Major depression impairs incentive processing: evidence from the heart and the face

Abstract Background The present study tested the hypothesis of a differential pattern of reward and punishment responsiveness in depression measuring effort mobilization during anticipation and facial expressions during consumption. Methods Twenty patients with major depressive disorder (MDD) and 20 control participants worked on a memory task under neutral, reward, and punishment instructions. Effort mobilization was operationalized as cardiovascular reactivity, while facial expressions were measured by facial electromyographic reactivity. Self-report measures for each phase complemented this multi-method approach. Results During anticipation, MDD patients showed weaker cardiac pre-ejection period (PEP) reactivity to reward and blunted self-reported wanting, but weaker PEP reactivity to punishment and unchanged self-reported avoidance motivation. During consumption, MDD patients showed reduced zygomaticus major muscle reactivity to reward and blunted self-reported liking, but unchanged corrugator supercilii muscle reactivity to punishment and unchanged self-reported disliking. Conclusions These findings demonstrate reduced effort mobilization during reward and punishment anticipation in depression. Moreover, they show reduced facial expressions during reward consumption and unchanged facial expressions during punishment consumption in depression.