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Neural basis of the emotional Stroop interference effect in major depression

  • M. T. Mitterschiffthaler (a1), S. C. R. Williams (a1), N. D. Walsh (a2), A. J. Cleare (a1), C. Donaldson (a1), J. Scott (a1) (a3) and C. H. Y. Fu (a1)...



A mood-congruent sensitivity towards negative stimuli has been associated with development and maintenance of major depressive disorder (MDD). The emotional Stroop task assesses interference effects arising from the conflict of emotional expressions consistent with disorder-specific self-schemata and cognitive colour-naming instructions. Functional neuroimaging studies of the emotional Stroop effect advocate a critical involvement of the anterior cingulate cortex (ACC) during these processes.


Subjects were 17 medication-free individuals with unipolar MDD in an acute depressive episode (mean age 39 years), and 17 age-, gender- and IQ-matched healthy volunteers. In an emotional Stroop task, sad and neutral words were presented in various colours, and subjects were required to name the colour of words whilst undergoing functional magnetic resonance imaging (fMRI). Overt verbal responses were acquired with a clustered fMRI acquisition sequence.


Individuals with depression showed greater increases in response time from neutral to sad words relative to controls. fMRI data showed a significant engagement of left rostral ACC (BA 32) and right precuneus during sad words in patients relative to controls. Additionally, rostral ACC activation was positively correlated with latencies of negative words in MDD patients. Healthy controls did not have any regions of increased activation compared to MDD patients.


These findings provide evidence for a behavioural and neural emotional Stroop effect in MDD and highlight the importance of the ACC during monitoring of conflicting cognitive processes and mood-congruent processing in depression.


Corresponding author

*Address for correspondence: M. Mitterschiffthaler, Ph.D., Neuroimaging Research Group, Clinical Neuroscience, PO Box 89; Institute of Psychiatry, De Crespigny Park, LondonSE5 8AF, UK. (Email:


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Banich, MT, Milham, MP, Atchley, R, Cohen, NJ, Webb, A, Wszalek, T, Kramer, AF, Liang, ZP, Wright, A, Shenker, J, Magin, R (2000). fMRI studies of Stroop tasks reveal unique roles of anterior and posterior brain systems in attentional selection. Journal of Cognitive Neuroscience 12, 9881000.
Banich, MT, Milham, MP, Jacobson, BL, Webb, A, Wszalek, T, Cohen, NJ, Kramer, AF (2001). Attentional selection and the processing of task-irrelevant information: insights from fMRI examinations of the Stroop task. Progress in Brain Research 134, 459470.
Beck, AT, Rush, AJ, Shaw, BF, Emery, Y (1979). Cognitive Therapy of Depression. Guilford Press: New York.
Beck, AT, Ward, CH, Mendelson, M, Mock, J, Erbaugh, J (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561571.
Bench, CJ, Frith, CD, Grasby, PM, Friston, KJ, Paulesu, E, Frackowiak, RS, Dolan, RJ (1993). Investigations of the functional anatomy of attention using the Stroop test. Neuropsychologia 31, 907922.
Botvinick, M, Nystrom, LE, Fissell, K, Carter, CS, Cohen, JD (1999). Conflict monitoring versus selection-for-action in anterior cingulate cortex. Nature 402, 179181.
Bower, GH (1981). Mood and memory. American Psychologist 36, 129148.
Bradley, BP, Mogg, K, Millar, N (1996). Implicit memory bias in clinical and non-clinical depression. Behaviour Research and Therapy 34, 865879.
Bradley, MM, Lang, PJ (1999). Affective Norms for English Words (ANEW). The NIMH Center for the Study of Emotion and Attention, University of Florida: Gainesville, FL.
Bush, G, Whalen, PJ, Rosen, BR, Jenike, MA, McInerney, SC, Rauch, SL (1998). The counting Stroop: an interference task specialized for functional neuroimaging – validation study with functional MRI. Human Brain Mapping 6, 270282.
Cabeza, R, Nyberg, L (2000). Imaging cognition II: An empirical review of 275 PET and fMRI studies. Journal of Cognitive Neuroscience 12, 147.
Caligiuri, MP, Ellwanger, J (2000). Motor and cognitive aspects of motor retardation in depression. Journal of Affective Disorders 57, 8393.
Carter, CS, Macdonald, AM, Botvinick, M, Ross, LL, Stenger, VA, Noll, D, Cohen, JD (2000). Parsing executive processes: strategic vs. evaluative functions of the anterior cingulate cortex. Proceedings of the National Academy of Sciences USA 97, 19441948.
Carter, CS, Mintun, M, Cohen, JD (1995). Interference and facilitation effects during selective attention: an H215O PET study of Stroop task performance. NeuroImage 2, 264272.
Clark, DM, Teasdale, JD (1982). Diurnal variation in clinical depression and accessibility of memories of positive and negative experiences. Journal of Abnormal Psychology 91, 8795.
Critchley, HD, Wiens, S, Rotshtein, P, Ohman, A, Dolan, RJ (2004). Neural systems supporting interoceptive awareness. Nature Neuroscience 7, 189195.
Dudley, R, O'Brien, J, Barnett, N, McGuckin, L, Britton, P (2002). Distinguishing depression from dementia in later life: a pilot study employing the Emotional Stroop task. International Journal of Geriatric Psychiatry 17, 4853.
Elliott, R, Dolan, RJ (1998). Activation of different anterior cingulate foci in association with hypothesis testing and response selection. NeuroImage 8, 1729.
Elliott, R, Rubinsztein, JS, Sahakian, BJ, Dolan, RJ (2002). The neural basis of mood-congruent processing biases in depression. Archives of General Psychiatry 59, 597604.
Ellis, HC, Ashbrook, PW (1988). Resource allocation model of the effects of depressed mood states on memory. In Affect, Cognition and Social Behaviour (ed. Fiedler, K. and Forgas, J. P.), pp. 2543. Hogrefe: Goettingen.
Erickson, K, Drevets, WC, Clark, L, Cannon, DM, Bain, EE, Zarate, CA Jr., Charney, DS, Sahakian, BJ (2005). Mood-congruent bias in affective go/no-go performance of unmedicated patients with major depressive disorder. American Journal of Psychiatry 162, 21712173.
Etkin, A, Egner, T, Peraza, DM, Kandel, ER, Hirsch, J (2006). resolving emotional conflict: a role for the rostral anterior cingulate cortex in modulating activity in the amygdala. Neuron 51, 871882.
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (1997). Structured Clinical Interview for DSM-IV Axis I Disorders, Patient Edition (SCID-P). Biometrics Research, New York State Psychiatric Institute: New York.
Francis, WN, Kucera, H (1982). Frequency Analysis of English Usage. Houghton Mifflin: Boston, MA.
Fu, CH, Vythelingum, GN, Brammer, MJ, Williams, SC, Amaro, E Jr., Andrew, CM, Yaguez, L, van Haren, NE, Matsumoto, K, McGuire, PK (2006). An fMRI study of verbal self-monitoring: neural correlates of auditory verbal feedback. Cerebral Cortex 16, 969977.
George, MS, Ketter, TA, Parekh, PI, Rosinsky, N, Ring, HA, Casey, BJ (1994). Regional brain activity when selecting a response despite interference: An H215O PET study of the Stroop and the emotional Stroop. Human Brain Mapping 1, 194209.
George, MS, Ketter, TA, Parekh, PI, Rosinsky, N, Ring, HA, Pazzaglia, PJ, Marangell, LB, Callahan, AM, Post, RM (1997). Blunted left cingulate activation in mood disorder subjects during a response interference task (the Stroop). Journal of Neuropsychiatry and Clinical Neuroscience 9, 5563.
Goldman-Rakic, PS (1988). Topography of cognition: parallel distributed networks in primate association cortex. Annual Review of Neuroscience 11, 137156.
Gotlib, IH, Cane, DB (1987). Construct accessibility and clinical depression: a longitudinal investigation. Journal of Abnormal Psychology 96, 199204.
Gotlib, IH, McCann, CD (1984). Construct accessibility and depression: an examination of cognitive and affective factors. Journal of Personality and Social Psychology 47, 427439.
Gruber, SA, Rogowska, J, Holcomb, P, Soraci, S, Yurgelun-Todd, D (2002). Stroop performance in normal control subjects: an fMRI study. NeuroImage 16, 349360.
Hamilton, M (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 5662.
John, CH (1988). Emotionality ratings and free-association norms of 240 emotional and non-emotional words. Cognition & Emotion 2, 4970.
Kerns, JG, Cohen, JD, MacDonald, III AW, Cho, RY, Stenger, VA, Carter, CS (2004). Anterior cingulate conflict monitoring and adjustments in control. Science 303, 10231026.
Kerr, N, Scott, J, Phillips, ML (2005). Patterns of attentional deficits and emotional bias in bipolar and major depressive disorder. British Journal of Clinical Psychology 44, 343356.
Koster, EH, De, RR, Goeleven, E, Franck, E, Crombez, G (2005). Mood-congruent attentional bias in dysphoria: maintained attention to and impaired disengagement from negative information. Emotion 5, 446455.
Krause, BJ, Schmidt, D, Mottaghy, FM, Taylor, J, Halsband, U, Herzog, H, Tellmann, L, Muller-Gartner, HW (1999). Episodic retrieval activates the precuneus irrespective of the imagery content of word pair associates. A PET study. Brain 122, 255263.
LaBar, KS, Gitelman, DR, Parrish, TB, Mesulam, M (1999). Neuroanatomic overlap of working memory and spatial attention networks: a functional MRI comparison within subjects. NeuroImage 10, 695704.
Langenecker, SA, Nielson, KA, Rao, SM (2004). fMRI of healthy older adults during Stroop interference. NeuroImage 21, 192200.
Lloyd, GG, Lishman, WA (1975). Effect of depression on the speed of recall of pleasant and unpleasant experiences. Psychological Medicine 5, 173180.
MacLeod, CM (1991). Half a century of research on the Stroop effect: an integrative review. Psychololgical Bulletin 109, 163203.
Malhi, GS, Lagopoulos, J, Sachdev, PS, Ivanovski, B, Shnier, R (2005). An emotional Stroop functional MRI study of euthymic bipolar disorder. Bipolar Disorder 7 (Suppl. 5), 5869.
Mayberg, HS (1997). Limbic-cortical dysregulation: a proposed model of depression. Journal of Neuropsychiatry and Clinical Neuroscience 9, 471481.
Mead, LA, Mayer, AR, Bobholz, JA, Woodley, SJ, Cunningham, JM, Hammeke, TA, Rao, SM (2002). Neural basis of the Stroop interference task: response competition or selective attention? Journal of the International Neuropsychological Society 8, 735742.
Murphy, FC, Sahakian, BJ, Rubinsztein, JS, Michael, A, Rogers, RD, Robbins, TW, Paykel, ES (1999). Emotional bias and inhibitory control processes in mania and depression. Psychological Medicine 29, 13071321.
Neshat-Doost, HT, Taghavi, MR, Moradi, AR, Yule, W, Dalgleish, T (1998). Memory for emotional trait adjectives in clinically depressed youth. Journal of Abnormal Psychology 107, 642650.
Nyberg, L, Persson, J, Habib, R, Tulving, E, McIntosh, AR, Cabeza, R, Houle, S (2000). Large scale neurocognitive networks underlying episodic memory. Journal of Cognitive Neuroscience 12, 163173.
Pardo, JV, Pardo, PJ, Janer, KW, Raichle, ME (1990). The anterior cingulate cortex mediates processing selection in the Stroop attentional conflict paradigm. Proceedings of the National Academy of Sciences USA 87, 256259.
Paus, T (2001). Primate anterior cingulate cortex: where motor control, drive and cognition interface. Nature Review Neuroscience 2, 417424.
Peterson, BS, Skudlarski, P, Gatenby, JC, Zhang, H, Anderson, AW, Gore, JC (1999). An fMRI study of Stroop word-color interference: evidence for cingulate subregions subserving multiple distributed attentional systems. Biological Psychiatry 45, 12371258.
Pinel, P, Dehaene, S, Riviere, D, LeBihan, D (2001). Modulation of parietal activation by semantic distance in a number comparison task. NeuroImage 14, 10131026.
Posner, MI (1980). Attention and Consciousness. Lawrence Erlbaum Associates: Mahwah, NJ.
Rogers, MA, Kasai, K, Koji, M, Fukuda, R, Iwanami, A, Nakagome, K, Fukuda, M, Kato, N (2004). Executive and prefrontal dysfunction in unipolar depression: a review of neuropsychological and imaging evidence. Neuroscience Research 50, 111.
Segal, ZV, Gemar, M, Truchon, C, Guirguis, M, Horowitz, LM (1995). A priming methodology for studying self-representation in major depressive disorder. Journal of Abnormal Psychology 104, 205213.
Talairach, J, Tournoux, P (1988). Co-planar Sterotaxic Atlas of the Human Brain. Thieme Medical Publishers Inc.: New York.
Taylor, JL, John, CH (2004). Attentional and memory bias in persecutory delusions and depression. Psychopathology 37, 233241.
Taylor, SF, Kornblum, S, Lauber, EJ, Minoshima, S, Koeppe, RA (1997). Isolation of specific interference processing in the Stroop task: PET activation studies. NeuroImage 6, 8192.
Taylor, SF, Kornblum, S, Minoshima, S, Oliver, LM, Koeppe, RA (1994). Changes in medial cortical blood flow with a stimulus-response compatibility task. Neuropsychologia 32, 249255.
Teasdale, JD, Fogarty, SJ (1979). Differential effects of induced mood on retrieval of pleasant and unpleasant events from episodic memory. Journal of Abnormal Psychology 88, 248257.
Teasdale, JD, Russell, ML (1983). Differential effects of induced mood on the recall of positive, negative and neutral words. British Journal of Clinical Psychology 22, 163171.
Tsourtos, G, Thompson, JC, Stough, C (2002). Evidence of an early information processing speed deficit in unipolar major depression. Psychological Medicine 32, 259265.
van den Heuvel, OA, Veltman, DJ, Groenewegen, HJ, Witter, MP, Merkelbach, J, Cath, DC, van Balkom, AJ, van Oppen, P, van Dyck, R (2005). Disorder-specific neuroanatomical correlates of attentional bias in obsessive-compulsive disorder, panic disorder, and hypochondriasis. Archives of General Psychiatry 62, 922933.
Wagner, G, Sinsel, E, Sobanski, T, Kohler, S, Marinou, V, Mentzel, HJ, Sauer, H, Schlosser, RGM (2006). Cortical inefficiency in patients with unipolar depression: an event-related fMRI study with the Stroop task. Biological Psychiatry 59 958965.
Watkins, PC, Vache, K, Verney, SP, Muller, S, Mathews, A (1996). Unconscious mood-congruent memory bias in depression. Journal of Abnormal Psychology 105, 3441.
Wechsler, D (1999). Wechsler Abbreviated Scale of Intelligence (WASI). Psychological Corporation Harcourt Brace & Co.: San Antonio, TX.
Whalen, PJ, Bush, G, McNally, RJ, Wilhelm, S, McInerney, SC, Jenike, MA, Rauch, SL (1998). The emotional counting Stroop paradigm: a functional magnetic resonance imaging probe of the anterior cingulate affective division. Biological Psychiatry 44, 12191228.
Williams, JM, Broadbent, K (1986). Distraction by emotional stimuli: use of a Stroop task with suicide attempters. British Journal of Clinical Psychology 25, 101110.


Neural basis of the emotional Stroop interference effect in major depression

  • M. T. Mitterschiffthaler (a1), S. C. R. Williams (a1), N. D. Walsh (a2), A. J. Cleare (a1), C. Donaldson (a1), J. Scott (a1) (a3) and C. H. Y. Fu (a1)...


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