ABNORMAL RESPONSE TO NEGATIVE FEEDBACK IN UNIPOLAR DEPRESSION - EVIDENCE FOR A DIAGNOSIS SPECIFIC IMPAIRMENT

Objectives-To assess in further detail the specific form of motivation al impairment influencing neuropsychological performance in depression -oversensitivity to perceived failure. The present study considers two questions: firstly whether this is specific to depression and secondl y how the effect relates to clinical features. Methods-Unipolar depres sed patients and matched controls were assessed on two neuropsychologi cal tests giving explicit performance feedback. The data were analysed in two separate studies to consider the questions above. The first st udy considered the specificity of the effect to depressed patients, us ing data on the same tests collected from other patient groups. The se cond study was a longitudinal assessment of the depressed patients on clinical recovery to determine whether the effect is specific to the d epressed state. Results-The effect was not seen in nondepressed patien t groups, either neurological or psychiatric groups. The longitudinal study showed a residual abnormal response to negative feedback on clin ical recovery. Conclusions-Abnormal response to negative feedback is s pecific to a primary diagnosis of depression and may be a trait rather than a state factor of the disorder. These results are discussed in r elation to the putative neuropathology of depression and also to cogni tive and behavioural accounts of the disorder. The findings presented here have important implications for establishing a link between mood and cognition in unipolar depression.