Cognitive dysfunction in depression: neurocircuitry and new therapeutic strategies

Major depressive disorder (MDD) is a disabling medical condition associated with significant morbidity, mortality and public health costs. However, neurocircuitry abnormalities underlying depression remain incompletely understood and consequently current treatment options are unfortunately limited in efficacy. Recent research has begun to focus specifically on cognitive aspects of depression and potential neurobiological correlates. Two fundamental types of cognitive dysfunction observed in MDD are cognitive biases, which include distorted information processing or attentional allocation toward negative stimuli, and cognitive deficits, which include impairments in attention, short-term memory and executive functioning. In this article, we present a selective review of current research findings in these domains and examine neuroimaging research that is beginning to characterize the neurocircuitry underlying these biases and deficits. We propose that deficient cognitive functioning, attention biases and the sustained negative affect characteristic of MDD can be understood as arising in part from dysfunctional prefrontal-subcortical circuitry and related disturbances in the cognitive control of emotion. Finally, we highlight potential new pharmacological and non-pharmacological therapeutic strategies for MDD based on an evolving mechanistic understanding of the disorder.     

The role of cluster B and C personality disturbance in the course of depression: a prospective study

The association between personality disturbance and depression has been noted consistently. Prospective tests of personality's impact on the course of depression, however, are lacking. In a sample of 159 undergraduates who experienced at least one prospective depressive episode, dimensional scores for clusters B and C personality disturbance were examined as prospective predictors of four indicators of the course of depression: severity, episode duration, symptomatic chronicity and number of episodes. Cluster C personality disturbance, characterized by anxious and fearful features, predicted depression chronicity. Cluster B, characterized by dramatic, emotional and/or erratic features, predicted severity and duration of depression. The findings are discussed in terms of the possible mechanisms underlying the effects of clusters B and C, as well as implications for future research.     

Behavioral Approach System (BAS) Sensitivity and Bipolar Spectrum Disorders: A Retrospective and Concurrent Behavioral High-Risk Design

In this article, we tested the vulnerability hypothesis of the behavioral approach system (BAS) hypersensitivity model of bipolar disorders. We examined whether self-reported BAS sensitivity predicts lifetime bipolar spectrum diagnoses as well as symptoms and personality characteristics associated with bipolar disorder using a retrospective and concurrent behavioral high-risk design. Participants with high (HBAS; n=28) or moderate (MBAS; n=24) BAS sensitivity were selected and given a lifetime psychiatric diagnostic interview and self-report measures of proneness to bipolar symptoms, current symptoms, and personality characteristics relevant to bipolarity. HBAS participants were significantly and substantially more likely to have a lifetime bipolar spectrum disorder diagnosis than were MBAS participants, but did not differ from MBAS participants in their likelihood of a unipolar depression diagnosis. Also, the HBAS group exhibited higher impulsivity and proneness to hypomanic symptoms than the MBAS group, and BAS-reward responsiveness predicted hypomanic personality characteristics. Finally, high behavioral inhibition system (BIS) sensitivity was associated with proneness to and current depressive symptoms.

Men’s Discomfort and Anticipated Sexual Misclassification Due to Counter-Stereotypical Behaviors: the Interplay between Traditional Masculinity Norms and Perceived Men’s Femininization

Sex Roles - The present research examines men’s self-conscious discomfort while imagining performing counter-stereotypical (traditionally feminine) behaviors as compared to stereotypical...