Using Functional MRI Neurofeedback to Modulate Self-blame in Major Depressive Disorder

Prior treatment

• Standard reasons for being unable to undergo MRI (e.g. metal implants)
• Prior specialist diagnosis of attention deficit hyperactivity disorder (ADHD), antisocial or borderline personality disorder
• Current recreational drug use

Other illness

• History of manic or hypomanic episodes, or schizophreniform or schizophrenia symptoms, or substance abuse
• History of violent behaviour or aggressive impulses
• History of neurological disorders such as seizures, loss of consciousness following brain injury or medical disorders affecting brain function, blood flow or metabolism
• History of learning disabilities, major medical, developmental or relevant other axis-I disorders
• Significant impairment of psychosocial functioning before the last MDE indicating the possibility of a comorbid personality disorder or autism spectrum disorder

Other

• Impairments of vision or hearing which cannot be corrected for during the treatment sessions
• Pregnant or breastfeeding
• Current intake of benzodiazepines, GABAergic or benzodiazepine receptor agonists
• Having MDD with the following characteristics:
  • Presenting with greater than 'low-risk' suicidality, violence or current self-harming behaviour
  • Experiencing a current MDE lasting more than 12 months

• Capacity to consent. Participants will be asked to complete consent before trial begins
• Understanding of verbal and written information given in English
• Online access
• Aged 18 or over
• Male or female
• Clinical diagnosis of MDD, with the following characteristics:
  • Meets Diagnostic and Statistical Manual V (DSM-V) criteria for MDD
  • Experience of a previous major depressive episode (MDE) lasting at least two months (evidence of recurrent depression)
  • Patients must have stable symptoms, lasting at least six weeks before experimental group randomisation
  • Exhibiting at least partial treatment resistance, evidenced by insufficient response to at least one psychological intervention or antidepressant intervention
  • Current use of antidepressants is not basis for exclusion, but patients must be on a stable dose for at least six weeks without improvement before the study start, and must remain at this dose throughout the study