[16] In a functional magnetic resonance imaging study of the brain, depressed patients were shown to be more accurate in their causal attributions of positive and negative social events than non-depressed participants, who demonstrated a positive bias.
[17] This difference was also reflected in the differential activation of the fronto-temporal network, higher activation for non self-serving attributions in non-depressed participants and for self-serving attributions in depressed patients, and reduced coupling of the dorsomedial prefrontal cortex seed region and the limbic areas when depressed patients made self-serving attributions.
[25] One study suggested that in real-world settings, depressed individuals are actually less accurate and more overconfident in their predictions than their non-depressed peers.
[27] Some have argued that the evidence is not more conclusive because no standard for reality exists, the diagnoses are dubious, and the results may not apply to the real world.
Due to most of these studies using designs that do not necessarily approximate real-world phenomena, the external validity of the depressive realism hypothesis is unclear.