Brain of Thrones: Cognitive Effort and Perceived Performance During a Cognitive Task in Major Depressive Disorder
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ORIGINAL ARTICLE
Brain of Thrones: Cognitive Effort and Perceived Performance During a Cognitive Task in Major Depressive Disorder Chelsea Wood‑Ross1 · Michael W. Best2 · Melissa Milanovic1 · Christopher R. Bowie1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Cognitive impairment is a characteristic feature of depression and a robust predictor of everyday functioning. Cognitive remediation is a promising treatment for neurocognitive dysfunction in depression. However, treatment studies have shown that those with depression often do not apply their cognitive gains to everyday life. Features of depression may account for mixed outcomes, including avoidance and negative perceptions of abilities. The present investigation examined how individuals with depression engage with a novel cognitive task created to resemble exercises used in cognitive remediation. Methods Twenty-eight individuals with depression and 24 healthy comparison (HC) participants completed a computerized cognitive task while EEG was recorded. Participants were asked to indicate how they would like to adjust task difficulty and how many of the trials they believed they got correct. Results Participants with depression did not significantly differ from HC on objective performance accuracy. However, participants with depression opted to decrease their difficulty level significantly more than HC on high challenge levels. Additionally, individuals with depression had significantly greater EEG alpha power on high challenge levels than low challenge levels, suggesting increased disengagement from the task on more challenging levels. Conclusions Avoidance of cognitive challenges in depression has implications for understanding mechanisms related to cognitive performance and efforts to modify cognitive impairment. Keywords Depression · Neurocognition · Cognitive remediation · Avoidance · Effort
Introduction Major depressive disorder (MDD) is the leading cause of disability worldwide, found to affect an estimated 4.4% of the world’s population in 2015 (World Health Organization, 2017) and an estimated 10.8% of the world’s population across the lifespan (Lim et al. 2018). Diagnostic criteria for MDD include difficulties with concentration and decision making (American Psychiatric Association 2013), Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10608-020-10145-w) contains supplementary material, which is available to authorized users. * Christopher R. Bowie [email protected] 1
Department of Psychology, Queen’s University, Kingston, ON K7L 3L3, Canada
Department of Psychology, University of Toronto Scarborough, Toronto, ON M1C 1A4, Canada
2
and measurement with traditional neuropsychological tools has shown that relative to healthy comparison participants, individuals with MDD experience impairments of small to moderate effect size in domains of processing speed, attention, memory and executive functions (Bora et al. 2013; Rock et al. 2014). By the ti
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