Abnormal Default System Functioning in Depression: Implications for Emotion Regulation

Abstract

Depression is widely seen as the result of difficulties in regulating emotions. Based on neuroimaging studies on voluntary emotion regulation, neurobiological models have focused on the concept of cognitive control, considering emotion regulation as a shift toward involving controlled processes associated with activation of the prefrontal and parietal executive areas, instead of responding automatically to emotional stimuli. According to such models, the weaker executive area activation observed in depressed patients is attributable to a lack of cognitive control over negative emotions. Going beyond the concept of cognitive control, psychodynamic models describe the development of individuals’ capacity to regulate their emotional states in mother-infant interactions during childhood, through the construction of the representation of the self, others, and relationships. In this mini-review, we link these psychodynamic models with recent findings regarding the abnormal functioning of the default system in depression. Consistently with psychodynamic models, psychological functions associated with the default system include self-related processing, semantic processes, and implicit forms of emotion regulation. The abnormal activation of the default system observed in depression may explain the dysfunctional aspects of emotion regulation typical of the condition, such as an exaggerated negative self-focus and rumination on self-esteem issues. We also discuss the clinical implications of these findings with reference to the therapeutic relationship as a key tool for revisiting impaired or distorted representations of the self and relational objects.

Line drawings reveal the structure of internal visual models conveyed by cortical feedback.

“…Internal models play an active role in many human behaviours including visual attention 42 , higher cognitive functions such as memory and action planning 43 , decision making 44 and mental time travel 45 . Moreover, internal models are affected in mental disorders including major depression 46 , schizophrenia 47 and autism spectrum disorder 48,49 . Previous work has shown differences in the characteristics of line drawings made by schizophrenic patients 50 and in the ability of autistic children to predict objects from fragmented line drawings 51 .…”

Is Our Self Related to Personality? A Neuropsychodynamic Model

“…The early growth and maturation of brain regions involved in self and social development (Pfeifer and Peake, 2012 ) is experience-dependent and requires nurturing self-other interactions in the context of attachment for developing the capacity to regulate cognitive and emotional states (Messina et al, 2016b ). For instance, a recent study (Brauer et al, 2016 ) indicated how 5-year old children exposed to higher maternal touch experiences show additional regional connectivity within the right dorso-medial prefrontal cortex and may benefit in terms of “social brain development.” In contrast, when an individual is denied these positive experiences, serious failures of self-development occur (Schore, 2005 ; Messina et al, 2016a ; Mucci, 2016 , 2018 ).…”

Dysregulated Anxiety and Dysregulating Defenses: Toward an Emotion Regulation Informed Dynamic Psychotherapy

“…On the other hand, difficulties in ER have been identified as putative risk and maintaining factors for several disorders ( Gratz et al, 2013 ). Poor emotion regulation has been linked to psychiatric disorders ( Barlow, 2002 ; Werner and Gross, 2010 ; Grecucci, 2012 ; Ehring, 2013 ; Mennin and Fresco, 2014 ; Messina et al, 2016a ), and more than 75% of psychiatric disorders are characterized by deficits in emotion regulation ( Kring and Werner, 2004 ). For example, anxiety, depression, and personality disorders are associated with specific dysregulated emotions ( Thayer and Lane, 2000 ; Mennin and Fresco, 2009 ; Schulze et al, 2011 ).…”