Amygdala reactivity to masked negative faces is associated with automatic judgmental bias in major depression: a 3 T fMRI study.

OBJECTIVE In a previous study, we demonstrated that amygdala reactivity to masked negative facial emotions predicts negative judgmental bias in healthy subjects. In the present study, we extended the paradigm to a sample of 35 inpatients suffering from depression to investigate the effect of amygdala reactivity on automatic negative judgmental bias and clinical characteristics in depression. METHODS Amygdala activity was recorded in response to masked displays of angry, sad and happy facial expressions by means of functional magnetic resonance imaging at 3 T. In a subsequent experiment, the patients performed an affective priming task that characterizes automatic emotion processing by investigating the biasing effect of subliminally presented emotional faces on evaluative ratings to subsequently presented neutral stimuli. RESULTS Significant associations between (right) amygdala reactivity and automatic negative judgmental bias were replicated in our patient sample (r=-0.59, p<0.001). Further, negatively biased evaluative processing was associated with severity and longer course of illness (r=-0.57, p=0.001). CONCLUSION Amygdala hyperactivity is a neural substrate of negatively biased automatic emotion processing that could be a determinant for a more severe disease course.