Negative Cognitive Bias Research Articles

Impairments of Implicit Emotional Neurocognitive Processing in College Students With Subthreshold Depression: An ERP Study.

Previous studies have proved that the people with subthreshold depression (SD) had negative cognitive bias in conscious level. However, it still remains a point of controversy whether they have impairment in unconscious level. The present study aimed to explore whether the implicit emotional processing differed between people with SD and healthy controls (HCs) and the details by analyzing the event-related potentials. We recruited 35 SD participants and 35 age- and sex-matched HCs to collect event-related potential data. A visual oddball task was used to investigate implicit emotional processing with three types of emotional pictures (positive, negative, and neutral as stimuli). The N2 and P3 components were used to compare the neurocognitive differences of implicit emotional processing between two groups. Compared with the HC group, the SD participants showed no significant differences in the amplitudes or latencies of the N2 component for any kind of emotional stimuli but smaller P3 amplitudes for all kinds of emotional stimuli. The P3 latencies for positive stimuli were slower than the negative ones in the SD group but not in the HC group. The SD group showed slower P3 latencies than the HC group only for positive stimuli. There was a positive correlation between Center for Epidemiological Survey, Depression Scale score and average N2 and P3 amplitudes. The SD people demonstrate implicit cognitive processing impairments, and the impairments of emotional cognitive processing in SD may exist mainly in evaluative stage and primarily for positive stimuli.

Cognitive bias modification to prevent depression (COPE): results of a randomised controlled trial.

Although efficacious treatments for major depression are available, efficacy is suboptimal and recurrence is common. Effective preventive strategies could reduce disability associated with the disorder, but current options are limited. Cognitive bias modification (CBM) is a novel and safe intervention that attenuates biases associated with depression. This study investigated whether the delivery of a CBM programme designed to attenuate negative cognitive biases over a period of 1 year would decrease the incidence of major depression among adults with subthreshold symptoms of depression. Randomised double-blind controlled trial delivered an active CBM intervention or a control intervention over 52 weeks. Two hundred and two community-dwelling adults who reported subthreshold levels of depression were randomised (100 intervention, 102 control). The primary outcome of interest was the incidence of major depressive episode assessed at 11, 27 and 52 weeks. Secondary outcomes included onset of clinically significant symptoms of depression, change in severity of depression symptoms and change in cognitive biases. Adherence to the interventions was modest though did not differ between conditions. Incidence of major depressive episodes was low. Conditions did not differ in the incidence of major depressive episodes. Likewise, conditions did not differ in the incidence of clinically significant levels of depression, change in the severity of depression symptoms or change in cognitive biases. Active CBM intervention did not decrease the incidence of major depressive episodes as compared to a control intervention. However, adherence to the intervention programme was modest and the programme failed to modify the expected mechanism of action.

Attentional control and estimation of the probability of positive and negative events

ABSTRACTPeople high in negative affect tend to think negative events are more likely than positive events (“probability bias”). Studies have found that weak attentional control exaggerates another negative affect-related cognitive bias – attentional bias – but it is not clear why this might be. We therefore wanted to know whether weak attentional control would be related to probability bias too. Four studies, with predominantly female student samples (N = 857), revealed correlations of around −.38 between attentional control and probability bias. This remained significant when trait anxiety and depression were controlled; there were no interactions between attentional control and negative affect. Studies 3 and 4 found that attentional control’s relationship with probability bias was partly mediated by emotion regulation ability. These results suggest attentional control is important for regulating affect-related cognitive biases, and for emotion regulation in general. Furthermore, because cognitive biases are thought to be important for maintaining emotional disorders, these results are also consistent with weak attentional control being a risk factor for these disorders.

Age-related changes in cognitive biases during adolescence

IntroductionAge has been found to moderate the relation between cognitive biases and psychopathology, yet little is known about normative age-related change in these biases during adolescence. Adolescence might be a key developmental period for changes in negatively biased information-processing, and understanding the trajectories of these processes in a typically developing population is a pre-requisite for further comprehending their association with psychopathology. MethodsThis study explores the effect of age on seven cognitive biases in a diverse community sample from the United Kingdom (N = 540) aged 10–17 years (309 were female) using self-report measures. ResultsAge demonstrated a positive linear association with three biases: threat interpretation, negative attributions and overgeneralizing scores. ConclusionsImportant changes take place during adolescence that may increase young people's negative cognitive biases. Empirical data on normative age-related changes in cognitive biases should be integrated into theoretical models of biased information-processing and psychopathology.

Neurocognitive mechanisms of prefrontal stimulation

The difficulty in treating mood and anxiety disorders has sparked clinical interest in novel treatments, such as transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC). However, underlying mechanisms of action are unclear. It is established that people with mood and anxiety disorders have negative cognitive biases, such as increased vigilance to threat. Psychiatric treatments have acute effects on these cognitive biases, which predict later therapeutic action. Such effects are proposed as cognitive biomarkers of response. A healthy volunteer investigation revealed an anxiolytic-like effect (reduced threat vigilance) of single-session tDCS on a behavioural test of proven clinical relevance (Ironside et al., 2016, Biological Psychiatry). Complementing this, we used functional imaging to reveal that, in a sample of trait anxious females, tDCS of the DLPFC increased activation in an attentional control network and reduced amygdala response to fearful face distractors (Ironside et al., under revision, JAMA Psychiatry). This provides causal evidence that modulating activity in the DLPFC inhibits amygdala response to threat, providing a potential neural mechanism for the previous reduction in vigilance to threat. Collectively, these results propose an emerging neurocognitive model of the mechanisms of action of tDCS. We also examined pairing tDCS with attentional bias modification training and found no effect of stimulation. However, DLPFC tDCS has been successfully paired with other paradigms such as cognitive control training. As highlighted in the next talks, we suggest that computationally specified learning tasks may be more sensitive. Together, findings point to an anxiolytic-like effect of DLPFC tDCS on cognitive and neural biomarkers relevant to mood and anxiety disorders, indicating potential neurocognitive mechanisms that may mediate the reported clinical efficacy of DLPFC tDCS. This has implications as the identification of treatment response markers that could aid patient selection for future trials and ultimately guide treatment selection for patients.

Negative emotional contagion and cognitive bias in common ravens (Corvus corax)

Emotional contagion is described as an emotional state matching between subjects, and has been suggested to facilitate communication and coordination in complex social groups. Empirical studies typically focus on the measurement of behavioral contagion and emotional arousal, yet, while highly important, such an approach often disregards an additional evaluation of the underlying emotional valence. Here, we studied emotional contagion in ravens by applying a judgment bias paradigm to assess emotional valence. We experimentally manipulated positive and negative affective states in demonstrator ravens, to which they responded with increased attention and interest in the positive condition, as well as increased redirected behavior and a left-eye lateralization in the negative condition. During this emotion manipulation, another raven observed the demonstrator's behavior, and we used a bias paradigm to assess the emotional valence of the observer to determine whether emotional contagion had occurred. Observers showed a pessimism bias toward the presented ambiguous stimuli after perceiving demonstrators in a negative state, indicating emotional state matching based on the demonstrators' behavioral cues and confirming our prediction of negative emotional contagion. We did not find any judgment bias in the positive condition. This result critically expands upon observational studies of contagious play in ravens, providing experimental evidence that emotional contagion is present not only in mammalian but also in avian species. Importantly, this finding also acts as a stepping stone toward understanding the evolution of empathy, as this essential social skill may have emerged across these taxa in response to similar socioecological challenges.

Association between negative cognitive bias and depression: A symptom-level approach.

Cognitive models of depression posit that negatively biased self-referent processing and attention have important roles in the disorder. However, depression is a heterogeneous collection of symptoms and all symptoms are unlikely to be associated with these negative cognitive biases. The current study involved 218 community adults whose depression ranged from no symptoms to clinical levels of depression. Random forest machine learning was used to identify the most important depression symptom predictors of each negative cognitive bias. Depression symptoms were measured with the Beck Depression Inventory-II. Model performance was evaluated using predictive R-squared (Rpred2), the expected variance explained in data not used to train the algorithm, estimated by 10 repetitions of 10-fold cross-validation. Using the self-referent encoding task (SRET), depression symptoms explained 34% to 45% of the variance in negative self-referent processing. The symptoms of sadness, self-dislike, pessimism, feelings of punishment, and indecision were most important. Notably, many depression symptoms made virtually no contribution to this prediction. In contrast, for attention bias for sad stimuli, measured with the dot-probe task using behavioral reaction time (RT) and eye gaze metrics, no reliable symptom predictors were identified. Findings indicate that a symptom-level approach may provide new insights into which symptoms, if any, are associated with negative cognitive biases in depression. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Positive and negative contexts predict duration of pig vocalisations

Emotions are mental states occurring in response to external and internal stimuli and thus form an integral part of an animal’s behaviour. Emotions can be mapped in two dimensions based on their arousal and valence. Whilst good indicators of arousal exist, clear indicators of emotional valence, particularly positive valence, are still rare. However, positively valenced emotions may play a crucial role in social interactions in many species and thus, an understanding of how emotional valence is expressed is needed. Vocalisations are a potential indicator of emotional valence as they can reflect the internal state of the caller. We experimentally manipulated valence, using positive and negative cognitive bias trials, to quantify changes in pig vocalisations. We found that grunts were shorter in positive trials than in negative trials. Interestingly, we did not find differences in the other measured acoustic parameters between the positive and negative contexts as reported in previous studies. These differences in results suggest that acoustic parameters may differ in their sensitivity as indicators of emotial valence. However, it is important to understand how similar contexts are, in terms of their valence, to be able to fully understand how and when acoustic parameters reflect emotional states.

Affective modulation of the associative-limbic subthalamic nucleus: deep brain stimulation in obsessive\u2013compulsive disorder

Affective states underlie daily decision-making and pathological behaviours relevant to obsessive–compulsive disorders (OCD), mood disorders and addictions. Deep brain stimulation targeting the motor and associative-limbic subthalamic nucleus (STN) has been shown to be effective for Parkinson’s disease (PD) and OCD, respectively. Cognitive and electrophysiological studies in PD showed responses of the motor STN to emotional stimuli, impairments in recognition of negative affective states and modulation of the intensity of subjective emotion. Here we studied whether the stimulation of the associative-limbic STN in OCD influences the subjective emotion to low-intensity positive and negative images and how this relates to clinical symptoms. We assessed 10 OCD patients with on and off STN DBS in a double-blind randomized manner by recording ratings of valence and arousal to low- and high-intensity positive and negative emotional images. STN stimulation increased positive ratings and decreased negative ratings to low-intensity positive and negative stimuli, respectively, relative to off stimulation. We also show that the change in severity of obsessive–compulsive symptoms pre- versus post-operatively interacts with both DBS and valence ratings. We show that stimulation of the associative-limbic STN might influence the negative cognitive bias in OCD and decreasing the negative appraisal of emotional stimuli with a possible relationship with clinical outcomes. That the effect is specific to low intensity might suggest a role of uncertainty or conflict related to competing interpretations of image intensity. These findings may have implications for the therapeutic efficacy of DBS.

Evidence for Right-Sided Horses Being More Optimistic than Left-Sided Horses.

Simple SummaryBehaviour that indicates stress or poor welfare in horses can be very subtle and, especially for the lay person, difficult to assess. Furthermore, the absence of such behaviour does not necessarily indicate a healthy mental state. Therefore, this study aimed to investigate whether a preference for the left or right forelimb in different tasks (motor laterality) or for left or right sensory organs (sensory laterality) indicates a positive mental state (positive cognitive bias—optimism) or negative mental state (negative cognitive bias—pessimism). This study demonstrates that horses that use the right forelimb more often when starting to move off from a standing position (initial forelimb use) are more likely to expect a neutral stimulus to be positive and to be in an optimistic mental state than horses that use the left forelimb. This knowledge about the horses’ mental state can help us to improve their welfare by minimizing negative events. Furthermore, evaluation of the mental state of animals by determining motor laterality is quicker and easier than conventional tests for cognitive bias that include a long period of training.An individual’s positive or negative perspective when judging an ambiguous stimulus (cognitive bias) can be helpful when assessing animal welfare. Emotionality, as expressed in approach or withdrawal behaviour, is linked to brain asymmetry. The predisposition to process information in the left or right brain hemisphere is displayed in motor laterality. The quality of the information being processed is indicated by the sensory laterality. Consequently, it would be quicker and more repeatable to use motor or sensory laterality to evaluate cognitive bias than to perform the conventional judgment bias test. Therefore, the relationship between cognitive bias and motor or sensory laterality was tested. The horses (n = 17) were trained in a discrimination task involving a box that was placed in either a “positive” or “negative” location. To test for cognitive bias, the box was then placed in the middle, between the trained positive and negative location, in an ambiguous location, and the latency to approach the box was evaluated. Results indicated that horses that were more likely to use the right forelimb when moving off from a standing position were more likely to approach the ambiguous box with a shorter latency (generalized linear mixed model, p < 0.01), and therefore displayed a positive cognitive bias (optimistic).

Cognitive biases predict symptoms of depression, anxiety and wellbeing above and beyond neuroticism in adolescence

BackgroundAdolescence represents a period of vulnerability to affective disorders. Neuroticism is considered a heritable risk factor for depression, but is not directly amenable to intervention. Therefore, it is important to identify the contributions of modifiable risk factors. Negative cognitive biases are implicated in the onset and maintenance of affective disorders in adults, and may represent modifiable risk factors in adolescence. Aim(s)This study sought to assess to what extent cognitive biases are able to predict depression, anxiety and wellbeing beyond that of neuroticism in adolescents. MethodsAdolescents (N = 99), recruited from Scottish secondary schools (54.5% female; mean age = 14.7), ensured a sample representing the breadth of the mental health spectrum. In line with prevalence estimates, 18% of this sample demonstrated clinical levels of depression symptoms. Cognitive biases of autobiographical memory, self-referential memory, ambiguous scenarios interpretation, facial expression recognition, rumination and dysfunctional attitudes were assessed. Depression, anxiety, and wellbeing were indexed using the Mood and Feelings Questionnaire, Spence Children's Anxiety Scale and the BBC Subjective Wellbeing Scale. ResultsRegression analyses demonstrated neuroticism to significantly predict depression, anxiety and wellbeing. The addition of cognitive biases resulted in a significant increase of explained variance with final models explaining just over 50% of variances of depression, anxiety and wellbeing. ConclusionThese findings demonstrate that cognitive biases explain mental health symptoms over and above that of neuroticism. Depressive symptomology was particularly related to self-referential memory bias, while anxiety was predicted by interpretive bias. The key clinical implication is that targeting specific biases based on diagnostic features may be of particular benefit in alleviating distress and promoting wellbeing.

Cognitive Interpretation Bias: The Effect of a Single Session Moderate Exercise Protocol on Anxiety and Depression.

Research conducted within the cognitive bias modification (CBM) paradigm has revealed that cognitive biases such as negative cognitive interpretation biases contribute to mental health disorders such as anxiety (Beard, 2011). It has been shown that exercise reduces anxiety (Ensari et al., 2015). Exercise has also been found to reduce negative cognitive attention biases (Tian and Smith, 2011), however, no research to date has investigated the effect of exercise on cognitive interpretation bias. The key aims of the current project is to investigate whether moderate exercise reduces self-reported symptoms of depression and stress. Additionally, to establish which intensity of exercise is required to achieve anxiety reduction and reduce an individual’s negative cognitive interpretation biases. Study 1 recruited a healthy sample of adult participants who were randomly assigned to one of two conditions: a walking exercise protocol or a control condition (n = 2 × 12). Participants completed anxiety and cognitive interpretation bias measures before and after the walking exercise or control condition. Those in the walking exercise condition presented less symptoms of trait anxiety on a measure of state and trait anxiety inventory (STAI), compared to controls relative to baseline measures following the intervention. Study 2 recruited frequent exercisers who were assigned to an exercise or control group (n = 2 × 24). Participants completed anxiety, depression, psychological stress, and cognitive interpretation bias measures before and after the exercise or control condition. Following the intervention, negative interpretation biases decreased in the exercise group and stayed stable in the control group. The exercise group also had significantly decreased anxiety, depression, and stress measures after the exercise condition, while controls did not. The research concludes that CBM holds promise for the management of mood disorders and exercise is an effective accompaniment to psychotherapy.

Negative Cognitive Bias and Perceived Stress: Independent Mediators of the Relation Between Mindfulness and Emotional Distress

Although a growing body of research has demonstrated the benefits of mindfulness for depression and anxiety, the mechanisms by which mindfulness reduces emotional distress are unclear. At least two mechanisms have been proposed: reduced negative cognitive bias and stress reduction. Although both mechanisms have received initial support, these proposed mechanisms have not been examined concurrently. The present studies examined the extent to which less negative cognitive bias and less perceived stress uniquely accounted for the association between mindfulness and emotional distress. In two studies, participants completed measures of trait mindfulness, perceived stress, negative cognitive bias, depression, and anxiety. Across both studies, results from parallel multiple mediation models indicated that both negative cognitive bias and perceived stress accounted for unique variance in the mindfulness–emotional distress association. That is, greater mindfulness was related to less negative cognitive bias and less perceived stress, which in turn were associated with less emotional distress. The results suggest that both stress reduction and negative cognitive bias may be mechanisms by which mindfulness confers benefits to psychological well-being.

The negative cognitive bias of self-schema in worriers

Worry represents a repetitive form of negative thinking, during which a cognitive attempt is made to anticipate and to prepare for possible damaging outcomes in the future. Research has demonstrated that self-schema is derived from past experience, which guides the processing of self-related unknowns and helps to make predictions. It remains unclear whether the repetitive negative anticipation during worry is based on the maladaptive self-schema. Previous studies have found that self-schema is closely related to the processing of self-related information. Therefore, we shall explore the distinctions of self-schema between high-level worriers and a control group with regard to self-related activities. We hypothesized that the negative cognitive bias of self-schema in worriers would be manifested through abnormally self-related activities and linguistic features. The participants were screened into two categories: the unit consisting of worriers and the control group. In Experiment 1, individuals with different levels of worry were tested for their self-related processing and their relationship with solely neutral stimuli. Experiment 2 was performed by combining the Sentence Completion Test to the first experiment to investigate the linguistic features common to worriers. Meanwhile, participants were asked to complete the Remote Association Test (RAT) to control their associative ability during tasks. The results of Experiment 1 indicated that: (i) compared to the control group, the worriers made more self-related judgments and displayed delayed reactions. (ii) The worriers demonstrated more negative relationships with the neutral stimuli and made automatic responses. The results obtained from Experiment 2 established that: (i) there were pronouncedly more negative sentences iterated by the set of worriers than by the control group. (ii) Compared to the control group, the worriers uttered more self-related words. Notably, no significant distinctions were found in the RAT between two groups, suggesting that there was no meaningful difference in the associative abilities of the two categories of participants. The research initiative confirmed that worriers tend to make more negative self-related judgments with regard to neutral prompts and that they are more likely to project negative concepts about themselves. The results revealed the negative self-schema in worriers and illustrated the psychology mechanism of those who are anxiety prone. The investigation also explained why worriers extensively anticipated negative outcomes about the unknown. This study would be beneficial to practitioners in the treatment of affective disorders in which worry is the primary characteristic.

Effects of appraisal training on responses to a distressing autobiographical event

Dysfunctional appraisals are a key factor suggested to be involved in the development and maintenance of PTSD. Research has shown that experimental induction of a positive or negative appraisal style following a laboratory stressor affects analogue posttraumatic stress symptoms. This supports a causal role of appraisal in the development of traumatic stress symptoms and the therapeutic promise of modifying appraisals to reduce PTSD symptoms. The present study aimed to extend previous findings by investigating the effects of experimentally induced appraisals on reactions to a naturally occurring analogue trauma and by examining effects on both explicit and implicit appraisals. Participants who had experienced a distressing life event were asked to imagine themselves in the most distressing moment of that event and then received either a positive or negative Cognitive Bias Modification training targeting appraisals (CBM-App). The CBM-App training induced training-congruent appraisals, but group differences in changes in appraisal over training were only seen for explicit and not implicit appraisals. However, participants trained positively reported less intrusion distress over the subsequent week than those trained negatively, and lower levels of overall posttraumatic stress symptoms. These data support the causal relationship between appraisals and trauma distress, and further illuminate the mechanisms linking the two.

The moderating role of cognitive biases on the relationship between negative affective states and psychotic-like experiences in non-clinical adults

Negative emotions and cognitive biases are important factors underlying psychotic symptoms and psychotic-like experiences (PLEs); however, it is not clear whether these factors interact when they influence psychotic phenomena. The aim of our study was to investigate whether psychosis-related cognitive biases moderate the relationship between negative affective states, i.e. anxiety and depression, and psychotic-like experiences. The study sample contains 251 participants who have never been diagnosed with psychiatric disorders. Anxiety, depression, cognitive biases, and psychotic-like experiences were assessed with self-report questionnaires. A moderation analysis was performed to examine the relationship between the study variables. The analyses revealed that the link between anxiety and positive PLEs is moderated by External Attribution bias, whereas the relationship between depression and positive PLEs is moderated by Attention to Threat bias. Attributional bias was also found to moderate the association between depression and negative subclinical symptoms; Jumping to Conclusions bias served as a moderator in the link between anxiety and depression and negative PLEs. Further studies in clinical samples are required to verify the moderating role of individual cognitive biases on the relationship between negative emotional states and full-blown psychotic symptoms.

Oestrous phase cyclicity influences judgment biasing in rats

The identification of cognitive bias has become an important measure of animal welfare. Negative cognitive biases develop from a tendency for animals to process novel information pessimistically. Judgment-bias testing is the commonplace methodology to detect cognitive biases. However, concerns with these methods have been frequently-reported; one of which being the discrepancy between male and female cognitive expression. The current study assessed the factors of social status and oestrus, to investigate whether oestrous cycle rotation, or subordination stress encouraged an increase in pessimistic responses. Female Sprague-Dawley rats (n = 24) were trained on an active-choice judgment bias paradigm. Responses to the ambiguous probe were recorded as optimistic or pessimistic. Oestrous phase was determined by assessing vaginal cytology in stained vaginal cell smears. Rats in the dioestrous phase and those rats considered to be subordinate demonstrated an increased percentage of pessimistic responses. However, no interaction between these factors was observed. This suggests that oestrous cyclicity can influence the judgment biases of female animals; a previously unreported finding. On this basis, researchers should be encouraged to account for both oestrous phase cyclicity and social status as an additional fixed effect in study design.

Parsing the heterogeneity of depression: An exploratory factor analysis across commonly used depression rating scales

BackgroundDue to the heterogeneity of depressive symptoms—which can include depressed mood, anhedonia, negative cognitive biases, and altered activity levels—researchers often use a combination of depression rating scales to assess symptoms. This study sought to identify unidimensional constructs measured across rating scales for depression and to evaluate these constructs across clinical trials of a rapid-acting antidepressant (ketamine). MethodsExploratory factor analysis (EFA) was conducted on baseline ratings from the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale (HAM-D), the Montgomery-Asberg Depression Rating Scale (MADRS), and the Snaith-Hamilton Pleasure Rating Scale (SHAPS). Inpatients with major depressive disorder (n = 76) or bipolar depression (n = 43) were participating in clinical ketamine trials. The trajectories of the resulting unidimensional scores were evaluated in 41 subjects with bipolar depression who participated in clinical ketamine trials. ResultsThe best solution, which exhibited excellent fit to the data, comprised eight factors: Depressed Mood, Tension, Negative Cognition, Impaired Sleep, Suicidal Thoughts, Reduced Appetite, Anhedonia, and Amotivation. Various response patterns were observed across the clinical trial data, both in treatment effect (ketamine versus placebo) and in degree of placebo response, suggesting that use of these unidimensional constructs may reveal patterns not observed with traditional scoring of individual instruments. LimitationsLimitations include: 1) small sample (and related inability to confirm measurement invariance); 2) absence of an independent sample for confirmation of factor structure; and 3) the treatment-resistant nature of the population, which may limit generalizability. ConclusionsThe empirical identification of unidimensional constructs creates more refined scores that may elucidate the connection between specific symptoms and underlying pathophysiology.

Depressive symptoms account for differences between self‐reported versus polysomnographic assessment of sleep quality in women with myofascial TMD

Patients with temporomandibular disorder (TMD) report poor sleep quality on the Pittsburgh Sleep Quality Index (PSQI). However, polysomnographic (PSG) studies show meagre evidence of sleep disturbance on standard physiological measures. The present aim was to analyse self-reported sleep quality in TMD as a function of myofascial pain, PSG parameters and depressive symptomatology. PSQI scores from 124 women with myofascial TMD and 46 matched controls were hierarchically regressed onto TMD presence, ratings of pain intensity and pain-related disability, in-laboratory PSG variables and depressive symptoms (Symptoms Checklist-90). Relative to controls, TMD cases had higher PSQI scores, representing poorer subjective sleep and more depressive symptoms (both P < 0·001). Higher PSQI scores were strongly predicted by more depressive symptoms (P < 0·001, R2 = 26%). Of 19 PSG variables, two had modest contributions to higher PSQI scores: longer rapid eye movement latency in TMD cases (P = 0·01, R2 = 3%) and more awakenings in all participants (P = 0·03, R2 = 2%). After accounting for these factors, TMD presence and pain ratings were not significantly related to PSQI scores. These results show that reported poor sleep quality in TMD is better explained by depressive symptoms than by PSG-assessed sleep disturbances or myofascial pain. As TMD cases lacked typical PSG features of clinical depression, the results suggest a negative cognitive bias in TMD and caution against interpreting self-report sleep measures as accurate indicators of PSG sleep disturbance. Future investigations should take account of depressive symptomatology when interpreting reports of poor sleep.

The role of cognitive biases in short-term psychodynamic psychotherapy.

Therapists may be attentive to changes in biased thinking across short-term dynamic psychotherapy for adjustment disorder. Therapists may foster the emergence of positive cognitive biases at mid-treatment for adjustment disorder.