Internal cognitive control in clinical depression: General but no emotion-specific impairments Evi De Lissnyder a , Ernst H.W. Koster a,n , Jonas Everaert a , Rik Schacht b , Dirk Van den Abeele c , Rudi De Raedt a a Ghent University, Department of Psychology, Henri Dunantlaan, 2, B-9000 Ghent, Belgium b RGC Zeeuws Vlaanderen, The Netherlands c Ghent University Hospital, Belgium article info Article history: Received 3 May 2011 Received in revised form 5 January 2012 Accepted 16 April 2012 Keywords: Switching Working memory Internal attention Rumination abstract Prior research has suggested that depression is characterized by impaired cognitive control. The present study sought to investigate internal cognitive control impairments related to emotional information and task settings in clinical depression (MDD, major depressive disorder). Internal cognitive control was operationalized as switching between internally held mental representations that required continuous updating in working memory and measured with the Internal Shift Task (IST). The results showed that MDD individuals were characterized by a general switching impairment. This switching impairment was neither influenced by the task-relevance of emotional information, nor influenced by the valence of the faces within the emotion condition. The impairment in cognitive control reflected in general switching impairments was related to rumination, a specific cognitive symptom and important risk factor of depression. The results of this study offer new insights into the relationship between depression and impaired cognitive control with potential clinical implications, informing treatment and prevention programmes. & 2012 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Major depressive disorder (MDD) is one of the most common and debilitating mental disorders (Kessler, 2003). Although current phar- macological and psychological interventions are quite effective in reducing depressive symptoms at the short term, relapse rates remain very high (Kessler et al., 2005). Given the high prevalence and recurrence rates of depression, an important research challenge is to identify the underlying vulnerability factors for depression. In the past, theoretical models of cognitive vulnerability for depression and related empirical studies have focused primarily on examining cognitive products or the negative content of depressive cognition. Recently, theoretical models highlight the importance of underlying cognitive processes that might be related to negative cognition and the core affective symptoms of depression, such as sustained negative affect and impaired emotion regulation (Joormann and D’Avanzato, 2010). Toward this goal, a wealth of research has investigated the relationship between depression and information processing impair- ments as cognitive vulnerability factors (Clark et al., 1999; Alloy et al., 2000). An enhanced theoretical understanding of information processing impairments in depression may help to improve current treatments by targeting the crucial cognitive risk factors. It has been proposed that impairments in the cognitive control functions of working memory might operate across the various cognitive biases, such as mood-congruent interpretation biases, memory biases, and attentional biases, acting as an important mechanism underlying depression (Joormann, 2005). Cognitive con- trol refers to the ability to override pre-potent responses and to inhibit the processing of irrelevant or previous relevant information. These abilities are related to the functioning of executive control processes, such as inhibition, switching, and updating in working memory (Miyake et al., 2000). Recently, a wealth of research has begun to investigate whether depression is related to cognitive control impairments using a variety of cognitive-experimental tasks. There is some neuropsychological evidence suggesting that depression is associated with general impairments in cognitive control. Research has indicated that depressed persons make more perseverative errors on the Wisconsin Card Sorting Task (WCST), a widely used measure of cognitive control and flex- ibility, suggesting switching impairments when processing non- emotional information (Merriam et al., 1999; Grant et al., 2001; Harvey et al., 2004). Research using the n-back task (Harvey et al., 2004), Go/Nogo (Kaiser et al., 2003), and the antisaccade task (Sweeney et al., 1998), has also provided some evidence for Contents lists available at SciVerse ScienceDirect journal homepage: www.elsevier.com/locate/psychres Psychiatry Research 0165-1781/$ - see front matter & 2012 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.psychres.2012.04.019 n Corresponding author. Fax: þ32 09 264 64 89. E-mail address: Ernst.Koster@UGent.be (E.H.W. Koster). Psychiatry Research 199 (2012) 124–130