Abstract
Why do some people see their glass as half-empty rather than half-full or even imagine that the glass will be filled in the future? Experimental methods can illuminate how individual differences in information processing style can profoundly impact mood or even result in disorders such as depression. A computerized cognitive bias modification intervention targeting interpretation bias in depression via positive mental imagery (CBM-I) was evaluated by investigating its impact on mental health and cognitive bias compared with a control condition. Twenty-six depressed individuals completed either positive imagery-focussed CBM-I or a control condition daily at home over one week. Outcome measures were collected pre-treatment and post-treatment and at two-week follow-up. Individuals in the positive condition demonstrated significant improvements from pre-treatment to post-treatment in depressive symptoms, cognitive bias and intrusive symptoms compared with the control condition. Improvements in depressive symptoms at two-week follow-up were at trend level. The results of this first controlled comparison of positive imagery-focussed CBM-I for depression further support the clinical potential of CBM-I and the development of a novel computerized treatment that could help patients imagine a more positive future. Broader implications concern the modification of individual differences in personality variables via their interaction with key information processing targets. Copyright © 2011 John Wiley & Sons, Ltd.
Highlights
Cognitive theories of depression emphasise the role of negative cognitive biases in the development and maintenance of the disorder (Beck, 1976)
For vividness ratings made during the IGen-Picture sessions, responders did not score significantly different, M = 3.43, SD = 0.78, than non-responders, M = 3.36, SD = 0.64; t(11) < 1. This pilot study is the first to compare the impact of a cognitive bias modification’ (CBM) promoting positive interpretation via mental imagery to a closely match control condition in a sample of individuals currently experiencing a major depressive episode
Approximately half the sample receiving the positive imagery-focussed CBM-I showed clinically significant change from pre-treatment to follow-up, corresponding to the proportion of ‘responders’ found in the case series by Blackwell and Holmes (2010). This compares to response rates found for treatments for depression, whether pharmacological or psychological (Hollon et al, 2002). These results provide further initial support for the continued development of computerized CBM as a novel intervention to target interpretation bias in depression
Summary
Cognitive theories of depression emphasise the role of negative cognitive biases in the development and maintenance of the disorder (Beck, 1976). Our understanding of the causal role of information processing biases in the development of individual differences in depression and trait anxiety has been greatly enhanced in recent years by the increased use of a set of experimental paradigms referred to as ‘cognitive bias modification’ (CBM; Koster, Fox, & MacLeod, 2009). These are procedures designed to directly target information processing biases in order to observe the effects on subsequent mood and behaviour, and they allow a test of causal hypotheses concerning the contributions of selective information processing to individual differences. Recent studies have even started to use CBM to investigate the relationship between different biases such as interpretation and memory (Salemink, Hertel, & Mackintosh, 2010; Tran, Hertel, & Joormann, 2011) and to study cognitive biases in children or adolescents (e.g. Lothmann, Holmes, Chan, & Lau, 2011; Vassilopoulos, Blackwell, Moberly, & Karahaliou, 2012)
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