Study involving IDOR uses virtual simulation to explore behavioral tendencies in individuals with the disorder 

A study investigated the unconscious inclinations that influence decision-making in people with depression. The innovative methodology aligned with one of the main trends in modern technology: the research was conducted by immersing participants in a virtual reality (VR) environment. With contributions from the D’Or Institute for Research and Education (IDOR) and other international institutions, the study was published in the scientific journal Journal of Psychiatric Research. Its findings offer new insights into the complex relationship between emotions and actions in depression. 

Depression is a debilitating mental disorder, often referred to as the “illness of the century” by the World Health Organization (WHO), affecting over 300 million people worldwide. In Latin America, Brazil has the highest number of reported cases, impacting nearly 6% of its population—an estimated 11.5 million individuals. 

There are numerous approaches to treating depression, but its subjective nature and multifactorial causes present significant challenges. Another difficulty is that the mental mechanisms underlying depression remain not fully understood by modern science. 

Action Tendencies in Depression

Given the importance of the relationship between emotions and actions in understanding depression, the study focused on the concept of “action tendencies” in diagnosed patients. These tendencies are internal impulses and inclinations that precede our actions and responses.

First recognized by Charles Darwin in his book The Expression of the Emotions in Man and Animals, action tendencies establish a proven link between emotion and behavior. According to Darwin, humans exhibit strong and involuntary tendencies to perform specific actions when experiencing certain mental states.

Testing Depression in Virtual Reality

The researchers hypothesized that individuals with depression would display action tendencies related to maladaptive guilt—characterized by excessive self-criticism, self-punishment, social withdrawal, and emotional detachment. This differs from adaptive guilt, which allows individuals to recognize mistakes, improve social interactions, and develop values.

To test this theory, the study recruited 98 individuals with depression and a control group of 40 participants without mental health issues. The researchers developed a pioneering approach using virtual reality, enabling participants to engage in social interactions related to guilt within simulated environments. The VR scenarios presented two types of situations: one where the participant had acted unfairly toward someone, and another where a hypothetical friend had wronged the participant.

During the experiment, participants were exposed to various scenarios and asked questions about their action tendencies related to guilt. For instance, in one situation, they were responsible for crashing a friend’s car, while in another, a friend had crashed theirs. The researchers then analyzed how participants reacted to these situations.

The choice of VR simulation was ideal for assessing action tendencies related to guilt due to the immersive nature of the technology. Unlike traditional methods—such as computerized or paper-based tests—VR offers a realistic and interactive environment that allows participants to fully engage with the scenario. This immersive aspect is crucial, as action tendencies rely heavily on an individual’s ability to imagine and convincingly place themselves within a given context.

Guilt Prevails in Both Behavioral Patterns

The results showed that participants with depression were more likely to experience urges to punish themselves and withdraw socially, regardless of who was at fault in each situation. Their action tendencies remained consistent whether they had acted wrongly or if a friend had mistreated them. When facing scenarios where they had committed a negative act, depressed individuals were less likely to apologize. Conversely, when a friend was responsible for wrongdoing, they rarely reacted with verbal aggression, instead choosing responses centered on withdrawal and guilt.

The study concluded that individuals with depression exhibited a significantly greater tendency to punish themselves in both situations. They also displayed a higher inclination to isolate themselves and a lower tendency to react aggressively compared to participants without mental disorders.

Recognizing the significance of this finding, the researchers conducted further analyses to explore potential links between self-punitive behavior and self-harm or suicidal tendencies—common concerns associated with depression.

Depression and Self-Punishment Tendencies

Since self-punishment was identified as the most distinguishing action tendency in depressed individuals, the researchers compared these results with the participants’ self-reported history of self-harm and suicide attempts. This information had been collected before the VR simulation through a detailed questionnaire.

The analyses revealed a correlation between self-punishment tendencies and a history of self-harm. However, no direct link was found between self-punishment and suicide attempts. This suggests that individuals with depression may have a propensity for self-harm as a maladaptive coping mechanism, but this does not necessarily mean they are more likely to attempt suicide. The researchers emphasize that suicidal behavior was not the primary focus of the study and that further research is needed to explore its relationship with depression in greater depth.

This groundbreaking study demonstrated the potential of immersive technologies like VR in psychological research. The virtual environment provided valuable insights, showing promise not only for scientific studies but also for developing prevention strategies related to depression and self-harm. The researchers highlight that their findings reveal new cognitive markers that could aid in early intervention and the creation of more personalized and effective treatment approaches, offering renewed hope in the understanding and treatment of depression.