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Somatic salience and sensory precision in persistent depression


Type

Thesis

Change log

Abstract

Persistent depression is a debilitating health condition with a poor prognosis even in the context of current gold-standard pharmacological and psychological interventions. A better understanding of the mechanisms contributing to its maintenance is needed to facilitate the development of more targeted psychological interventions. Bayesian predictive processing models of depression propose that negative emotional and physiological outcomes arise in depressive illness as a result of disturbed interoceptive precision estimation in depressed individuals; however, evidence from the clinical and cognitive neuroscience literatures suggests the hypothesis that sensory precision is attenuated in persistent depression across sensory modalities in general. A series of studies was designed to index sensory precision across somatic and auditory modalities and to identify the level at which any disruption manifested in persistently-depressed participants relative to controls. Study 1 (Chapter 3) measured baseline signal discriminability under conditions of focused attention. Study 2 (Chapter 4) measured the impact of failures of voluntary attention on signal discriminability. Study 3 (Chapter 5) used a simulation approach to model sensory precision in the first two studies and to identify mechanisms which could successfully predict the data. Studies 4 (Chapter 6) and 5 (Chapter 7) measured attentional capture by task-irrelevant and predictive sensory cues respectively. Study 6 (Chapter 8) partially replicated Studies 4 and 5 and used the resulting data to estimate the group-level sensory precision and salience parameters of a predictive processing model of precision optimization. The results suggest that sensory precision is attenuated in persistent depression across sensory modalities, and that this attenuation results from disturbances of voluntary and involuntary attention rather than baseline perceptual sensitivity. Under conditions of voluntary attention, reduced sensory precision may result from efforts at resource conservation; and under conditions of involuntary attentional capture, it may be related to a loss of target discriminability and salience. Conversely, the bottom-up salience of somatic stimuli was uniquely enhanced among depressed participants and was predicted by high anxiety and by low interoceptive sensibility. These findings open up new avenues for investigation of the mechanisms underlying persistent forms of depression, and have direct implications for clinical practice with respect to psychological intervention.

Description

Date

2020-07

Advisors

Dalgleish, Tim

Keywords

Somatic, Attention, Depression, Predictive processing

Qualification

Doctor of Philosophy (PhD)

Awarding Institution

University of Cambridge
Sponsorship
MRC (1223851)
Medical Research Council Studentship