Exploring the link between a prior for active avoidance and apathy, anhedonia, and depression - a network analysis.

Abstract

Background: Learned helplessness has been suggested as a mechanism through which anhedonia in depression is developed. It has been theorised that this stems from a generalised pessimistic prior belief about the probability of success when attempting to actively avoid negative outcomes, thereby resulting in apathy and reduced motivation. Yet, how such a prior may relate to depression and apathy is unknown. Here, we leveraged a novel method based on cognitive tasks and Bayesian modelling to extract a reliable generalised prior expressing the probability with which negative outcomes are expected to be actively avoidable.

Methods: We quantified this prior in 521 non-clinical participants. We then used Bayesian network analysis to explore how the prior's mean relates to total scores of the PHQ-9 depression scale, specific items of the PHQ-9, and six subscales measuring apathy, motivation, and emotional reactivity.

Results: We found that the mean of the prior is positively related to the tendency to get motivated to initiate and maintain goal-directed actions, as measured with the Apathy Motivation Index (AMI) and not hedonic capacity as measured by the Snaith-Hamilton Pleasure Scale. Moreover, the same reverse-coded behavioural apathy subscale in the AMI was related to the total score of the PHQ-9 independently of hedonic capacity. Finally, the prior belief was itself not directly linked to depressive symptoms or total scores of the PHQ-9.

Conclusion: These results indicate that our behavioural measure of helplessness is indirectly related to depressive symptoms through behavioural activation and independently of hedonic capacity.