Duan Suqian, Valmaggia Lucia, Fennema Diede, Moll Jorge, Zahn Roland
Department of Psychological Medicine, Centre for Affective Disorders, UK.
Department of Psychology, UK; South London and Maudsley, NHS Trust, UK; Ku Leuven, Belgium.
J Psychiatr Res. 2023 May;161:77-83. doi: 10.1016/j.jpsychires.2023.02.031. Epub 2023 Mar 6.
Action tendencies are implicit cognitive and motivational states before an action is taken, such as feeling like hiding when experiencing shame or guilt, independent of the actions people decide to take. Such "action tendencies" are key to understanding the maladaptive impact of self-blame in depression. For example, feeling like "hiding" in a text-based task was previously associated with recurrence risk in remitted depression. Despite their functional importance, action tendencies have not been systematically investigated in current depression, which was the aim of this pre-registered study.
We developed and validated the first virtual reality (VR) assessment of blame-related action tendencies and compared current depression (n = 98) with control participants (n = 40). The immersive VR-task, pre-programmed on devices sent to participants' homes, used hypothetical social interactions, in which either participants (self-agency) or their friend (other-agency) were described to have acted inappropriately.
Compared with controls, people with depression showed a maladaptive profile: particularly in the other-agency condition, rather than feeling like verbally attacking their friend, they were prone to feeling like hiding, and punishing themselves. Interestingly, feeling like punishing oneself was associated with a history of self-harm but not suicide attempts.
Current depression and self-harm history were linked with distinctive motivational signatures, paving the way for remote VR-based stratification and treatment.
行动倾向是在采取行动之前的隐性认知和动机状态，例如在感到羞耻或内疚时想要躲藏的感觉，这与人们决定采取的行动无关。这种“行动倾向”是理解自责在抑郁症中产生适应不良影响的关键。例如，在基于文本的任务中想要“躲藏”的感觉之前与缓解期抑郁症的复发风险相关。尽管它们具有功能重要性，但行动倾向在当前抑郁症中尚未得到系统研究，这就是这项预先注册研究的目的。
我们开发并验证了第一个关于与责备相关的行动倾向的虚拟现实（VR）评估，并将当前抑郁症患者（n = 98）与对照组参与者（n = 40）进行了比较。沉浸式VR任务预先编程在发送到参与者家中的设备上，使用假设的社交互动，其中描述参与者（自我能动性）或他们的朋友（他人能动性）行为不当。
与对照组相比，抑郁症患者表现出一种适应不良的特征：特别是在他人能动性条件下，他们不是倾向于口头攻击他们的朋友，而是容易想要躲藏和惩罚自己。有趣的是，想要惩罚自己的感觉与自我伤害史相关，但与自杀未遂无关。
当前的抑郁症和自我伤害史与独特的动机特征相关，为基于远程VR的分层和治疗铺平了道路。
