More rumination and less effective emotion regulation in previously depressed women with preserved executive functions

Background: Major depressive disorder is associated with very high recurrence rates, and specific vulnerability factors that increase the risk for repeated episodes should be identified. Impaired executive functions have repeatedly been found in remitted populations. The current study included both neutral and emotional executive tasks, and we expected to find impaired performance in unmedicated previously depressed women compared to controls. Furthermore, we hypothesized that the executive functions inhibition and shifting would be related to the ability to apply cognitive reappraisal and to avoid unhealthy rumination. Methods: Inhibition and shifting data derived from neutral and emotional computerized tasks, and questionnaire data on emotion regulation and trait rumination, were obtained from previously depressed (n = 109) and never-depressed women (n = 64) and analyzed in independent samples t-tests. A logistic regression analysis investigated the ability of emotion regulation and rumination to predict depression vulnerability. The associations of executive functions to emotion regulation and rumination were investigated in a series of linear regression analyses. Participants on psychotropic medication were excluded from all analyses of executive performance. Results: Previously depressed participants, the majority of which had experienced recurrent episodes, matched control participants on both neutral and emotional executive tasks. However, significantly more rumination and expressive suppression, and less cognitive reappraisal, were found in the previously depressed group. Executive function was unrelated to rumination and emotion regulation in this sample. Conclusions: Previously depressed women whose executive function was intact were characterized by ruminative tendencies and more frequent use of expressive suppression. Trait rumination and expressive suppression are known to increase depression risk, but were unrelated to executive functions in this population. This indicates that unhealthy emotion regulation strategies may be targeted directly in preventive interventions.