Increased Amygdala Response to Shame in Remitted Major Depressive Disorder

Abstract

Proneness to self-blaming moral emotions such as shame and guilt is increased in major depressive disorder (MDD), and may play an important role in vulnerability even after symptoms have subsided. Social psychologists have argued that shame-proneness is relevant for depression vulnerability and is distinct from guilt. Shame depends on the imagined critical perception of others, whereas guilt results from one’s own judgement. The neuroanatomy of shame in MDD is unknown. Using fMRI, we compared 21 participants with MDD remitted from symptoms with no current co-morbid axis-I disorders, and 18 control participants with no personal or family history of MDD. The MDD group exhibited higher activation of the right amygdala and posterior insula for shame relative to guilt (SPM8). This neural difference was observed despite equal levels of rated negative emotional valence and frequencies of induced shame and guilt experience across groups. These same results were found in the medication-free MDD subgroup (N = 15). Increased amygdala and posterior insula activations, known to be related to sensory perception of emotional stimuli, distinguish shame from guilt responses in remitted MDD. People with MDD thus exhibit changes in the neural response to shame after symptoms have subsided. This supports the hypothesis that shame and guilt play at least partly distinct roles in vulnerability to MDD. Shame-induction may be a more sensitive probe of residual amygdala hypersensitivity in MDD compared with facial emotion-evoked responses previously found to normalize on remission.

In Search of Neural Endophenotypes of Postpartum Psychopathology and Disrupted Maternal Caregiving

“…Specifically, amygdala activation to negative faces has been replicated in major depressive disorder (MDD) (11–18) and is associated with the ruminative quality (19) and negative bias to emotional information in MDD (20) that represents exaggerated responses to negative emotional stimuli. Heightened amygdala activity to negative emotional stimuli (11–15,17–21) may also serve as a marker of persistent effects of past MDD, which was shown in some (21–23) but not other studies (14,17,24,25) of individuals who recovered from depression versus controls.…”

Resting-State Brain Fluctuation and Functional Connectivity Dissociate Moral Injury from Posttraumatic Stress Disorder

“…Interestingly, studies on shame and guilt [15] have also reported findings in amygdala and dorsal anterior cingulate cortex (dACC) that are hyper-responsive in PTSD [18]. For instance, Pulcu et al [19] detected increased amygdala response to shame in remitted major depressive disorder. For another example, Wagner et al [20] found that guilt in healthy subjects elicited stronger activations in dACC and amygdala than shame.…”

Individual differences in social reward and threat expectancies linked to grey matter volumes in key regions of the social brain

“…162 Our findings support cognitive models such as the constructive episodic simulation hypothesis, 165,166 as we show that the neural structures underpinning attentional biases also underpin prospective ones. Other research has found that pSTS activity is related to remembering and imagining socially threatening situations; 71,72 and is increased during such simulations in individuals with SAD. 167 Surprisingly, we did not find that amygdala volume directly correlates with individuals' STE, despite its wellestablished role in threat processing, including anticipation of social evaluation 168 and a proposed role in mediating temperamental shyness.…”

“…70 The pSTS and amygdala are also active during the simulation of social evaluative threat and embarrassment. 71,72 Here, we used VBM to identify correlations between SRE and/or STE and rGMV across the whole brain. We dissected and quantified the unique and overlapping rGMV correlates of SRE and STE using a combination of raw LODESTARS scores and LODESTARS scores that were orthogonalised (residualised) with respect to one another.…”