Abnormal Default System Functioning in Depression: Implications for Emotion Regulation

Abstract

Depression is widely seen as the result of difficulties in regulating emotions. Based on neuroimaging studies on voluntary emotion regulation, neurobiological models have focused on the concept of cognitive control, considering emotion regulation as a shift toward involving controlled processes associated with activation of the prefrontal and parietal executive areas, instead of responding automatically to emotional stimuli. According to such models, the weaker executive area activation observed in depressed patients is attributable to a lack of cognitive control over negative emotions. Going beyond the concept of cognitive control, psychodynamic models describe the development of individuals' capacity to regulate their emotional states in mother-infant interactions during childhood, through the construction of the representation of the self, others, and relationships. In this mini-review, we link these psychodynamic models with recent findings regarding the abnormal functioning of the default system in depression. Consistently with psychodynamic models, psychological functions associated with the default system include self-related processing, semantic processes, and implicit forms of emotion regulation. The abnormal activation of the default system observed in depression may explain the dysfunctional aspects of emotion regulation typical of the condition, such as an exaggerated negative self-focus and rumination on self-esteem issues. We also discuss the clinical implications of these findings with reference to the therapeutic relationship as a key tool for revisiting impaired or distorted representations of the self and relational objects.

Keywords: default system; depression; emotion regulation; neuroimaging; psychodynamic; psychotherapy; self.

FIGURE 1

Graphical representation of foci of perfusion reported in association with depression. Graphical representation of foci of brain activity reported in studies that have compared depressed patients and healthy controls (in yellow decreased activations, in violet increased activations), located in executive areas [in red, retrieved from http://neurosynth.org/; (Yarkoni et al., 2011)], and default system (Raichle et al., 2001b).