Symptom Dynamics and Attention in Depression: Fatigue and Low Positive Affect are Associated With Reduced Orienting Efficiency

Abstract

Depression is a heterogeneous mental disorder involving a complex interplay between potential etiological and maintenance factors. The current study examined how depression heterogeneity is related to attentional functioning. Relying on person-specific network models, we explored the associations between symptom centrality (expected influence) and impairments in attention (orienting, alerting and executive control). Participants (N = 82) with ongoing and remitted depression were enrolled to 13 days of intensive assessment of depression symptoms in their daily life using a smartphone app. Based on these data, personspecific network models were estimated using vector autoregression modelling. Orienting, alerting and executive control were assessed using the Attentional Network Test in the laboratory. Person-specific networks showed large variability in symptom dynamics. Higher centrality for low positive affect and fatigue were associated with reduced orienting efficiency (r = .35, p < .05; r = .30, p < .05, respectively). Results are discussed in relation to anhedoniaand reward-related processes. In conclusion, this study points towards the importance of individual symptom dynamics when considering cognitive functioning in depression.