Attentional Bias In Depression Research Articles

Deployment of attention to facial expressions varies as a function of emotional quality-but not in alexithymic individuals.

Alexithymia is a risk factor for emotional disorders and is characterized by differences in automatic and controlled emotion processing. The multi-stimulus free-viewing task has been used to detect increased negative and reduced positive attentional biases in depression and anxiety. In the present eye-tracking study, we examined whether lexical emotional priming directs attention toward emotion-congruent facial expressions and whether alexithymia is related to impairments in lexical priming and spontaneous attention deployment during multiple face perception. A free-viewing task with happy, fearful, angry, and neutral faces shown simultaneously was administered to 32 alexithymic and 46 non-alexithymic individuals along with measures of negative affect and intelligence. Face presentation was preceded by masked emotion words. Indices of initial orienting and maintenance of attention were analyzed as a function of prime or target category and study group. Time to first fixation was not affected by prime category or study group. Analysis of fixation duration yielded a three-way interaction. Alexithymic individuals exhibited no prime or target category effect, whereas non-alexithymic individuals showed a main effect of target condition, fixating happy faces longer than neutral and angry faces and fearful faces longer than angry faces. Our results show evidence of attentional biases for positive and fearful social information in non-alexithymic individuals, but not in alexithymic individuals. The lack of spontaneous attentional preference for these social stimuli in alexithymia might contribute to a vulnerability for developing emotional disorders. Our data also suggest that briefly presented emotion words may not facilitate gaze orientation toward emotion-congruent stimuli.

Decreased intersubject synchrony in dynamic valence ratings of sad movie contents in dysphoric individuals

Emotional reactions to movies are typically similar between people. However, depressive symptoms decrease synchrony in brain responses. Less is known about the effect of depressive symptoms on intersubject synchrony in conscious stimulus-related processing. In this study, we presented amusing, sad and fearful movie clips to dysphoric individuals (those with elevated depressive symptoms) and control participants to dynamically rate the clips’ valences (positive vs. negative). We analysed both the valence ratings’ mean values and intersubject correlation (ISC). We used electrodermal activity (EDA) to complement the measurement in a separate session. There were no group differences in either the EDA or mean valence rating values for each movie type. As expected, the valence ratings’ ISC was lower in the dysphoric than the control group, specifically for the sad movie clips. In addition, there was a negative relationship between the valence ratings’ ISC and depressive symptoms for sad movie clips in the full sample. The results are discussed in the context of the negative attentional bias in depression. The findings extend previous brain activity results of ISC by showing that depressive symptoms also increase variance in conscious ratings of valence of stimuli in a mood-congruent manner.

The Effect of Alexithymia on Attentional Bias Toward Emotional Stimuli in Depression: An Eye-Tracking Study.

Alexithymia—reflecting deficits in cognitive emotion processing—is highly prevalent in individuals with depressive disorders. Subsequently, mixed evidence for attentional bias is found in these individuals. Alexithymia may be a potential influencing factor for attentional bias in depression. In the current study, 83 currently depressed (CD) and 76 never-depressed (ND) controls completed an eye-tracker task consisting of valenced (non)-social pictures. Alexithymia scores were also included as a moderator as both a continuous and categorical measure (so high vs. low alexithymia). No group difference or moderating effect of alexithymia was found on attentional bias. Thus, alexithymic symptoms, included both dimensionally and categorically, may not influence biased attentional processing in depression compared to ND individuals. Thus, it is important to explore other potential explaining factors for the equivocal results found on biased attentional processing of emotional information in depression.

Cloud-Based Functional Magnetic Resonance Imaging Neurofeedback to Reduce the Negative Attentional Bias in Depression: A Proof-of-Concept Study

Individuals with depression show an attentional bias toward negatively valenced stimuli and thoughts. In this proof-of-concept study, we present a novel closed-loop neurofeedback procedure intended to remediate this bias. Internal attentional states were detected in real time by applying machine learning techniques to functional magnetic resonance imaging data on a cloud server; these attentional states were externalized using a visual stimulus that the participant could learn to control. We trained 15 participants with major depressive disorder and 12 healthy control participants over 3 functional magnetic resonance imaging sessions. Exploratory analysis showed that participants with major depressive disorder were initially more likely than healthy control participants to get stuck in negative attentional states, but this diminished with neurofeedback training relative to controls. Depression severity also decreased from pre- to posttraining. These results demonstrate that our method is sensitive to the negative attentional bias in major depressive disorder and showcase the potential of this novel technique as a treatment that can be evaluated in future clinical trials.

A randomized controlled trial of gaze-contingent music reward therapy for major depressive disorder.

Heightened attention allocation toward negative-valanced information and reduced attention allocation toward positive-valanced information represent viable targets for attention bias modification in major depressive disorder. Accordingly, we conducted a randomized controlled trial testing the efficacy of a novel gaze-contingent attention bias modification procedure for major depressive disorder. Sixty patients with major depressive disorder were randomly assigned to either eight training sessions of feedback-based gaze-contingent music reward therapy designed to divert patients' gaze toward positive over sad stimuli, or to a control condition which entailed eight sessions of gaze-noncontingent music. Clinician-rated and self-reported measures of depression, and proportion of dwell-time on sad faces, were assessed pretreatment, posttreatment, and at a 3-month follow-up. Gaze-contingent music reward therapy produced a greater reduction in dwell-time on sad faces compared with the control condition, but it failed to generalize to novel faces. Both groups manifested similarly significant reductions in depression symptoms from pre- to posttreatment that were maintained at follow-up. Exploratory analyses suggest that first-episode patients may benefit more from this therapy than patients with a history of multiple episodes. Gaze-contingent music reward therapy can modify attention biases in depression, but clear differential clinical effects did not emerge. Theoretical and practical implications are discussed.

Attentional biases in depression: Relation to disorder severity, rumination, and anhedonia

IntroductionAccording to cognitive models of depression, selective attentional biases (ABs) for mood-congruent information are core vulnerability factors of depression maintenance. However, findings concerning the presence of these biases in depression are mixed. This study aims to clarify the presence of these ABs among individuals with clinical and subclinical depression. MethodWe compared three groups based on a semi-structured diagnostic interview and a depressive symptoms scale (BDI-II): 34 individuals with major depressive disorder (clinically depressed); 35 with a dysphoric mood but without the criteria of major depressive disorder (i.e., subclinically depressed), and 26 never been depressed individuals. We examined AB for sad and happy materials in three modified versions of the exogenous cueing task using scenes, facial expressions, and words. Brooding, anhedonia, and anxiety were also evaluated. ResultsIn contrast to our hypotheses, there were no ABs for negative or positive information, regardless of the task and the groups. Neither the association between AB toward negative information and brooding nor the one between AB away from positive stimuli and anhedonia was significant. Bayes factors analyses revealed that the present pattern of findings does not result from a lack of statistical power. DiscussionOur results raise questions about how common AB is in depression. From a theoretical point of view, because individuals with depression did not exhibit AB, our results also seemingly challenge the claim that AB figures prominently in the maintenance of depression. We believe the present null results to be particularly useful for future meta-research in the field.

CBT and positive psychology interventions for clinical depression promote healthy attentional biases: An eye-tracking study.

Although there is a growing interest in the role of attentional biases in depression, there are no studies assessing changes in these biases after psychotherapeutic interventions. We used a validated eye-tracking procedure to assess pre-post therapy changes in attentional biases toward emotional information (i.e., happy, sad, and angry faces) when presented with neutral information (i.e., neutral faces). The sample consisted of 75 participants with major depression or dysthymia. Participants were blindly assigned to one of two 10 weekly sessions of group therapy: a cognitive behavior therapy intervention (N=41) and a positive psychology intervention (N=34). Both treatments were equally efficacious in improving depressive symptoms (p=.0001, η²=.68). A significant change in attentional performance after therapy was observed irrespective of the intervention modality. Comparison of pre-post attentional measures revealed a significant reduction in the total time of fixations (TTF) looking at negative information (i.e., sad and angry faces) and a significant increase in the TTF looking at positive information (i.e., happy faces)-all p < .02. Findings reveal for the first time that psychotherapeutic interventions are associated with a significant change in attentional biases as assessed by a direct measure of attention. Furthermore, these changes seem to operate in the same direction typically found in healthy populations (i.e., a bias away from negative information and a parallel bias toward positive information). These findings illustrate the importance of considering attentional biases as clinical markers of depression and suggest the viability of modifying these biases as a potential tool for clinical change.

Measurement and Modification for Attentional Bias in Depression

Measurement and Modification for Attentional Bias in Depression

Modulation of Physiological Responses as Indices of Attentional Bias in Dysphoria

The experimental results on attentional bias in depression have been contradictory. Research on physiological correlates that validate attentional bias have been scarce. The aim of the present study was to evaluate physiological responses associated with attentional bias in dysphoria. Heart rate and the galvanic skin response were recorded in 30 dysphoric individuals and 30 nondysphoric individuals while they performed an emotional Stroop task. Dysphoric individuals exhibited attentional bias and heart rate deceleration in response to unpleasant words. Nondysphoric individuals exhibited attentional bias toward pleasant words, accompanied by a higher skin conductance response. These results suggest that heart rate deceleration in response to unpleasant words correlated with attentional bias in dysphoric individuals.

La modification du biais attentionnel dans les troubles anxieux et la dépression : une revue synthétique de la littérature

IntroductionAccording to the theoretical models in cognitive psychopathology, the susceptibility to develop an emotional disorder is causally related to the presence of cognitive biases in the information treatment process such as attention, memory and interpretation biases. Researchers are collecting data supporting the idea that it is possible to modify the cognitive biases and the clinical symptoms as well. The present paper focuses on the modification of attentional bias and symptoms in both anxiety disorders and depression. MethodAfter a brief recall about the nature of attentional biases in anxiety and depression disorders, the article offers a synthetic review of the recent literature on attentional bias modification (ABM) in these mental disorders. First, it explains and debates the methodology mostly employed in this domain. Secondly, it presents the main results with a critical viewpoint especially on the therapeutic interests of these findings by answering a series of questions relevant for the clinical practice. ResultsIn anxiety disorders, the attentional bias selectively favors information that is the most threatening for the trouble. The attentional bias in depression is characterized by a preference toward negative information and is also likely to have an absence of bias for positive information compared to healthy subjects. The attentional bias is most often modified using the so-called dot probe task. However, poor psychometric properties have been now repetitively reported. What are the effects of attentional bias modification on anxiety disorders? The research showed that only one session of ABM is sufficient to modify the bias toward threat and to reduce the emotional vulnerability when people are exposed to stressful situations. These findings have been reported for different anxiety disorders and in adults, adolescents and children. Can the attentional bias modification be envisaged as a therapeutic intervention of anxiety disorders? To answer to this question, patients have been exposed to several ABM sessions. Furthermore, a variety of outcomes measures (subjective, behavioural and physiological) have been taken. The researchers reported a modification of the attentional bias and an improvement of a variety of clinical symptoms. The results of one meta-analysis revealed that more ABM sessions lead to a more extended bias modification. However, another meta-analysis failed to show that a more extended bias modification leads to a greater improvement of the clinical symptoms. This report puts forward the need to enhance our knowledge on the causal relationship between the attentional bias and clinical symptoms. More recently, researchers have developed ABM training at home or via smartphone but the results are mitigated. Is it useful to combine the modification of attentional bias to another clinical intervention to treat anxiety disorders? A few studies have been conducted and even if some of them reported positive findings, overall, the results are reserved. Further, given the number of dropout reported, the effectiveness of the current ABM paradigm in a real-world setting is questionable. What are the effects of attentional bias modification on depression? A few small studies on ABM for depression have been published. Researchers found that ABM sessions lead to a reduced bias for negative stimuli but it is likely that this is only for individuals suffering from a low level of depression. The research on ABM in depression seems to be more successful in the use of ABM as a means to prevent the depressive relapse. ConclusionThe ABM paradigm seems to be efficient to treat anxiety disorders even if its capacity to improve the clinical symptoms remains small. In depression, its efficiency remains to be established. So, researchers are now trying to alleviate the use of the current ABM paradigm or to innovate new paradigms to make ABM more exploitable in the context of a therapeutic treatment.

The Causal Role of Attentional Bias in a Cognitive Component of Depression

Cognitive theories have, for years, postulated the causal role of attentional biases in depression and low self-esteem. However, this assumption has been based predominantly on correlational findings. With the advent of attentional bias modification techniques (Mathews &amp; MacLeod, 2002), it became possible to modify attentional bias experimentally. The purpose of this study was to ascertain whether negative attentional biases are trainable and causally linked to changes in important characteristics of depression, namely self-esteem. Participants completed negative attentional training and a stress induction task. Consistent with the diathesis-stress model, a combination of negative attentional biases and stress resulted in changes in self-esteem, which was used as an indicator of depression. The effects on self-esteem were specific to the type of stimuli used. These findings have important implications for our understanding of self-esteem, cognitive models of depression, and for the future of cognitive bias modification research in self-esteem and depression.

Editorial: Behavioral and physiological bases of attentional biases: paradigms, participants, and stimuli.

Editorial: Behavioral and physiological bases of attentional biases: paradigms, participants, and stimuli.

Double attention bias for positive and negative emotional faces in clinical depression: Evidence from an eye-tracking study

Background and objectivesAccording to cognitive models, attentional biases in depression play key roles in the onset and subsequent maintenance of the disorder. The present study examines the processing of emotional facial expressions (happy, angry, and sad) in depressed and non-depressed adults. MethodsSixteen unmedicated patients with Major Depressive Disorder (MDD) and 34 never-depressed controls (ND) completed an eye-tracking task to assess different components of visual attention (orienting attention and maintenance of attention) in the processing of emotional faces. ResultsCompared to ND, participants with MDD showed a negative attentional bias in attentional maintenance indices (i.e. first fixation duration and total fixation time) for sad faces. This attentional bias was positively associated with the severity of depressive symptoms. Furthermore, the MDD group spent a marginally less amount of time viewing happy faces compared with the ND group. No differences were found between the groups with respect to angry faces and orienting attention indices. LimitationsThe current study is limited by its cross-sectional design. ConclusionsThese results support the notion that attentional biases in depression are specific to depression-related information and that they operate in later stages in the deployment of attention.

Electrophysiological evidence of the time course of attentional bias in non-patients reporting symptoms of depression with and without co-occurring anxiety.

Anxiety is characterized by attentional biases to threat, but findings are inconsistent for depression. To address this inconsistency, the present study systematically assessed the role of co-occurring anxiety in attentional bias in depression. In addition, the role of emotional valence, arousal, and gender was explored. Ninety-two non-patients completed the Penn State Worry Questionnaire (Meyer et al., 1990; Molina and Borkovec, 1994) and portions of the Mood and Anxiety Symptom Questionnaire (Watson et al., 1995a,1995b). Individuals reporting high levels of depression and low levels of anxiety (depression only), high levels of depression and anxiety (combined), or low levels of both (control) completed an emotion-word Stroop task during event-related brain potential recording. Pleasant and unpleasant words were matched on emotional arousal level. An attentional bias was not evident in the depression-only group. Women in the combined group had larger N200 amplitude for pleasant than unpleasant stimuli, and the combined group as a whole had larger right-lateralized P300 amplitude for pleasant than unpleasant stimuli, consistent with an early and later attentional bias that is specific to unpleasant valence in the combined group. Men in the control group had larger N200 amplitude for pleasant than unpleasant stimuli, consistent with an early attentional bias that is specific to pleasant valence. The present study indicates that the nature and time course of attention prompted by emotional valence and not arousal differentiates depression with and without anxiety, with some evidence of gender moderating early effects. Overall, results suggest that co-occurring anxiety is more important than previously acknowledged in demonstrating evidence of attentional biases in depression.

Eeg Coherence between Prefrontal and Posterior Cortical Regions is Related to Negative Personality Traits

Eeg Coherence between Prefrontal and Posterior Cortical Regions is Related to Negative Personality Traits

Cognitive inhibition in depression

Cognitive inhibition is a key mechanism in the regulation of emotion. There is emerging evidence that depression is characterized by deficits in the inhibition of mood-congruent material. These deficits could result in prolonged processing of negative, goal-irrelevant aspects of presented information thereby hindering recovery from negative mood and leading to the sustained negative affect that characterizes depressive episodes. Indeed, it has been suggested that deficits in cognitive inhibition lie at the heart of memory and attention biases in depression, and set the stage for ruminative responses to negative events and negative mood states. A ruminative response style results in a heightened vulnerability to experience episodes of major depression. Recent research has demonstrated that deficient inhibition of negative material is associated with heightened rumination. In this article, we review the depression literature with a focus on studies that investigate cognitive inhibition in depressed participants and in participants who report a history of major depressive episodes. In addition, we summarize neurobiological findings that indicate a strong relation between depression and deficits in inhibition and we take a closer look at the relation of inhibition, rumination and mood regulation.

Attentional biases for angry faces in unipolar depression

Past research has demonstrated that depression is associated with dysfunctional processing of emotional information. Recent studies demonstrate that a bias in the attentional processing of negative information may be an important cognitive vulnerability factor underlying the onset and maintenance of depression. However, to date, the nature of this attentional bias is still poorly understood and further exploration of this topic to advance current knowledge of attentional biases in depression seems imperative. This study examined attentional biases for angry facial expressions presented for 1000 ms in 20 patients with major depressive disorder (MDD) and 20 non-depressed control participants (NC) matched for age and gender using an emotional modification of the Exogenous Cueing task. Patients with MDD showed maintained attention for angry faces compared with neutral faces. In comparison with non-depressed participants they showed a stronger attentional engagement for angry faces. In contrast, the NC group directed attention away from angry faces, more rapidly disengaging their attention compared with neutral faces. This pattern of results supports the assumption that MDD is characterized by deficits in the attentional processing of negative, interpersonal information and suggests a 'protective' bias in non-depressed individuals. Implications in relation to previous research exploring cognitive and interpersonal functioning in depression are discussed.

Chapter 22 A neural network model of attention biases in depression

Publisher Summary This chapter discusses the physiologically constrained framework for understanding the role of depression in attention to negative information. A computational neural network is used to evaluate predictions based on this framework. Data from a number of experiments are used to evaluate the model's predictions. The goal in producing the computational model is to reproduce salient aspects of attention to emotional information, including the gradual perception and recognition of emotional and nonemotional aspects of a stimulus. Nodes in the model are not intended to strictly represent groups of human neurons, or capture the details of brain structures. Rather, the general hypothesis that parallel connected systems are responsible for the recognition of affective and semantic aspects of information is represented. The model can be used to make predictions regarding the time course of emotional information processing on the lexical decision and valence identification tasks. Physiological constraints on attention to emotional information help to resolve ambiguities regarding the location and time course of attention biases in depression. Depressive attention biases could involve excessive attention to nonemotional features of information (biased hippocampal system processing), excessive attention to emotional features (biased amygdala system processing), or feedback between affective and semantic processing systems.

Biases of attention and memory in disorders of anxiety and depression

Theoretical frameworks and experimental paradigms derived from cognitive psychology provide a valuable approach to the investigation of cognitive aspects of disorders of anxiety and depression. Review of the literature provides strong evidence of attentional bias towards threat stimuli in anxiety, though evidence of comparable attentional bias in depression is weaker. There is also strong evidence of memory bias towards mood-congruent materials in depression, though comparable evidence regarding anxiety-congruent memory is mixed. A variety of theoretical frameworks for explaining such phenomena have been advanced, using concepts such as networks, schema and mental models. There is a need now for theoretical frameworks that address themselves to the specificity of the empirical phenomena. Clinical and empirical implications of these findings and models are discussed, including developments in diathesis-stress models of psychopathology, the use of experimental-cognitive paradigms in clinical assessment, and the prospect of therapeutic applications.