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已发表论文
探究高攻击性抑郁症患者的风险决策：一项事件相关电位研究
Authors Huang L, Zhang Q, Pan W, Li Q, Wang Z, Liu Y, Geng F, Wang K, Zhang M, Zhu C
Received 3 June 2025
Accepted for publication 21 August 2025
Published 16 September 2025 Volume 2025:18 Pages 1993—2008
DOI https://doi.org/10.2147/PRBM.S538756
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Gabriela Topa
Lei Huang,1,* Qingqing Zhang,1,* Woxin Pan,1 Qianqian Li,2 Zixu Wang,1 Yiming Liu,1 Feng Geng,2 Kai Wang,1,3– 6 Mengzhu Zhang,7 Chunyan Zhu1– 5
1School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230032, People’s Republic of China; 2Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, People’s Republic of China; 3Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, People’s Republic of China; 4Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230032, People’s Republic of China; 5Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230032, People’s Republic of China; 6Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China; 7Affiliated Psychological Hospital of Anhui Medical University, Anhui Mental Health Center, Hefei Fourth People’s Hospital, Hefei, 230032, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Mengzhu Zhang, Email zhangmengzhu2021@163.com Chunyan Zhu, Email ayswallow@126.com
Background: Beyond self-injurious and suicidal behaviors, depressed patients may show outward aggression. However, it remains unclear whether high levels of aggression in depressed patients are associated with abnormalities in decision-making processes and altered sensitivity to feedback.
Methods: Ninety-six depressed patients were recruited and divided into two groups (n = 48 patients each) based on aggression. Patients completed psychological tests (Balloon Analog Risk Task and Iowa Gambling Task [IGT]), with event-related potentials recorded during the IGT to measure neural responses to feedback.
Results: Depressed patients with high aggression showed stronger risk aversion on the IGT compared to those with low aggression. Electrophysiological findings indicated that depressed patients with high aggression generate larger feedback-related negativity (FRN) components in response to losses, as well as greater FRN amplitude differences between loss and win. The FRN difference wave (loss–win) was significantly correlated with higher scores on the anger dimension of the Buss-Perry Aggression Questionnaire, trait anger scale, emotion regulation difficulties, and depression severity, supporting heightened feedback sensitivity as a mechanism underlying aggression in depression.
Limitations: The cross-sectional design limits causal inference, and the relatively small ERP subsample may affect generalizability of electrophysiological findings.
Conclusion: Depressed patients with high aggression exhibited stronger electrophysiologic responses to negative feedback during risky decision-making. This hypersensitivity may contribute to aggression in depression, highlighting a potential clinical target for interventions that modulate feedback sensitivity or emotional reactivity.
Keywords: depressed patients, high aggression, risky decision-making, iowa gambling task, event-related potentials, ERPs
1School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230032, People’s Republic of China; 2Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, People’s Republic of China; 3Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, People’s Republic of China; 4Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230032, People’s Republic of China; 5Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230032, People’s Republic of China; 6Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China; 7Affiliated Psychological Hospital of Anhui Medical University, Anhui Mental Health Center, Hefei Fourth People’s Hospital, Hefei, 230032, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Mengzhu Zhang, Email zhangmengzhu2021@163.com Chunyan Zhu, Email ayswallow@126.com
Background: Beyond self-injurious and suicidal behaviors, depressed patients may show outward aggression. However, it remains unclear whether high levels of aggression in depressed patients are associated with abnormalities in decision-making processes and altered sensitivity to feedback.
Methods: Ninety-six depressed patients were recruited and divided into two groups (n = 48 patients each) based on aggression. Patients completed psychological tests (Balloon Analog Risk Task and Iowa Gambling Task [IGT]), with event-related potentials recorded during the IGT to measure neural responses to feedback.
Results: Depressed patients with high aggression showed stronger risk aversion on the IGT compared to those with low aggression. Electrophysiological findings indicated that depressed patients with high aggression generate larger feedback-related negativity (FRN) components in response to losses, as well as greater FRN amplitude differences between loss and win. The FRN difference wave (loss–win) was significantly correlated with higher scores on the anger dimension of the Buss-Perry Aggression Questionnaire, trait anger scale, emotion regulation difficulties, and depression severity, supporting heightened feedback sensitivity as a mechanism underlying aggression in depression.
Limitations: The cross-sectional design limits causal inference, and the relatively small ERP subsample may affect generalizability of electrophysiological findings.
Conclusion: Depressed patients with high aggression exhibited stronger electrophysiologic responses to negative feedback during risky decision-making. This hypersensitivity may contribute to aggression in depression, highlighting a potential clinical target for interventions that modulate feedback sensitivity or emotional reactivity.
Keywords: depressed patients, high aggression, risky decision-making, iowa gambling task, event-related potentials, ERPs