The impact of perfectionism and anxiety traits on action monitoring in major depressive disorder

Abstract

Perfectionism and anxiety features are involved in the clinical presentation and neurobiology of major depressive disorder (MDD). In MDD, cognitive control mechanisms such as action monitoring can adequately be investigated applying electrophysiological registrations of the error-related negativity (ERN) and error positivity (Pe). It is also known that traits of perfectionism and anxiety influence ERN amplitudes in healthy subjects. The current study explores the impact of perfectionism and anxiety traits on action monitoring in MDD. A total of 39 MDD patients performed a flankers task during an event-related potential (ERP) session and completed the multidimensional perfectionism scale (MPS) with its concern over mistakes (CM) and doubt about actions (DA) subscales and the trait form of the State Trait Anxiety Inventory. Multiple regression analyses with stepwise backward elimination revealed MPS-DA to be a significant predictor (R2:0.22) for the ERN outcomes, and overall MPS (R2:0.13) and MPS-CM scores (R2:0.18) to have significant predictive value for the Pe amplitudes. Anxiety traits did not have a predictive capacity for the ERPs. MPS-DA clearly affected the ERN, and overall MPS and MPS-CM influenced the Pe, whereas no predictive capacity was found for anxiety traits. The manifest impact of perfectionism on patients’ error-related ERPs may contribute to our understanding of the action-monitoring process and the functional significance of the Pe in MDD. The divergent findings for perfectionism and anxiety features also indicate that the wide range of various affective personality styles might exert a different effect on action monitoring in MDD, awaiting further investigation.

How personal standards perfectionism and evaluative concerns perfectionism affect the error positivity and post-error behavior with varying stimulus visibility

“…Whereas some electrophysiological studies (e.g., Pieters et al, 2007;Schrijvers et al, 2010;Stahl et al, 2015;Tops et al, 2013) have shown a relationship between perfectionism and the Ne/ERN, we did not (see Supplement 2), which might be a result of task specifics like the varying stimulus visibility, which might have induced uncertainty, or the difficulty of establishing a stimulus-response representation at an early level of processing. Moreover, we did not examine the influence of response uncertainty in our study, which might have additionally affected the ERP components (see Wessel, 2012).…”

“…On the basis of prior perfectionism-related findings (Schrijvers et al, 2010;Stahl et al, 2015;Tops et al, 2013), we expected to find a higher Pe amplitude for participants with high PSP than for those with low PSP. If this is a sign of PSPrelated variations in error-processing efficiency, it should be reflected in a greater number of correct decisions and a higher post-error accuracy (perhaps accompanied by post-error slowing) for high-PSP than for low-PSP participants.…”

“…A positive relationship between ECP and the Pe amplitude (e.g., Schrijvers et al, 2010;Tops et al, 2013) could be a sign of higher affective involvement after error commission among high-ECP participants. Stahl et al (2015) found both higher Pe amplitudes and higher post-error accuracy for high-PSP relative to low-PSP participants (i.e., a higher percentage of correct responses after error responses), which points to faster error evidence accumulation being used to improve performance after error commission.…”

“…In healthy samples (Stahl, Acharki, Kresimon, Völler, & Gibbons, 2015;Tops, Koole, & Wijers, 2013) as well as clinical samples (Pieters et al, 2007;Schrijvers, De Bruijn, Destoop, Hulstijn, & Sabbe, 2010), variations have been observed in the neural correlates of error processing as a function of perfectionism.…”

Neural evidence that conscious awareness of errors is reduced in depression following a traumatic brain injury

“…Alternatively, the ERN may be unaffected by MDD, as a number of other studies have indicated (Olvet et al, 2010;Schrijvers et al, 2008Schrijvers et al, , 2009, or modulated by symptoms that vary in MDD, for example apathy or psychomotor retardation (Schrijvers et al, 2008). Another possibility is that the ERN is related to response uncertainty rather than depression severity (Schrijvers, De Bruijn, Destoop, Hulstijn, & Sabbe, 2010). Performance in the current study showed no differences between groups, suggesting the task was not sufficiently difficult to modulate response uncertainty between groups.…”