Response stereotypy A reformulation of emotional deficits in MDD

Considered collectively, these findings indicate, contrary to what might be assumed, that diminished emotional reactivity in depression is not restricted to positively valenced stimuli. Rather, it appears that depressed persons exhibit a more general insensitivity to environmental stimuli. Although there is not yet a fully developed theoretical framework to account for this stereotyped and inflexible pattern of emotional reactivity (Davidson et al., 2000), it is nevertheless consistent with conceptualizations that emphasize depressed persons' pervasive withdrawal from environmental events (Nesse, 2000). Indeed, considerable evidence indicates that depressed persons exhibit a reduced sensitivity to changing emotional contexts. For example, compared with nondepressed controls, depressed persons have been found to show less affective modulation of startle (Allen et al., 1999), less electromyographic modulation during affective imagery (Gehricke & Shapiro, 2000; Greden et al., 1986), less facial reactivity in response to expressive facial stimuli (Wexler et al., 1993), less valence-related modulation of event-related brain potentials (Deldin et al., 2001), less differential neural responding to emotion face stimuli (Gotlib et al., 2001), and a lack of autonomic responding to a variety of stimuli (Dawson et al., 1977).

The results of naturalistic studies also indicate that depressed individuals exhibit emotional stereotypy, showing little modulation of their facial affect (e.g., Andreasen, 1979; Kulhara & Chadda, 1987) or vocal characteristics (e.g., Hargreaves et al., 1965). These findings are especially important because they indicate that depressed individuals exhibit stereotyped emotional responses in social situations. Indeed, as we will discuss in the following section, we believe that the capacity to shift affect appropriately is crucial if one is to interact effectively with others. In this context, therefore, the lack of affective modulation among depressed individuals is likely to have important implications for their social functioning.

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