Insensitivity to Success and Failure: An Experimental Study of Performance-Based Feedback in Depression

Objective: This experimental study set out to examine the effects of performance feedback (success or failure) on depressed emotions and self-serving attribution bias in inpatients suffering from Major Depressive Disorder (MDD). Methods: The study was based on a 2 × 2 experimental design in which 71 MDD patients and 59 healthy controls participated. Both groups (MDD and controls) were randomly assigned to two conditions: success or failure in the performance feedback. A section of Raven’s Standard Progressive Matrices (SPM) was used as a bogus test of the participants’ reasoning abilities, and the Core Depressive Factor of the Zung Self-Rating Depression Scale was used to measure changes in depressed emotion in the subjects following the performance feedback. Participants then rated the accuracy of the SPM as a measure of their reasoning capacity. Results: The levels of depressed emotions in patients with MDD did not differ significantly under the two feedback conditions. In contrast, depressed emotion levels increased significantly in healthy individuals in response to failure feedback but did not change in response to success feedback. With regard to the ratings of SPM accuracy, there was no significant difference across the two feedback conditions for depressed patients; however, the accuracy ratings were higher in the success condition than in the failure condition for the controls. Conclusion: Individuals with MDD exhibit blunted emotional reactivity when experiencing new positive or negative social stimuli, supporting the theory of Emotion Context Insensitivity. In addition, self-serving attribution bias does not occur in MDD, which is consistent with the theory of learned helplessness in depression.