Mechanisms of Depression and Anhedonia in Adolescents: Linking Sleep to Reward- and Stress-Related Brain Function

NCT05691439 | Recruiting

• 2 other identifiers: 217730R01MH126109
• Study Type: interventional
• Target: 150
• Locations: 1 country
• Sites: 1

Brief Summary

This research will use biobehavioral approaches to generate understanding about the linkages between sleep duration and timing, stressful life events, and depressive symptoms in adolescents, with a long-term aim of developing effective preventative interventions.

Conditions

Depression in Adolescence

Outcome Measures

Primary Outcomes (5)

• Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Depression Scale - Short Form (8-item)

  The Patient-Reported Outcomes Measurement Information System (PROMIS) scale for Depression (8-item short form) will be administered at baseline, after each 2-week interval of intensive monitoring, and at follow-up, in reference to the past 7 days. The measure uses 5-point Likert scales, with scores ranging from 8 to 40 and higher scores indicating higher depression and lower scores indicating better outcome. Raw scores are converted to standardized T-scores using conversion tables published on the PROMIS website (nihpromis.org). T-scores of 50 represent the mean of the standardized sample.

  2 months

• Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Positive Affect Scale - Short Form (8-item)

  The Patient-Reported Outcomes Measurement Information System (PROMIS)scale for Positive Affect (8-item short form) will be administered at baseline, after each 2-week interval of intensive monitoring, and at follow-up, in reference to the past 7 days. The measure uses 5-point Likert scales, with scores ranging from 8 to 40 and higher scores indicating higher positive affect and better outcome. Raw scores are converted to standardized T-scores using conversion tables published on the PROMIS website (nihpromis.org). T-scores of 50 represent the mean of the standardized sample.

  2 months

• Dimensional Anhedonia Rating Scale (DARS)

  The Dimensional Anhedonia Rating Scale (DARS) will be used to assess state anhedonia related to 4 domains: hobbies, food/drink, social activities, and sensory experience. The 17-item measure assesses hedonic experiences "right now" using 4-point Likert scales. The DARS has high reliability and good convergent and divergent validity. The DARS scores range from 0 to 68, with higher scores indicating lower anhedonia and better outcome.

  2 months

• Reward-related brain function

  Functional magnetic resonance imaging (fMRI) during the Monetary Incentive Delay (MID) task will be used to measure blood oxygen level dependent (BOLD) regional response and functional connectivity related to anticipation and receipt of monetary rewards. This task reliably elicits activation in neural reward circuitry and is sensitive to depression and sleep/circadian factors.

  2 weeks

• Stress-related brain function

  Stress-related brain function will be indexed using autonomic and neuroendocrine measures taken before and during the Trier Social Stress Task (TSST). The TSST is a lab-based social-evaluative threat task that reliably elicits subjective stress and increases in the stress-hormone cortisol.

  2 weeks

Study Arms (2)

Sleep extension and advance "Lark Routine"

EXPERIMENTAL

Participants go to bed 90 minutes earlier than their typical average bedtime to extend sleep duration and advance sleep timing

Behavioral: Sleep extension and advance

Regular sleep duration and timing "Owl Routine"

ACTIVE COMPARATOR

Participants go to bed at their typical average bedtime

Behavioral: Regular sleep duration and timing

Interventions

Sleep extension and advance BEHAVIORAL

Participants in the sleep extension and advance condition will maintain a stable sleep schedule that extends sleep duration and advances bedtime by 90 min relative to weekday bedtime. This chronotherapeutic manipulation will include blocking phase-delaying light in the evening using goggles with orange lenses ("blue blockers") beginning 2 h prior to bedtime, and 30 min of 506 lux blue-green light exposure in the morning beginning at rise time using bright light goggles (ReTimer Pty Ltd., Australia). Schedule and chronotherapy adherence will be reinforced using motivational techniques (e.g., securing motivation, preplanning, problem-solving), requiring participants to text the study coordinator and complete morning assessments at rise time, and monetary incentives.

Also known as: Lark routine

Sleep extension and advance "Lark Routine"

Regular sleep duration and timing BEHAVIORAL

Participants in the regular sleep duration and timing condition will keep a stable sleep schedule that matches their typical weekday sleep opportunity and timing. Schedule adherence will be reinforced using motivational techniques (e.g., securing motivation, preplanning, problem-solving), requiring participants to text the study coordinator and complete morning assessments at rise time, and monetary incentives.

Also known as: Owl routine

Regular sleep duration and timing "Owl Routine"

Eligibility Criteria

• Age: 14 Years - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• years of age
• Currently in high school
• short and late sleep (weekday sleep duration ≤ 7 h and bedtime ≥ 22:30 (10:30 pm); n=100) or long and early sleep (weekday sleep duration \> 7 hours and bedtime ≤ 22:30 (10:30 pm); n=50), indexed by the Munich Chronotype Questionnaire
• Lifetime stressful event frequency ≥ 2 on the Stress and Adversity Inventory (STRAIN) Screener
• Depressive symptom severity t-score greater than or equal to 45 on the Patient Reported Outcomes (PROMIS) Depression scale
• English language fluency

You may not qualify if:

• Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for current moderate to severe alcohol/substance use disorder (≥4 symptoms);
• Current clinician-provided diagnosis of narcolepsy or idiopathic hypersomnia;
• Lifetime diagnosis of bipolar or schizophrenia spectrum disorder;
• Certain medical conditions (e.g., serious neurological disorder, heart failure or serious heart trouble, history of head injury with unconsciousness \> 5 minutes);
• Conditions that are contraindicated for magnetic resonance imaging (MRI; e.g., ferrous metal in the body);
• Positive screen for participant-reported eye disease, epilepsy, or photosensitizing medications that are contraindicated during the manipulation condition when bright light is administered (e.g., psychiatric neuroleptic drugs \[e.g., phenothiazine\], psoralen drugs, antiarrhythmic drugs \[e.g., amiodarone\], antimalarial and antirheumatic drugs, porphyrin drugs used in photodynamic treatment of skin diseases);
• Use of melatonin if participant is not willing to discontinue use for the duration of the study.
• We will schedule around (i.e., delay appointments as needed) to avoid the timeframe of the following events:
• urgent suicide risk, defined by moderate/severe risk per Columbia Suicide Severity Rating Scale (CSSRS) and clinician determination that current risk requires immediate action;
• travel across two or more time zones within the month prior to the overnight study visits;
• beginning or ending a prescribed medication within 2 months of the observational study;
• prescribed medication dose changes within the timeframe calculated as 5x the drug's half-life \[the time to reach pharmacokinetic steady-state\] before the initiation of the observational or experimental studies;
• anticipated change in prescribed medications or medication dosing during the observational or experimental studies;
• current symptoms of airborne infectious illness prior to laboratory visits.
• Participants with positive breathalyzer screen (blood alcohol level \> .02) will be rescheduled for an alternative overnight visit date.

Sponsors & Collaborators

• University of Oregon: lead
• Oregon Research Institute: collaborator
• University of Pittsburgh: collaborator
• National Institute of Mental Health (NIMH): collaborator

Study Sites (1)

University of Oregon

Eugene, Oregon, 97403, United States

RECRUITING

Study Officials

• Melynda D Casement, PhD

  University of Oregon

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Amanda Johnson

CONTACT

541-346-4107; anj@uoregon.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: BASIC SCIENCE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor of Psychology

Study Record Dates

• First Submitted: September 7, 2022
• First Posted: January 20, 2023
• Study Start: March 27, 2023
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): December 31, 2026
• Last Updated: November 17, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will share
• Time Frame: We will make available to the research community any resource that is presented in a publication that is published or accepted for publication. We agree to release and share data in a timely manner, but no later than one year following completion of the funded project period or the date of publication of the main findings from our final data set.
• Access Criteria: In order to gain access to data, researchers who were not part of the original research protocol as defined by the University of Oregon IRB application must submit a detailed description of their project to the Investigator Committee. The proposal must include the investigator's personal identification and institutional affiliation, a current CV, qualifications, estimated duration of the proposed research, source of financial support, and a conflict of interest statement. The protocol described must include study aims, background and significance, and methods and types of analysis, and a description of the data requested and list of variables. Once approved, the investigator must complete the necessary University of Oregon IRB exempt research application form and document completion of a responsible conduct of research program. Data will not be provided that could identify individual research participants or that the original consent form expressly forbade.

Locations

US (1)