Discussion
MDD, depression, depressed
Novel personalized and non-invasive treatments for depression are urgently needed, especially among adolescents where MDD prevalence has been steadily increasing [This multisite protocol will result in several key contributions to the field. First, this study will test mindfulness-based real-time fMRI neurofeedback as a potential treatment specifically for adolescents with MDD. The current protocol, to our knowledge, is one of very few studies testing any form of fMRI neurofeedback for depressed adolescents [That the current study tests a single session of real-time fMRI neurofeedback is both a key strength and a limitation. MRI is expensive and constrained to geographical locations where scanners are accessible [An additional limitation of the present study, particularly for aim 1, is the absence of a true control group. The present study will not be able to fully rule out the influence of confounding factors on changes in DMN connectivity, such as placebo effects [In summary, this project will test whether a non-invasive personalized mbNF protocol can guide adolescents with MDD to downregulate default mode network connectivity. This protocol builds on encouraging pilot findings [