Exploring the Link Between a Prior Belief for Active Avoidance and Apathy, Anhedonia, and Depression: A Network...

Learned helplessness has been suggested as a mechanism through which anhedonia in depression is developed. It has been theorized that this stems from a generalized pessimistic prior belief about the probability of success when attempting to actively avoid negative outcomes, thereby resulting in apathy and reduced motivation. However, how such a prior belief may relate to depression and apathy is unknown. Here, we leveraged a novel method based on cognitive tasks and Bayesian modeling to extract a reliable generalized prior belief expressing the probability with which negative outcomes are expected to be actively avoidable.

We quantified this prior belief in 521 nonclinical participants. Then we used Bayesian network analysis to explore how the prior's mean was related to total scores of the Patient Health Questionnaire-9 (PHQ-9) depression scale, specific items of the PHQ-9, and 6 subscales measuring apathy, motivation, anhedonia, and emotional reactivity.

We found that the mean of the prior belief was positively related to the tendency to get motivated to initiate and maintain goal-directed actions as measured with the Apathy Motivation Index (AMI) and not hedonic capacity as measured by the Snaith-Hamilton Pleasure Scale. Moreover, the same reverse-coded behavioral apathy subscale in the AMI was related to the total score of the PHQ-9 independently of hedonic capacity. Finally, the prior belief itself was not directly linked to depressive symptoms or PHQ-9 total scores.

These results indicate that our behavioral measure of helplessness is indirectly related to depressive symptoms through behavioral activation and independently of hedonic capacity.