title: The specificity of Pavlovian regulation is associated with recovery from depression.
abstract: BACKGROUND
  Changes in reflexive emotional responses are hallmarks of depression, but how emotional reflexes make an impact on adaptive decision-making in depression has not been examined formally. Using a Pavlovian-instrumental transfer (PIT) task, we compared the influence of affectively valenced stimuli on decision-making in depression and generalized anxiety disorder compared with healthy controls; and related this to the longitudinal course of the illness.
  
  
  METHODS
  A total of 40 subjects with a current DSM-IV-TR diagnosis of major depressive disorder, dysthymia, generalized anxiety disorder, or a combination thereof, and 40 matched healthy controls performed a PIT task that assesses how instrumental approach and withdrawal behaviours are influenced by appetitive and aversive Pavlovian conditioned stimuli (CSs). Patients were followed up after 4-6 months. Analyses focused on patients with depression alone (n = 25).
  
  
  RESULTS
  In healthy controls, Pavlovian CSs exerted action-specific effects, with appetitive CSs boosting active approach and aversive CSs active withdrawal. This action-specificity was absent in currently depressed subjects. Greater action-specificity in patients was associated with better recovery over the follow-up period.
  
  
  CONCLUSIONS
  Depression is associated with an abnormal influence of emotional reactions on decision-making in a way that may predict recovery.
authors: Wellcome Trust Centre for Neuroimaging,University College London,London,UK.
authors: Q J M
authors: QJ
authors: Huys
authors: Charité Universitätsmedizin Berlin,Campus Charité Mitte,Berlin,Germany.
authors: M
authors: M
authors: Gölzer
authors: Charité Universitätsmedizin Berlin,Campus Charité Mitte,Berlin,Germany.
authors: E
authors: E
authors: Friedel
authors: Charité Universitätsmedizin Berlin,Campus Charité Mitte,Berlin,Germany.
authors: A
authors: A
authors: Heinz
authors: Radboud University Medical Center,Donders Institute for Brain,Cognition and Behaviour,Centre for Cognitive Neuroimaging,Nijmegen,The Netherlands.
authors: R
authors: R
authors: Cools
authors: Gatsby Computational Neuroscience Unit,University College London,London,UK.
authors: P
authors: P
authors: Dayan
authors: Wellcome Trust Centre for Neuroimaging,University College London,London,UK.
authors: R J
authors: RJ
authors: Dolan
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology*; D001604:Berlin; D003214:Conditioning, Classical; D003463:Cues; D003657:Decision Making; D003863:Depression / Q000175:diagnosis*; D003865:Major Depressive Disorder / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004644:Emotions; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Decision-making; Pavlovian-instrumental transfer; emotional reactions; major depressive disorder