasted activation during APS with activation during NSP to isolate regions contributing to APS. RESULTS: Rumination was associated with having generated fewer solutions during APS and with a failure to recruit the angular gyrus (AG) and the medial frontal gyrus (MFG) during APS. Rumination was associated with greater MFG activation during NSP and stronger connectivity between the AG and the rostrolateral prefrontal cortex (RLPFC) during APS relative to NSP. Findings were not driven by clinical status. LIMITATIONS: The use of an extreme groups approach can result in overestimation of effects sizes. CONCLUSIONS: Ruminators fail to recruit regions with the default network (DN) that support APS. In particular, a failure to recruit the AG during APS may drive the abstract thinking style previously shown to explain depressed ruminator's difficulty generating concrete solutions. Targeting this mechanism directly may reduce rumination.

4 Article Brain mechanisms of anxiety's effects on cognitive control in major depressive disorder. 2016

Jones, N P / Chase, H W / Fournier, J C. ·Department of Psychiatry,University of Pittsburgh School of Medicine,Pittsburgh, PA,USA. ·Psychol Med · Pubmed #27291341.

ABSTRACT: BACKGROUND: Adults with major depressive disorder (MDD) demonstrate increased susceptibility to interfering effects of anxiety on cognitive control; although under certain conditions adults with MDD are able to compensate for these effects. The brain mechanisms that may facilitate the ability to compensate for anxiety either via the recruitment of additional cognitive resources or via the regulation of interference from anxiety remain largely unknown. To clarify these mechanisms, we examined the effects of anxiety on brain activity and amygdala-prefrontal functional connectivity in adults diagnosed with MDD. METHOD: A total of 22 unmedicated adults with MDD and 18 healthy controls (HCs) performed the Tower of London task under conditions designed to induce anxiety, while undergoing a functional magnetic resonance imaging assessment. RESULTS: During the easy condition, the MDD group demonstrated equivalent planning accuracy, longer planning times, elevated amygdala activity and left rostrolateral prefrontal cortex (RLPFC) hyperactivity relative to HCs. Anxiety mediated observed group differences in planning times, as well as differences in amygdala activation, which subsequently mediated observed differences in RLPFC activation. During the easy condition, the MDD group also demonstrated increased negative amygdala-dorsolateral prefrontal cortex (DLPFC) connectivity which correlated with improved planning accuracy. During the hard condition, HCs demonstrated greater DLPFC activation and stronger negative amygdala-DLPFC connectivity, which was unrelated to planning accuracy. CONCLUSIONS: Our results suggest that persons with MDD compensate for anxiety-related limbic activation during low-load cognitive tasks by recruiting additional RLPFC activation and through increased inhibitory amygdala-DLPFC communication. Targeting these neural mechanisms directly may improve cognitive functioning in MDD.

5 Article Gains in employment status following antidepressant medication or cognitive therapy for depression. 2015

Fournier, Jay C / DeRubeis, Robert J / Amsterdam, Jay / Shelton, Richard C / Hollon, Steven D. ·Jay C. Fournier, PhD, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Robert J. DeRubeis, PhD, Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania; Jay Amsterdam, MD, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Richard C. Shelton, MD, Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, Birmingham, Alabama; Steven D. Hollon, PhD, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA. ·Br J Psychiatry · Pubmed #24925985.

ABSTRACT: BACKGROUND: Depression can adversely affect employment status. AIMS: To examine whether there is a relative advantage of cognitive therapy or antidepressant medication in improving employment status following treatment, using data from a previously reported trial. METHOD: Random assignment to cognitive therapy (n = 48) or the selective serotonin reuptake inhibitor paroxetine (n = 93) for 4 months; treatment responders were followed for up to 24 months. Differential effects of treatment on employment status were examined. RESULTS: At the end of 28 months, cognitive therapy led to higher rates of full-time employment (88.9%) than did antidepressant medication among treatment responders (70.8%), χ(2) 1 = 5.78, P = 0.02, odds ratio (OR) = 5.66, 95% CI 1.16-27.69. In the shorter-term, the main effect of treatment on employment status was not significant following acute treatment (χ(2) 1 = 1.74, P = 0.19, OR = 1.77, 95% CI 0.75-4.17); however, we observed a site×treatment interaction (χ(2) 1 = 6.87, P = 0.009) whereby cognitive therapy led to a higher rate of full-time employment at one site but not at the other. CONCLUSIONS: Cognitive therapy may produce greater improvements in employment v. medication, particularly over the longer term.

6 Article The Personalized Advantage Index: translating research on prediction into individualized treatment recommendations. A demonstration. 2014

DeRubeis, Robert J / Cohen, Zachary D / Forand, Nicholas R / Fournier, Jay C / Gelfand, Lois A / Lorenzo-Luaces, Lorenzo. ·Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America. · Department of Psychiatry, The Ohio State University, Columbus, Ohio, United States of America. · Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America. ·PLoS One · Pubmed #24416178.

ABSTRACT: BACKGROUND: Advances in personalized medicine require the identification of variables that predict differential response to treatments as well as the development and refinement of methods to transform predictive information into actionable recommendations. OBJECTIVE: To illustrate and test a new method for integrating predictive information to aid in treatment selection, using data from a randomized treatment comparison. METHOD: Data from a trial of antidepressant medications (N = 104) versus cognitive behavioral therapy (N = 50) for Major Depressive Disorder were used to produce predictions of post-treatment scores on the Hamilton Rating Scale for Depression (HRSD) in each of the two treatments for each of the 154 patients. The patient's own data were not used in the models that yielded these predictions. Five pre-randomization variables that predicted differential response (marital status, employment status, life events, comorbid personality disorder, and prior medication trials) were included in regression models, permitting the calculation of each patient's Personalized Advantage Index (PAI), in HRSD units. RESULTS: For 60% of the sample a clinically meaningful advantage (PAI≥3) was predicted for one of the treatments, relative to the other. When these patients were divided into those randomly assigned to their "Optimal" treatment versus those assigned to their "Non-optimal" treatment, outcomes in the former group were superior (d = 0.58, 95% CI .17-1.01). CONCLUSIONS: This approach to treatment selection, implemented in the context of two equally effective treatments, yielded effects that, if obtained prospectively, would rival those routinely observed in comparisons of active versus control treatments.

7 Article Amygdala and whole-brain activity to emotional faces distinguishes major depressive disorder and bipolar disorder. 2013

Fournier, Jay C / Keener, Matthew T / Almeida, Jorge / Kronhaus, Dina M / Phillips, Mary L. ·Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. ·Bipolar Disord · Pubmed #23911154.

ABSTRACT: OBJECTIVES: It can be clinically difficult to distinguish depressed individuals with bipolar disorder (BD) and major depressive disorder (MDD). To examine potential biomarkers of difference between the two disorders, the current study examined differences in the functioning of emotion-processing neural regions during a dynamic emotional faces task. METHODS: During functional magnetic resonance imaging, healthy control adults (HC) (n = 29) and depressed adults with MDD (n = 30) and BD (n = 22) performed an implicit emotional-faces task in which they identified a color label superimposed on neutral faces that dynamically morphed into one of four emotional faces (angry, fearful, sad, happy). We compared neural activation between the groups in an amygdala region-of-interest and at the whole-brain level. RESULTS: Adults with MDD showed significantly greater activity than adults with BD in the left amygdala to the anger condition (p = 0.01). Results of whole-brain analyses (at p < 0.005, k ≥ 20) revealed that adults with BD showed greater activity to sad faces in temporoparietal regions, primarily in the left hemisphere, whereas individuals with MDD demonstrated greater activity than those with BD to displays of anger, fear, and happiness. Many of the observed BD-MDD differences represented abnormalities in functioning compared to HC. CONCLUSIONS: We observed a dissociation between depressed adults with BD and MDD in the processing of emerging emotional faces. Those with BD showed greater activity during mood-congruent (i.e., sad) faces, whereas those with MDD showed greater activity for mood-incongruent (i.e., fear, anger, and happy) faces. Such findings may reflect markers of differences between BD and MDD depression in underlying pathophysiological processes.

8 Article Differential change in specific depressive symptoms during antidepressant medication or cognitive therapy. 2013

Fournier, Jay C / DeRubeis, Robert J / Hollon, Steven D / Gallop, Robert / Shelton, Richard C / Amsterdam, Jay D. ·Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. fournierjc@upmc.edu ·Behav Res Ther · Pubmed #23644038.

ABSTRACT: Cognitive therapy and antidepressant medications are effective treatments for depression, but little is known about their relative efficacy in reducing individual depressive symptoms. Using data from a recent clinical trial comparing cognitive therapy, antidepressant medication, and placebo in the treatment of moderate-to-severe depression, we examined whether there was a relative advantage of any treatment in reducing the severity of specific depressive symptom clusters. The sample consisted of 231 depressed outpatients randomly assigned to: cognitive therapy for 16 weeks (n = 58); paroxetine treatment for 16 weeks (n = 116); or pill placebo for 8 weeks (n = 57). Differential change in five subsets of depressive symptoms was examined: mood, cognitive/suicide, anxiety, typical-vegetative, and atypical-vegetative symptoms. Medication led to a greater reduction in cognitive/suicide symptoms relative to placebo by 4 weeks, and both active treatments reduced these symptoms more than did placebo by 8 weeks. Cognitive therapy reduced the atypical-vegetative symptoms more than placebo by 8 weeks and more than medications throughout the trial. These findings suggest that medications and cognitive therapy led to different patterns of response to specific symptoms of depression and that the general efficacy of these two well-validated treatments may be driven in large part by changes in cognitive or atypical-vegetative symptoms.

9 Article Heterogeneity of amygdala response in major depressive disorder: the impact of lifetime subthreshold mania. 2013

Fournier, J C / Keener, M T / Mullin, B C / Hafeman, D M / Labarbara, E J / Stiffler, R S / Almeida, J / Kronhaus, D M / Frank, E / Phillips, M L. ·Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA. fournierjc@upmc.edu ·Psychol Med · Pubmed #22571805.

ABSTRACT: BACKGROUND: Patients with major depressive disorder (MDD) present with highly heterogeneous symptom profiles. We aimed to examine whether individual differences in amygdala activity to emotionally salient stimuli were related to heterogeneity in lifetime levels of depressive and subthreshold manic symptoms among adults with MDD. METHOD: We compared age- and gender-matched adults with MDD (n = 26) with healthy controls (HC, n = 28). While undergoing functional magnetic resonance imaging, participants performed an implicit emotional faces task: they labeled a color flash superimposed upon initially neutral faces that dynamically morphed into one of four emotions (angry, fearful, sad, happy). Region of interest analyses examined group differences in amygdala activity. For conditions in which adults with MDD displayed abnormal amygdala activity versus HC, within-group analyses examined amygdala activity as a function of scores on a continuous measure of lifetime depression-related and mania-related pathology. RESULTS: Adults with MDD showed significantly greater right-sided amygdala activity to angry and happy conditions than HC (p < 0.05, corrected). Multiple regression analyses revealed that greater right-amygdala activity to the happy condition in adults with MDD was associated with higher levels of subthreshold manic symptoms experienced across the lifespan (p = 0.002). CONCLUSIONS: Among depressed adults with MDD, lifetime features of subthreshold mania were associated with abnormally elevated amygdala activity to emerging happy faces. These findings are a first step toward identifying biomarkers that reflect individual differences in neural mechanisms in MDD, and challenge conventional mood disorder diagnostic boundaries by suggesting that some adults with MDD are characterized by pathophysiological processes that overlap with bipolar disorder.

10 Article The role of personality pathology in depression treatment outcome with psychotherapy and pharmacotherapy. 2012

Levenson, Jessica C / Wallace, Meredith L / Fournier, Jay C / Rucci, Paola / Frank, Ellen. ·Department of Psychology, University of Pittsburgh, PA 15213, USA. ·J Consult Clin Psychol · Pubmed #22823857.

ABSTRACT: BACKGROUND: Depressed patients with comorbid personality pathology may fare worse in treatment for depression than those without this additional pathology, and comorbid personality pathology may be associated with superior response in one form of treatment relative to another, though recent findings have been mixed. We aimed to evaluate the effect of personality pathology on time to remission of patients randomly assigned to 1 of 2 treatment strategies for depression and to determine whether personality pathology moderated the effect of treatment assignment on outcome. METHOD: Individuals undergoing an episode of unipolar major depression (n = 275) received interpersonal psychotherapy (Klerman, Weissman, Rounsaville, & Chevron, 1984) or selective serotonin reuptake inhibitor (SSRI) pharmacotherapy for depression. Depressive symptoms were measured with the HRSD-17. Remission was a mean HRSD-17 score of 7 or below over a period of 3 weeks. Personality disorders were measured according to SCID-II diagnoses, and personality pathology was measured dimensionally by summing the positive probes on the SCID-II. RESULTS: The presence of at least 1 personality disorder was not a significant predictor of time to remission, but a higher level of dimensionally measured personality pathology and the presence of borderline personality disorder were associated with a longer time to remission. Personality pathology did not moderate the effect of treatment assignment on time to remission. CONCLUSIONS: The findings suggest that depressed individuals with comorbid personality pathology generally fare worse in treatment for depression, although in this report, the effect of personality pathology did not differ by the type of treatment received.