ARTICLE UPDATE - An investigation of the cognitive and experiential features of intrusive memories in depression.

Williams AD, Moulds ML.

Memory, 15, 912-920

Intrusive autobiographical memories of negative past events are a clinical feature common to post-traumatic stress disorder (PTSD) and depression. Recent investigations provide increasing evidence that shared cognitive processes are linked to the maintenance of intrusive memories in both conditions. Still absent from the existing literature, however, is a systematic examination of the basic content and defining characteristics of intrusive memories in depression. This study sought to: (i) outline the content and features of intrusive memories in depression, and (ii) investigate whether intrusion characteristics linked to the persistence of intrusive memories in PTSD are also characteristic of intrusive memories in depression. A sample of undergraduate students (n=250) were interviewed and assessed for the presence of an intrusive memory in the past week, and completed a battery of measures that indexed cognitive and affective responses to the memory. Consistent with prediction, intrusive memories contained high levels of sensory experience and were marked by a sense of "nowness". In accord with studies with PTSD samples, sensory features accounted for unique variance in the prediction of depression severity, over and above that accounted for by intrusion frequency. This pattern of findings was replicated in a dysphoric (BDI-II>/=12) sub-sample of participants. Our results underscore the value of drawing on theoretical conceptualisations and empirical findings from the post-traumatic stress literature to extend our understanding of intrusive memories in depression.

ARTICLE UPDATE - Amygdala reactivity to masked negative faces is associated with automatic judgmental bias in major depression: a 3 T fMRI study.

Dannlowski U, Ohrmann P, Bauer J, Kugel H, Arolt V, Heindel W, Kersting A, Baune BT, Suslow T.

Journal of Psychiatry Neuroscience, in press

OBJECTIVE: In a previous study, we demonstrated that amygdala reactivity to masked negative facial emotions predicts negative judgmental bias in healthy subjects. In the present study, we extended the paradigm to a sample of 35 inpatients suffering from depression to investigate the effect of amygdala reactivity on automatic negative judgmental bias and clinical characteristics in depression. METHODS: Amygdala activity was recorded in response to masked displays of angry, sad and happy facial expressions by means of functional magnetic resonance imaging at 3 T. In a subsequent experiment, the patients performed an affective priming task that characterizes automatic emotion processing by investigating the biasing effect of subliminally presented emotional faces on evaluative ratings to subsequently presented neutral stimuli. RESULTS: Significant associations between (right) amygdala reactivity and automatic negative judgmental bias were replicated in our patient sample (r = -0.59, p < 0.001). Further, negatively biased evaluative processing was associated with severity and longer course of illness (r = -0.57, p = 0.001). CONCLUSION: Amygdala hyperactivity is a neural substrate of negatively biased automatic emotion processing that could be a determinant for a more severe disease course.

ARTICLE UPDATE - Neuronal correlates of emotional processing in patients with major depression.

Frodl T, Scheuerecker J, Albrecht J, Kleemann AM, Müller-Schunk S, Koutsouleris N, Möller HJ, Brückmann H, Wiesmann M, Meisenzahl E.

World Journal of Biological Psychiatry, in press

Affective facial processing is an important component of interpersonal relationships, which is altered in patients with major depression. The study was designed to examine differences in functional brain activity between patients with major depression and healthy controls using functional magnetic resonance imaging (fMRI). Twelve patients with major depression and 12 age-, gender- and handedness-matched healthy controls were studied using fMRI. Subjects had to match facial emotional expressions in explicit trials, and gender of the presented faces in implicit trials. Patients showed higher blood oxygen level-dependent (BOLD) responses to implicit emotional stimuli than healthy controls in the left dorsolateral prefrontal cortex and the left precentral gyrus. Patients show a failure of deactivation in ACC, right dorsolateral prefrontal cortex (DLPFC) and right superior frontal cortex. Moreover, they exhibited smaller differences in BOLD responses in the left superior temporal lobe for the implicit contrasted to the explicit task, and in the cerebellum for the explicit contrasted to the implicit task compared to those of controls. Altered activation of the prefrontal cortex and anterior cingulum during emotion processing is a key feature of major depression.

ARTICLE UPDATE - Neural Biases to Covert and Overt Signals of Fear: Dissociation by Trait Anxiety and Depression

Leanne M. Williams, Andrew H. Kemp, Kim Felmingham, Belinda J. Liddell, Donna M. Palmer and Richard A. Bryant

Journal of Cognitive Neuroscience, 19, 1595-1608

Although biases toward signals of fear may be an evolutionary adaptation necessary for survival, heightened biases may be maladaptive and associated with anxiety or depression. In this study, event-related potentials (ERPs) were used to examine the time course of neural responses to facial fear stimuli (versus neutral) presented overtly (for 500 msec with conscious attention) and covertly (for 10 msec with immediate masking to preclude conscious awareness) in 257 nonclinical subjects. We also examined the impact of trait anxiety and depression, assessed using psychometric ratings, on the time course of ERPs. In the total subject group, controlled biases to overtly processed fear were reflected in an enhancement of ERPs associated with structural encoding (120–220 msec) and sustained evaluation persisting from 250 msec and beyond, following a temporo-occipital to frontal topography. By contrast, covert fear processing elicited automatic biases, reflected in an enhancement of ERPs prior to structural encoding (80–180 msec) and again in the period associated with automatic orienting and emotion encoding (230–330 msec), which followed the reverse frontal to temporo-occipital topography. Higher levels of trait anxiety (in the clinical range) were distinguished by a heightened bias to covert fear (speeding of early ERPs), compared to higher depression which was associated with an opposing bias to overt fear (slowing of later ERPs). Anxiety also heightened early responses to covert fear, and depression to overt fear, with subsequent deficits in emotion encoding in each case. These findings are consistent with neural biases to signals of fear which operate automatically and during controlled processing, feasibly supported by parallel networks. Heightened automatic biases in anxiety may contribute to a cycle of hypervigilance and anxious thoughts, whereas depression may represent a "burnt out" emotional state in which evaluation of fear stimuli is prolonged only when conscious attention is allocated.

ARTICLE UPDATE - Inhibition Versus Switching Deficits in Different Forms of Rumination

Whitmer, Anson J.; Banich, Marie T.

Psychological Science, 18, 546-553.

Individuals who depressively ruminate about their current dysphoria tend to perseverate more than nonruminators. The goal of the current study was to determine whether such perseverative tendencies are associated with an inability to switch attention away from old to new information or with an inability to effectively inhibit the processing of previously relevant information. We used a task-switching paradigm that can distinguish between these two processes. Two experiments showed that depressive rumination is associated with a deficit in inhibiting prior mental sets. The second experiment also demonstrated that, in contrast to depressive rumination, angry and intellectual rumination are associated with difficulties in switching to a new task set, but not with inhibition of a prior task set. This study suggests that different forms of rumination are associated with different cognitive mechanisms and that both deficits may contribute to the perseveration that is associated with ruminative tendencies.

ARTICLE UPDATE - Emotion recognition from dynamic emotional displays following anterior cingulotomy and anterior capsulotomy for chronic depression

Nathan Ridout, Ronan E. O’Carroll, Barbara Dritschel, David Christmasd, Muftah Eljamel and Keith Matthews

Neuropsychologia, in press

Four patients that had received an anterior cingulotomy (ACING) and five patients that had received both an ACING and an anterior capsulotomy (ACAPS) as an intervention for chronic, treatment refractory depression were presented with a series of dynamic emotional stimuli and invited to identify the emotion portrayed. Their performance was compared with that of a group of non-surgically treated patients with major depression (n = 17) and with a group of matched, never-depressed controls (n = 22). At the time of testing, four of the nine neurosurgery patients had recovered from their depressive episode, whereas five remained depressed. Analysis of emotion recognition accuracy revealed no significant differences between depressed and non-depressed neurosurgically treated patients. Similarly, no significant differences were observed between the patients treated with ACING alone and those treated with both ACING and ACAPS. Comparison of the emotion recognition accuracy of the neurosurgically treated patients and the depressed and healthy control groups revealed that the surgically treated patients exhibited a general impairment in their recognition accuracy compared to healthy controls. Regression analysis revealed that participants’ emotion recognition accuracy was predicted by the number of errors they made on the Stroop colour-naming task. It is plausible that the observed deficit in emotion recognition accuracy was a consequence of impaired attentional control, which may have been a result of the surgical lesions to the anterior cingulate cortex.