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Cognitive reappraisal modulates performance following negative feedback in patients with major depressive disorder

Published online by Cambridge University Press:  05 January 2010

A.-K. Fladung ,
U. Baron ,
I. Gunst  and
M. Kiefer
A.-K. Fladung*
Affiliation:
Department of Psychiatry and Psychotherapy, University of Ulm, Germany
U. Baron
Affiliation:
Department of Psychiatry and Psychotherapy, University of Ulm, Germany
I. Gunst
Affiliation:
Department of Psychiatry and Psychotherapy, University of Ulm, Germany
M. Kiefer
Affiliation:
Department of Psychiatry and Psychotherapy, University of Ulm, Germany
*
*Address for correspondence: Dr A.-K. Fladung, University of Ulm, Department of Psychiatry and Psychotherapy, Leimgrubenweg 12-14, 89075Ulm, Germany. (Email: anne-katharina.fladung@uni-ulm.de)
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Abstract

Background

Depressed patients show impaired performance following negative feedback; the probability of committing an error is increased immediately after an error. This deficit is assumed to be highly specific and to represent a trait marker of major depressive disorder (MDD). Inconsistencies in currently available data could reflect inter-individually different strategies to regulate negative affect. The present study examined modulation of performance following negative feedback by cognitive reappraisal to regulate aversive affect in depressed patients.

Method

Thirty-three depressed patients and 33 control subjects performed tasks of varying difficulty over a prolonged time. Emotional feedback was given immediately after each trial. Performance was further analysed within subgroups using cognitive reappraisal of aversive events with high and low frequency.

Results

A significant group by task difficulty interaction for absolute number of subsequent errors revealed that depressed patients were especially impaired when receiving negative feedback more frequently. An increased probability of subsequent errors was shown in patients irrespective of task difficulty. Analysis of subgroups revealed higher absolute number and probability of subsequent errors only in depressed patients habitually not using cognitive reappraisal to regulate aversive emotions. Depressed patients using this strategy did not differ from controls.

Conclusions

The present results replicate the observation of impaired performance in depressed patients following failure feedback. Most importantly, a subgroup of patients who habitually rely on cognitive reappraisal of aversion-eliciting events, such as negative performance feedback, was not impaired. This modulatory influence of emotion regulation strategies on performance subsequent to negative feedback suggests that training emotion regulation in achievement situations should be incorporated in current concepts to prevent relapse.

Keywords

Major depressionperformance feedbackreappraisal
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 10 , October 2010 , pp. 1703 - 1710
Copyright
Copyright © Cambridge University Press 2010

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