Attentional bias and childhood maltreatment in clinical depression - An eye-tracking study

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Major depressive disorder (MDD) has been found to be associated with biased attention to emotional stimuli: increased attention for dysphoric information and/or decreased attention for positive information compared to healthy individuals. A history of childhood maltreatment (CM) has been discussed as a factor that might have an impact on the occurrence and extent of biased attention in depression. The present study examined the association between CM and attention for facial emotions in currently depressed patients using eye-tracking methodology. In a free viewing paradigm, 31 individuals with MDD and 31 healthy subjects viewed images of four facial expressions (happy, sad, angry, and neutral). Dwell time on each facial expression was used as an indicator of attention allocation. Childhood maltreatment was assessed using the German version of the Childhood Trauma Questionnaire. Depressed patients showed shorter gaze durations for happy faces compared to healthy controls. This result is in line with the assumption that depression goes along with a loss of elaborative processing of positive stimuli. No group differences were observed concerning dwell times on negative faces. However, CM was associated with reduced attention for angry and sad facial expressions in the depressed sample. Depressed individuals with a history of CM seem to avoid processing of threatening or burdensome stimuli. Early life adversity appears to impact attention allocation in depressed individuals and might help to explain discordant results in the literature regarding biased attention to negative facial expressions in depression.