From brain imaging to intervention: Disruptions of emotional reactivity in unipolar depression

Abstract

Depressed individuals often engage in prolonged, elaborative negative thinking. This pattern is hypothesized to result from increased and uninhibited feedback between brain structures responsible for recognizing emotional features of information. This article reviews a variety of behavioral, physiological, and neuroimaging data supporting this formulation. Data suggest that depression is characterized by increased and sustained behavioral, peripheral physiological, and limbic reactivity to emotional information, as well as decreased prefrontal control, which has been implicated in inhibiting limbic regions. Neuroimaging data increasingly supports the notion that these phenomena are related: amygdala and prefrontal activity vary inversely, and this connectivity is decreased in depression. To the extent that these mechanisms are important for maintaining depression, addressing them in treatment could be useful. Thus initial efforts are reviewed examining how basic science regarding disruptions in emotional reactivity in depression can be translated to the clinic. In particular, a novel "neurobehavioral" intervention that targets brain mechanisms underlying disruptions of emotional reactivity in unipolar depression via "cognitive control training" is described.