Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-22T09:36:54.108Z Has data issue: false hasContentIssue false
  • English
  • Français

Social-economical decision making in current and remitted major depression

Published online by Cambridge University Press:  10 October 2014

E. Pulcu ,
E. J. Thomas ,
P. D. Trotter ,
M. McFarquhar ,
G. Juhasz ,
B. J. Sahakian ,
J. F. W. Deakin ,
I. M. Anderson ,
R. Zahn  and
R. Elliott
E. Pulcu
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK
E. J. Thomas
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK
P. D. Trotter
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK
M. McFarquhar
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK
G. Juhasz
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
B. J. Sahakian
Affiliation:
Department of Psychiatry and MRC Wellcome Trust Behavioural and Clinical Neuroscience Institute, The University of Cambridge, Cambridge, UK
J. F. W. Deakin
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK
I. M. Anderson
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK
R. Zahn
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK Neuroscience and Aphasia Research Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Psychological Sciences, Manchester, UK
R. Elliott*
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK
*
*Address for correspondence: Dr R. Elliott, Neuroscience and Psychiatry Unit, The University of Manchester, Medical School, Stopford Building, Oxford Road, Manchester M13 9PL, UK. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background.

Prosocial emotions related to self-blame are important in guiding human altruistic decisions. These emotions are elevated in major depressive disorder (MDD), such that MDD has been associated with guilt-driven pathological hyper-altruism. However, the impact of such emotional impairments in MDD on different types of social decision-making is unknown.

Method.

In order to address this issue, we investigated different kinds of altruistic behaviour (interpersonal cooperation and fund allocation, altruistic punishment and charitable donation) in 33 healthy subjects, 35 patients in full remission (unmedicated) and 24 currently depressed patients (11 on medication) using behavioural-economical paradigms.

Results.

We show a significant main effect of clinical status on altruistic decisions (p = 0.04) and a significant interaction between clinical status and type of altruistic decisions (p = 0.03). More specifically, symptomatic patients defected significantly more in the Prisoner's Dilemma game (p < 0.05) and made significantly lower charitable donations, whether or not these incurred a personal cost (p < 0.05 and p < 0.01, respectively). Currently depressed patients also reported significantly higher guilt elicited by receiving unfair financial offers in the Ultimatum Game (p < 0.05).

Conclusions.

Currently depressed individuals were less altruistic in both a charitable donation and an interpersonal cooperation task. Taken together, our results challenge the guilt-driven pathological hyper-altruism hypothesis in depression. There were also differences in both current and remitted patients in the relationship between altruistic behaviour and pathological self-blaming, suggesting an important role for these emotions in moral and social decision-making abnormalities in depression.

Keywords

Charitable donationguiltmajor depressive disorderPrisoner's DilemmaUltimatum Game
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 6 , April 2015 , pp. 1301 - 1313
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text rev. American Psychiatric Association: Washington, DC.Google Scholar
Anderson, IM, Juhasz, G, Thomas, E, Downey, D, McKie, S, Deakin, JFW, Elliott, R (2011). The effect of acute citalopram on face emotion processing in remitted depression: a pharmacoMRI study. European Neuropsychopharmacology 21, 140–148.Google Scholar
Arnone, D, McKie, S, Elliott, R, Thomas, EJ, Downey, D, Juhasz, G, Williams, SR, Deakin, JW, Anderson, IM (2012). Increased amygdala responses to sad but not fearful faces in major depression: relation to mood state and pharmacological treatment. American Journal of Psychiatry 169, 841–850.Google Scholar
Beddington, J, Cooper, CL, Field, J, Goswami, U, Huppert, FA, Jenkins, R, Jones, HS, Kirkwood, TBL, Sahakian, BJ, Thomas, SM (2008). The mental wealth of nations. Nature 455, 1057–1060.Google Scholar
Blair, RJR (1995). A cognitive developmental approach to morality: investigating the psychopath. Cognition 57, 1–29.Google Scholar
Boyd, R, Gintis, H, Bowles, S, Richerson, PJ (2003). The evolution of altruistic punishment. Proceedings of the National Academy of Sciences USA 100, 3531–3535.Google Scholar
Camerer, C (2003). Behavioral Game Theory: Experiments in Strategic Interaction. Princeton University Press: Princeton, NJ.Google Scholar
Carmody, TJ, Rush, AJ, Bernstein, I, Warden, D, Brannan, S, Burnham, D, Woo, A, Trivedi, MH (2006). The Montgomery Äsberg and the Hamilton ratings of depression: a comparison of measures. European Neuropsychopharmacology 16, 601–611.Google Scholar
Crockett, MJ, Clark, L, Tabibnia, G, Lieberman, MD, Robbins, TW (2008). Serotonin modulates behavioral reactions to unfairness. Science 320, 1739.Google Scholar
de Hooge, IE, Breugelmans, SM, Zeelenberg, M (2008). Not so ugly after all: when shame acts as a commitment device. Journal of Personality and Social Psychology 95, 933.Google Scholar
De Hooge, IE, Zeelenberg, M, Breugelmans, SM (2007). Moral sentiments and cooperation: differential influences of shame and guilt. Cognition and Emotion 21, 1025–1042.Google Scholar
de Quervain, DJ-F, Fischbacher, U, Treyer, V, Schellhammer, M, Schnyder, U, Buck, A, Fehr, E (2004). The neural basis of altruistic punishment. Science 305, 1254–1258.Google Scholar
Destoop, M, Schrijvers, D, De Grave, C, Sabbe, B, De Bruijn, ERA (2012). Better to give than to take? Interactive social decision-making in severe major depressive disorder. Journal of Affective Disorders 137, 98–105.CrossRefGoogle ScholarPubMed
Drevets, WC, Price, JL, Simpson, JR, Todd, RD, Reich, T, Vannier, M, Raichle, ME (1997). Subgenual prefrontal cortex abnormalities in mood disorders. Nature 386, 824–827.Google Scholar
Eshel, N, Roiser, JP (2010). Reward and punishment processing in depression. Biological Psychiatry 68, 118–124.Google Scholar
Farrell, J, Ware, R (1989). Evolutionary stability in the repeated prisoner's dilemma. Theoretical Population Biology 36, 161–166.Google Scholar
First, MB, Spitzer, RL, Miriam, G, Williams, JBW (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition. (SCID-I/NP). Biometrics Research, New York State Psychiatric Institute: New York.Google Scholar
Fujiwara, T (2009). Is altruistic behavior associated with major depression onset? PLoS ONE 4, e4557.Google Scholar
Green, S, Moll, J, Deakin, JFW, Hulleman, J, Zahn, R (2013). Proneness to decreased negative emotions in major depressive disorder when blaming others rather than oneself. Psychopathology 46, 34–44.Google Scholar
Green, S, Ralph, ML, Moll, J, Deakin, W, Zahn, R (2012). Guilt-selective functional disconnection of anterior temporal and subgenual cortices in major depressive disorder. Archives of General Psychiatry 173, 1014–1021.Google Scholar
Haley, WE, Strickland, BR (1986). Interpersonal betrayal and cooperation: effect of self-evaluation in depression. Journal of Personality and Social Psychology 50, 386–391.Google Scholar
Hamilton, WD (1963). The evolution of altruistic behavior. The American Naturalist 97, 354–356.Google Scholar
Harle, KM, Allen, JJB, Sanfey, AG (2010). The impact of depression on social economic decision making. Journal of Abnormal Psychology 119, 440–446.Google Scholar
Harlé, KM, Sanfey, AG (2010). Incidental sadness biases social economic decisions in the Ultimatum Game. Emotion 7, 876.Google Scholar
Hawley, C, Gale, T, Sivakumaran, T (2002). Defining remission by cut off score on the MADRS: selecting the optimal value. Journal of Affective Disorders 72, 177–184.CrossRefGoogle ScholarPubMed
Hayter, AJ (1984). A proof of the conjecture that the Tukey-Kramer multiple comparisons procedure is conservative. Annals of Statistics 12, 61–75.Google Scholar
Hoffman, E, McCabe, K, Smith, VL (1996). Social distance and other-regarding behavior in dictator games. American Economic Review 86, 653–660.Google Scholar
Hokanson, JE, Sacco, WP, Blumberg, SR, Landrum, GC (1980). Interpersonal behavior of depressive individuals in a mixed motive game. Journal of Abnormal Psychology 89, 320–332.Google Scholar
Jacquet, J, Hauert, C, Traulsen, A, Milinski, M (2011). Shame and honour drive cooperation. Biology Letters 7, 899–901.Google Scholar
Jacquet, J, Hauert, C, Traulsen, A, Milinski, M (2012). Could shame and honor save cooperation? Communicative & Integrative Biology 5, 209–213.Google Scholar
Ketelaar, T, Au, WT (2003). The effects of feelings of guilt on the behaviour of uncooperative individuals in repeated social bargaining games: an affect-as-information interpretation of the role of emotion in social interaction. Cognition & Emotion 17, 429–453.Google Scholar
Kim, S, Thibodeau, R, Jorgensen, RS (2011). Shame, guilt, and depressive symptoms: a meta-analytic review. Psychological Bulletin 137, 68.Google Scholar
Mokros, A, Menner, B, Eisenbarth, H, Alpers, GW, Lange, KW, Osterheider, M (2008). Diminished cooperativeness of psychopaths in a Prisoner's Dilemma game yields higher rewards. Journal of Abnormal Psychology 117, 406–413.Google Scholar
Moll, J, Krueger, F, Zahn, R, Pardini, M, de Oliveira-Souzat, R, Grafman, J (2006). Human fronto-mesolimbic networks guide decisions about charitable donation. Proceedings of the National Academy of Sciences USA 103, 15623–15628.Google Scholar
Montgomery, SA, Asberg, M (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry 134, 382–389.Google Scholar
Murphy, J, Vuchinich, R, Simpson, C (2001). Delayed reward and cost discounting. Psychological Record 51, 571–588.Google Scholar
O'Connor, LE, Berry, JW, Lewis, T, Mulherin, K, Crisostomo, PD (2007). Empathy and depression: the moral system on overdrive. In: Empathy and Mental Illness (ed. Farrow, T. F. D. and Woodruff, P. W. R.), pp. 49–75. Cambridge University Press: Cambridge.Google Scholar
O'Connor, LE, Berry, JW, Lewis, T, Stiver, DJ (2012). Empathy-based pathogenic guilt, pathological altruism, and psychopathology. Pathological Altruism 10.Google Scholar
O'Connor, LE, Berry, JW, Weiss, J, Bush, M, Sampson, H (1997). Interpersonal guilt: the development of a new measure. Journal of Clinical Psychology 53, 73–89.Google Scholar
O'Connor, LE, Berry, JW, Weiss, J, Schweitzer, D, Sevier, M (2000). Survivor guilt, submissive behaviour and evolutionary theory: the down-side of winning in social comparison. British Journal of Medical Psychology 73, 519–530.Google Scholar
Pulcu, E, Trotter, P, Thomas, E, McFarquhar, M, Juhasz, G, Sahakian, B, Deakin, J, Zahn, R, Anderson, I, Elliott, R (2013 a). Temporal discounting in major depressive disorder. Psychological Medicine 44, 1825–1834.Google Scholar
Pulcu, E, Zahn, R, Elliott, R (2013 b). The role of self-blaming moral emotions in major depression and their impact on social-economical decision making. Frontiers in Psychology 4, 1–17.Google Scholar
Pulcu, E, Zahn, R, Moll, J, Trotter, PD, Thomas, EJ, Juhasz, G, Deakin, JFW, Anderson, IM, Sahakian, BJ, Elliott, R (2014). Enhanced subgenual cingulate response to altruistic decisions in remitted major depressive disorder. NeuroImage: Clinical 4, 701–710.CrossRefGoogle ScholarPubMed
Radke, S, Schäfer, IC, Müller, BW, de Bruijn, ER (2013). Do different fairness contexts and facial emotions motivate ‘irrational’ social decision-making in major depression? An exploratory patient study. Psychiatry Research 210, 438–443.Google Scholar
Rapoport, A (1965). Prisoner's Dilemma: A Study in Conflict and Cooperation. University of Michigan Press: Ann Arbor, MI.Google Scholar
Rilling, JK, Sanfey, AG (2011). The neuroscience of social decision-making. Annual Review of Psychology 62, 23–48.Google Scholar
Sanfey, AG, Rilling, JK, Aronson, JA, Nystrom, LE, Cohen, JD (2003). The neural basis of economic decision-making in the ultimatum game. Science 300, 1755–1758.Google Scholar
Scheele, D, Mihov, Y, Schwederski, O, Maier, W, Hurlemann, R (2013). A negative emotional and economic judgment bias in major depression. European Archives of Psychiatry and Clinical Neuroscience 263, 675–683.Google Scholar
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R, Dunbar, GC (1998). The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry 59, 22–33.Google Scholar
Tangney, JP (1990). Assessing individual differences in proneness to shame and guilt: development of the self-conscious affect and attribution inventory. Journal of Personality and Social Psychology 59, 102.Google Scholar
Tangney, JP, Stuewig, J, Mashek, DJ (2007). Moral emotions and moral behavior. Annual Review of Psychology 58, 345.Google Scholar
Tellegen, A, Watson, D, Clark, L (1988). Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of Personality and Social Psychology 54, 1063–1070.Google Scholar
Zahn, R, de Oliveira-Souza, R, Moll, J (2012). Moral emotions. In Handbook of Human Affective Neuroscience (ed. Armory, J. and Vuilleumier, P.). Cambridge University Press: New York, NY.Google Scholar
Supplementary material: File

Pulcu Supplementary Material

Supplementary Material

Download Pulcu Supplementary Material(File)
File 20.1 KB