The effects of attention retraining on depressive mood and cortisol responses to depression‐related stimuli1

Although it has been reported that attentional bias at an early stage is found in depression, no study has investigated the effects of modification of attentional bias at an early stage on depressive mood and cortisol response to a stressor. Therefore, this study tested the hypotheses that the modification of attentional bias at an early stage would reduce depressive mood and cortisol response. Fifty‐three participants were allocated alternately either to the training or the control group. They were administered attention retraining for modification of attentional bias or a sham attention task, and then underwent a stress task. With respect to depressive mood response, depressive mood increased in response to a stress task in the control group, while for high‐dysphoric participants in the training group, depressive mood response remained constant. These results indicate that attention retraining is efficacious for reducing depressive mood response. With respect to cortisol response, the percentage change in cortisol is associated with the amount of change in the attentional bias index scores. The results suggest the possibility that attention retraining could reduce cortisol response.     

Revisiting the past and back to the future: Horizons of cognition and emotion research

ABSTRACT

To commemorate that Cognition & Emotion was established three decades ago, we asked some distinguished scholars to reflect on past research on the interface of cognition and emotion and prospects for the future. The resulting papers form the Special Issue on Horizons in Cognition and Emotion Research. The contributions to Horizons cover both the field in general and a diversity of specific topics, including affective neuroscience, appraisal theory, automatic evaluation, embodied emotion, emotional disorders, emotion-linked attentional bias, emotion recognition, emotion regulation, lifespan development, motivation, and social emotions. We hope that Horizons will spark constructive debates, while offering guidance for the future growth and development of research on the interface between cognition and emotion. Finally, we provide an update on how Cognition & Emotion has fared over the past year, and announce some changes in editorial policies and the editorial board.     

Brooding rumination and attentional biases in currently non-depressed individuals: an eye-tracking study

Both rumination and attentional biases have been proposed as key components of the RDoC Negative Valence Systems construct of Loss. Although theorists have proposed that rumination, particularly brooding rumination, should be associated with increased sustained attention to depression-relevant information, it is not clear whether this link would be observed in a non-depressed sample or whether it is specific to brooding versus reflective rumination. To address these questions, the current study examined the link between brooding rumination and attentional biases in a sample of non-depressed individuals (n?=?105). Attentional biases were assessed using eye tracking during a passive viewing task in which participants were presented with 2?×?2 arrays of angry, happy, sad, and neutral faces. In line with predictions, higher levels of brooding rumination were associated with greater sustained attention to sad faces and less sustained attention to happy faces. These results remained significant after controlling for participants’ prior history of major depression and current nonclinical level of depressive symptoms, suggesting that the link between brooding rumination and attentional biases is at least partially independent of current or past depression.     

Self-referential schemas and attentional bias predict severity and naturalistic course of depression symptoms

Attentional bias and self-referential schemas have been observed in numerous cross-sectional studies of depressed adults and are theorised to maintain negative mood. However, few longitudinal studies have examined whether maladaptive cognition predicts the course of depressive symptoms. Fifty-seven adults with elevated depression symptoms were assessed for negative attentional bias using a dot-probe task with eye-tracking and self-referential schemas using a self-referent encoding task. Participants subsequently completed five weekly depression symptom assessments. Participants with more negative self-referential schemas had higher baseline depression symptoms (r?=?.55). However, participants who spent more time attending to negative words showed greater symptom worsening over time (r?=?.42). The findings for negative self-referential schemas replicate past research, while the findings for negative attention bias represent the first evidence showing that attentional biases predict naturalistic symptom course. This work suggests that negative attention biases maintain depression symptoms and represent an important treatment target for neurocognitive therapeutics.     

Impact of a brief auditory attention training on a modified colour-word Stroop task in a high anxiety and worry sample

Poor attentional control leads to attentional biases that are implicated in psychological distress. Attention Training Technique (ATT) is an auditory intervention designed to strengthen attentional control. Research indicates that ATT alleviates anxiety and depressive symptoms. This study is a randomised control trial with repeated measures that tested if a lab-based, single-exposure of ATT strengthened attentional control. Forty-six nonclinical, high anxiety/worry participants received either ATT or a sham control intervention. Attentional control was assessed using the standard and a modified version of the colour-word Stroop task. The modified version incorporated tactile interference to increase perceptual load. A series of mixed effects models, simple contrasts, and z-tests were used to evaluate if cross-modal interference worsened, and whether ATT was beneficial to, attentional control. Tactile interference increased reaction times but, when Stroop interference was controlled for, this was only true on incongruent trials. The impact of ATT was greatest under high perceptual load.     

Time-course of attention to negative stimuli: Negative affectivity, anxiety, or dysphoria?

Although biased attention to emotional stimuli is considered a vulnerability factor for anxiety and dysphoria, research has infrequently related such attentional biases to dimensional models of vulnerability for anxiety and mood disorders. In two studies (Study 1, n = 64; Study 2, n = 168), we evaluate the differential associations of general negative affectivity, anxiety, and dysphoria with biases in selective attention among nonclinical participants selected to vary in both anxiety and dysphoria. Across both studies, preferential processing of angry faces at a 300-ms exposure duration was associated with a general tendency to experience a range of negative affect, rather than being specific to symptoms of either anxiety or dysphoria. In the second study, we found evidence of a suppressor relationship between anxiety and dysphoria in the prediction of delayed attentional biases (1,000 ms) for sad faces. In particular, dysphoria was specifically associated with biased attention toward sad cues, but only after statistically accounting for anxiety; by contrast, anxiety was specifically associated with attentional avoidance of sad cues, but only after statistically accounting for dysphoria. These results suggest that the specificity of relationships between components of negative affectivity and attention to emotional stimuli varies as a function of the time course at which attentional biases are assessed, highlighting the importance of evaluating both anxiety and dysphoria in research on attentional processing of emotional stimuli. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

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.     

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.     

Cognition and Emotion over twenty-five years

In the 25 years since its foundation, Cognition and Emotion has become a leading psychological journal of research on emotion. Here we review some of the ways in which this has occurred. Questions have included how parallel systems of cognition and emotion can operate in emotion regulation and psychological therapies (including the issue of free will), how the cognitive approach to emotion works, how emotion affects attention, memory, and decision making, and how emotion research is moving beyond the individual mind into the space of the interpersonal.     

Computerized attention retraining for individuals with elevated health anxiety

Background and Objectives: Current cognitive-behavioral theorists conceptualize hypochondriasis as excessive health anxiety (HA). Growing evidence suggests that elevated HA is associated with attentional bias (AB) toward potential health-threat information. Design: This study aimed to examine the effects of attention retraining among individuals with elevated HA, using the established attention modification programs (AMP) designed to train participants to disengage attention from ideographically chosen health-threat words. Methods: Thirty-six randomly assigned individuals with elevated HA completed eight twice-weekly sessions of the AMP (n = 18) or the attention control condition (ACC; n = 18). Results: Despite using the well-established AMP protocol widely used within the field of anxiety disorders, we did not find evidence for change in AB following training. Further, AMP did not outperform ACC in reducing HA and other relevant emotional symptoms. However, both AMP and ACC evidenced overall significant symptom reduction in most of the outcome measures, including overall HA, anxiety sensitivity, general depression and anxiety, and somatic complaints. Conclusions: Further research is needed to better understand the effects and mechanisms of AMP as a possible cognitive intervention for HA.     

Three decades of Cognition & Emotion: A brief review of past highlights and future prospects

Over the past three decades, Cognition & Emotion has been one of the world’s leading outlets for emotion research. In this article, we review past highlights of and future prospects for the journal. Our tour of history covers three periods: The first period, from 1987 to 1999, was a pioneering era in which cognitive theories began to be applied to the scientific analysis of emotion. The second period, from 2000 to 2007, was characterised by a sharp increase in the number of empirical research papers, a lot of which were concerned with automatic processing biases and their implications for clinical psychology. During the third period, from 2008 to 2017, a new focus emerged on self-regulatory processes and their implications for emotion. We then turn to the present profile of Cognition & Emotion and introduce our new editorial team. Finally, we consider how the journal’s future success can be continued and increased by a) providing authors with fast and high-quality feedback; b) offering attractive publication formats, including the newly introduced Registered Reports for pre-registered studies; and c) consolidating key methodological paradigms with reproducible findings.     

List of Reviewers

ABSTRACT

Anxious individuals report disproportionately negative expectations concerning the future, termed the negative expectancy bias. In contrast, ageing is associated with an inflated expectancy for positive future events. A recent study [Steinman, S. A., Smyth, F. L., Bucks, R. S., MacLeod, C., &; Teachman, B. A. (2013). Anxiety-linked expectancy bias across the adult lifespan. Cognition and Emotion, 27, 345–355. doi:10.1080/02699931.2012.711743] found using an interpretation bias task, a negative expectancy bias in young adults and positive expectancy bias in older adults with high trait anxiety. Extending this, the current study examined expectancy bias for positive, negative and ambiguously emotionally toned information in younger and older adults with clinical levels of depression and anxiety to community control groups, thus allowing examination of both disorder status and age on biases. Clinical participants reported a pervasive tendency to expect negative events relative to positive regardless of whether the current scenarios were positive, negative or ambiguous. Older adults showed greater expectancy for future positive scenarios when the initial scenario was negative or ambiguous. Age moderated the negative expectancy bias shown by clinical participants for ambiguous scenarios. Clinical disorders in older adults attenuated the positive expectancy bias that was otherwise strong in community participants. These findings provide further evidence for age differences in processing of emotionally toned information, with older adults showing a greater expectancy for positive future events.     

Training attention improves decision making in individuals with elevated self-reported depressive symptoms

Depression is often characterized by attentional biases toward negative items and away from positive items, which likely affects reward and punishment processing. Recent work has reported that training attention away from negative stimuli reduced this bias and reduced depressive symptoms. However, the effect of attention training on subsequent learning has yet to be explored. In the present study, participants were required to learn to maximize reward during decision making. Undergraduates with elevated self-reported depressive symptoms received attention training toward positive stimuli prior to performing the decision-making task (n = 20; active training). The active-training group was compared to two other groups: undergraduates with elevated self-reported depressive symptoms who received placebo training (n = 22; placebo training) and a control group with low levels of depressive symptoms (n = 33; nondepressive control). The placebo-training depressive group performed worse and switched between options more than did the nondepressive controls on the reward maximization task. However, depressives that received active training performed as well as the nondepressive controls. Computational modeling indicated that the placebo-trained group learned more from negative than from positive prediction errors, leading to more frequent switching. The nondepressive control and active-training depressive groups showed similar learning from positive and negative prediction errors, leading to less-frequent switching and better performance. Our results indicate that individuals with elevated depressive symptoms are impaired at reward maximization, but that the deficit can be improved with attention training toward positive stimuli.     

Attentional Processing of Threat in Bipolar Disorder: Going Beyond Mood-Congruency

Emotional processing in bipolar disorder (BD) entails a complex attentional pattern not merely restricted to happy or sad biases, but also directed towards threatening information. This study examined threat-related bias on attentional orienting when participants were not instructed about the presentation of emotional stimuli (i.e., implicit instructions). An emotional dot-probe task in which an emotional face (i.e., threat, sad, happy) is simultaneously displayed with a neutral face was applied to BD individuals in their different episodes: mania (n?=?26), depression (n?=?24), and euthymia (n?=?28) as well as to a group of healthy controls (n?=?28). Symptomatic BD patients (i.e., in a manic or depressive episode) showed an attentional orienting bias toward threatening faces but not for happy or sad faces, while euthymic BD patients did not exhibit any attentional bias for emotional stimuli. A bias toward happy faces was found in the control group. Threat-related bias was not related to the severity of affective and anxiety symptoms in BD. When attention is not explicitly directed to emotional information, threat-related bias may characterize attentional orienting during mania and depression, but may be attenuated during euthymia.

     

Covert and overt orienting of attention to emotional faces in anxiety

Attentional biases for emotional faces were investigated in high, medium, and low anxiety groups (N = 54) using a probe detection task. Four types of facial expression (threat, sad, happy, neutral) were used to examine the specificity of the bias. Attentional bias measures were derived from manual reaction times (RTs) to probes and the direction of initial eye movement (EM) to the faces. The RT data indicated enhanced vigilance for threat rather than neutral faces in high and medium, but not low, state anxiety. The bias for negative faces appeared to be a combined function of stimulus threat value and the individual's anxiety level. The RT bias did not seem to depend on overt orienting, as many participants made few EMs. However, those who made frequent EMs to the faces showed concordance between the RT and EM bias measures, and so the RT measure of attentional bias for negative versus positive faces at 500 ms appears to provide a valid index of the direction of initial orienting to emotional stimuli. There was no evidence of an anxiety - related bias for happy faces (predicted by the emotionality hypothesis), nor a dysphoria - related bias for sad faces. However, increased dysphoria scores were associated with reduced attentiveness to happy faces.     

Biased attention and dysphoria: Manipulating selective attention reduces subsequent depressive symptoms

Selective attention for dysphoric stimuli has been observed in individuals with depression and those at risk for depression. To date, no studies have investigated the effects of directly manipulating selective attention for dysphoric stimuli on depressive symptoms. Mild to moderately depressed college students (N=34) were randomly assigned to complete 4 sessions of either attention training (AT) or no training (NT) during a two-week period. Participants completed self-reported assessments of depressive symptoms at baseline, post-training, and follow-up. Participants in the AT condition had a significantly greater decrease in depressive symptoms from baseline to follow-up than participants in the NT condition. This group difference was mediated by change in attention bias. Our findings suggest that biased attention may have a causal role in the maintenance of depressive symptoms.     

Attentional mechanisms associated with repressive distancing

This research explores the role of attentional shift and disengagement in repressive distancing. During a target-detection task in which emotional and neutral facial expressions were used as cues, participants received performance feedback intended to elicit a negative emotional reaction that rendered the task either threatening or not threatening to self-concept. When the task was perceived to threaten self-concept, repressors distanced themselves by rapidly disengaging their attention from the facial expressions rather than by slowly shifting or not shifting their attention to the facial expressions. Attentional disengagement was accompanied by sympathetic nervous system activity suggestive of a defense response. This research provides further insight into the nature and consequences of the interplay of dispositional tendencies, situational contexts, and higher order cognitive influences in attentional behavior.     

Attentional biases in dysphoria: An eye-tracking study of the allocation and disengagement of attention

This study looked for evidence of biases in the allocation and disengagement of attention in dysphoric individuals. Participants studied images for a recognition memory test while their eye fixations were tracked and recorded. Four image types were presented (depression-related, anxiety-related, positive, neutral) in each of two study conditions. For the simultaneous study condition, four images (one of each type) were presented simultaneously for 10 seconds, and the number of fixations and the total fixation time to each image was measured, similar to the procedure used by Eizenman et al. (2003) and Kellough, Beevers, Ellis, and Wells (2008). For the sequential study condition, four images (one of each type) were presented consecutively, each for 4 seconds; to measure disengagement of attention an endogenous cuing procedure was used (Posner, 1980). Dysphoric individuals spent significantly less time attending to positive images than non-dysphoric individuals, but there were no group differences in attention to depression-related images. There was also no evidence of a dysphoria-related bias in initial shifts of attention. With respect to the disengagement of attention, dysphoric individuals were slower to disengage their attention from depression-related images. The recognition memory data showed that dysphoric individuals had poorer memory for emotional images, but there was no evidence of a conventional mood-congruent memory bias. Differences in the attentional and memory biases observed in depressed and dysphoric individuals are discussed.     

Social anxiety and difficulty disengaging threat: evidence from eye-tracking

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.     

Selective attention and avoidance on a pictorial cueing task during stress in clinically anxious and depressed participants

Although it is well established that attentional biases exist in anxious populations, the specific components of visual orienting towards and away from emotional stimuli are not well delineated. The present study was designed to examine these processes. We used a modified spatial cueing task to assess the speed of engagement and disengagement from supraliminal and masked pictorial cues depicting threat, dysphoria, or neutral content in 36 clinically anxious, 41 depressed and 41 control participants. Participants were randomly assigned to a stress or neutral condition. During stress, anxious participants were slow to disengage from masked left hemifield pictures depicting threat or dysphoria, but were quick to disengage from supraliminal threat pictures. Information processing in anxious participants during stress was characterized by early selective attention of emotional stimuli, occurring prior to full conscious awareness, followed by effortful avoidance of threat. Depressed participants were distinct from the anxious group, displaying selective attention for stimuli depicting dysphoria, but not threat, during the neutral condition. In sum, attentional biases in clinical populations are associated with difficulties in the disengagement component of visual orienting. Further, a vigilant-avoidant pattern of attentional bias may represent a strategic attempt to compensate for the early activation of a fear response.