Abstract
Despite increasing knowledge about the brain mechanisms underlying major depressive disorder (MDD), efforts to explore the neural underpinnings of emotional processing among individuals with MDD and their relationship with neural abnormalities and the maintenance of depression, are still ongoing. This exploratory fMRI study examined the nature of neural responses to emotional faces and their relationship with dysfunctional attitudes among unmedicated individuals with MDD. Twenty-five unmedicated individuals with MDD and 23 control participants completed a facial emotion perception task and self-report questionnaires, including the Beck Depression Inventory-II (BDI-II) and the Dysfunctional Attitude Scale (DAS). Participants with MDD (vs. control participants) showed less accuracy in identifying mildly (50%) and intensely (100%) happy, and mildly (50%) sad faces. Whole-brain analyses reflected increased activation in bilateral inferior frontal gyrus, left posterior (in response to 50% and 100% sad vs. neutral faces) left anterior (in response to 50% sad vs. neutral faces), right anterior, and right middle cingulate cortices (in response to 100% sad vs. neutral faces) among participants with MDD. No group differences were observed in neural responses to happy faces. Hyperactivity in the left inferior frontal gyrus during negative emotion perception was correlated with the DAS’ Performance Evaluation scores in the MDD group. This study highlighted that hyperactivity in the inferior frontal gyrus during negative facial emotion processing is associated with dysfunctional attitudes among people with MDD. The findings warrant further fMRI research to yield neural evidence for cognitive models of depression.
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Data Availability
The data for this study cannot be publicly shared owing to issues regarding participant consent; we do not have the participants’ permission to publicly share the data in their entirety. Thus, de-identified data that support the findings of this study can be availed from the corresponding author on reasonable request.
References
Adolphs, R. (2003). Cognitive neuroscience of human social behaviour. Nature Reviews Neuroscience, 4(3), 165–178. https://doi.org/10.1038/nrn1056
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Beck, A. T. (1967). Depression: Clinical, experimental, and theoretical aspects. Hoeber Medical Division, Harper & Row.
Beck, A. T. (1976). Cognitive therapy and the emotional disorders. International Universities Press.
Beck, A. T. (2002). Cognitive models of depression. Clinical Advances in Cognitive Psychotherapy: Theory and Application, 14(1), 29–61.
Beck, A. T., & Bredemeier, K. (2016). A unified model of depression: Integrating clinical, cognitive, biological, and evolutionary perspectives. Clinical Psychological Science, 4(4), 596–619. https://doi.org/10.1177/2167702616628523
Beck, A. T., Steer, R. A., & Brown, G. (1996). Beck depression inventory–II. Psychological Corporation. https://doi.org/10.1037/t00742-000
Bekker, M. H., & van Mens-Verhulst, J. (2007). Anxiety disorders: Sex differences in prevalence, degree, and background, but gender-neutral treatment. Gender Medicine, 4, S178–S193. https://doi.org/10.1016/S1550-8579(07)80057-X
Bistricky, S. L., Ingram, R. E., & Atchley, R. A. (2011). Facial affect processing and depression susceptibility: Cognitive biases and cognitive neuroscience. Psychological Bulletin, 137(6), 998–1028.
Bourke, C., Douglas, K., & Porter, R. (2010). Processing of facial emotion expression in major depression: A review. Australian & New Zealand Journal of Psychiatry, 44(8), 681–696. https://doi.org/10.3109/00048674.2010.496359
Briceño, E. M., Weisenbach, S. L., Rapport, L. J., Hazlett, K. E., Bieliauskas, L. A., Haase, B. D., Ransom, M. T., Brinkman, M. L., Peciña, M., Schteingart, D. E., Starkman, M. N., Giordani, B., Welsh, R. C., Noll, D. C., Zubieta, J. K., & Langenecker, S. A. (2013). Shifted inferior frontal laterality in women with major depressive disorder is related to emotion-processing deficits. Psychological Medicine, 43(7), 1433–1445. https://doi.org/10.1017/s0033291712002176
Burns, D. D., & Spangler, D. L. (2001). Do changes in dysfunctional attitudes mediate changes in depression and anxiety in cognitive behavioral therapy? Behavior Therapy, 32(2), 337–369. https://doi.org/10.1016/S0005-7894(01)80008-3
Cane, D. B., Olinger, L. J., Gotlib, I. H., & Kuiper, N. A. (1986). Factor structure of the dysfunctional attitude scale in a student population. Journal of Clinical Psychology, 42(2), 307–309. https://doi.org/10.1002/1097-4679(198603)42:2%3c307::AID-JCLP2270420213%3e3.0.CO;2-J
Castanheira, L., Silva, C., Cheniaux, E., & Telles-Correia, D. (2019). Neuroimaging correlates of depression—implications to clinical practice [Mini Review]. Frontiers in Psychiatry, 10, 703. https://doi.org/10.3389/fpsyt.2019.00703
Cosmides, L., & Tooby, J. (2000). Evolutionary psychology and the emotions. In M. Lewis & J. M. Haviland-Jones (Eds.), Handbook of emotions (pp. 91–115). Guilford Press.
Cristea, I. A., Huibers, M. J. H., David, D., Hollon, S. D., Andersson, G., & Cuijpers, P. (2015). The effects of cognitive behavior therapy for adult depression on dysfunctional thinking: A meta-analysis. Clinical Psychology Review, 42, 62–71. https://doi.org/10.1016/j.cpr.2015.08.003
Csukly, G., Telek, R., Filipovits, D., Takács, B., Unoka, Z., & Simon, L. (2011). What is the relationship between the recognition of emotions and core beliefs: Associations between the recognition of emotions in facial expressions and the maladaptive schemas in depressed patients. Journal of Behavior Therapy and Experimental Psychiatry, 42(1), 129–137. https://doi.org/10.1016/j.jbtep.2010.08.003
Dalili, M. N., Penton-Voak, I. S., Harmer, C. J., & Munafò, M. R. (2015). Meta-analysis of emotion recognition deficits in major depressive disorder. Psychological Medicine, 45(6), 1135–1144. https://doi.org/10.1017/S0033291714002591
Davey, C. G., Breakspear, M., Pujol, J., & Harrison, B. J. (2017). A brain model of disturbed self-appraisal in depression. American Journal of Psychiatry, 174(9), 895–903. https://doi.org/10.1176/appi.ajp.2017.16080883
Demenescu, L. R., Kortekaas, R., den Boer, J. A., & Aleman, A. (2010). Impaired attribution of emotion to facial expressions in anxiety and major depression. PLoS ONE, 5(12), e15058.
Demenescu, L. R., Renken, R., Kortekaas, R., van Tol, M. J., Marsman, J. B., van Buchem, M. A., van der Wee, N. J., Veltman, D. J., den Boer, J. A., & Aleman, A. (2011). Neural correlates of perception of emotional facial expressions in out-patients with mild-to-moderate depression and anxiety. A multicenter fMRI study. Psychol Med, 41(11), 2253–2264. https://doi.org/10.1017/s0033291711000596
Dong, D., Li, C., Zhong, X., Gao, Y., Cheng, C., Sun, X., Xiong, G., Ming, Q., Zhang, X., Wang, X., & Yao, S. (2020). Neuroticism modulates neural activities of posterior cingulate cortex and thalamus during psychosocial stress processing. Journal of Affective Disorders, 262, 223–228. https://doi.org/10.1016/j.jad.2019.11.003
Eklund, A., Nichols, T. E., & Knutsson, H. (2016). Cluster failure: Why fMRI inferences for spatial extent have inflated false-positive rates. Proceedings of the National Academy of Sciences, 113(28), 7900–7905. https://doi.org/10.1073/pnas.1602413113
Etkin, A., Egner, T., & Kalisch, R. (2011). Emotional processing in anterior cingulate and medial prefrontal cortex. Trends in Cognitive Sciences, 15(2), 85–93. https://doi.org/10.1016/j.tics.2010.11.004
Fales, C. L., Barch, D. M., Rundle, M. M., Mintun, M. A., Mathews, J., Snyder, A. Z., & Sheline, Y. I. (2009). Antidepressant treatment normalizes hypoactivity in dorsolateral prefrontal cortex during emotional interference processing in major depression. Journal of Affective Disorders, 112(1), 206–211. https://doi.org/10.1016/j.jad.2008.04.027
Feng, C., Yan, X., Huang, W., Han, S., & Ma, Y. (2018). Neural representations of the multidimensional self in the cortical midline structures. NeuroImage, 183, 291–299. https://doi.org/10.1016/j.neuroimage.2018.08.018
Fournier, J. C., Keener, M. T., Almeida, J., Kronhaus, D. M., & Phillips, M. L. (2013). Amygdala and whole-brain activity to emotional faces distinguishes major depressive disorder and bipolar disorder. Bipolar Disorders, 15(7), 741–752. https://doi.org/10.1111/bdi.12106
Fu, C. H., Williams, S. C., Cleare, A. J., Brammer, M. J., Walsh, N. D., Kim, J., Andrew, C. M., Pich, E. M., Williams, P. M., Reed, L. J., Mitterschiffthaler, M. T., Suckling, J., & Bullmore, E. T. (2004). Attenuation of the neural response to sad faces in major depression by antidepressant treatment: A prospective, event-related functional magnetic resonance imaging study. Archives of General Psychiatry, 61(9), 877–889. https://doi.org/10.1001/archpsyc.61.9.877
Fu, C. H., Williams, S. C., Cleare, A. J., Scott, J., Mitterschiffthaler, M. T., Walsh, N. D., Donaldson, C., Suckling, J., Andrew, C., Steiner, H., & Murray, R. M. (2008). Neural responses to sad facial expressions in major depression following cognitive behavioral therapy. Biological Psychiatry, 64(6), 505–512. https://doi.org/10.1016/j.biopsych.2008.04.033
Gotlib, I. H., Krasnoperova, E., Yue, D. N., & Joormann, J. (2004). Attentional biases for negative interpersonal stimuli in clinical depression. Journal of Abnormal Psychology, 113(1), 127–135. https://doi.org/10.1037/0021-843X.113.1.121
Gotlib, I. H., Sivers, H., Gabrieli, J. D., Whitfield-Gabrieli, S., Goldin, P., Minor, K. L., & Canli, T. (2005). Subgenual anterior cingulate activation to valenced emotional stimuli in major depression. NeuroReport, 16(16), 1731–1734. https://doi.org/10.1097/01.wnr.0000183901.70030.82
Greenberg, P. E., Fournier, A. A., Sisitsky, T., Pike, C. T., & Kessler, R. C. (2015). The economic burden of adults with major depressive disorder in the United States (2005 and 2010). The Journal of Clinical Psychiatry, 76(2), 5356. https://doi.org/10.4088/JCP.14m09298
Groenewold, N. A., Opmeer, E. M., de Jonge, P., Aleman, A., & Costafreda, S. G. (2013). Emotional valence modulates brain functional abnormalities in depression: Evidence from a meta-analysis of fMRI studies. Neuroscience & Biobehavioral Reviews, 37(2), 152–163. https://doi.org/10.1016/j.neubiorev.2012.11.015
Groves, S. J., Pitcher, T. L., Melzer, T. R., Jordan, J., Carter, J. D., Malhi, G. S., ... & Porter, R. J. (2018). Brain activation during processing of genuine facial emotion in depression: Preliminary findings. Journal of Affective Disorders, 225, 91-96.
Hamilton, J. P., Etkin, A., Furman, D. J., Lemus, M. G., Johnson, R. F., & Gotlib, I. H. (2012). Functional neuroimaging of major depressive disorder: A meta-analysis and new integration of baseline activation and neural response data. American Journal of Psychiatry, 169(7), 693–703. https://doi.org/10.1176/appi.ajp.2012.11071105
Hasin, D. S., Sarvet, A. L., Meyers, J. L., Saha, T. D., Ruan, W. J., Stohl, M., & Grant, B. F. (2018). Epidemiology of adult DSM-5 major depressive disorder and its specifiers in the United States. JAMA Psychiatry, 75(4), 336–346. https://doi.org/10.1001/jamapsychiatry.2017.4602
Jiang, W., Yin, Z., Pang, Y., Wu, F., Kong, L., & Xu, K. (2012). Brain functional changes in facial expression recognition in patients with major depressive disorder before and after antidepressant treatment: A functional magnetic resonance imaging study. Neural Regeneration Research, 7(15), 1151–1157. https://doi.org/10.3969/j.issn.1673-5374.2012.15.005
Keedwell, P. A., Andrew, C., Williams, S. C., Brammer, M. J., & Phillips, M. L. (2005). A double dissociation of ventromedial prefrontal cortical responses to sad and happy stimuli in depressed and healthy individuals. Biological Psychiatry, 58(6), 495–503. https://doi.org/10.1016/j.biopsych.2005.04.035
Kerestes, R., Ladouceur, C. D., Meda, S., Nathan, P. J., Blumberg, H. P., Maloney, K., Ruf, B., Saricicek, A., Pearlson, G. D., & Bhagwagar, Z. (2012). Abnormal prefrontal activity subserving attentional control of emotion in remitted depressed patients during a working memory task with emotional distracters. Psychological Medicine, 42(1), 29–40. https://doi.org/10.1017/S0033291711001097
Kohler, C. G., Hoffman, L. J., Eastman, L. B., Healey, K., & Moberg, P. J. (2011). Facial emotion perception in depression and bipolar disorder: A quantitative review. Psychiatry Research, 188(3), 303–309. https://doi.org/10.1016/j.psychres.2011.04.019
Korgaonkar, M. S., Grieve, S. M., Etkin, A., Koslow, S. H., & Williams, L. M. (2013). Using standardized fMRI protocols to identify patterns of prefrontal circuit dysregulation that are common and specific to cognitive and emotional tasks in major depressive disorder: First wave results from the iSPOT-D study. Neuropsychopharmacology, 38(5), 863–871. https://doi.org/10.1038/npp.2012.252
Krause, F. C., Linardatos, E., Fresco, D. M., & Moore, M. T. (2021). Facial emotion recognition in major depressive disorder: A meta-analytic review. Journal of Affective Disorders, 293, 320–328. https://doi.org/10.1016/j.jad.2021.06.053
Kwon, S. (1994). Reliability, validity and factor structure of the Korean version of dysfunctional attitude scale. Psychological Science, 3(1), 100–111.
Lawrence, N. S., Williams, A. M., Surguladze, S., Giampietro, V., Brammer, M. J., Andrew, C., Frangou, S., Ecker, C., & Phillips, M. L. (2004). Subcortical and ventral prefrontal cortical neural responses to facial expressions distinguish patients with bipolar disorder and major depression. Biological Psychiatry, 55(6), 578–587. https://doi.org/10.1016/j.biopsych.2003.11.017
Lee, K. U., Kim, J., Yeon, B., Kim, S. H., & Chae, J. H. (2013). Development and standardization of extended ChaeLee Korean facial expressions of emotions. Psychiatry investigation, 10(2), 155.
LeMoult, J., & Gotlib, I. H. (2019). Depression: A cognitive perspective. Clinical Psychology Review, 69, 51–66. https://doi.org/10.1016/j.cpr.2018.06.008
LeMoult, J., Joormann, J., Sherdell, L., Wright, Y., & Gotlib, I. H. (2009). Identification of emotional facial expressions following recovery from depression. Journal of Abnormal Psychology, 118(4), 828–833. https://doi.org/10.1037/a0016944
Lieberman, M. D., & Cunningham, W. A. (2009). Type I and Type II error concerns in fMRI research: Re-balancing the scale. Social Cognitive and Affective Neuroscience, 4(4), 423–428. https://doi.org/10.1093/scan/nsp052
Lim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-Rohani, H., ... & Pelizzari, P. M. (2012). A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 380(9859), 2224-2260. https://doi.org/10.1016/S0140-6736(12)61766-8
Matthews, S. C., Strigo, I. A., Simmons, A. N., Yang, T. T., & Paulus, M. P. (2008). Decreased functional coupling of the amygdala and supragenual cingulate is related to increased depression in unmedicated individuals with current major depressive disorder. Journal of Affective Disorders, 111(1), 13–20. https://doi.org/10.1016/j.jad.2008.05.022
Ming, Q., Zhong, X., Zhang, X., Pu, W., Dong, D., Jiang, Y., Gao, Y., Wang, X., Detre, J. A., Yao, S., & Rao, H. (2017). State-independent and dependent neural responses to psychosocial stress in current and remitted depression. American Journal of Psychiatry, 174(10), 971–979. https://doi.org/10.1176/appi.ajp.2017.16080974
Miskowiak, K. W., & Carvalho, A. F. (2014). “Hot” cognition in major depressive disorder: A systematic review. CNS & Neurological Disorders - Drug Targets, 13(10), 1787–1803. https://doi.org/10.2174/1871527313666141130205713
Nielson, K. A., Langenecker, S. A., & Garavan, H. (2002). Differences in the functional neuroanatomy of inhibitory control across the adult life span. Psychology and Aging, 17(1), 56–71. https://doi.org/10.1037//0882-7974.17.1.56
Norbury, R., Selvaraj, S., Taylor, M. J., Harmer, C., & Cowen, P. J. (2010). Increased neural response to fear in patients recovered from depression: A 3T functional magnetic resonance imaging study. Psychological Medicine, 40(3), 425–432. https://doi.org/10.1017/S0033291709990596
Ochsner, K. N., & Gross, J. J. (2014). The neural bases of emotion and emotion regulation: A valuation perspective. In J. J. Gross (Ed.), Handbook of Emotion Regulationn (2nd ed., pp. 23–42). Guilford.
Omori, M., Yamada, H., Murata, T., Sadato, N., Tanaka, M., Ishii, Y., Isaki, K., & Yonekura, Y. (1999). Neuronal substrates participating in attentional set-shifting of rules for visually guided motor selection: A functional magnetic resonance imaging investigation. Neuroscience Research, 33(4), 317–323. https://doi.org/10.1016/s0168-0102(99)00022-x
Pizzagalli, D. A. (2011). Frontocingulate dysfunction in depression: Toward biomarkers of treatment response. Neuropsychopharmacology, 36(1), 183–206. https://doi.org/10.1038/npp.2010.166
Roiser, J. P., & Sahakian, B. J. (2013). Hot and cold cognition in depression. CNS Spectrums, 18(3), 139–149. https://doi.org/10.1017/S1092852913000072
Roiser, J. P., Linden, D. E., Gorno-Tempinin, M. L., Moran, R. J., Dickerson, B. C., & Grafton, S. T. (2016). Minimum statistical standards for submissions to Neuroimage: Clinical. NeuroImage: Clinical, 12, 1045–1047. https://doi.org/10.1016/j.nicl.2016.08.002
Rolls, E. T., Cheng, W., Du, J., Wei, D., Qiu, J., Dai, D., Zhou, Q., Xie, P., & Feng, J. (2020). Functional connectivity of the right inferior frontal gyrus and orbitofrontal cortex in depression. Social Cognitive and Affective Neuroscience, 15(1), 75–86. https://doi.org/10.1093/scan/nsaa014
Rubinow, D. R., & Post, R. M. (1992). Impaired recognition of affect in facial expression in depressed patients. Biological Psychiatry, 31(9), 947–953. https://doi.org/10.1016/0006-3223(92)90120-O
Sheline, Y. I., Barch, D. M., Donnelly, J. M., Ollinger, J. M., Snyder, A. Z., & Mintun, M. A. (2001). Increased amygdala response to masked emotional faces in depressed subjects resolves with antidepressant treatment: An fMRI study. Biological Psychiatry, 50(9), 651–658. https://doi.org/10.1016/s0006-3223(01)01263-x
Simmons, J. P., Nelson, L. D., & Simonsohn, U. (2011). False-positive psychology: Undisclosed flexibility in data collection and analysis allows presenting anything as significant. Psychological Science, 22(11), 1359–1366. https://doi.org/10.1177/0956797611417632
Smith, M. M., Sherry, S. B., Vidovic, V., Hewitt, P. L., & Flett, G. L. (2020). Why does perfectionism confer risk for depressive symptoms? A meta-analytic test of the mediating role of stress and social disconnection. Journal of Research in Personality, 86, 103954. https://doi.org/10.1016/j.jrp.2020.103954
Stuhrmann, A., Suslow, T., & Dannlowski, U. (2011). Facial emotion processing in major depression: A systematic review of neuroimaging findings. Biology of Mood & Anxiety Disorders, 1(1), 10. https://doi.org/10.1186/2045-5380-1-10
Sung, H. M., Kim, J. B., Park, Y. N., Bai, D. S., Lee, S. H., & Ahn, H. N. (2008). A study on the reliability and the validity of Korean version of the Beck Depression Inventory-II (BDI-II). Korean Society of Biological Therapies in Psychiatriy, 14(2), 201–212.
Surguladze, S. A., Young, A. W., Senior, C., Brébion, G., Travis, M. J., & Phillips, M. L. (2004). Recognition accuracy and response bias to happy and sad facial expressions in patients with major depression. Neuropsychology, 18(2), 212–218. https://doi.org/10.1037/0894-4105.18.2.212
Suslow, T., Konrad, C., Kugel, H., Rumstadt, D., Zwitserlood, P., Schöning, S., Ohrmann, P., Bauer, J., Pyka, M., Kersting, A., Arolt, V., Heindel, W., & Dannlowski, U. (2010). Automatic mood-congruent amygdala responses to masked facial expressions in major depression. Biological Psychiatry, 67(2), 155–160. https://doi.org/10.1016/j.biopsych.2009.07.023
Thirion, B., Pinel, P., Mériaux, S., Roche, A., Dehaene, S., & Poline, J.-B. (2007). Analysis of a large fMRI cohort: Statistical and methodological issues for group analyses. NeuroImage, 35(1), 105–120. https://doi.org/10.1016/j.neuroimage.2006.11.054
Tzourio-Mazoyer, N., Landeau, B., Papathanassiou, D., Crivello, F., Etard, O., Delcroix, N., Mazoyer, B., & Joliot, M. (2002). Automated anatomical labeling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain. NeuroImage, 15(1), 273–289. https://doi.org/10.1006/nimg.2001.0978
Venn, H. R., Watson, S., Gallagher, P., & Young, A. H. (2006). Facial expression perception: An objective outcome measure for treatment studies in mood disorders? International Journal of Neuropsychopharmacology, 9(2), 229–245. https://doi.org/10.1017/S1461145705006012
Victor, T. A., Furey, M. L., Fromm, S. J., Ohman, A., & Drevets, W. C. (2010). Relationship between amygdala responses to masked faces and mood state and treatment in major depressive disorder. Archives of General Psychiatry, 67(11), 1128–1138. https://doi.org/10.1001/archgenpsychiatry.2010.144
Weightman, M. J., Knight, M. J., & Baune, B. T. (2019). A systematic review of the impact of social cognitive deficits on psychosocial functioning in major depressive disorder and opportunities for therapeutic intervention. Psychiatry Research, 274, 195–212. https://doi.org/10.1016/j.psychres.2019.02.035
Weissman, A. N., & Beck, A. T. (1978). Development and validation of the Dysfunctional Attitude Scale: A preliminary investigation the annual meeting of the Education Research Association, Toronto, Canada.
Wolfensberger, S. P. A., Veltman, D. J., Hoogendijk, W. J. G., De Ruiter, M. B., Boomsma, D. I., & de Geus, E. J. C. (2008). The neural correlates of verbal encoding and retrieval in monozygotic twins at low or high risk for depression and anxiety. Biological Psychology, 79(1), 80–90. https://doi.org/10.1016/j.biopsycho.2008.01.002
Zhong, M., Wang, X., Xiao, J., Yi, J., Zhu, X., Liao, J., Wang, W., & Yao, S. (2011). Amygdala hyperactivation and prefrontal hypoactivation in subjects with cognitive vulnerability to depression. Biological Psychology, 88(2), 233–242. https://doi.org/10.1016/j.biopsycho.2011.08.007
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This research was supported by the Brain Research Program of the National Research Foundation (NRF), funded by the Korean government (MSIT) (No. NRF-2017M3C7A1048040). The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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BK, JH, and SC were involved in the design and conceptualization of the study. Material preparation and data collection were performed by BK and DP. BK, JH, DP, and HM contributed to the data analysis and first draft preparation. BK, JH, and SC reviewed and edited the manuscript. JH contributed to the funding acquisition. All authors read and approved the final manuscript.
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Kim, BR., Hur, JW., Park, DS. et al. Increased neural responses to negative facial emotions and their relationship with dysfunctional attitudes among unmedicated individuals with major depressive disorder. Curr Psychol 42, 20409–20420 (2023). https://doi.org/10.1007/s12144-022-03144-5
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DOI: https://doi.org/10.1007/s12144-022-03144-5