Heightened neural sensitivity to social pain and social gain in major depressive disorder.
Social rejection represents a proximal risk factor for depression onset that is thought to activate a neuro-cognitive alarm system for social and physical pain. However, emerging evidence suggests that both social pain and social gain share an overlapping neural substrate. This remains unexplored in the context of depression. Eighteen participants with Major Depressive Disorder (MDD) and 21 controls listened to and vividly revisited autobiographical social experiences in an ecologically valid script-driven imagery paradigm using naturalistic memory narratives. An overlapping neural substrate in the dorsal anterior cingulate cortex and anterior insula was activated while revisiting both social-inclusion and -rejection experiences relative to neutral ones. These same regions were more active in MDD compared to controls for both rejection and inclusion narratives. Our findings add to the evidence for an overlapping neural substrate of complex representations for both positive and negative social signals and suggest a heightened neural sensitivity in MDD towards any socially salient information as opposed to selective sensitivity towards negative social experiences.