More rumination and less effective emotion regulation in previously depressed women with preserved executive functions

BMC Psychiatry

Nils Inge Landrø¹  Catherine Harmer²  Martin Aker¹ 

[1] Clinical Neuroscience Research Group, Department of Psychology, Psykologisk institutt, University of Oslo, Blindern, Oslo 0317, Norway;Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford OX3 7JX, UK

关键词: Remitted MDD;    Depression;    Rumination;    Emotion regulation;    Executive function;   

Others  :  1092018
DOI  :  10.1186/s12888-014-0334-4

 received in 2014-08-15, accepted in 2014-11-12,  发布年份 2014

【 摘 要 】

Background

Major depressive disorder is associated with very high recurrence rates, and specific vulnerability factors that increase the risk for repeated episodes should be identified. Impaired executive functions have repeatedly been found in remitted populations. The current study included both neutral and emotional executive tasks, and we expected to find impaired performance in unmedicated previously depressed women compared to controls. Furthermore, we hypothesized that the executive functions inhibition and shifting would be related to the ability to apply cognitive reappraisal and to avoid unhealthy rumination.

Methods

Inhibition and shifting data derived from neutral and emotional computerized tasks, and questionnaire data on emotion regulation and trait rumination, were obtained from previously depressed (n = 109) and never-depressed women (n = 64) and analyzed in independent samples t-tests. A logistic regression analysis investigated the ability of emotion regulation and rumination to predict depression vulnerability. The associations of executive functions to emotion regulation and rumination were investigated in a series of linear regression analyses. Participants on psychotropic medication were excluded from all analyses of executive performance.

Results

Previously depressed participants, the majority of which had experienced recurrent episodes, matched control participants on both neutral and emotional executive tasks. However, significantly more rumination and expressive suppression, and less cognitive reappraisal, were found in the previously depressed group. Executive function was unrelated to rumination and emotion regulation in this sample.

Conclusions

Previously depressed women whose executive function was intact were characterized by ruminative tendencies and more frequent use of expressive suppression. Trait rumination and expressive suppression are known to increase depression risk, but were unrelated to executive functions in this population. This indicates that unhealthy emotion regulation strategies may be targeted directly in preventive interventions.

【 授权许可】

   
2014 Aker et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. American Psychiatric Association, Washington, DC; 2000.
• [2]Kessler RC, Berglund P, Demler O, Jin R, Merikangas K, Walters EE: Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005, 62:593-602.
• [3]Solomon DA, Keller MB, Leon AC, Mueller TI, Lavori PW, Shea M, Coryell W, Warshaw M, Turvey C, Maser JD, Endicott J: Multiple recurrences of major depressive disorder. Am J Psychiatry 2000, 157:229-233.
• [4]Boland RJ, Keller MB: Course and outcome of depression. In Handbook of Depression. 2nd edition. Edited by Gotlib IH, Hammen CL. Guilford, New York; 2009:23-43.
• [5]Depression in adults: the treatment and management of depression in adults. National Health Service, United Kingdom; 2009.
• [6]Snyder HR: Major depressive disorder is associated with broad impairments on neuropsychological measures of executive function: a meta-analysis and review. Psychol Bull 2013, 139:81-132.
• [7]Wagner S, Doering B, Helmreich I, Lieb K, Tadic A: A meta-analysis of executive dysfunctions in unipolar major depressive disorder without psychotic symptoms and their changes during antidepressant treatment. Acta Psychiatr Scand 2012, 125:281-292.
• [8]Bora E, Harrison BJ, Yücel M, Pantelis C: Cognitive impairment in euthymic major depressive disorder: a meta-analysis. Psychol Med 2013, 43:2017-2026.
• [9]Hasselbalch BJ, Knorr U, Kessing LV: Cognitive impairment in the remitted state of unipolar depressive disorder: a systematic review. J Affect Disord 2011, 134:20-31.
• [10]Bradley BP, Mogg K, Lee SC: Attentional biases for negative information in induced and naturally occurring dysphoria. Behav Res Ther 1997, 35:911-927.
• [11]Williams J, Mathews A, MacLeod C: The emotional Stroop task and psychopathology. Psychol Bull 1996, 120(1):3-24.
• [12]De Lissnyder E, Koster EH, Derakshan N, De Raedt R: The association between depressive symptoms and executive control impairments in response to emotional and non-emotional information. Cogn Emot 2010, 24:264-280.
• [13]Peckham AD, McHugh R, Otto MW: A meta-analysis of the magnitude of biased attention in depression. Depress Anxiety 2010, 27:1135-1142.
• [14]Vanderhasselt M-A, De Raedt R, Dillon DG, Dutra SJ, Brooks N, Pizzagalli DA: Decreased cognitive control in response to negative information in patients with remitted depression: an event-related potential study. J Psychiatry Neurosci 2012, 37:250-258.
• [15]Joormann J, Gotlib IH: Emotion regulation in depression: relation to cognitive inhibition. Cogn Emot 2010, 24:281-298.
• [16]Nolen-Hoeksema S: Responses to depression and their effects on the duration of depressive episodes. J Abnorm Psychol 1991, 100:569-582.
• [17]Ehring T, Fischer S, Schnülle J, Bosterling A, Tuschen-Caffier B: Characteristics of emotion regulation in recovered depressed versus never depressed individuals. Person Indiv Diff 2008, 44:1574-1584.
• [18]Ehring T, Tuschen-Caffier B, Schnülle J, Fischer S, Gross JJ: Emotion regulation and vulnerability to depression: spontaneous versus instructed use of emotion suppression and reappraisal. Emotion 2010, 10:563-572.
• [19]Holden C: Sex and the suffering brain. Science 2005, 308:1574-1577.
• [20]Nolen-Hoeksema S, Wisco BE, Lyubomirsky S: Rethinking rumination. Perspect Psychol Sci 2008, 3:400-424.
• [21]Jose PE, Brown I: When does the gender difference in rumination begin? gender and age differences in the use of rumination by adolescents. J Youth Adolesc 2008, 37:180-192.
• [22]Joormann J, Gotlib IH: Updating the contents of working memory in depression: interference from irrelevant negative material. J Abnorm Psychol 2008, 117:182-192.
• [23]Philippot P, Brutoux F: Induced rumination dampens executive processes in dysphoric young adults. J Behav Ther Exp Psych 2008, 39:219-227.
• [24]Watkins E, Brown R: Rumination and executive function in depression: an experimental study. J Neurol Neurosurg Psychiatry 2002, 72:400-402.
• [25]Whitmer AJ, Gotlib IH: Switching and backward inhibition in major depressive disorder: the role of rumination. J Abnorm Psychol 2012, 121:570-578.
• [26]Goeleven E, De Raedt R, Baert S, Koster EH: Deficient inhibition of emotional information in depression. J Affect Disord 2006, 93:149-157.
• [27]Harmer CJ, Goodwin GM, Cowen PJ: Why do antidepressants take so long to work? a cognitive neuropsychological model of antidepressant drug action. British J Psychiatry 2009, 195:102-108.
• [28]Bestgen Y, Dupont V: Is negative priming a reliable measure for studying individual differences in inhibition? Current Psychol Cogn 2000, 19:287-305.
• [29]Friedman NP, Miyake A: The relations among inhibition and interference control functions: a latent-variable analysis. J Exp Psychol-Gen 2004, 133:101-135.
• [30]Tipper SP: Does negative priming reflect inhibitory mechanisms? a review and integration of conflicting views. Quarterly J Exp Psychol A-Hum Exp Psychol 2001, 54A:321-343.
• [31]Beck AT, Steer RA, Brown GK: Beck Depression Inventory-II (BDI-II) Manual [Norwegian translation, 2005]. Harcourt Assessment, Inc., Norway; 1996.
• [32]Beck AT, Steer RA: Beck Anxiety Inventory Manual [Norwegian translation 2005]. Norway, Pearson Assessment; 1990.
• [33]Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG: AUDIT - Alcohol Use Disorders Identification Test. Guidelines for use in primary care. Second edition. World Health Organization, Geneva, Switzerland; 2001.
• [34]Berman AH, Bergman H, Palmstierna T, Schlyter F: Evaluation of the Drug Use Disorders Identification Test (DUDIT) in criminal justice and detoxification settings and in a Swedish population sample. Eur Addict Res 2005, 11:22-31.
• [35]Treynor W, Gonzalez R, Nolen-Hoeksema S: Rumination reconsidered: a psychometric analysis. Cogn Ther Res 2003, 27:247-259.
• [36]Gross JJ, John OP: Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. J Pers Soc Psychol 2003, 85:348-362.
• [37]Delis DC, Kaplan E, Kramer J: Delis-Kaplan Executive Function System. Psychological Corporation, San Antonio, TX; 2001.
• [38]Stroop J: Studies of interference in serial verbal reactions. J Exp Psychol 1935, 18:643-662.
• [39]Aker M, Landrø NI: Executive control of emotional processing: a set-shifting task. Clin Neuropsychol, in press
• [40]Grant DA, Berg E: A behavioral analysis of degree of reinforcement and ease of shifting to new responses in a Weigl-type card-sorting problem. J Exp Psychol 1948, 38:404-411.
• [41]Heaton RK: Wisconsin Card Sorting Test Computer Version 4. Research edition. Lutz, FL: PAR; 2005.
• [42]Lundqvist D, Flykt A, Öhman A: The Karolinska Directed Emotional Faces - KDEF. CD ROM from Department of Clinical Neuroscience, Psychology section, Karolinska institutet, ISBN 91-630-7164-9; 1998. http://emotionlab.se/resources/kdef.
• [43]Logan GD, Cowan WB, Davis KA: On the ability to inhibit simple and choice reaction time responses: a model and a method. J Exp Psychol-Hum Percept Perform 1984, 10:276-291.
• [44]Osman A, Kornblum S, Meyer DE: The point of no return in choice reaction time: controlled and ballistic stages of response preparation. J Exp Psychol-Hum Percept Perform 1986, 12:243-258.
• [45]Verbruggen F, Chambers CD, Logan GD: Fictitious inhibitory differences: how skewness and slowing distort the estimation of stopping latencies. Psychol Sci 2013, 24:352-362.
• [46]Verbruggen F, De Houwer J: Do emotional stimuli interfere with response inhibition? evidence from the stop signal paradigm. Cogn Emot 2007, 21:391-403.
• [47]Wechsler D: Weschsler Abbreviated Scale of Intelligence (WASI). (Norwegian version: 2007). Pearson Assessment, Stockholm, Sweden; 1999.
• [48]Clarke H, Walker S, Dalley J, Robbins T, Roberts A: Cognitive inflexibility after prefrontal serotonin depletion is behaviorally and neurochemically specific. Cereb Cortex 2007, 17:18-27.
• [49]Kessing LV: Cognitive impairment in the euthymic phase of affective disorder. Psychol Med 1998, 28:1027-1038.
• [50]Paelecke-Habermann Y, Pohl J, Leplow B: Attention and executive functions in remitted major depression patients. J Affect Disord 2005, 89:125-135.
• [51]Aldao A, Nolen-Hoeksema S: Specificity of cognitive emotion regulation strategies: a transdiagnostic examination. Behav Res Ther 2010, 48:974-983.
• [52]Thomas E, Elliott R, McKie S, Arnone D, Downey D, Juhasz G, Deakin J, Anderson I: Interaction between a history of depression and rumination on neural response to emotional faces. Psychol Med 2011, 41:1845-1855.
• [53]Joormann J, Dkane M, Gotlib IH: Adaptive and maladaptive components of rumination? diagnostic specificity and relation to depressive biases. Behav Ther 2006, 37:269-280.
• [54]Joormann J, Nee DE, Berman MG, Jonides J, Gotlib IH: Interference resolution in major depression. Cogn Aff Behav Neurosci 2010, 10:21-33.
• [55]Olatunji BO, Naragon-Gainey K, Wolitzky-Taylor KB: Specificity of rumination in anxiety and depression: a multimodal meta-analysis. Clin Psychol-Sci Pr 2013, 20:225-257.
• [56]Marroquin BM, Fontes M, Scilletta A, Miranda R: Ruminative subtypes and coping responses: active and passive pathways to depressive symptoms. Cogn Emot 2010, 24:1446-1455.
• [57]Demeyer I, De Lissnyder E, Koster EH, De Raedt R: Rumination mediates the relationship between impaired cognitive control for emotional information and depressive symptoms: a prospective study in remitted depressed adults. Behav Res Ther 2012, 50:292-297.
• [58]John OP, Gross JJ: Healthy and unhealthy emotion regulation: personality processes, individual differences, and life span development. J Personality 2004, 72:1301-1333.
• [59]Nigg JT: On inhibition/disinhibition in developmental psychopathology: views from cognitive and personality psychology and a working inhibition taxonomy. Psychol Bull 2000, 126:220-246.
• [60]Gotlib IH, Hammen CL: Handbook of Depression. Guilford Press, New York, NY; 2002.
• [61]Miyake A, Friedman NP, Emerson MJ, Witzki AH, Howerter A: The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: a latent variable analysis. Cogn Psychol 2000, 41:49-100.
• [62]Alvarez JA, Emory E: Executive function and the frontal lobes: a meta-analytic review. Neuropsychol Rev 2006, 16:17-42.
• [63]Alexopoulos GS, Raue P, Arean P: Problem-solving therapy versus supportive therapy in geriatric major depression with executive dysfunction. Am J Geriatr Psychiatry 2003, 11:46-52.
• [64]Dolcos F, Iordan AD, Dolcos S: Neural correlates of emotion–cognition interactions: a review of evidence from brain imaging investigations. J Cogn Psychol 2011, 23:669-694.
• [65]Matud M: Gender differences in stress and coping styles. Person Indiv Diff 2004, 37:1401-1415.
• [66]Thayer JF, Rossy LA, Ruiz-Padial E, Johnsen BH: Gender differences in the relationship between emotional regulation and depressive symptoms. Cogn Ther Res 2003, 27:349-364.
• [67]Garnefski N, Teerds J, Kraaij V, Legerstee J, van den Kommer T: Cognitive emotion regulation strategies and depressive symptoms: differences between males and females. Person Indiv Diff 2004, 36:267-276.
• [68]Vanderhasselt M-A, Kuhn S, De Raedt R: Healthy brooders employ more attentional resources when disengaging from the negative: an event-related fMRI study. Cogn Aff Beh Neurosci 2011, 11:207-216.
• [69]Lo BCY, Lau S, S-h C, Allen NB: The impact of rumination on internal attention switching. Cogn Emot 2012, 26:209-223.