Aberrant insula activity to negative and reduced learning from positive prediction errors as mechanisms underlying maladaptive self-belief formation in depression

Maladaptive self-beliefs are a core symptom of major depressive disorder. These beliefs are perpetuated by a negatively biased integration of self-related feedback. Understanding the neurocomputational mechanisms of biased belief updating may help to counteract maladaptive beliefs and the maintenance of depression. The present study uses a belief-updating task and functional neuroimaging to examine the neurocomputational mechanisms associated with self-related feedback processing in individuals with major depression and matched healthy controls. We hypothesized that increased symptom burden in depression is associated with negatively biased self-belief updating and altered neural tracking of social feedback. Our findings show that depression is related to reduced incorporation of unexpected positive feedback, with higher symptom burden alongside heightened insula reactivity to unexpected negative feedback. The interplay of increased neural responsiveness to negative feedback and the reduced learning from positive feedback provide new insights into cognitive distortions in depression and may explain the persistence of maladaptive self-beliefs and, thus, the maintenance of depression.