Proceedings of the Annual Meeting of the Cognitive Science Society

Negative self-referential bias (NSB) is a core feature of depression, yet its neural correlates and relevance for relapse remains unclear. This study examined whether behavioral and neural markers of NSB predict relapse following prophylactic psychotherapy. In a two-year prospective fMRI study embedded within a randomized trial of Mindfulness-Based Cognitive Therapy and Well-being-focused Cognitive Therapy, remitted depressed outpatients completed a self-referential encoding task before and after treatment and were followed longitudinally. NSB predicted greater depressive symptoms but not relapse. In contrast, greater frontal default mode network and salience network reactivity during negative self-referential processing predicted relapse. Whole-brain analysis identified elevated prefrontal activation and somatosensory deactivation as relapse biomarkers, with treatment-related attenuation of somatosensory deactivation predicting lower relapse risk. Somatosensory deactivation emerged as the strongest overall predictor of relapse. These findings suggest that relapse vulnerability reflects not only exaggerated prefrontal negative self-processing but also insufficient recruitment of somatosensory systems supporting embodied self-experience.