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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Neuroscience

Background:

  • Major Depressive Disorder (MDD) is increasingly understood as a condition affecting daily functioning.
  • Previous research in other conditions distinguished between competence (skill ability) and real-world functioning, but this multi-level approach has not been applied to MDD.
  • This study introduces a multidimensional, multi-level framework to assess functioning in MDD.

Purpose of the Study:

  • To investigate differences in competence, functional disability, and self-perceived competence between individuals with MDD and healthy comparisons (HC).
  • To explore the relationship between competence accuracy and self-perception of performance in adaptive and interpersonal domains.
  • To determine if group membership (MDD vs. HC) moderates this relationship.

Main Methods:

  • A multidimensional (adaptive, interpersonal) and multi-level (competence, performance) approach was used.
  • Participants included individuals with MDD (n=42) and healthy comparisons (HC) (n=24).
  • Standardized measures assessed competence, functional disability, and self-perceived competence, with between-group analyses and moderation analysis employed.

Main Results:

  • The MDD group demonstrated significantly lower competence, greater functional disability, and lower self-perceived competence across adaptive and interpersonal domains.
  • Group membership did not moderate the link between competence and self-perceived competence in the adaptive domain.
  • In the interpersonal domain, competence and self-perceived abilities aligned in HC but not in the MDD group, indicating a moderation effect.

Conclusions:

  • A multi-level assessment approach is effective for evaluating functioning in MDD.
  • Performance-based measures of functional competence are sensitive indicators for MDD.
  • Objective measurement is vital, as individuals with MDD may inaccurately assess their own abilities.