Neural, Behavioral, and Speech Indicators of Mood-Congruent Bias in Major Depressive Disorder Emotional and Cognitive Dynamics in Depression

Aim: This study aims to explore the neural, behavioral, and speech indicators of mood-congruent bias in Major Depressive Disorder (MDD), investigating the relationship between emotional processing biases and cognitive control deficits in MDD. Method: Using a novel video paradigm during fMRI, facial expressions (happy/sad) were subliminally presented (16.7 ms) congruent or incongruent with video content (happy/sad) in a large sample (N = 126; MDD: n = 60, Control: n = 66). Psychological testing and speech recordings during a storytelling task of positive and negative life events were conducted outside the scanner. Results: During dynamic emotional cues, faster and more accurate detection was apparent when the emotion of the video content and the subliminal prime expression were congruent. Patients exhibited reduced task performance (subjective ratings and reaction times) compared to controls. Reduced accuracy was found in MDD particularly when happy videos were interrupted by a sad primer. Neuroimaging showed increased activation in the right inferior and middle occipital and temporal gyri. An interaction between speech features and psychological measures was not moderated by the group. Conclusion: Neuroimaging reflects compensatory mechanisms in MDD, indicating increased cognitive effort in processing emotional content. Multimodal evidence highlights the coexistence and mutual contribution of emotional and cognitive mechanisms, which together underscore maladaptive patterns that may exacerbate mood-congruent biases and the persistence and intensity of depressive symptoms. This research was supported by the Brain Imaging Facility at the Interdisciplinary Center for Clinical Research within the Faculty of Medicine, RWTH Aachen University, and the International Research Training Group (IRTG2150). Funding was provided by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under grant number 269953372/GRK2150 and SFB-TRR 379 – 512007073. This work was supported by the FZJ-NST Bilateral Cooperation Program, funded by the Forschungszentrum Jülich and the National Research Council of Science & Technology (Global-22-001). notReviewed other