title: Better to give than to take? Interactive social decision-making in severe major depressive disorder.
abstract: BACKGROUND
  Although recent studies focusing on major depressive disorder (MDD) suggest altered social decision-making, studies using the Ultimatum Game (UG) in patients with severe, clinical MDD do not exist. Moreover, all aforementioned studies so far focused on responder behavior and thus fairness considerations; to this date, no one investigated social interactive behavior which involves proposer behavior possibly requiring second-order mentalizing as well.
  
  
  METHODS
  Thirty-nine MDD patients and 22 healthy controls played a modified UG, both in the roles of responder and proposer against the same partner.
  
  
  RESULTS
  MDD patients accepted both fair and unfair offers as many times as the healthy controls in their role as responder. Importantly, however, in the role of proposer MDD patients offered significantly more than the control group did.
  
  
  CONCLUSIONS
  Most patients were treated with psychotropic medication.
  
  
  CONCLUSIONS
  Responder behavior demonstrates that MDD patients are capable of making social decisions on fairness considerations in the same way as healthy controls do. The observed proposer behavior, however, could indicate that MDD patients are more focused on avoiding rejection. These findings provide unique evidence that social decision-making--as studied in a realistic context--is disturbed in MDD.
authors.affiliation: Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Universiteitsplein 1, Antwerp, Belgium. marianne.destoop@ua.ac.be
authors.forename: Marianne
authors.initials: M
authors.lastname: Destoop
authors.forename: Didier
authors.initials: D
authors.lastname: Schrijvers
authors.forename: Carmen
authors.initials: C
authors.lastname: De Grave
authors.forename: Bernard
authors.initials: B
authors.lastname: Sabbe
authors.forename: Ellen R A
authors.initials: ER
authors.lastname: De Bruijn
mesh_terms: D000328:Adult; D003657:Decision Making; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D012381:Role Playing; D012919:Social Behavior; D056345:Theory of Mind