Self Focus in Bipolar Disorder: A Functional Magnetic Resonance Imaging (fMRI) Study

Negative rumination, a specific form of self-focus, characterized by repetitively focusing on
one's symptoms of distress, and the possible causes and consequences of these symptoms, is a
hallmark of depression. Nearly a decade of research has culminated in evidence that the
tendency to engage in negative rumination is highly correlated with depressive symptoms.
Rumination also plays a critical role in the etiology and maintenance of depressed states and
predicts risk for mania in bipolar disorder. Despite the central role of rumination in major
depression and bipolar disorder, there have been few studies to date investigating the
functional neuroanatomy of negative rumination, and no studies of positive rumination. The
few neuroimaging studies that have utilized measures of the tendency to engage in negative
rumination have focused on brain functioning when performing tasks that involve processing
emotional or self-referential stimuli, but they have not studied resting state activity or
functional activity during negative and positive rumination. We are examining both resting
state activity and functional activity during negative and positive rumination and during
self-processing to study the relationship between the neural correlates of
rumination/self-focus and self-processing in major depression and bipolar disorder.

Inclusion Criteria Healthy Controls:

- Right-handed (as determined by the Handedness Inventory; Oldfield, 1971)

- Normal or corrected-to normal vision and hearing

Exclusion Criteria for Healthy Controls:

- Any current or past psychiatric history

- Significant medical, psychiatric or neurological illness

- Currently taking antidepressants, mood stabilizers, or benzodiazepines

- Positive MR screen (e.g., metal implant, claustrophobia, etc)

Inclusion Criteria for Patients with Major Depression:

- Current diagnosis of MDD

- Right-handed (as determined by the Handedness Inventory; Oldfield, 1971)

- Normal or corrected-to normal vision and hearing

Exclusion Criteria for MDD Patients:

- If a history of substance abuse, at least 6 months in remission

- Current suicidal ideation or history of suicide attempts

- Positive MR screen (e.g., metal implant, claustrophobia, etc)

Inclusion Criteria for patients with BPAD:

- Current diagnosis of BPAD

- Right-handed (as determined by the Handedness Inventory; Oldfield, 1971)

- Normal or corrected-to normal vision and hearing

Exclusion Criteria for BPAD Patients:

- If a history of substance abuse, at least 6 months in remission

- Current suicidal ideation or history of suicide attempts

- Positive MR screen (e.g., metal implant, claustrophobia, etc)