[969 words, 4-5 minute read]
Do you recall ever wanting to lie around all day doing nothing?
Have you ever felt so unmotivated or uninterested in life that you began questioning your life purpose?
Answered ‘yes’ to any of the above questions? If so, you’re not alone… feeling this way on one-off occasions is normal! But a loss of interest that persists over time (usually two weeks or longer) and makes a person engage in fewer activities than before can be termed ‘apathy’ and might indicate an underlying disorder like depression…
Doing our part for apathetic folk, we investigated the possibility that impairments in generating options for action might underlie apathy through checking whether the two were associated…
Read on to quench thy curiosity!
A “Symptom-Level” Approach to Depression
You’re probably no stranger to the widespread nature of depression – whose unabating prevalence is undeniably concerning – but what might come as news to you is that a whopping 256 unique combinations of symptoms can warrant a clinical diagnosis of depression! Flabbergasted? Understandably so! We were too!
But the above mind-boggling statistic does more than just astonish; it highlights that treating depression might best be achieved by targeting particular depressive symptoms rather than the disorder as a whole!
Among competing symptoms of depression, apathy emerges a clear winner, as a key facet of the common multi-dimensional depressive symptom “anhedonia”, typically associated with poor clinical outcomes and resistance to or worsening after treatment…
Apathy: What is Suspected
Researchers reason that apathy might stem from impairments in processing rewards, since, compared to their healthy counterparts, depressed patients are less likely to show biases for rewarding stimuli, less willing to exert physical effort for rewards, and often even less willing to take risks for rewards!
But, real life is a different ball game altogether; rarely are we given rewarding options for behaviour on a platter… we must usually think of these ourselves. Alas, this crucial pre-decisional stage of option generation in reward processing has unfortunately been ignored… a problem we’re here to fix!
Since depressed patients show difficulty retrieving specific memories (tending to recall categorical or generic memories instead), apathy might stem from an impaired capacity to generate options because of lower/lacking access to specific long-term memories…
Ergo, we investigated: Are apathy scores negatively associated with option generation capacity?
But Wait…
Speaking of being served options on a platter… wouldn’t people with more social support have greater access to these figurative platters? This might make their own option generation capacities less related/unrelated to any apathy they experience…
Ergo, we also investigated: Is the association between apathy and option generation weaker at higher levels of social support?
Our Study
Since depression typically emerges in young adulthood, we recruited 69 participants aged 18-30 years to maximise our chances of garnering wide-ranging depressive profiles and ergo apathy levels.
Participants initially completed a simple option generation task, in which they heard brief verbal descriptions of hypothetical real-life scenarios and verbally generated options for action in response. We investigated the total number of options participants came up with when asked to generate options maximally, across 10 scenarios, five of which were “open” (open-ended; e.g., “It’s a rainy and cold Sunday. What could you do?”), and the remaining five “problem-solving” (e.g., “You are in a foreign city and you’re totally lost. What could you do?”).
We also assessed participants’ verbal fluency, which could impact their ability to articulate options and was thus accounted for in our analyses!
Next, we had participants complete standardised questionnaires measuring their levels of apathy, depression and social support.
What we Discovered
- Our sample was predominantly sub-clinically depressed, meaning that most participants (~77%) met criteria for no/minimal to mild depression.
- Option generation capacities were not associated with apathy levels, even when we analysed their inter-correlation across open and problem-solving scenarios separately.
- Apathy levels and option generation capacities were unrelated regardless of social support levels.
- Social support levels negatively predicted apathy levels.
Conclusions (And Some Limitations)
Our study suggests that among sub-clinically depressed individuals, not option generation but other aspects of reward processing might underlie apathy. Ergo, researchers trying to figure apathy out should probably focus less on option generation and more on other aspects of reward processing!
Unfortunately, though, since we assessed all our constructs simultaneously or cross-sectionally, the age-old ‘chicken or egg first’ dilemma comes into play. To truly rule out option generation impairments as underlying apathy, we’d want to do something like get a bunch of people to feel constricted options-wise and then confirm that their behaviour is not apathy-consistent!
Nonetheless, if you’re trying to help out a friend with apathy, subtly bombarding them with lists of things to consider doing appears not to be the answer, even in ambiguous situations. It seems that your friend might need assistance with what comes after this initial phase of whipping up lists of options!
Do our findings apply to depressed patients too? Unfortunately, we cannot answer this, as our participant pool was predominantly sub-clinically depressed, rather than clinically depressed. Another teeny issue is that people hugely vary in their abilities to accurately introspectively judge their apathy, depression, and social support; ergo, future studies could benefit from using assessments from friends, family, and clinicians besides self-reported measurements!
Also, since option generation in everyday life often takes inspiration from perceptual stimuli and the presence of interaction partners, it would be cool for future studies to leverage technological advancements and study option generation in dynamic virtual reality environments better mimicking real-life contexts…
But the good news is that you might potentially be able to mitigate your friend’s apathy simply by providing them with social support, for instance by reminding them often that you are there for them if they need you! Easy enough? We think so!
Enjoyed reading this article? Any comments? We’d love to hear your thoughts below!
References
- Johnson, S. (2022, January 7). The depression paradox: Treatments are better, but prevalence remains the same. Big Think. Retrieved from https://bigthink.com/neuropsych/depression-treatment-prevalence-paradox/
- Defining Unique Subtypes in Depression. (n.d.). Advances in Psychiatry. Retrieved from https://www.nyp.org/publications/professional-advances/psych/defining-unique-subtypes-in-depression
- What to know about apathy in depression. (n.d.). Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/apathy-depression
- Kieslich, K., Valton, V., & Roiser, J. P. (2022). Pleasure, reward value, prediction error and anhedonia. Anhedonia: Preclinical, Translational, and Clinical Integration, 281-304. https://doi.org/10.1007/7854_2021_295
- Husain, M., & Roiser, J. P. (2018). Neuroscience of apathy and anhedonia: a transdiagnostic approach. Nature Reviews Neuroscience, 19(8), 470-484. https://doi.org/10.1038/s41583-018-0029-9
- Overgeneral autobiographical memory. (n.d.). Wikipedia. Retrieved from https://en.wikipedia.org/wiki/Overgeneral_autobiographical_memory
Credits
First/Cover photo from Pexels: https://www.pexels.com/photo/woman-in-gray-turtleneck-sweater-sitting-on-brown-leather-couch-4114918/
Second photo from Pexels: https://www.pexels.com/photo/stationery-on-green-surface-7718886/
Third photo from Pexels: https://www.pexels.com/photo/group-of-people-reading-book-sitting-on-chair-711009/
Fourth photo from Pexels: https://www.pexels.com/photo/silhouette-photo-of-woman-against-during-golden-hour-39853/
Fifth photo from Pexels: https://www.pexels.com/photo/woman-adjusting-her-virtual-reality-headset-3761262/
Sixth photo from Pexels: https://www.pexels.com/photo/persons-hands-with-rainbow-colors-3693897/