Appetitive motivation in MDD

A number of theorists have hypothesized that appetitive motivation is deficient in depression (Clark et al., 1994; Depue & Iacono, 1989; Fowles, 1988). Evidence for this idea is robust. A common set of clinical features of depression, for example, involves impairment in appetitive motivation: depressed individuals frequently exhibit anhedonia, psychomotor retardation, fatigue, anorexia, and apathy. These features are all easily interpretable in terms of a reduced responsivity to appetitive stimuli and/or a reduced drive to engage with positive or rewarding features of the external environment in MDD. Not surprisingly, and also consistent with this interpretation, depressed individuals have been found to report lower levels of appetitive motivation than do nondepressed controls (Kasch et al., 2002).

Perhaps the strongest evidence of appetitive deficits comes from laboratory studies in which positive emotional stimuli are presented to depressed individuals. For example, compared with nondepressed controls, depressed individuals have been found to exhibit less positive emotion-expressive behavior in response to pleasant film and pleasant drink stimuli (Berenbaum & Oltmanns, 1992), and pleasant slides (Sloan et al., 2001), and to be less behaviorally responsive to reward contingencies (Henriques & Davidson, 2000). Depressed individuals have also been shown to be characterized by attenuated reports of positive emotion in response both to slides depicting pleasant scenes (Allen et al., 1999; Sloan et al., 1997,2001) and to an amusing film clip (Rottenberg et al., 2002). Finally, and perhaps most germane to our focus on social functioning, in our laboratory we have found that smiling human faces evoke less neural reactivity (as measured by functional magnetic resonance imaging [fMRI]) in depressed individuals than in nondepressed controls (Gotlib et al., 2001). Indeed, based in part on this accumulating evidence, clinical theorists and researchers have argued that deficits in appetitive motivation are a characteristic emotional "signature" of depression that distinguishes this disorder from other forms of psychopathology (e.g., Clark et al., 1994; Henriques & Davidson, 1991).

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