Abstract

Objectives To describe a new framework ‘SENSO’ (sensitivity to social signal) that emphasizes that acute depressed patients show abnormal cognitive, emotional and biological responses to positive and negative social signals with impaired monitoring of social acceptance. Methods We will review evidence that Major Depression is associated with increasing vulnerability to social rejection and social stress. We will also discuss a recent meta-analysis realized by our group evaluating neural correlates of social exclusion tasks in healthy subjects. Results Major Depression is clearly precipitated by major social life-events. These social events increase the need for subjects to monitor their level of social acceptance and induce stress response. Self-propagatory processes (i.e. excessive reassurance seeking, negative feedback seeking) generate in depressed patients a vicious circle leading to increase sensitivity to social rejection. Social exclusion tasks in healthy subjects induce increased activation in ventromedial prefrontal cortex, subgenual cortex and insula, regions implicated in self-processing and production of negative emotion. Conclusion Results of our literature review and of our meta-analysis stress the importance of studying interpersonal processes and their neural correlates in depressive phenomena. They emphasize the role of salient and default mode networks in the pathophysiology of major depression.

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