Rumination and attention in major depression

Up until recently, it had been assumed that attentional biases for negative information do not exist in depression. However studies using post-conscious exposure durations have produced contradictory results. The limitations of common attentional tasks, suitability of stimulus materials and differences in stimulus duration times may have contributed to these inconsistencies. We aimed to address many of these issues and examine attentional responses in major depression at two post-conscious exposure times. We also investigated possible roles for rumination and distraction in increasing and lessening attentional biases for negative information. We used a fully controlled experimental design to test the effects of both induced and trait rumination and distraction on attention in patients with major depression and healthy controls. Attention was assessed using the dot-probe task. The findings revealed an attentional bias for negative information in depressed patients only at the longer post-conscious exposure duration. Furthermore although this bias was not influenced by either induced or trait distraction, it was related to trait rumination. Overall, the results showed that depression is associated with a strategic attentional bias towards negative information and that this bias is stronger in individuals who habitually ruminate.     

Understanding associations between negatively biased attention and depression and social anxiety: positively biased attention is key

ABSTRACT

Background and objectives: Although research supports the premise that depressed and socially anxious individuals direct attention preferentially toward negative emotional cues, little is known about how attention to positive emotional cues might modulate this negative attention bias risk process. The purpose of this study was to determine if associations between attention biases to sad and angry faces and depression and social anxiety symptoms, respectively, would be strongest in individuals who also show biased attention away from happy faces.

Methods: Young adults (N?=?151; 79% female; M?=?19.63 years) completed self-report measures of depression and social anxiety symptoms and a dot probe task to assess attention biases to happy, sad, and angry facial expressions.

Results: Attention bias to happy faces moderated associations between attention to negatively valenced faces and psychopathology symptoms. However, attention bias toward sad faces was positively and significantly related to depression symptoms only for individuals who also selectively attended toward happy faces. Similarly, attention bias toward angry faces was positively and significantly associated with social anxiety symptoms only for individuals who also selectively attended toward happy faces.

Conclusions: These findings suggest that individuals with high levels of depression or social anxiety symptoms attend preferentially to emotional stimuli across valences.     

What Do People Really Think of Me? Evaluating Bias in Interpersonal Predictions Over the Course of Cognitive-Behavioral Therapy of Depression

Cognitive behavioral therapy (CBT) of depression is hypothesized to achieve its effects by correcting negative biases. However, little research has tested how biases change over the course of CBT. We focus on biases in interpersonal judgments and examine whether changes in biases occur in CBT and are associated with symptom improvements. A sample of 126 adults (60% women, mean age 31.7, 83% White) participated in CBT of depression. Observers provided ratings of patients participating in two interpersonal tasks on three occasions. Patients were asked to predict observers’ ratings. In a thin slice (TS) task, observers evaluated how patients came across in a brief segment in which patients talked about themselves. In a Standard Interaction Task (SIT), observers rated the social skills patients displayed in challenging role plays. The difference between patient predictions and observer ratings provided measures of bias in these interpersonal judgments. TS and SIT bias became significantly less pessimistic and more realistic over the course of CBT. Improvements in TS bias were associated with a faster reduction in symptoms, whereas there was a non-significant trend for improvement in SIT bias being associated with faster symptom reduction. Consistent with the CBT model, negative interpersonal biases became more realistic throughout a course of CBT for depression and at least some of the changes in bias were related to therapeutic outcomes. We encourage future researchers to continue examining for whom and under which conditions correcting such biases produces the greatest benefits.     

阈下抑郁个体对负性情绪刺激的注意解脱困难

本研究拟采用点探测范式及不同情绪内容的面孔刺激（高兴、中性、悲伤和愤怒）考察阈下抑郁个体的负性注意偏向及其内在机制。点探测任务中情绪面孔配对呈现（负性-中性、正性-中性）,配对面孔中的情绪线索位置与靶刺激的位置构成负性一致/不一致和正性一致/不一致条件,同时实验中加入“中性-中性”面孔线索作为一致和不一致条件的对比基线来考察注意偏向的内在机制。结果发现,阈下抑郁个体在负性不一致条件下的反应时显著长于负性一致条件,表明阈下抑郁个体具有对负性刺激的注意偏向;进一步比较发现,阈下抑郁个体在负性不一致条件下的反应时显著的长于“中性-中性”基线条件,而负性一致条件与基线之间差异不显著,表明阈下抑郁个体的负性注意偏向为对负性刺激的注意解脱困难。结果另发现,阈下抑郁个体未能像无抑郁对照组个体表现出对正性刺激的注意偏向。结果表明,处于阈下抑郁状态的个体表现出对负性刺激的注意偏向,具体为对负性刺激的注意解脱困难,其原因可能是由于阈下抑郁个体在注意控制和情绪调节功能上的紊乱。     

Attention bias in youth: Associations with youth and mother's depressive symptoms moderated by emotion regulation and affective dynamics during family interactions

Recent research has highlighted the potential role of attention bias for emotional stimuli as a possible cognitive risk factor for depression in youth. However, differences in youth emotion regulation or maternal affect may moderate the association between maternal and youth depression and youth attention biases. The current study investigated the relationship between maternal and youth depressive symptoms and youth (aged 11–17 years) attention bias for sad and happy faces in 59 mother–youth dyads, examining whether positive and negative maternal affect observed during structured interaction tasks or youth emotion regulation tendencies moderated associations between maternal and youth depression and attention biases. Youth suppression interacted with maternal and youth depression to predict sad attentional biases in youth, while maternal positive affect interacted with maternal depression to predict happy attention biases in youth.     

Deployment of attention in clinical depression during symptom remission

The purpose of the current study was to investigate deployment of attention in clinically depressed patients during the process of symptom remission. Previous research indicates a non-depressed protective bias in attention whereas depressed individuals evidence no bias. A deployment-of-attention task based on negative, positive, and neutral adjectives was administered twice to 15 inpatients with major depression and 15 normal controls, at about 6 weeks apart. From test 1 to test 2, severity of patients' depressive symptoms improved significantly. Acutely depressed patients tended to show an attentional bias towards negative information whereas partially remitted patients manifested no attentional bias. Non-depressed individuals attended less to negative information than (acutely and partially remitted) depressed patients. Non-depressed participants but not depressed patients avoid negative information demonstrating a protective processing bias. Depressed patients are not characterized by a shift towards a pronounced protective pattern during symptom remission.     

Attentional bias to respiratory- and anxiety-related threat in children with asthma

This study investigated attentional biases in children with asthma. The study aimed at testing whether children with asthma are vigilant to asthma and/or anxiety cues. Thirty-six children (18 with asthma and 18 healthy controls) aged 9–12 completed a computerised dot probe task designed to measure attentional bias to three different categories of words: asthma, anxiety symptom and general negative emotion. Main caregiver anxiety was also assessed, as was frequency of inhaler use for those with asthma. Children with asthma showed an attentional bias towards asthma words but not anxiety or general negative emotion words. Children without asthma showed no significant attentional biases to any word categories. Caregiver anxiety was correlated with asthma word attentional bias in the asthma group. The findings indicate that attentional bias is present in children with asthma. Further research is required to ascertain if this exacerbates or maintains health-related problems.     

Combined behavioural markers of cognitive biases are associated with anhedonia

Biases towards negative information, as well as away from positive information, are associated with psychopathology. Examining biases in multiple processes has been theorised to be more predictive than examining bias in any process alone. Anhedonia is a core symptom of psychopathology and predictive of future psychopathological symptoms. Finding that combined biases are associated with anhedonia would advance knowledge of the nature of emotional processing biases and the value of objective performance-based measures for identifying early risk markers. Participants (N?=?139) completed tasks that assess latency bias (dot probe) and biased recognition (two-alternative forced-choice) of emotional information, as well as an anhedonia measure. An index was computed for each task’s performance reflecting biased processing of positive and negative words. Only combined biases on both tasks were associated with anhedonia. Attentional bias was positively associated with anhedonia, but only when recognition bias for emotional words was high. Thus, assessing biases in multiple domains increased sensitivity to uncover relationships between emotional processing biases and anhedonic symptoms.     

Attentional and interpretative biases in appearance concern: An investigation of biases in appearance-related information processing

The present study examined associations between high levels of appearance concern and information processing biases in interpretation and attention. An opportunity sample (N = 79) categorised ambiguous stimuli as related or unrelated to appearance. Participants then responded to the same stimuli in a modified visual dot-probe task assessing attentional bias. Participant responses were assessed in relation to level of appearance concern. The results indicated a valence specific bias towards interpretation of ambiguous stimuli as negative and appearance-related in individuals with higher levels of concern. There was also evidence of attentional bias towards information perceived as appearance-related in participants with higher levels of appearance concern. The study findings suggest that association between appearance-orientated information processing biases and level of appearance concern; this association may lead to mutually reinforcing bias and concern.     

Examining attentional biases underlying trait anxiety in younger and older adults

Previous research has not adequately assessed the independent contributions of component attentional processes to anxiety-linked biases. MacLeod and Sadler developed a novel, lexical decision task using negative and neutral word stimuli, to enable the independent measurement of attentional engagement and disengagement. Their results suggest that anxiety-linked attentional biases are associated with facilitated attentional engagement with negative information. The present study aimed to determine the replicability of these findings, with two important extensions. First, this study included positive word stimuli in the lexical decision task, to determine whether anxiety-linked attentional biases exist only towards negative information, or toward emotionally arousing information in general. Second, this study explored age-related differences in anxiety-linked attentional biases. Younger (N=32) and older adults (N=32) with both high and low trait anxiety completed the lexical decision task. The results suggest that heightened anxiety may be associated with a deficit in engaging with positive words. No age-related differences in anxiety-linked attentional biases were apparent.     

Biases in affective forecasting and recall in individuals with depression and anxiety symptoms

The authors used experience sampling to investigate biases in affective forecasting and recall in individuals with varying levels of depression and anxiety symptoms. Participants who were higher in depression symptoms demonstrated stronger (more pessimistic) negative mood prediction biases, marginally stronger negative mood recall biases, and weaker (less optimistic) positive mood prediction and recall biases. Participants who were higher in anxiety symptoms demonstrated stronger negative mood prediction biases, but positive mood prediction biases that were on par with those who were lower in anxiety. Anxiety symptoms were not associated with mood recall biases. Neither depression symptoms nor anxiety symptoms were associated with bias in event prediction. Their findings fit well with the tripartite model of depression and anxiety. Results are also consistent with the conceptualization of anxiety as a "forward-looking" disorder, and with theories that emphasize the importance of pessimism and general negative information processing in depressive functioning.     

Attention training and the threat bias: an ERP study

Anxiety is characterized by exaggerated attention to threat. Several studies suggest that this threat bias plays a causal role in the development and maintenance of anxiety disorders. Furthermore, although the threat bias can be reduced in anxious individuals and induced in non-anxious individual, the attentional mechanisms underlying these changes remain unclear. To address this issue, 49 non-anxious adults were randomly assigned to either attentional training toward or training away from threat using a modified version of the dot probe task. Behavioral measures of attentional biases were also generated pre- and post-training using the dot probe task. Event-related potentials (ERPs) were generated to threat and non-threat face pairs and probes during pre- and post-training assessments. Effects of training on behavioral measures of the threat bias were significant, but only for those participants showing pre-training biases. Attention training also influenced early spatial attention, as measured by post-training P1 amplitudes to cues. Results illustrate the importance of taking pre-training attention biases in non-anxious individuals into account when evaluating the effects of attention training and tracking physiological changes in attention following training.     

Threat-based cognitive biases in anxious children: comparison with non-anxious children before and after cognitive behavioural treatment

Attention and interpretation biases for threat stimuli were assessed in 19 anxious (ANX) children before and after cognitive behavioural therapy (CBT), and compared with responses from 19 non-anxious (NA) control children collected over the same period. Attentional bias was assessed using a picture version of the visual probe task with threat, neutral and pleasant pictures. Threat interpretation bias was assessed using both a homographs task in which children used homograph words in a sentence and their neutral or threatening meaning was assessed, and a stories task in which children rated their negative emotion, danger judgments, and influencing ability in ambiguous situations. ANX children showed attention biases towards threat on the visual probe task and threat interpretation biases on the stories task but not the homographs task at pre-treatment in comparison with NA children. Following treatment, ANX children's threat interpretation biases as assessed on the stories task reduced significantly to within levels comparable to NA children. However, ANX children continued to show larger attentional biases towards threat than pleasant pictures on the visual probe task at post-treatment, whereas NA children did not show attentional biases. Moreover, a residual threat interpretation style on the stories task at post-treatment was associated with higher anxiety symptoms in both ANX and NA children.     

Intergenerational transmission of attentional bias and anxiety

Earlier evidence has revealed a bi‐directional causal relationship between anxiety and attention biases in adults and children. This study investigated the prospective and concurrent relations between anxiety and attentional bias in a sample of 89 families (mothers, fathers, and first‐born children). Parents’ and children's attentional bias was measured when children were 7.5 years old, using both a visual probe task and visual search task with angry versus happy facial expressions. Generalized and social anxiety symptoms in parents and children were measured when children were 4.5 and 7.5 years old. Anxiety in parents and children was prospectively (but not concurrently) related to their respective attentional biases to threat: All participants showed a larger attentional bias to threat in the visual search (but not in the visual probe) task if they were more anxious at the 4.5 (but not at the 7.5) year measurement. Moreover, parents’ anxiety levels were prospectively predictive of the visual search attentional bias of their children after controlling for child anxiety. More anxiety in mothers at 4.5 years was related to a faster detection of angry among happy faces, while more anxiety in fathers predicted a faster detection of happy among angry faces in children at 7.5 years. We found no direct association between parental and child attentional biases. Our study contributes to the recently emerging literature on attentional biases as a potential mechanism in the intergenerational transmission of anxiety by showing that parents’ anxiety rather than parents’ attentional bias contributes to the intergenerational transmission of risk for child anxiety.     

Mood-congruent attentional bias in dysphoria: maintained attention to and impaired disengagement from negative information

Attentional bias to negative information has been proposed to be a cognitive vulnerability factor for the development of depression. In 2 experiments, the authors examined mood-congruent attentional bias in dysphoria. In both experiments, dysphoric and nondysphoric participants performed an attentional task with negative, positive, and neutral word cues preceding a target. Targets appeared either at the same or at the opposite location of the cue. Overall, results indicate that dysphoric participants show maintained attention for negative words at longer stimulus presentations, which is probably caused by impaired attentional disengagement from negative words. Furthermore, nondysphoric participants maintain their attention more strongly to positive words. These results are discussed in relation to recent developments in the pathogenesis and treatment of depression.     

Enhanced probing of attentional bias: The independence of anxiety-linked selectivity in attentional engagement with and disengagement from negative information

Cognitive models of anxiety posit that an attentional bias to negative information plays a causal role in elevated anxiety vulnerability and dysfunction. There has been considerable recent interest in determining whether this attentional bias reflects facilitated attentional engagement with and/or impaired attentional disengagement from negative information. We concur with the claim of investigators who have noted that the methodologies previously employed to dissociate engagement and disengagement biases are not optimal for this purpose. In the present study, we employ a novel methodology, the Attentional Response to Distal vs. Proximal Emotional Information (ARDPEI) task, which enables the discrete assessment of these two types of attentional selectivity. The findings demonstrate that facilitated attentional engagement with and impaired attentional disengagement from negative information both characterise elevated anxiety vulnerability. Further, these biases represent distinctive facets of anxiety-linked attentional selectivity. We discuss the potentially differing roles that engagement and disengagement biases may play in the development and/or maintenance of anxiety vulnerability and dysfunction.     

手机成瘾与抑郁：社交焦虑和负性情绪信息注意偏向的多重中介作用

为考察手机成瘾与抑郁的关系, 研究同时整合情绪和认知两方面因素, 探讨了社交焦虑和负性情绪信息注意偏向在手机成瘾和抑郁之间的多重中介作用。研究1共有545名大学生完成了大学生手机成瘾倾向量表、贝克抑郁量表和社会交往焦虑量表。研究2选取51名大学生采用问卷法和2(配对面孔表情的情绪类型: 负性、中性) × 2(探测点位置: 与负性情绪面孔表情同侧、与负性情绪面孔表情异侧)的被试内实验设计。结果表明: (1)手机成瘾、社交焦虑和抑郁两两间存在显著正相关, 且社交焦虑在手机成瘾和抑郁之间起完全中介作用; (2)社交焦虑和负性情绪信息注意偏向在手机成瘾与抑郁的关系中起链式中介作用, 而负性情绪信息注意偏向在手机成瘾与抑郁间的单独中介效应不显著。具体而言, 手机成瘾通过两条路径影响抑郁: 一是社交焦虑的单独中介作用; 二是社交焦虑→负性情绪信息注意偏向的链式中介作用。     

Effects of threat cues on attentional shifting, disengagement and response slowing in anxious individuals

According to cognitive models of anxiety, attentional biases for threat may cause or maintain anxiety states. Previous research using spatial cueing tasks has been interpreted in terms of difficulty in disengaging attention from threat in anxious individuals, as indicated by contrasts of response times (RTs) from threat cue versus neutral cue trials. However, on spatial cueing tasks, differences in RT between threat cue and neutral cue trials may stem from a slowing effect of threat on RT, as well as effects on allocation of visuospatial attention. The present study examined the effects of threat cues on both attentional cueing and response slowing. High and low anxious individuals completed a central cue task, which assessed threat-related response slowing, and a spatial cueing task, which assessed attentional biases for angry, happy and neutral faces. Results indicated that interpretation of the anxiety-related bias for threat depended on whether the effect of response slowing was taken into account. The study illustrates an important problem in using the modified spatial cueing task to assess components of threat-related attentional bias. As this experimental method may reflect both threat-related attentional cueing and response slowing effects, it cannot be assumed to provide pure measures of shift or disengagement components of attention bias.     

Lack of an Attention Bias Away From Relatively Negative Faces in Dysphoria Is Not Related to Biased Emotion Identification

Eye-tracking-based attention research has consistently shown a lack of a normative attentional bias away from dysphoric face stimuli in depression, characterizing the attention system of non-depressed individuals. However, this more equal attention allocation pattern could also be related to biased emotion identification, namely, an inclination of depressed individuals to attribute negative emotions to non-negative stimuli when processing mood-congruent stimuli. Here, we examined emotion identification as a possible mechanism associated with attention allocation when processing emotional faces in depression. Attention allocation and emotion identification of participants with high (HD; n = 30) and low (LD; n = 30) levels of depression symptoms were assessed using two corresponding tasks previously shown to yield significant findings in depression, using the same face stimuli (sad, happy, and neutral faces) across both tasks. We examined group differences on each task and possible between-task associations. Results showed that while LD participants dwelled longer on relatively positive faces compared with relatively negative faces on the attention allocation task, HD participants showed no such bias, dwelling equally on both. Trait anxiety did not affect these results. No group differences were noted for emotion identification, and no between-task associations emerged. Present results suggest that depression is characterized by a lack of a general attention bias toward relatively positive faces over relatively negative faces, which is not related to a corresponding bias in emotion identification.     

Affective asynchrony and the measurement of the affective attitude component

Theoretical models of social phobia propose that biased attention contributes to the maintenance of symptoms; however these theoretical models make opposing predictions. Specifically, whereas Rapee and Heimberg (1997) suggested the biases are characterised by hypervigilance to threat cues and difficulty disengaging attention from threat, Clark and Wells (1995) suggested that threat cues are largely avoided. Previous research has been limited by the almost exclusive reliance on behavioural response times to experimental tasks to provide an index of attentional biases. The current study evaluated the relationship between the time-course of attention and symptoms of social anxiety and depression. Forty-two young adults completed a dot-probe task with emotional faces while eye-movement data were collected. The results revealed that increased social anxiety was associated with attention to emotional (rather than neutral) faces over time as well as difficulty disengaging attention from angry expressions; some evidence was found for a relationship between heightened depressive symptoms and increased attention to fear faces.