The Mental Simulation of Motor Incapacity in Depression
The Mental Simulation of Motor Incapacity in Depression
Running head: MENTAL SIMULATION IN DEPRESSION
The Mental Simulation of Motor Incapacity in Depression
Lisa M. Lindeman and Lyn Y. Abramson
University of Wisconsin, Madison
Abstract
In depression, negative beliefs are coupled with profound physical weakness. Specifically, the belief that one is incapable of altering events in order to prevent expected negative outcomes or bring about positive outcomes leads to bodily symptoms characterized by low energy, slow motor movement and delays in the initiation of movement. The purpose of this paper is to present a theoretical model describing the causal mechanisms that link these cognitive and somatic elements of depression. We propose that 1) the inability to alter events is conceptualized metaphorically as motor incapacity, 2) as part of this conceptualization, the experience of motor incapacity is mentally simulated, and 3) this simulation leads to both subjective feelings of lethargy and peripheral physiological changes consistent with motor incapacity.
The Mental Simulation of Motor Incapacity in Depression
According to cognitive theories of depression, depression is prompted by negative cognitive evaluations of life events (Abramson et al., 1989, 2002; Beck, 1967, 1987; Clark, Beck, & Alford, 1999). These negative evaluations involve “the expectation that highly desired outcomes will not occur or that highly aversive outcomes will occur and that one cannot change this situation” (Abramson et al., 2002, p. 269) Specifically, depression arises when a negative life event of personal importance is evaluated as stable (likely to persist over time) and global (likely to affect many other areas of life), expected to lead to other negative consequences, and taken as evidence that one is unworthy or deficient. Thus, a proximal, sufficient cause of depression is hopelessness, where, in the face of negative events believed to be pervasive and enduring, people believe that they are powerless.
Hopelessness leads to a cluster of bodily symptoms that include low energy, retarded initiation of voluntary responses, and psychomotor retardation (Abramson et al., 1989; Joiner et al., 2001). Psychomotor retardation is characterized by immobility or slowed motor movement, delays in motor activity, postural slumping, attenuated facial expression, and slowed speech (Parker & Brotchie, 1992; Widlцcher, 1983). Psychomotor retardation is positively correlated with the degree and onset of depression (Nelson & Charney, 1981; Parker, 1990; Rush et al., 1994; Parker et al., 1994) and Global Assessment of Function (GAF) but not psychotic symptoms (Hickie, Mason, & Parker, 1996). Psychomotor retardation also clusters together with sadness on the Hamilton Depression Rating Scale (items 1 and 8) in people with major depression, according to a factor analysis (Cleary & Guy, 1975). Psychomotor retardation severity is correlated with the success of therapeutic interventions (Widlцcher & Daniel, 1983), predicts fluoxetine nonresponse (Taylor, 2004), and mediates the negative effects of maternal depression on emotional development in children (Beeber & Leeman, 2002).
How does hopelessness, or the belief that one is incapable of avoiding negative events or reaching a goal, lead to slowed motor movements and lethargy? Although cognitive theories of depression (e.g., Abramson, 2002; Beck, 1987) assert that deficits in response initiation follow naturally from expectations of powerlessness and hopelessness, we suggest that explanations for this link should and can be elaborated. It seems intuitive that the promise of failure should dampen efforts to succeed. However, why should hopelessness with respect to an abstract goal, like building a positive reputation, lead to impaired response initiation with respect to concrete motor goals, like reaching for a cup of tea? In other words, why should a perceived inability to alter abstract aspects of life foster an inability to alter ones physical surroundings? Recent research on embodied cognition, conceptual metaphor, and mental imagery offers some clues. Mental concepts appear to involve the mental simulation of sensory perceptions and motor actions. For concepts regarding intangibles, such as honor, obligation, or freedom, these sensorimotor simulations are often metaphorical (Gallese & Lakoff, 2005). For example, on this basis, the concept of freedom from political oppression involves simulating the ability to freely move ones body. These simulations are the bodily experiences