ArticleFrontiers in psychiatry2026
Self-esteem instability in major depressive disorder: a computational analysis of expectation updating in response to performance feedback.
Article in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Major Depressive Disorder (MDD) is consistently associated with low self-esteem; however, how self-evaluative beliefs are updated in response to environmental feedback in MDD remains poorly understood. In this study, we tested the hypothesis that low self-esteem in MDD reflects dynamic instability driven by altered processing of social-evaluative information, rather than a simple static deficit. Methods: The study enrolled 60 patients with MDD and 30 healthy control participants. All participants completed a Social Comparison-Based Performance Task in which experimentally manipulated positive and negative performance feedback, presented relative to others, was used to modulate perceived social rank. Trial-by-trial changes in performance expectations following feedback were modeled computationally to derive sensitivity coefficients for positive (k_positive) and negative (k_negative) feedback. Results: Relative to healthy controls, the MDD group exhibited significantly lower baseline self-esteem, as measured by the Rosenberg Self-Esteem Scale (RSES), as well as lower initial performance expectations at task onset (p < 0.001). Computational modeling revealed that patients with MDD exhibited significantly greater sensitivity of performance expectation updating to both positive (p < 0.001, r = -0.45) and negative (p < 0.001, r = -0.53) feedback compared with healthy controls. Limitations: Study limitations include the lack of control for psychotropic medications and the recruitment of a sample restricted to outpatients with moderate symptom severity. Conclusions: Low self-esteem in MDD is better characterized by instability in self-related belief dynamics rather than a simple static deficit. Therapeutic interventions may therefore benefit from targeting heightened sensitivity to environmental feedback and promoting self-esteem stability, rather than focusing solely on increasing self-esteem levels.
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