title: Neural correlates of self-referential processing and implicit self-associations in chronic depression.
abstract: BACKGROUND
  Patients with depression tend to process negative information with regard to the self (i.e. self-referential processing). A better understanding of the neural underpinnings of self-referential processing in patients with depression is clinically important as it can inform on potential treatment targets.
  
  
  METHODS
  This fMRI study sought to study the neural correlates of self-referential processing in patients with chronic major depressive disorder (cMDD) (n=17) and non-patient controls (n=18) using a passive processing paradigm. Stimuli consisted of positive, negative, negative depression related and neutral personality trait words or non-words. Participants were instructed to indicate whether a presented word was an existing word or a non-word while undergoing an fMRI scan. Participants also completed an explicit and an implicit measure of positive and negative self-associations outside the scanner.
  
  
  RESULTS
  Non-patient controls had relatively increased activity in the medial prefrontal cortex (mPFC) during processing of negative depression related vs. neutral words whereas patients with cMDD had relatively decreased activity. Non-patient controls had relatively increased dorsolateral prefrontal cortex (dlPFC) activity during processing of positive vs. neutral words whereas patients with cMDD had relatively decreased activity. Explicit but not implicit self-associations with depression related words were associated with neural activity in the mPFC and the dlPFC.
  
  
  CONCLUSIONS
  The study did not include a clinical control group and therefore the specificity of findings remains unknown.
  
  
  CONCLUSIONS
  The distinct neural processing of emotional self-relevant stimuli in the mPFC and the dlPFC in patients with cMDD might represent an emotional blunting response towards negative self-relevant stimuli.
authors.affiliation: MRC Cognition and Brain Sciences Unit, Cambridge, United Kingdom; Department of Clinical Psychological Science, Maastricht University, The Netherlands. Electronic address: Fritz.Renner@mrc-cbu.cam.ac.uk.
authors.forename: Fritz
authors.initials: F
authors.lastname: Renner
authors.affiliation: Department of Clinical Psychological Science, Maastricht University, The Netherlands.
authors.forename: Nicolette
authors.initials: N
authors.lastname: Siep
authors.affiliation: Department of Clinical Psychological Science, Maastricht University, The Netherlands.
authors.forename: Jill
authors.initials: J
authors.lastname: Lobbestael
authors.affiliation: Department of Clinical Psychology, University of Amsterdam, The Netherlands.
authors.forename: Arnoud
authors.initials: A
authors.lastname: Arntz
authors.affiliation: Department of Cognitive Neuroscience, Maastricht University, The Netherlands; Department of Psychiatry and Neuropsychology, University Hospital Maastricht, The Netherlands.
authors.forename: Frenk P M L
authors.initials: FP
authors.lastname: Peeters
authors.affiliation: Department of Clinical Psychology, VU University Amsterdam, The Netherlands; Department of Psychology, University of Pennsylvania, USA.
authors.forename: Marcus J H
authors.initials: MJ
authors.lastname: Huibers
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000503:physiopathology* / Q000523:psychology; D004644:Emotions / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008606:Mental Processes / Q000502:physiology*; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000502:physiology
keywords: Chronic major depressive disorder; Implicit self-associations; Neuroimaging; Self-referential processing