Abstract
Changes in reflexive emotional responses are hallmarks of depression, but how emotional reflexes make an impact on adaptive decision-making in depression has not been examined formally. Using a Pavlovian-instrumental transfer (PIT) task, we compared the influence of affectively valenced stimuli on decision-making in depression and generalized anxiety disorder compared with healthy controls; and related this to the longitudinal course of the illness. A total of 40 subjects with a current DSM-IV-TR diagnosis of major depressive disorder, dysthymia, generalized anxiety disorder, or a combination thereof, and 40 matched healthy controls performed a PIT task that assesses how instrumental approach and withdrawal behaviours are influenced by appetitive and aversive Pavlovian conditioned stimuli (CSs). Patients were followed up after 4-6 months. Analyses focused on patients with depression alone (n = 25). In healthy controls, Pavlovian CSs exerted action-specific effects, with appetitive CSs boosting active approach and aversive CSs active withdrawal. This action-specificity was absent in currently depressed subjects. Greater action-specificity in patients was associated with better recovery over the follow-up period. Depression is associated with an abnormal influence of emotional reactions on decision-making in a way that may predict recovery.
Highlights
Computational theories of valuation provide a quantitative framework linking emotions to choices
Depression is associated with an abnormal influence of emotional reactions on decision-making in a way that may predict recovery
They have carved out distinguishable but interacting decision-making systems (Daw & Dayan, 2014) including a reflective goal-directed system where choices are flexibly based on a prospective consideration of likely outcomes, and an ‘automatic’ Pavlovian system that inflexibly mandates evolutionarily ingrained reflex responses to emotional stimuli (Dayan et al 2006; Guitart-Masip et al 2011)
Summary
Computational theories of valuation provide a quantitative framework linking emotions to choices. They have carved out distinguishable but interacting decision-making systems (Daw & Dayan, 2014) including a reflective goal-directed system where choices are flexibly based on a prospective consideration of likely outcomes, and an ‘automatic’ Pavlovian system that inflexibly mandates evolutionarily ingrained reflex responses to emotional stimuli (Dayan et al 2006; Guitart-Masip et al 2011). In the context of depression, the interaction between these systems is worth investigating as it might provide a quantitative handle on how reflexive emotional responses shape reflective cognitions, and vice versa (Huys et al 2015). Using a Pavlovian-instrumental transfer (PIT) task, we compared the influence of affectively valenced stimuli on decision-making in depression and generalized anxiety disorder compared with healthy controls; and related this to the longitudinal course of the illness
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