Cognition and Depression: Current Status and Future Directions
Open accessAbstract
Cognitive theories of depression posit that people's thoughts, inferences, attitudes, and interpretations, and the way in which they attend to and recall information, can increase their risk for depression. Three mechanisms have been implicated in the relation between biased cognitive processing and the dysregulation of emotion in depression: inhibitory processes and deficits in working memory, ruminative responses to negative mood states and negative life events, and the inability to use positive and rewarding stimuli to regulate negative mood. In this review, we present a contemporary characterization of depressive cognition and discuss how different cognitive processes are related not only to each other, but also to emotion dysregulation, the hallmark feature of depression. We conclude that depression is characterized by increased elaboration of negative information, by difficulties disengaging from negative material, and by deficits in cognitive control when processing negative information. We discuss treatment implications of these conclusions and argue that the study of cognitive aspects of depression must be broadened by investigating neural and genetic factors that are related to cognitive dysfunction in this disorder. Such integrative investigations should help us gain a more comprehensive understanding of how cognitive and biological factors interact to affect the onset, maintenance, and course of depression.
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Such neural network alterations are posited to contribute to impaired regulatory control of stimulus-driven affective processing, producing rigid negative biases evident across a wide range of implicit information processing domains (e.g., negative appraisals of self, environment, future; preferential attention and memory for negative stimuli).
“Such neural network alterations are posited to contribute to impaired regulatory control of stimulus-driven affective processing 7,45 , producing rigid negative biases evident across a wide range of implicit information processing domains (e.g., negative appraisals of self, the environment, and the future 46 ; preferential attention and memory for negative stimuli 45,47 ).”
From Neuroplasticity in cognitive and psychological mechanisms of depression: an integrative model (2020) · cites this paper as [45]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredAttention shows valence-specific alterations in depressed patients including attentional preference for dysphoric stimuli and biases away from positive stimuli.
“Attention, which acts as an initial filter on the information entering conscious awareness, shows valence-specific alterations in depressed patients including attentional preference for dysphoric stimuli and biases away from positive stimuli 45,47,83 .”
From Neuroplasticity in cognitive and psychological mechanisms of depression: an integrative model (2020) · cites this paper as [45]
In “Perception and Attention” (page not provided), the review reports a bias toward negative material in depression, particularly difficulty disengaging once it has captured attention. It does not establish a bias away from positive stimuli, and it cautions that evidence for faster initial orienting toward negative stimuli is mixed. (LLM, conf=0.85)
Experimental — accuracy not yet measuredMajor depression is characterized by a strong disturbance in working memory.
“major depression is characterized by a strong disturbance in WM (Banich et al., 2009; Foland-Ross & Gotlib, 2012; Gotlib & Joormann, 2010; Joormann, 2018; Kaiser et al., 2015).”
From Baseline-dependent effect of dopamine’s precursor L-tyrosine on working memory gating but not updating (2020) · cites this paper as Gotlib & Joormann, 2010
The Inhibition and Cognitive Control section reports difficulties removing and manipulating negative material in working memory in depressed participants. But the Cognitive Deficits in Depression section describes mixed results on general working-memory tasks, including studies finding few or no differences. The source therefore supports a more specific disturbance, not the unqualified claim of a strong disturbance in working memory overall. Page numbers were not supplied in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredObjective measures of neuro-cognition are impacted in depression.
“Additionally, we used a multidimensional approach to evaluate trial outcomes; symptom assessments were complemented with evaluation of change in subjective mental health behaviors and quality of life, as well as change in objective measures of neuro-cognition that are impacted in depression [31–37].”
From Personalized machine learning guided intervention for optimizing lifestyle behaviors in depression: a pilot study (2026) · cites this paper as [31]
Depression can be associated with cognitive deficits.
“Notably, while depression can be associated with cognitive deficits [31–37]”
From Personalized machine learning guided intervention for optimizing lifestyle behaviors in depression: a pilot study (2026) · cites this paper as [31]
Cognitive reappraisal is correlated with adaptive outcomes, such as lower depression.
“Cognitive reappraisal is correlated with adaptive outcomes, such as lower depression [25]”
From Effects of Mindfulness and Life-Skills Training on Emotion Regulation and Anxiety Symptoms in Chinese Migrant Children: A Randomized Controlled Trial. (2024) · cites this paper as [25]
Expressive suppression implies an intentional inhibition of behaviors associated with negative emotions.
“It is different to expression suppression, which implies an intentional inhibition of behaviors associated with negative emotions [25].”
From Effects of Mindfulness and Life-Skills Training on Emotion Regulation and Anxiety Symptoms in Chinese Migrant Children: A Randomized Controlled Trial. (2024) · cites this paper as [25]
The ‘Cognitive Biases and Emotion Regulation in Depression’ section mentions emotion suppression as a regulation strategy but does not define expressive suppression. The ‘Inhibition and Cognitive Control’ section discusses suppressing thoughts and processing negative material, not intentionally inhibiting behaviors associated with negative emotions. Searches for expressive suppression and behavioral expression found no passage addressing the claimed definition; page numbers were unavailable in our copy. (LLM, conf=0.74)
Experimental — accuracy not yet measuredThe blunted signal in attention-related brain areas during switching in MDD may underlie the increased switch-related response latencies at a behavioral level in this group and putatively reflect deficits in attention control at the clinical level.
“This blunted signal in attention-related brain areas during switching in MDD may underlie the previously outlined increased switch-related response latencies at a behavioral level in this group, and putatively reflect deficits in attention control at the clinical level of this disorder [58].”
From Cognitive inflexibility in obsessive-compulsive disorder and major depression is associated with distinct neural correlates (2013) · cites this paper as [58]
Acute stress triggers affective and cognitive changes similar to biased information processing characteristic of depression.
“In parallel, acute stress has been shown to trigger affective and cognitive changes similar to biased information processing characteristic to depression (Gotlib and Joormann, 2010).”
From The interplay between stress, inflammation, and emotional attention: relevance for depression (2019) · cites this paper as Gotlib and Joormann, 2010
The functional abnormalities might underlie the increased sensitivity to negative emotional stimuli and the difficulty in disengaging from them, which is contained in the construct of negative bias in depression.
“These functional abnormalities might underlie the increased sensitivity to negative emotional stimuli and the difficulty in disengaging from them, which is contained in the construct of negative bias in depression (58,59).”
From Relation Between Structural and Functional Connectivity in Major Depressive Disorder (2013) · cites this paper as [59]
Cognitive deficits such as memory and attention problems are common during depressive episodes.
“Investigations of cognition-emotion interactions have revealed that cognitive deficits, such as problems with memory and attention, are common during depressive episodes (Gotlib and Joormann 2010; Levin et al. 2007).”
From Executive Function Deficits in Daily Life Prospectively Predict Increases in Depressive Symptoms (2014) · cites this paper as Gotlib and Joormann 2010
It has been suggested that executive-function deficits play an active role in depressive episodes.
“Once considered an epiphenomenon of depression (Austin et al. 2001), it has been suggested that EF deficits play an active role in depressive episodes (Gotlib and Joormann 2010).”
From Executive Function Deficits in Daily Life Prospectively Predict Increases in Depressive Symptoms (2014) · cites this paper as Gotlib and Joormann 2010
Depressed patients tend to spend more time attending to negative information such as sad faces than neutral or positive information.
“A large body of research, largely utilizing the Dot Probe56 or Emotional Stroop Task57 has shown that depressed patients tend to spend more time attending to negative information, such as sad faces than neutral or positive information (for review see refs. 58,59).”
From Paying attention to attention in depression (2019) · cites this paper as [58]
Depressed patients' attention tends to linger longer on negative information such as sad faces than healthy controls do.
“Generally speaking, depressed patients’ attention tends to linger longer on negative information such as sad faces than healthy controls do, which suggests a negative bias in the way that depressed individuals sample information from their environments.”
From Paying attention to attention in depression (2019) · cites this paper as [58]
Self-reports are affected by recall bias, and depressed patients have been found to alter the content of past experiences when asked to retrieve them retrospectively.
“Likewise, self-reports are affected by recall bias. In other words, depressed patients have been found to alter the content of past experiences when asked to retrieve them retrospectively [8,9], judging symptoms as more severe [10] or increasing the elaboration of negative information [11].”
From Current state and future directions of technology-based ecological momentary assessment and intervention for major depressive disorder: a systematic review (2019) · cites this paper as [11]
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- Authors
- Gotlib, I. H., & Joormann, J.
- Affiliations
- Stanford University (US)
- University of Miami (US)
- Venue
- Annual Review of Clinical Psychology
- Publisher
- Annual Reviews
- Published
- 2010-03-01
- Volume
- 6
- Issue
- 1
- Pages
- 285-312
- ISSN
- 1548-5943 (ISSN-L)
- 1548-5951
- PMC
- PMC2845726
- OpenAlex
- W2110004174
- Cited by
- 2,420
- References
- 179
- Citations by year
- 2026: 162 · 2025: 174 · 2024: 163 · 2023: 161 · 2022: 164 · 2021: 184 · 2020: 151 · 2019: 191 · 2018: 155 · 2017: 196 · 2016: 154 · 2015: 161 · 2014: 128 · 2013: 107 · 2012: 83
- FWCI
- 10.53
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Annual Review of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH074849, R01MH059259)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- depression, cognitive theories of depression, depressive cognitions, emotional dysregulation, cognitive control, rumination, working memory deficits, inhibitory processes, reward processing, therapeutic implications, genetic factors, neural factors
- MeSH terms
- Cognition Disorders, Depressive Disorder, Major, Major Depressive Disorder, Humans, Life Change Events, Mental Processes, Neuropsychological Tests, Psychological Theory, Severity of Illness Index, Prevalence
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