Emotion anticipation and processing in depression: Behavioral, neural, and physiological reactivity

• Published in: EUROPEAN PSYCHIATRY Vol. 68; no. 1; p. e68
• Main Authors: Wlad, Magdalena, Struckmann, Wiebke, Persson, Jonas, Rosén, Jörgen, Fällmar, David, Bodén, Robert, Gingnell, Malin
• Format: Journal Article Publication
• Language: English
• Published: England Cambridge University Press 11.06.2025
• Subjects: Adult; Anhedonia - physiology; anterior cingulate cortex; Anticipation, Psychological - physiology; Arousal - physiology; Brain - physiopathology; Brain Mapping; Brain research; Case-Control Studies; Data analysis; depression; electrodermal activity; Emotions; Emotions - physiology; Female; functional magnetic resonance imaging; Galvanic Skin Response - physiology; Gyrus Cinguli - physiopathology; Humans; Hyperactivity; insula; Magnetic Resonance Imaging; Male; Mental depression; Mental disorders; Mental health; Middle Aged; Physiology; salience network; Scanners; Substance abuse treatment; Young Adult; Sweden; electrodermal activity; depression; insula; salience network; anterior cingulate cortex; functional magnetic resonance imaging
• ISSN: 0924-9338; 1778-3585; 1778-3585
• DOI: 10.1192/j.eurpsy.2025.10043

Depression is characterized by disturbed emotion processing, with aberrant neural and physiological responses to emotional stimuli. Here, we applied an emotion anticipation and processing paradigm to investigate brain neural and electrodermal reactivities in patients with depression compared with healthy controls. The study included 42 patients (27 females) and 44 healthy controls (21 females). Subjects underwent functional magnetic resonance imaging with simultaneous measurement of electrodermal activity. During scanning, red or green color cues were presented, followed by pictures of negative or positive valence, respectively. Behavioral valence and arousal ratings of the picture stimuli were conducted after scanning. Anhedonia was assessed through a semi-structured interview in both subject groups. Patients perceived positive pictures as less positive than controls did. Positive anticipation (i.e., green color cues) elicited stronger activations in the anterior cingulate cortex and the right insula in patients than in healthy controls, indicating salience network disturbances. An exploratory analysis of all regions in the Automated Anatomical Labeling Atlas 2 found significant differences in activity to positive anticipation between groups in several brain regions involved in cognition and emotion processing. Positive and negative anticipation elicited stronger electrodermal responses in healthy controls. However, electrodermal reactivity to negative pictures was higher in patients than in controls. Ongoing depression affects emotion anticipation and processing at the behavioral, neural, and physiological levels. These findings contribute to increased understanding of the disorder.