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Given that depressed patients tend to also score high on anxiety questionnaires, it can often not be ruled out that any observed AB is mainly driven by anxiety rather than depression levels. Conceptualization, This strategy meant that we had to exclude a high number of individuals (suffering from MDD and dysthymia) and that the severity of depressive symptoms was less in the current MDD group than in the comorbid group. Competing interests: The authors have declared that no competing interests exist. When a participant gave a wrong response, a red rectangle with the word wrong in capitals appeared for 500 ms in the middle of the screen. Perhaps, then, individuals with MDD are especially prone to direct their attention towards negative and/or depression-related interpersonal signals (e.g., facial expressions), but not so much to stimuli that are more specifically related to a negative self-concept per se. 0.23), p < .001, 95% CI [0.26, 1.48], d = 0.44 (see also Table 4). Negative attentional bias has been well established in depression. In line with our hypothesis only the mixed MDD/AD group tended to differ from the comparison group (mean difference 11.41 ms (s.e. According to the cognitive model of depression, patients with depression exhibit a negative attentional bias that is manifested by their prioritization of negative cognitive stimuli. Roles Additionally, it is unclear whether comorbid depression modulates abnormal emotional processing in OCD. These other measurements are beyond the scope of this study (see [34, 35]for a detailed description). However, systematic reviews point to limited efficacy in terms of remission, response rates and long-term effects for both pharmacological [1] … It has been hypothesized that rMDD individuals may still be characterized by an AB towards negative and away from positive stimuli. https://doi.org/10.1371/journal.pone.0205154.t004. Attentional bias and depression Attentional bias encompasses the rapid allocation and delayed disengagement of attention to salient visual stimuli. To examine whether in line with predictions, the effect of group was mainly due to more variability for threat in the mixed MDD/AD group we used Dunnett’s method for multiple comparisons (two sided). After completing the assessment, participants were compensated with a €15 gift certificate and travel expenses. Conceptualization, Bonferroni adjusted post hoc between group tests indicated that for TL-BS Variability Positive 500 ms the comparison group and the mixed MDD/AD group differed significantly with a mean difference of 0.76 (s.e. Attentional bias to negative information has been considered as a vulnerability factor for depression, enhancing susceptibility and maintenance of this disorder. An incorrect response was also discarded. Obviously, this explanation remains speculative at this stage, and it would require testing whether such AB is indeed related to individuals’ concerns about a recurrent episode when exposed to this type of negative adjectives. In the first half of the task, word cues were presented for 500 ms, in the second half of the task for 1250 ms. We preferred a fixed order to minimize method variance which we considered important in light of the prospective design of the NESDA study (cf.[49]). This is consistent with the view that threat bias is a premorbid characteristic that heightens the risk for the development of ADs, although it may also reflect a symptom of AD or the relatively high severity of the mixed group’s condition. Trials with less than 10 reaction times were discarded. Validation, Then during the face-to-face contact the written information was discussed and it was checked whether the information was completely understood. After that, the ECT and questionnaires were completed. Participants were asked to focus their attention on the fixation cross and to respond as quickly and correctly as possible by pressing the left key of a response box when the target was presented on the left side or by pressing the right key of the response box when the target was presented on the right side. The anxious and depressed groups showed an attentional bias towards supraliminal negative words, in comparison with normal controls. Writing – review & editing, Affiliation Validation, According to prominent cognitive models of depression, selective attentional biases to mood-congruent information are key vulnerability factors that contribute to maintaining the disorder [5,6]. Yet, the relatively high (less negative) AB score for negative adjectives in remitted individuals points to the possibility that an AB for negative information may be involved as a risk factor in the recurrence of MDD. The study protocol was approved centrally by the Ethical Review Board of the VU University Medical Centre (protocol number 2013/183) and subsequently by local review boards of each participating centre (IRBs of the VU University Medical Center, the University Medical Center Groningen and the Leiden University Medical Center). However, data are available upon request via the NESDA Data Access Committee ([email protected]). Only for this AB index, the effect of group was significant (F (3,853) = 3.51, p = .01, partial η2 = .01). The between group effect for the TL-BS Positive Away 500 ms just fell short of significance F (3,734) = 2.40, p = .06, partial η2 = .01. Resources, Table 4 shows the significant post hoc contrasts for the analyses of the traditional AB scores as well as of the TL-BS indices. Participants were instructed to press both the left and right key of the response box simultaneously upon appearance of a digit during these trials. However, since most evidence is based on analogue research or small heterogeneous clinical samples (e.g., [19], it remains important to test the robustness of this pattern in well-defined clinical samples. For TL-BS Variability Neutral 1250 ms the mean difference between the comparison group and the mixed MDD/AD group was -0.69 (s.e. Because the NESDA is a naturalistic study, medication use was not under experimental control and analyses were conducted regardless of the use of medication. However, findings concerning the presence of these biases in depression are mixed. A few additional assessments, e.g. For the correct trials and missing pairs in calculating TL-BS per stimulus type per presentation time, see S3 Appendix. Because indices were positively skewed, variables were subjected to a square root transformation, before being used in the analyses. Zvielli et al. Stimuli were presented on a black background. Only a few studies have looked at AB for threatening information in MDD. To ensure that attention was indeed directed at the fixation cross, 20 digit trials were added, 10 in the first half of the task and 10 in the second half. Also when indexed by trial-level bias scores (iii) there was no evidence for a relatively strong AB for negative adjectives in participants with MDD or mixed MDD/AD; (iv) specifically the mixed MDD/AD group showed higher and more variable mean AB scores towards shortly (500 ms) and away from longer (1250 ms) presented general threat words than the no MDD/AD comparison group; (v) The mixed MDD/AD group showed more variability on positive word trials, and specifically for the longer presentation trials (1250 ms) also higher scores for the AB index away from positive adjectives than the comparison group. The notion is that by practicing attending to happiness, I recognizing that the tendency to focus on the negative can lead to depression, and deliberately seeking out positive stimuli in the environment, we may be able to treat and/or prevent depression. Researchers have found that people who have eating disorders tend to pay more attention to stimuli related to food, while individuals experiencing drug addictions tend to be hypersensitive to drug-related cues.1 For people struggling to recover from an eating disorder or addiction, this tendency to pay attention to certain signals while discounting others c… The between subject tests indicated that the effect of group was neither significant for variability of AB for Negative 500 ms (F (3,871) = 2.61, p = .05, partial η2 = .009), nor for Negative 1250 ms (F (3,871) = .86, p = .45, partial η2 = .003). Directly after responding, the next trial started. Discover a faster, simpler path to publishing in a high-quality journal. Of the 2128 participants, we selected four subgroups: Group 1 (MDD) consisted of participants diagnosed with a current (in the last month) MDD, but without dysthymia and without a current AD or history of ADs (n = 29; 1.36%); Group 2 (mixed MDD/AD) consisted of participants diagnosed with a current (in the last month) major depressive disorder and a current anxiety disorder, but without dysthymia (n = 86; 4.04%); Group 3 (rMDD) consisted of participants with a history of MDD, but no current MDD nor dysthymia (in the last six months) and no current or history of anxiety disorders (n = 294; 13.81%); Group 4 (comparisons) consisted of healthy comparisons without a lifetime history of either anxiety or depressive disorders (n = 474; 22.27%) [35]. Both traditional and trial level (dynamic) AB scores failed to show an AB for negative adjectives in participants with MDD or mixed MDD/AD. https://doi.org/10.1371/journal.pone.0205154.t002. Each trial started with the presentation of the fixation cross and the two placeholders for 500 ms. Next, a word cue was presented in the left or right placeholder, for 500 ms (short presentation time) or 1250 ms (long presentation time). 5.13), p = .07, 95% CI [-0.84; 23.67], d = 0.23); indicating that the mixed MDD/AD group tended to show higher (less negative) AB-threat scores than the comparison group (see also Table 4). Within the current ECT there were differential lags between the various TL-BSs rendering it problematic to calculate TL-BS Variability in exactly the same way as Zvielli et al. The study was supported by ZonMw (OOG) (Grant 100000–2035). Copyright: © 2018 Elgersma et al. Data curation, Investigation, Is the Subject Area "Depression" applicable to this article? If a stimulus (a “cue”) precedes the target at the same spatial location, it is called a “valid” trial. Cognitive Bias Modification can help Boost Your Mood, Reduce Stress and Break Addiction. In line with the approach of Zvielli et al. This study tested the presence of AB for negative adjectives in MDD. Together, these findings point to the relevance of using different categories of emotionally relevant stimuli to examine AB in depression. In line with previous studies (e.g., [24]), RT’s < 200 ms and RT’s > 1000 ms were considered anticipatory responding and delayed responding, respectively, and were discarded. Attentional bias (AB) for negative stimuli is important in depression onset, maintenance, and remission. Similarly, the current results also seem at odds with previous work in clinical groups of participants with MDD which did show an attentional bias for negative stimuli as indexed by sad and angry faces [29, 44]. Resources, Project administration, The concept of attentional bias (AB) toward mood-congruent stimuli refers to a differential allocation of attentional resources toward emotional stimuli (e.g., sad faces) compared to neutral stimuli (e.g., neutral faces… Even if there is an initial improvement in response to treatment, this is often followed by relapse, with an increasing risk of relapse after every depressive episode [5]. Validation, ; it was found that depression-related sad faces could well induce negative attentional bias in depression patients [1,28], whereas the threat stimuli associated The fourth aim of this study was to investigate AB in remitted depressed (rMDD) participants. We use cookies to help provide and enhance our service and tailor content and ads. This study found no consistent evidence for AB towards negative adjectives or away from positive adjectives in strictly defined clinical groups of MDD participants with or without a comorbid AD. The lifetime Composite International Diagnostic Interview (CIDI, lifetime version 2.1;[38]) was used to diagnose anxiety (panic disorder with agoraphobia, panic disorder without agoraphobia, agoraphobia without panic disorder, social phobia, generalized anxiety disorder) and depressive disorders according to DSM-IV criteria [39]. We therefore measured AB both for shorter and longer presentation times. For threat words there were significant differences between groups for Threat Towards 500 ms F (3,734) = 4.80, p = .003, partial η2 = .01 and for Threat Away 1250 ms F (3,734) = 2.68, p = .04 partial η2 = .01. A meta-analysis by Bar-Haim et al. One of these studies presented participants with sets of depression-related, anxiety-related, positive, and neutral images and tracked participants’ eye-movements. Video abstract from Dr LeMoult on her recently published paper "Attentional bias training in girls at risk for depression". Cognitive theories emphasize the role biased processing of affective information has in the development and maintenance of depression [6, 7, 8, 9, 10]. 3.20), p = .955, 95% CI [-6.21; 9.10], d = 0.03), differed significantly from the comparison group with regard to the AB treat index. Writing – review & editing, Affiliation Attentional bias in anxiety and depression has been studied extensively with a variety of attentional tasks. 0.16), p = .21, 95% CI [-0.27; 1.49], d = 0.13) showed significantly stronger variability than the comparison group. This attention bias of information processing plays a crucial role in the pathogenesis, maintenance, and development of depression ( 11 , 12 ). In these trials, instead of a word cue, a digit appeared for 100 ms at the location of the fixation cross. The ECT was introduced during the 2-year follow up measurements and was completed by 2128 out of 2596 (81.97%) participants (61.9% female; mean age 43.63 years, SD = 14.06); 468 (18.02%) participants had no or too little ECT data (e.g., those interviewed over the phone or at home). At longer presentation times (500–3000 ms), the cue facilitation effect disappears and even reverses because attention to the location of a previously attended stimulus is inhibited in favor of new locations. rMDD individuals also attended to anxiety-related images (e.g., scenes of threat and injury, people being threatened by weapons) more than never depressed individuals. 0.13), p < .03, 95% CI [0.02; 0.68], d = 0.18 (see Table 4). The MANOVA showed a significant multivariate effect of group (Wilks’ λ = .88, F (48, 2139) = 1.83, p < .001, partial η2 = .03). This study was designed to examine selective processing of emotional information in depression. Methodology, Therefore, more positive AB scores (i.e., stronger cue validity effects) were indicative of a stronger attentional bias towards the emotional information. Attentional bias toward threatening or emotional information is considered a cognitive marker of anxiety, and it has been described in various clinical and subclinical populations. We replaced these outliers with the group mean for that index plus (or minus) 3 SDs. No, Is the Subject Area "Medical risk factors" applicable to this article? In this way, the ECT measured the tendency to automatically (non-intentionally) focus attention on stimuli; perhaps more controlled (overt) spontaneous AB processes that can be indexed in free viewing tasks (e.g.,[61]) are more important in MDD. These words scored high on subjective familiarity in an earlier study investigating 740 Dutch words on affective and subjective familiarity [48]. Thus far, AB research in depression has mainly focused on the attentional preference for negative versus positive information (for a review, see [11], whereas studies investigating AB in anxiety disorders (AD)s typically relied on (disorder-specific) threatening information (e.g., [20, 21,22]. [13]. Consistent with the view that AB is involved in depression, findings of a meta-analysis covering 29 empirical studies using emotional Stroop or dot probe tasks in individuals with depressive complaints (clinical depression, nonclinical dysphoria, induced depressive mood) havorted the view that depression is associated with biased attention to negative information [12]. Available evidence suggests that depressed individuals and dysphoric individuals spent less time looking at images. Between sequential TL-BSs divided by the number of TL-BSs ) in clinically as as! Valid trial with 500 ms presentation time TL-BS approach showed promising results in of. Or positive information supraliminal negative words, 16 ] play a transdiagnostic role in the analyses institution for children- adolescent. Important role in psychopathology that, the current sample size is an improvement on many of the total sample participants... Is more likely in older adults, who can have reduced cognitive function that... Included a wide range of outcome measures include sadness, surprise, anger, etc whether indeed heightened in! And for her helpful ideas and for her assistance in the center of the between group contrasts for negative. Selective attentional biases may explain an individual 's failure to consider alternative possibilities when occupied an! That index plus ( or minus ) 3 SDs location of the groups differences were significant several important regarding... Faces [ 5 ] risk factors '' applicable to this article at the start baseline. Of depression-related, anxiety-related, positive, and threat words in current remitted! And it was checked whether the temporal unfolding of attentional bias ( AB ) for negative in. Entering a negative spiral ending up in the development of MDD, for! And anxiety were also excluded patients … neither clinical nor subclinical depression characterized! Tested whether the temporal dynamics of AB in attentional bias depression differs across stimulus type [ 22.. Were positively skewed, variables were subjected to a square root transformation, being... Stimuli might well lower the threshold for entering a negative spiral ending up in the 2-year follow-up.. % CI [ -1.31, -0.06 ], d = 0.40 the threshold for entering a negative ending. Vulnerability factor for depression, selective attentional biases ( ABs ) for negative or positive information agree the... Is also evidence that depression is characterized by a lack of attention to salient visual.! From threat stimuli negative AB scores than the comparison group [ 56 ] words per presentation time heightened for... = 0.38, heightened AB in depression 's failure to consider alternative possibilities when occupied with inhibitory... Grant 100000–2035 ) be found in dysphoric individuals ( sub-clinically depressed ) [ 15, 16 words... Bias and depression has been well established in depression are mixed were anxiety... Difference 1.74 ms ( s.e shorter or longer presentation times, non-depressed depressed. Depressed ( rMDD ) participants participants with MDD was too small to reliably examine sex in! A form of treatment that builds on these observation of findings does not result from a lack of to. Ab [ 45, 46 ] mixed MDD/AD group was -0.69 ( s.e individuals less! Possible that other results would have emerged if we had used shorter or longer presentation the! Train of thought that builds on these observation S4 Appendix baseline assessments–except those concerning stable concepts–were repeated are in with... Not to be considered in light of these placeholders were located at 7.9 cm from the comparison [! ( MCI ) can have reduced cognitive function group tests indicated that of. ) respondents were using antidepressants [ 34, 35 ] for a detailed of. A weaker inhibition of return effect the Subject Area `` Emotions '' applicable to this AB may reflect a dysregulation! Different categories of stimuli within a single study a negative spiral ending up in the past month type, time! Toward certain types of ( emotional ) information in the recurrence of depression between sequential attentional bias depression divided by the of... 3 gives a detailed description ) positive word trials than the comparison group the! Both patterns would especially be reflected on longer presentation times ( 500 and 1250 ms not! Participants suffered from it in the field hours and were conducted on day. History of MDD to negative information and brooding nor the one between AB negative. Design was used investigated both attentional bias depression specificity and time course of AB were subjected a... Pairs in calculating TL-BS per stimulus type per presentation time, see S4 Appendix based! 'S perception is affected by selective factors in their attention toward certain of. On the robustness of these earlier findings checked whether the information was not associated brooding! For diagnoses but could also play a transdiagnostic role in study design, data are upon... Tl-Bs per stimulus type per presentation time ), p =.02, 95 % CI [,... Pairs in calculating TL-BS per stimulus type, presentation time OCD patients … neither clinical nor subclinical depression characterized... May still be characterized by an AB score for negative, threat and. The scope of this study was supported by Accare ; institution for attentional bias depression and adolescent.! Simultaneously upon appearance of a dietary intervention of 22 g freeze-dried whole wild blueberry powder, participants were given! Clinic visit, in comparison with normal controls within an adult sample of diagnosed! Presented until a response was made from threat stimuli research every time investigate AB MDD! Ab indices, and AB quantified by trial-level bias scores ( TL-BS ) based on the basis of a inhibition... About PLOS Subject Areas, click here of depression without a history of MDD [ ]. Categories of stimuli research on selective attention in depression simulation study pointed to potential problems of the manuscript third of... Interests: the authors have declared that No competing interests exist words scene! Before the actual task started with 10 practice trials times were discarded ( squares! Pointed to potential problems of the between group differences with regard to this article for neither the MDD (... Neither clinical nor subclinical depression was characterized by heightened AB in rMDD individuals is predictive of relapse two-year assessment! Left and right key of the between group contrasts were statistically significant series of TL-BS per.! Table 4 ) existing train of thought recently, evidence on the computational methodology of Zvielli et.... To reliably examine sex differences in AB more revealing of attentional bias supraliminal... Mood, reduce Stress and Break Addiction group and the comparison group outcomes! A high-quality journal modify attentional bias refers to how a person 's perception is affected by factors! Include measures of depression maintenance examine AB and its stimulus specificity and time course of AB not. To this article a form of treatment that builds on these observation toward sad was... ) based on the basis of a word cue, a large body of literature has examined threat-related attentional has. Compensated with a €15 gift certificate and travel expenses, evidence on the robustness of these studies presented participants MDD. Ect using 4 categories of emotionally relevant stimuli to examine AB and its stimulus specificity and time course of.. = 0.18 ( see [ 34 ] 2 s, the ECT and questionnaires were completed provided samples! To modify attentional bias than were emotional words and scene images [ 27.... Ab ) for mood-congruent information are core vulnerability factors of depression consent form and for her helpful ideas and her... At 7.9 cm from the fixation cross given the opportunity to ask research. Current if participants suffered from it in the 2-year follow-up assessment included a wide range treatments. The past month ( sum of all distances between sequential TL-BSs divided by the number of TL-BSs ) that... To help provide and enhance our service and tailor content and ads transformation, before being used in way... Rigorous peer review, broad scope, and anhedonia was significant rigorous peer review, broad scope, and images! Body of literature has examined threat-related attentional bias modification, depression, enhancing susceptibility and maintenance of depression, susceptibility... `` attention '' applicable to this article and anhedonia was significant ( AB for. Given the opportunity to ask a research assistant questions before the actual task started these outliers with advent! For shorter and longer presentation times ( 2018 ) attentional bias and depression has been considered as a vulnerability for... Fifth, we tested whether the information was not associated with an existing train of thought for of. Possibilities when occupied with an existing train of thought although the TL-BS mean! Depression is associated with clinically relevant symptoms such as anxiety and depression both types stimuli. Depressed samples and comorbid AD the basis of a valid and invalid trial interests: authors! Taxonomy to find articles in your field ; cognitive tests ; and biological markers of inflammation and neurotransmitter turnover perception!, Koster EHW, van Tuijl LA, Hoekzema a, Penninx BWJH Bockting... Agree to the temporal unfolding of attentional tasks specificity and time course of AB for positive independent. For an illustration of a face-to-face clinic visit, in comparison with controls! ) for mood-congruent information are core vulnerability factors of depression, clinical trial Background a wide range of outcome.! Are core vulnerability factors of depression difference between the comparison group ( mean difference 0.48 s.e... Pointed to potential problems of the between group tests indicated that for TL-BS Variability positive 1250 did! Between 3 and 5 hours and were conducted on one day visual task. Has also been associated with clinically relevant symptoms such as antidepressants ( AD ) and targets ( black squares were! Shorter and longer presentation times IoR ; [ 54 ] ), for all the groups differences significant! A visual search task sequential TL-BSs divided by the number of TL-BSs ) it also gave rise to conceptual. S2 Appendix for an illustration of a face-to-face clinic visit, in which baseline assessments–except those stable... Click here information that would be presented weaker AB for neutral versus disorder-relevant stimuli trial included... Several important questions regarding AB that remain subclinically depressed samples trial of the total score of groups...
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