Behavioral And Electrophysiological Study Of Impaired Interpersonal Function Of Depression

Objectives: Impairments in interpersonal relationships in depression present as irritability, pessimism, and withdrawal, and play an important role in the onset and maintenance of the disorder. The impaired social interaction may be persistent or may recover more slowly than symptom changes, so it will influence the prognosis and increase the social burden. However, we know little about the neurological causes of this impaired interpersonal function. The interpersonal problems of depression may be due to negative cognitive deviation, anhedonia, and emotional regulation deficits. This study used the event-related brain potential(ERP) version of the Cyberball paradigm to investigate the emotions and neural activities in depressive patients during social acceptance and ostracism simultaneously to explore neuropsychological mechanisms.Methods(1) After 27 depressed patients and 23 healthy controls(HCs) performed a virtual ball tossing game(Cyberball) which included two conditions: inclusion and exclusion, the Positive and Negative Affect Schedule(PANAS) and a brief Need-Threat Scale(NTS) were used to assess the positive and negative effect and the fulfillment of basic needs of subjects.(2) Electrophysiological data were recorded when 27 depressed patients and 23 healthy controls(HCs) performed a virtual ball tossing game(Cyberball) which included two conditions: inclusion and exclusion. Moreover, the relationship between the ERP data of depression and clinical symptoms was analyzed.Results:(一)(1) PANAS: 1At baseline, patients scored lower than HCs on positive affect(t=-2.928, P<0.01) and higher on negative affect were(t=4.090, P<0.01). 2Statistical analysis on scores of PANAS showed the expected blocking effects on both positive affect(PA) and negative affect(NA)(F(1,49)=67.437, P<0.001; F(1,49)=18.020,P<0.001). 3 There was a significant group effect on PA(F(1,49)=7.357, P<0.01). But the group effect on NA(F(1,49)=0.072, P>0.05) was not significant.(2)NTS: 1The analysis on scales of NTS revealed the expected block effects for all the four fundamental human needs(belonging, self-esteem, control, and meaningful existence): F(2,48)=111.659, P<0.001; F(2,48)=70.214, P<0.001; F(2,48)=57.978, P<0.001; F(2,48)=61.034, P<0.001, and block group interaction effects for self-esteem and control needs were also significant(F(2,48)=3.407, P<0.05; F(2,48)=5.446, P<0.05). The group main effects for the four basic needs were not significant(P-values >0.1). 2Follow-up analyses showed that patients were more threatened on self-esteem and control needs during social inclusion(t=–2.193, P<0.05; t=–1.916, P=0.061), but were not different from HCs during social exclusion. 3 Further simple analyses showed a significant decrease of scores on self-esteem and control needs between the inclusion and exclusion block and an increase between the exclusion block and 10 min after exclusion for HCs(P-values<0.01). For patients, there were no significant differences for self-esteem and control needs between the exclusion block and 10 min after exclusion(P-values >0.1).(二)1 Omnibus 2(block: inclusion and exclusion) × 2(group: patients and HCs) × 3(electrode: FZ, FCZ, and CZ) repeated measures analyses of variance(ANOVAs) were conducted. Results showed a significant effect for block(F(1,49)=6.794, P<0.05), electrode(F(1,49)=5.363, P<0.01), and group(F(1,49)=5.646, P<0.05), but the interaction effect of the block group was not significant(F(1,49)=1.360, P>0.05). 2 The group effect of social inclusion and social exclusion on P3 was conducted respectively. Results showed a less positive-going wave for patients during inclusion Cyberball(F(1,49)=4.269, P<0.05). The differences on P3 for exclusion Cyberball categories were not significant(F(1,49)=0.994, P>0.05). 3We determined that the average amplitudes of P3 in soical inclusion were not significant correlated with BDI scales(r=–0.248, P=0.213), but the symptoms of anhedonia in patients were borderline significant with the average amplitudes of P3(r=–0.331, P=0.092).Conclusions: 1 Exclusion Cyberball compared to inclusion Cyberball caused a decrease in positive affect and an increase in negative affect and also decreased basic need satisfaction for both groups. Patients with depression showed more prolonged negative effects of ostracism than did HCs after the social exclusion task. 2 The behavioral and electrophysiological results indicated that the interpersonal problems in depressive patients were mainly due to deficits in processing pleasure rather than aversive social cues.