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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: [email protected])
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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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References

Abramson, LY, Seligman, ME, Teasdale, JD (1978). Learned helplessness in humans: critique and reformulation. Journal of Abnormal Psychology 87, 49–74.Google Scholar
APA (1994). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Press: Washington, DC.Google Scholar
Aschenbrenner, S, Tucha, O, Lange, K (2000). Regensburg Word Fluency Test; Regensburger Wortfluessigkeits-Test (RWT). Testzentrale: Goettingen, Germany.Google Scholar
Austin, MP, Mitchell, P, Wilhelm, K, Parker, G, Hickie, I, Brodaty, H, Chan, J, Eyers, K, Milic, M, Hadzi-Pavlovic, D (1999). Cognitive function in depression: a distinct pattern of frontal impairment in melancholia? Psychological Medicine 29, 73–85.CrossRefGoogle ScholarPubMed
Basso, MR, Bornstein, RA (1999). Relative memory deficits in recurrent versus first-episode major depression on a word-list learning task. Neuropsychology 13, 557–563.CrossRefGoogle ScholarPubMed
Bazin, N, Perruchet, P, De Bonis, M, Feline, A (1994). The dissociation of explicit and implicit memory in depressed patients. Psychological Medicine 24, 239–245.Google Scholar
Beats, BC, Sahakian, BJ, Levy, R (1996). Cognitive performance in tests sensitive to frontal lobe dysfunction in the elderly depressed. Psychological Medicine 26, 591–603.CrossRefGoogle ScholarPubMed
Beblo, T, Baumann, B, Bogerts, B, Wallesch, C, Herrmann, M (1999). Neuropsychological correlates of major depression: a short-term follow-up. Cognitive Neuropsychiatry 4, 333–341.CrossRefGoogle Scholar
Beck, AT (1967). Depression: Clinical, Experimental and Theoretical Aspects. Harper and Row: New York.Google Scholar
Beck, AT (1987). Cognitive models of depression. Journal of Cognitive Psychotherapy 1, 5–37.Google Scholar
Beck, AT, Ward, CH, Mendelson, M, Mock, J, Erbaugh, J (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561–571.CrossRefGoogle ScholarPubMed
Brody, AL, Barsom, MW, Bota, RG, Saxena, S (2001). Prefrontal-subcortical and limbic circuit mediation of major depressive disorder. Seminars in Clinical Neuropsychiatry 6, 102–112.Google Scholar
Christensen, H, Griffiths, K, Mackinnon, A, Jacomb, P (1997). A quantitative review of cognitive deficits in depression and Alzheimer-type dementia. Journal of the International Neuropsychological Society 3, 631–51.CrossRefGoogle ScholarPubMed
Danion, JM, Willard-Schroeder, D, Zimmermann, MA, Grange, D, Schlienger, JL, Singer, L (1991). Explicit memory and repetition priming in depression. Preliminary findings. Archives of General Psychiatry 48, 707–711.Google Scholar
Davidson, ML (1972). Univariate versus multivariate tests in repeated-measures experiments. Psychological Bulletin 77, 446–452.Google Scholar
Davidson, RJ, Pizzagalli, D, Nitschke, JB, Putnam, K (2002). Depression: perspectives from affective neuroscience. Annual Review of Psychology 53, 545–574.CrossRefGoogle ScholarPubMed
Dilling, H, Mombour, W, Schmidt, MH (1991). International Classification of Mental and Behavioral Disorders. ICD-10, chapter V. Huber: Bern, Switzerland.Google Scholar
Drevets, WC (2000). Neuroimaging studies of mood disorders. Biological Psychiatry 48, 813–829.Google Scholar
Elliott, R (1998). The neuropsychological profile in unipolar depression. Trends in Cognitive Sciences 2, 447–454.CrossRefGoogle ScholarPubMed
Elliott, R, Baker, SC, Rogers, RD, O'Leary, DA, Paykel, ES, Frith, CD, Dolan, RJ, Sahakian, BJ (1997 a). Prefrontal dysfunction in depressed patients performing a complex planning task: a study using positron emission tomography. Psychological Medicine 27, 931–942.Google Scholar
Elliott, R, Sahakian, BJ, Herrod, JJ, Robbins, TW, Paykel, ES (1997 b). Abnormal response to negative feedback in unipolar depression: evidence for a diagnosis specific impairment. Journal of Neurology, Neurosurgery, and Psychiatry 63, 74–82.CrossRefGoogle ScholarPubMed
Elliott, R, Sahakian, BJ, McKay, AP, Herrod, JJ, Robbins, TW, Paykel, ES (1996). Neuropsychological impairments in unipolar depression: the influence of perceived failure on subsequent performance. Psychological Medicine 26, 975–989.CrossRefGoogle ScholarPubMed
Fossati, P, Ergis, AM, Allilaire, JF (2002). Executive functioning in unipolar depression: a review. Encephale 28, 97–107.Google ScholarPubMed
Fossati, P, Harvey, PO, Le Bastard, G, Ergis, AM, Jouvent, R, Allilaire, JF (2004). Verbal memory performance of patients with a first depressive episode and patients with unipolar and bipolar recurrent depression. Journal of Psychiatric Research 38, 137–144.Google Scholar
Gauggel, S, Billino, J (2002). The effects of goal setting on the arithmetic performance of brain-damaged patients. Archives of Clinical Neuropsychology 17, 283–294.Google Scholar
Goldberg, TE, Gold, JM, Greenberg, R, Griffin, S, Schulz, SC, Pickar, D, Kleinman, JE, Weinberger, DR (1993). Contrasts between patients with affective disorders and patients with schizophrenia on a neuropsychological test battery. American Journal of Psychiatry 150, 1355–1362.Google ScholarPubMed
Gomez, RG, Fleming, SH, Keller, J, Flores, B, Kenna, H, DeBattista, C, Solvason, B, Schatzberg, AF (2006). The neuropsychological profile of psychotic major depression and its relation to cortisol. Biological Psychiatry 60, 472–478.Google Scholar
Hamilton, M (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry 23, 56–62.Google Scholar
Harvey, PO, Fossati, P, Pochon, JB, Levy, R, Lebastard, G, Lehericy, S, Allilaire, JF, Dubois, B (2005). Cognitive control and brain resources in major depression: an fMRI study using the n-back task. NeuroImage 26, 860–869.Google Scholar
Harvey, PO, Le Bastard, G, Pochon, JB, Levy, R, Allilaire, JF, Dubois, B, Fossati, P (2004). Executive functions and updating of the contents of working memory in unipolar depression. Journal of Psychiatric Research 38, 567–576.CrossRefGoogle ScholarPubMed
Hertel, PT (1998). Relation between rumination and impaired memory in dysphoric moods. Journal of Abnormal Psychology 107, 166–172.Google Scholar
Hertel, PT (2000). The cognitive-initiative account of depression-related impairments in memory. In The Psychology of Learning and Motivation: Advances in Research and Theory (ed. Medin, DL), pp. 47–71. Academic Press: San Diego.Google Scholar
Hertel, PT, Rude, SS (1991). Depressive deficits in memory: focusing attention improves subsequent recall. Journal of Experimental Psychology. General 120, 301–309.Google Scholar
Heubrock, D (1992). The Auditory-Verbal Learning Test (AVLT) in clinical and experimental neuropsychology: administration evaluation and research findings. Zeitschrift fuer Differentielle und Diagnostische Psychologie 3, 161–174.Google Scholar
Hill, SK, Keshavan, MS, Thase, ME, Sweeney, JA (2004). Neuropsychological dysfunction in antipsychotic-naive first-episode unipolar psychotic depression. American Journal of Psychiatry 161, 996–1003.Google Scholar
Janca, A, Hiller, W (1996). ICD-10 checklists – a tool for clinicians' use of the ICD-10 classification of mental and behavioral disorders. Comprehensive Psychiatry 37, 180–187.CrossRefGoogle ScholarPubMed
Landro, NI, Stiles, TC, Sletvold, H (2001). Neuropsychological function in nonpsychotic unipolar major depression. Neuropsychiatry, Neuropsychology, and Behavioral Neurology 14, 233–240.Google Scholar
Locke, EA, Latham, GP (1990). A Theory of Goal Setting and Task Performance. Prentice-Hall: Englewood Cliffs, NJ.Google Scholar
Locke, EA, Latham, GP (2002). Building a practically useful theory of goal setting and task motivation. A 35-year odyssey. American Psychologist 57, 705–717.Google Scholar
Murphy, FC, Sahakian, BJ, Rubinsztein, JS, Michael, A, Rogers, RD, Robbins, TW, Paykel, ES (1999). Emotional bias and inhibitory control processes in mania and depression. Psychological Medicine 29, 1307–1321.Google Scholar
Oswald, WD, Roth, E (1987). Number Combination Test; Zahlen-Verbindungs-Test (ZVT). Testzentrale: Goettingen, Germany.Google Scholar
Porter, RJ, Gallagher, P, Thompson, JM, Young, AH (2003). Neurocognitive impairment in drug-free patients with major depressive disorder. British Journal of Psychiatry 182, 214–220.Google Scholar
Richards, PM, Ruff, RM (1989). Motivational effects on neuropsychological functioning: comparison of depressed versus nondepressed individuals. Journal of Consulting and Clinical Psychology 57, 396–402.CrossRefGoogle ScholarPubMed
Rund, BR, Sundet, K, Asbjornsen, A, Egeland, J, Landro, NI, Lund, A, Roness, A, Stordal, KI, Hugdahl, K (2006). Neuropsychological test profiles in schizophrenia and non-psychotic depression. Acta Psychiatrica Scandinavica 113, 350–359.Google Scholar
Savard, RJ, Rey, AC, Post, RM (1980). Halstead–Reitan Category Test in bipolar and unipolar affective disorders. Relationship to age and phase of illness. Journal of Nervous and Mental Disease 168, 297–304.CrossRefGoogle ScholarPubMed
Schatzberg, AF, Posener, JA, DeBattista, C, Kalehzan, BM, Rothschild, AJ, Shear, PK (2000). Neuropsychological deficits in psychotic versus nonpsychotic major depression and no mental illness. American Journal of Psychiatry 157, 1095–1100.Google Scholar
Scheurich, A, Muller, MJ, Szegedi, A, Anghelescu, I, Klawe, C, Lorch, B, Kappis, B, Bialonski, HG, Haas, S, Hautzinger, M (2004). Neuropsychological status of alcohol-dependent patients: increased performance through goal-setting instructions. Alcohol and Alcoholism 39, 119–125.Google Scholar
Schmidt, KH, Metzler, P (1992). Vocabulary Test. Beltz: Weinheim, Germany.Google Scholar
Schwarzer, R (1992). Self-efficacy: Thought Control of Action. Hemisphere: Washington, DC.Google Scholar
Seligman, M (1974). Depression and learned helplessness. In The Psychology of Depression: Contemporary Theory and Research (ed. Friedman, R and Katz, M), pp. 83–125. Winston-Wiley: Washington, DC.Google Scholar
Shah, PJ, O'Carroll, RE, Rogers, A, Moffoot, AP, Ebmeier, KP (1999). Abnormal response to negative feedback in depression. Psychological Medicine 29, 63–72.Google Scholar
Sobin, C, Sackeim, HA (1997). Psychomotor symptoms of depression. American Journal of Psychiatry 154, 4–17.Google Scholar
Sweeney, JA, Kmiec, JA, Kupfer, DJ (2000). Neuropsychologic impairments in bipolar and unipolar mood disorders on the CANTAB neurocognitive battery. Biological Psychiatry 48, 674–684.CrossRefGoogle ScholarPubMed
Tewes, U (1991). Wechsler Adult Intelligence Scale – Revised (WAIS-R) – German Version. Huber: Bern.Google Scholar
Veiel, HO (1997). A preliminary profile of neuropsychological deficits associated with major depression. Journal of Clinical and Experimental Neuropsychology 19, 587–603.Google Scholar
Wittchen, HU, Pfister, H (1997). DIA-X-Interview. Swets Test Services: Frankfurt, Germany.Google Scholar
Zakzanis, KK, Leach, L, Kaplan, E (1998). On the nature and pattern of neurocognitive function in major depressive disorder. Neuropsychiatry, Neuropsychology, and Behavioral Neurology 11, 111–119.Google ScholarPubMed