Social cognition in major depressive disorder: A new paradigm?

Abstract

Social cognition refers to the brain mechanisms by which we process social information about other humans and ourselves. Alterations in interpersonal and social functioning are common in major depressive disorder, though only poorly addressed by current pharmacotherapies. Further standardized tests, such as depression ratings or neuropsychologic tests, used in routine practice provide very little information on social skills, schemas, attributions, stereotypes and judgments related to social interactions. In this article, we review recent literature on how healthy human brains process social decisions and how these processes are altered in major depressive disorder. We especially focus on interactive paradigms (e.g., game theory based tasks) that can reproduce daily life situations in laboratory settings. The evidences we review, together with the rich literature on the protective role of social networks in handling stress, have implications for developing more ecologically-valid biomarkers and interventions in order to optimize functional recovery in depressive disorders.

The impact and measurement of social dysfunction in late‐life depression: an evaluation of current methods with a focus on wearable technology

“…Firstly, as highlighted at the beginning of this review, social functioning is negatively affected by depression and as such, is a potential target for treatment. Indeed, studies suggest that patients rate improvements in social functioning as a particularly important treatment outcome (Billeke et al ., ). Therefore speech data have the potential to be an ecologically valid outcome measure.…”

“…For example, the cardinal symptoms of MDD (such as anhedonia, irritability and becoming withdrawn) likely directly contribute to poor social functioning in patients (Steger & Kasdan, ). Similarly, MDD has frequently been associated with impaired social cognition, for example, impaired emotion recognition (Szanto et al ., ) and Theory of Mind deficits (Lee et al ., 2005; Wolkenstein et al ., 2011; for a recent review, see Billeke et al ., ). In addition, there is evidence to suggest that a diagnosis of MDD (and the symptoms of MDD) may, in turn, lead to reduced trust from the patients' social contacts on account of the stereotypes associated with a mental health diagnosis (Aromaa et al ., 2012).…”

“…Therefore, it is perhaps unsurprising that following a review of research on social cognition in MDD, Billeke et al . () conclude that studies using ‘more ecologically valid biomarkers’ are required.…”

The stress–reward–mentalizing model of depression: An integrative developmental cascade approach to child and adolescent depressive disorder based on the Research Domain Criteria (RDoC) approach

“…Somewhat surprisingly, despite the centrality of interpersonal problems and distortions in cognitive-affective schemas of self and others in many theories of depression, research has only relatively recently begun to focus on the neural circuitry underlying mentalizing in depression in both adults and youth (Billeke, Boardman, & Doraiswamy, 2013;. Although the neural circuits involved in mentalizing are distinct from those involved in attention and general (cognitive) reasoning and other cognitive systems such as planning, memory, and executive functioning (Adolphs, 2015;Van Overwalle, 2011), mentalizing is partly dependent on these capacities and, in turn, fosters THE STRESS-REWARD-MENTALIZING MODEL OF DEPRESSION 23 them.…”

Top-Down Control of Serotonin Systems by the Prefrontal Cortex: A Path toward Restored Socioemotional Function in Depression

“…As a result, socioemotional behaviors are rarely used as endpoints in antidepressant clinical trials (Table 1). 4, 5 Yet consistent evidence shows that humans suffering from MDD withdraw socially and engage in behaviors that trigger hostility and rejection from interaction partners. These patients often rate their interpersonal difficulties as the most disabling aspect of the disease, which results in the erosion of social support and eventually isolation.…”