Association between cognitive vulnerability to depression - dysfunctional attitudes and glycaemic control among in-patients with type 2 diabetes in a hospital in Beijing: a multivariate regression analysis.

This cross-sectional study aimed to investigate the relationship between glycosylated haemoglobin (HbA1c) and cognitive vulnerability to depression (dysfunctional attitudes) in patients with type 2 diabetes mellitus. A total of 245 valid records from June 2016 to December 2016 were collected from a hospital in Beijing. Participants were asked to complete four questionnaires (Dysfunctional Attitudes Scale, Automatic Thoughts Questionnaire, Zung Self-rating Depression Scale, and World Health Organization Quality of Life Instrument-Short Form) to assess mental health and quality of life. Multivariate regression analysis was conducted to determine the correlations between HbA1c, mental health, quality of life and other clinical variables. The results showed that dysfunctional attitudes were associated with HbA1c, with a standardized regression coefficient (ß) of .13 (p = .01), although 1 h C-peptide (ß = -.75, p < .0001) was the most significant predictor of HbA1c in the regression model. The results indicated that dysfunctional attitudes, as a cognitive vulnerability to depression, were a relevant factor in HbA1c, although further studies are needed to establish the nature of the connection between dysfunctional attitudes and glycaemic control in diabetes patients.

Effects of an experimentally induced inflammatory stimulus on motivational behavior in remitted depressed patients.

BACKGROUND: Acute inflammation is associated with sickness behavior characterized by reduced motivation for pleasurable activities in humans. The current study investigated the effect of an experimentally induced inflammatory stimulus on motivational reward in people who remitted from depression. METHODS: This randomized, double-blind crossover study involved 12 participants, 5 with remitted major depressive disorder (rMDD) and 7 healthy controls (HC), who received an injection of typhoid vaccine and placebo (or vice-versa) intramuscularly at least one week apart. At baseline and between 4 and 6 h post-injection on both days, participant mood was measured using the profile of mood states (POMS), and injection blood samples were collected for cytokines measurement. All participants completed the Effort Expenditure for Rewards Task (EEfRT), a behavioral paradigm measuring effort-based decision-making before and 4 h post-both injections. Generalized linear mixed modeling was used to evaluate group differences in choosing the hard over easy task to obtain a monetary reward. RESULTS: Typhoid vaccine increased IL-6 in all participants. On the EEfRT, a significant interaction between treatment condition (typhoid vs. placebo) and participant group (HC vs. rMDD) was found (p = .004). Analyses of simple effects within treatment conditions found that after placebo, HCs were more likely to choose the harder task than rMDD (OR = 3.21; p = .013). However, after the typhoid vaccine, no differences were found between rMDD and HC (p = .397). Analyses within participant groups found that the probability of choosing a hard task was higher after placebo for HC (OR = 1.37; p = .045), but not different within rMDD (p = .241). For HC at baseline, mood was significantly lower following injection with typhoid vaccine, relative to placebo (b = -1.03, p < .001); however, this effect should be considered coincidental, given that mood rating was taken prior to injection. For rMDD patients 4-6 h post-injection, mood was significantly lower following typhoid vaccine, relative to placebo (b = -0.981, p < .001 b = -0.77, p < .001). Finally, for HC receiving placebo, mood was significantly lower 4-6 h post-injection, relative to baseline (b = -1.76, p < .001). CONCLUSIONS: Our preliminary findings suggest persistent deficits in motivational reward processing function despite clinical improvement in remitted depressed patients.

Early indicators of vulnerability to depression: The role of rumination and heart rate variability.

BACKGROUND: Despite the evidence of increased levels of rumination and reduced heart rate variability (HRV) in depression, whether these measures can be considered early indicators of vulnerability to depression has yet to be investigated. Therefore, the present study aimed to investigate both levels of rumination and resting HRV in individuals with familial risk for depression that is the most reliable risk factor for the disorder. METHODS: Rumination and vagally-mediated HRV were assessed using the Ruminative Response Scale and a smartphone-based photoelectric volumetric pulse wave assay, respectively, in 25 individuals who had family history of depression (but did not report current depressive symptoms), 15 individuals who reported depressive symptoms (but had no family history of depression), and 25 controls (without depressive symptoms and family history of depression). RESULTS: Individuals with depressive symptoms and those with a family history of depression were characterized by higher levels of rumination and lower cardiac vagal control than controls. LIMITATIONS: Given the small sample size, this study should be used to design larger confirmatory studies; the cross-sectional nature of the study does not allow discussing the results in terms of cause-effect relationships. CONCLUSIONS: Our findings suggested that individuals at risk of developing depression, also in absence of depressive symptoms, are defined by defective self-regulation capacity that may lead to future depression episodes. Increased ruminative thoughts and reduced HRV may represent early indicators of vulnerability to depression. Effective prevention programs designed to reduce rumination and/or increase HRV may reduce the risk of developing a full-blown depressive episode.

Self-Reported Depression Is Associated With Aberration in Emotional Reactivity and Emotional Concept Coding.

Cognitive impairment, alterations in mood, emotion dysregulation are just a few of the consequences of depression. Despite depression being reported as the most common mental disorder worldwide, examining depression or risks of depression is still challenging. Emotional reactivity has been observed to predict the risk of depression, but the results have been mixed for negative emotional reactivity (NER). To better understand the emotional response conflict, we asked our participants to describe their feeling in meaningful sentences alongside reporting their reactions to the emotionally evocative words. We presented a word on the screen and asked participants to perform two tasks, rate their feeling after reading the word using the self-assessment manikin (SAM) scale, and describe their feeling using the property generation task. The emotional content was analyzed using a novel machine-learning algorithm approach. We performed these two tasks in blocks and randomized their order across participants. Beck Depression Inventory (BDI) was used to categorize participants into self-reported non-depressed (ND) and depressed (D) groups. Compared to the ND, the D group reported reduced positive emotional reactivity when presented with extremely pleasant words regardless of their arousal levels. However, no significant difference was observed between the D and ND groups for negative emotional reactivity. In contrast, we observed increased sadness and inclination toward low negative context from descriptive content by the D compared to the ND group. The positive content analyses showed mixed results. The contrasting results between the emotional reactivity and emotional content analyses demand further examination between cohorts of self-reported depressive symptoms, no-symptoms, and MDD patients to better examine the risks of depression and help design early interventions.

Regional homogeneity and functional connectivity patterns in major depressive disorder, cognitive vulnerability to depression and healthy subjects.

BACKGROUND: Cognitive vulnerability to depression (CVD) is a high risk for depressive disorder. Recent studies focus on individuals with CVD to determine the neural basis of major depressive disorder (MDD) neuropathology. However, whether CVD showed specific or similar brain functional activity and connectivity patterns, compared to MDD, remain largely unknown. METHODS: Here, using resting-state functional magnetic resonance imaging in subjects with CVD, healthy controls (HC) and MDD, regional homogeneity (ReHo) and resting-state functional connectivity (R-FC) analyses were conducted to assess local synchronization and changes in functional connectivity patterns. RESULTS: Significant ReHo differences were found in right posterior lobe of cerebellum (PLC), left lingual gyrus (LG) and precuneus. Compared to HC, CVD subjects showed increased ReHo in the PLC, which was similar to the difference found between MDD and HC. Compared to MDD patients, CVD subjects showed decreased ReHo in PLC, LG, and precuneus. R-FC analyses found increased functional connections between LG and left inferior parietal lobule, posterior cingulate cortex, and dorsolateral prefrontal cortex in CVD compared to both HC and MDD. Moreover, Regional mean ReHo values were positively correlated with Center for Epidemiologic Studies Depression Scale scores. CONCLUSION: These analyses revealed that PLC and functional connections between LG and left inferior parietal lobule, posterior cingulate cortex, and dorsolateral prefrontal cortex may be a potential marker for CVD.

Low ß2 Main Peak Frequency in the Electroencephalogram Signs Vulnerability to Depression.

Objective: After an intense and repeated stress some rats become vulnerable to depression. This state is characterized by persistent low serum BDNF concentration. Our objective was to determine whether electrophysiological markers can sign vulnerability to depression. Methods: Forty-three Sprague Dawley rats were recorded with supradural electrodes above hippocampus and connected to wireless EEG transmitters. Twenty-nine animals experienced four daily social defeats (SD) followed by 1 month recovery. After SD, 14 rats had persistent low serum BDNF level and were considered as vulnerable (V) while the 15 others were considered as non-vulnerable (NV). EEG signals were analyzed during active waking before SD (Baseline), just after SD (Post-Stress) and 1 month after SD (Recovery). Results: We found that V animals are characterized by higher high θ and α spectral relative powers and lower ß2 main peak frequency before SD. These differences are maintained at Post-Stress and Recovery for α spectral relative powers and ß2 main peak frequency. Using ROC analysis, we show that low ß2 main peak frequency assessed during Baseline is a good predictor of the future state of vulnerability to depression. Conclusion: Given the straightforwardness of EEG recordings, these results open the way to prospective studies in humans aiming to identify population at-risk for depression.

Memory biases in remitted depression: the role of negative cognitions at explicit and automatic processing levels.

BACKGROUND AND OBJECTIVES: Cognitive models propose that depression is caused by dysfunctional schemas that endure beyond the depressive episode, representing vulnerability factors for recurrence. However, research testing negative cognitions linked to dysfunctional schemas in formerly depressed individuals is still scarce. Furthermore, negative cognitions are presumed to be linked to biases in recalling negative self-referent information in formerly depressed individuals, but no studies have directly tested this association. In the present study, we evaluated differences between formerly and never-depressed individuals in several experimental indices of negative cognitions and their associations with the recall of emotional self-referent material. METHODS: Formerly (n = 30) and never depressed individuals (n = 40) completed measures of explicit (i.e., scrambled sentence test) and automatic (i.e., lexical decision task) processing to evaluate negative cognitions. Furthermore participants completed a self-referent incidental recall task to evaluate memory biases. RESULTS: Formerly compared to never depressed individuals showed greater negative cognitions at both explicit and automatic levels of processing. Results also showed greater recall of negative self-referent information in formerly compared to never-depressed individuals. Finally, individual differences in negative cognitions at both explicit and automatic levels of processing predicted greater recall of negative self-referent material in formerly depressed individuals. LIMITATIONS: Analyses of the relationship between explicit and automatic processing indices and memory biases were correlational and the majority of participants in both groups were women. CONCLUSIONS: Our findings provide evidence of negative cognitions in formerly depressed individuals at both automatic and explicit levels of processing that may confer a cognitive vulnerability to depression.

Sesgos de atención selectiva como factor de mantenimiento y vulnerabilidad a la depresión: una revisión crítica / Selective attentional biases as a maintenance and vulnerability factor in depression: a critical review

En este trabajo se revisan los estudios que han examinado la presencia de sesgos de atención selectiva en la depresión, comparando el rendimiento de personas con y sin depresión (clínica y subclínica) en tareas experimentales cognitivas. Los datos recientes mediante técnicas de registro de movimientos oculares indican que la depresión se caracteriza por la presencia de un procesamiento atencional sostenido hacia información negativa y una ausencia de sesgos a información positiva. Asimismo, se considera la evidencia empírica acerca del papel causal de estos sesgos en el inicio y mantenimiento de la depresión, la cual sugiere que estos sesgos atencionales hacia información negativa y positiva, asociados a un estilo de respuesta rumiativo y a estrategias ineficaces de regulación emocional, pueden ser marcadores estables de vulnerabilidad a la depresión. Las implicaciones clínicas de estos hallazgos y las futuras líneas de investigación en este campo son discutidas.

This review examines studies that have addressed the presence of selective attentional biases in depression (clinical and subclinical samples) in several experimental cognitive tasks. Current data using eye-tracking techniques indicate that depression is characterized by the presence of sustained attentional processing towards negative information and absence of biases towards positive information. Available empirical evidence about the causal role of these biases on the onset and maintenance of depression suggests that these biases, in association with a ruminative style and ineffective emotional regulation strategies, could be stable vulnerability markers of depression. Clinical implications of these findings and future research in this field are discussed.