4.5 Article

Allostasis, Action, and Affect in Depression: Insights from the Theory of Constructed Emotion

Journal

ANNUAL REVIEW OF CLINICAL PSYCHOLOGY
Volume 18, Issue -, Pages 553-580

Publisher

ANNUAL REVIEWS
DOI: 10.1146/annurev-clinpsy-081219-115627

Keywords

metabolism; affect; emotion; interoception; predictive processing; allostasis; depression

Funding

  1. National Cancer Institute [U01CA193632]
  2. National Institute of Mental Health [R01MH113234, R01MH109464]
  3. National Institute on Aging [R56AG058745]
  4. National Science Foundation [BCS1947972]
  5. Elizabeth R. Koch Foundation
  6. US Army Research Institute for the Behavioral and Social Sciences [W911NF-16-1-019]

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The theory of constructed emotion is a systems neuroscience approach that aims to understand the nature of emotion. It proposes that allostatic dysregulation is a vulnerability for mental and physical illnesses. The review suggests that symptoms in major depressive disorder (MDD) may be associated with problems in energy regulation. This approach challenges the current understanding of MDD and offers novel hypotheses for its development, progression, treatment, and prevention.
The theory of constructed emotion is a systems neuroscience approach to understanding the nature of emotion. It is also a general theoretical framework to guide hypothesis generation for how actions and experiences are constructed as the brain continually anticipates metabolic needs and attempts to meet those needs before they arise (termed allostasis). In this review, we introduce this framework and hypothesize that allostatic dysregulation is a trans-disorder vulnerability for mental and physical illness. We then review published findings consistent with the hypothesis that several symptoms in major depressive disorder (MDD), such as fatigue, distress, context insensitivity, reward insensitivity, and motor retardation, are associated with persistent problems in energy regulation. Our approach transforms the current understanding of MDD as resulting from enhanced emotional reactivity combined with reduced cognitive control and, in doing so, offers novel hypotheses regarding the development, progression, treatment, and prevention of MDD.

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