Major depressive disorder (MDD) is strongly linked to social withdrawal and interpersonal problems which characterize the disorder and further aggravate symptoms. Investigating the nature of impaired emotional-social functioning as a basis of interpersonal functioning in MDD has been widely restricted to static stimuli and behavioral emotion recognition accuracy. The present study aimed at examining higher order emotional processes, namely empathic responses and its components, emotion recognition accuracy and affective responses in 28 MDD patients and 28 healthy control participants. The dynamic stimulus material included 96 short video clips depicting actors expressing basic emotions by face, voice prosody, and sentence content. Galvanic skin conductance measurements revealed implicit processes in the multimethod assessment of empathy. Overall, patients displayed lower empathy, emotion accuracy, and affective response rates than controls. Autonomous arousal was higher in patients. A generalized emotion processing deficit is in line with the "emotional context insensitivity" (ECI) theory which proposes decreased overall responsiveness to emotional stimuli. The dissociation between hypo-reactivity in explicit and hyper-reactivity in implicit measures of emotion processing can be related to the "limbic-cortical dysregulation" model of depression. Our findings support the dissociation of autonomic and subjective emotional responses which may account for interpersonal as well as emotional deficits in depression.
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