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Experimental evidence for a motivational origin of cognitive impairment in major depression

Published online by Cambridge University Press:  16 November 2007

A. Scheurich ,
A. Fellgiebel ,
I. Schermuly ,
S. Bauer ,
R. Wölfges  and
M. J. Müller
A. Scheurich*
Affiliation:
Department of Psychiatry, University of Mainz, Mainz, Germany
A. Fellgiebel
Affiliation:
Department of Psychiatry, University of Mainz, Mainz, Germany
I. Schermuly
Affiliation:
Department of Psychiatry, University of Mainz, Mainz, Germany
S. Bauer
Affiliation:
Department of Psychiatry, University of Mainz, Mainz, Germany
R. Wölfges
Affiliation:
Department of Psychiatry, University of Mainz, Mainz, Germany
M. J. Müller
Affiliation:
Department of Psychiatry, University of Mainz, Mainz, Germany
*
*Address for correspondence: Dr A. Scheurich, Dipl. Psych., Department of Psychiatry, University of Mainz, Untere Zahlbacher Str. 8, D-55131 Mainz, Germany. (Email: scheurich@psychiatrie.klinik.uni-mainz.de)
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Abstract

Background

Diagnostic criteria and empirical evidence support the existence of cognitive deficits in depression. However, depressed mood, loss of interest and low self-efficacy might influence cognitive performance.

Method

Goal-setting instructions were used to promote motivation in depressed patients and control subjects during neuropsychological assessment. The resulting performance was compared with performance using standard instructions. Sixty in-patients with non-psychotic unipolar depression and 60 age- and education-matched healthy control subjects were assessed with standard neuropsychological tests [the Auditory Verbal Learning Test (AVLT), the Digit Symbol Test (DST), the Regensburg Word Fluency Test (RWT), and the Number Combination Test (Zahlen-Verbindungs-Test, ZVT)] using either goal-setting or standard test instructions.

Results

Depressed patients showed lower baseline performance and lower generalized self-efficacy (p<0.0005) than controls. However, goal-setting instructions significantly improved patients' memory performance by 10% [AVLT: F(5, 54)=3.611, p=0.007] and psychomotor performance by 13% [ZVT: F(3, 56)=3.667, p=0.017]. Consequently, patients and control subjects demonstrated similar results when goal-setting instructions were applied. Goal-setting instructions showed a statistical trend, increasing patients' performance in the DST by 12% [F(1, 58)=2.990, p=0.089], although their verbal fluency measured by the RWT did not increase. No significant correlations of increased performance with generalized self-efficacy were found.

Conclusions

Cognitive deficits in depressed patients are influenced by motivational shortcomings. Because generalized self-efficacy failed to correlate to increased test performance, future research needs to disentangle the effective components of goal-setting instructions. Task-specific self-efficacy as well as enhancement of task-focused attention might underlie the significant goal-setting effect in depressed patients.

Keywords

Cognitive deficitsdepressive episodegoal settingmotivational resourcesneuropsychological testing
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 2 , February 2008 , pp. 237 - 246
Copyright
Copyright © Cambridge University Press 2007

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