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Depression, Hypervigilance When Expecting Pain Linked

Higher emotional reactivity in major depressive disorder may reduce ability to modulate pain

MONDAY, Nov. 3 (HealthDay News) -- Individuals with major depressive disorder may have increased emotional reactivity while anticipating a painful stimulus followed by a lowered ability to modulate their pain experience, according to research published in the November issue of the Archives of General Psychiatry.

Irina A. Strigo, Ph.D., of the University of California San Diego, and colleagues analyzed data from 15 young adults with major depressive disorder and 15 matched individuals without the disorder. Participants engaged in a computerized performance task, which alerted them to upcoming moderately painful heat stimuli on their forearms, while undergoing functional MRI.

Those with major depressive disorder had increased activation of the amygdala, right anterior insular region and dorsal anterior cingulate cortex while anticipating pain, implying that they had increased affective processing before experiencing pain, the investigators found. More right amygdala activation during pain anticipation was linked to higher levels of perceived helplessness, the researchers report.

"To our knowledge, this is the first study to examine the neural correlates of anticipatory pain processing in young, unmedicated individuals with current major depressive disorder. Cognitive models of depression suggest that depressed individuals negatively bias their expectations, thereby creating conflict with the environment. The increased activation within the amygdala, anterior insular and anterior cingulate cortex in subjects with major depressive disorder during anticipation of pain found herein is consistent with this cognitive model and may represent a neural correlate of hypervigilant monitoring of negative information in major depressive disorder," the authors write.

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