"Under either model, the basic mechanism is the same: perception of threat is reduced when bad expectations are violated and negative associations are unlearned."
Under predictive processing, though, discouraged people don't sense encouraging signals as strongly, and lack confidence that good news is a salient, motivating signal.
"Depression, traditionally viewed as a disorder characterized by negative cognitive biases, is associated with disrupted reward prediction error encoding and signaling. Accumulating evidence also suggests that depression is characterized by impaired local and long-range prediction signaling across multiple sensory domains." Depression, then, is sensory. If people typically can't unsee optical illusions despite rationally understanding how the illusions work, directly fixing depressed sensory processing with reasoning seems unlikely to work. Depressed people's vision sees less contrast. Their motor activity is less confident. It's as if they sense the world through a fog of uncertainty, and that may be so. "Generative models help an individual formulate predictions about incoming sensory information that are tested against incoming sensory inputs and produce prediction errors. Prediction errors, in turn, are used by the brain to revise its model of the world by updating predictions in order to minimize prediction errors (Friston, 2010)." The less confident predictions about sensory input are, the more inconclusive the results when they're tested against incoming input, and the less reason to register prediction error to revise the predictions. In depression, it seems, a fog of uncertainty unnecessarily stifles motivation.
In some circumstances, though, a fog of uncertainty is a discouraging but accurate reflection of reality. These circumstances (say, a string of disorienting misdiagnoses, especially needlessly victim-blaming ones) are ones people with chronic pain are more likely to have been through. According to predictive processing, seeing what we expect to see is largely efficient, not necessarily confirmation bias. But because we do see what we expect to see, discouraged people are prone to oversampling discouraging information.
How do you get a person whose very sensory system lacks confidence in good news to believe it?
Specificity is good, but perception of distress is holistic, and it can be tough to trust good news (like "my knee hurts less than expected") when it comes embedded in overall "ooginess" (like "but now I've got a migraine and my ankle hurts"). People with chronic pain often juggle several problems at once, and their brains may not be particularly impressed by one problem subsiding if others flare.
If specific tests help convince a hesitant brain, it may also help if these tests require minimal self-monitoring. Checking whether knee pain lasts at least a week means *looking* for knee pain a whole week. That's awfully close to the rumination "this kind of disposition" is counseled to avoid. Easy measurements of what you can do without a significant increase in discomfort, like blocks walked or weight lifted, are less overwhelming to keep track of, and harder to psych yourself out over. Speaking just for myself, if I were set the assignment of checking whether a distressing level of knee pain lasted for an entire week and I found that it did, I'd wrack myself with guilt, doubt, and despair over whether I *really* felt that much pain, or just *thought* I did because I'm some kind of gloomy Gus too unmotivated to succeed.
"Under either model, the basic mechanism is the same: perception of threat is reduced when bad expectations are violated and negative associations are unlearned."
Under predictive processing, though, discouraged people don't sense encouraging signals as strongly, and lack confidence that good news is a salient, motivating signal.
"Depression, traditionally viewed as a disorder characterized by negative cognitive biases, is associated with disrupted reward prediction error encoding and signaling. Accumulating evidence also suggests that depression is characterized by impaired local and long-range prediction signaling across multiple sensory domains." Depression, then, is sensory. If people typically can't unsee optical illusions despite rationally understanding how the illusions work, directly fixing depressed sensory processing with reasoning seems unlikely to work. Depressed people's vision sees less contrast. Their motor activity is less confident. It's as if they sense the world through a fog of uncertainty, and that may be so. "Generative models help an individual formulate predictions about incoming sensory information that are tested against incoming sensory inputs and produce prediction errors. Prediction errors, in turn, are used by the brain to revise its model of the world by updating predictions in order to minimize prediction errors (Friston, 2010)." The less confident predictions about sensory input are, the more inconclusive the results when they're tested against incoming input, and the less reason to register prediction error to revise the predictions. In depression, it seems, a fog of uncertainty unnecessarily stifles motivation.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8927302/
In some circumstances, though, a fog of uncertainty is a discouraging but accurate reflection of reality. These circumstances (say, a string of disorienting misdiagnoses, especially needlessly victim-blaming ones) are ones people with chronic pain are more likely to have been through. According to predictive processing, seeing what we expect to see is largely efficient, not necessarily confirmation bias. But because we do see what we expect to see, discouraged people are prone to oversampling discouraging information.
How do you get a person whose very sensory system lacks confidence in good news to believe it?
Specificity is good, but perception of distress is holistic, and it can be tough to trust good news (like "my knee hurts less than expected") when it comes embedded in overall "ooginess" (like "but now I've got a migraine and my ankle hurts"). People with chronic pain often juggle several problems at once, and their brains may not be particularly impressed by one problem subsiding if others flare.
If specific tests help convince a hesitant brain, it may also help if these tests require minimal self-monitoring. Checking whether knee pain lasts at least a week means *looking* for knee pain a whole week. That's awfully close to the rumination "this kind of disposition" is counseled to avoid. Easy measurements of what you can do without a significant increase in discomfort, like blocks walked or weight lifted, are less overwhelming to keep track of, and harder to psych yourself out over. Speaking just for myself, if I were set the assignment of checking whether a distressing level of knee pain lasted for an entire week and I found that it did, I'd wrack myself with guilt, doubt, and despair over whether I *really* felt that much pain, or just *thought* I did because I'm some kind of gloomy Gus too unmotivated to succeed.
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