Neural, Behavioral, and Speech Indicators of Mood-Congruent Bias in Major Depressive Disorder

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.