attentional bias depression

Neither the MDD group (mean difference 0.18 (s.e. Validation, Controls, non-depressed and depressed OCD patients … If AB for negative adjectives and/or general threat stimuli would set people at risk for recurrence, this would provide an important lead for clinicians to better tailor their interventions to prevent recurrent episodes of both depressive and anxiety disorders. Given the stimulus onset asynchrony used in the current study (500 and 1250 ms), negative cue validity effects were to be expected. An incorrect response was also discarded. Therefore, the current study distinguished between groups of participants with MDD (and no AD) and participants with MDD and comorbid AD. 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. Yes The between subject tests indicated that the multivariate effect of group was mainly carried by the AB index of negative adjectives specifically for long duration trials (1250 ms). Several limitations of this study need to be considered. Supervision, For TL-BS Variability Positive 1250 ms, the mean difference between the comparison group and the mixed MDD/AD group was 0.87 (s.e. This attentional bias feeds, reinforces, and prolongs depressive thought patterns, and serves as an underlying risk factor for depressive symptom onset and relapse. 0.13), p < .03, 95% CI [0.02; 0.68], d = 0.18 (see Table 4). However, this does not seem to be a very convincing explanation, since the mixed group that was included in the current design did not show an AB for negative adjectives either. Taken together, the available evidence suggests that depressed individuals are characterized by heightened AB for negative information and lowered AB for positive information. 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. This pattern indicates that for both presentation times the mixed MDD/AD group showed more variability on positive word trials than the comparison group. Attentional bias is described as the preferential attention toward certain types of (emotional) information in the environment. Our study included assessment in a currently anxious cohort using threat-related stimuli (fearful faces). Methodology, [30]argued that previous findings concerning AB were explained by a failure to take the importance of the dynamic nature of AB into account. The number of trial types among which pairings have to be made is increased considerably from 3 in the dot probe task to 8 in the currently analyzed ECT. According to cognitive models of depression, selective attentional biases (ABs) for mood-congruent information are core vulnerability factors of depression maintenance. Based on this view, Zvielli, et al. We assumed that both patterns would especially be reflected on longer presentation times. Attentional bias to negative information has been considered as a vulnerability factor for depression, enhancing susceptibility and maintenance of this disorder. Yes https://doi.org/10.1371/journal.pone.0205154.s001, https://doi.org/10.1371/journal.pone.0205154.s002, https://doi.org/10.1371/journal.pone.0205154.s003, https://doi.org/10.1371/journal.pone.0205154.s004. Methodology, Furthermore, attentional bias has been shown to play an important role in the development and maintenance of depressive and anxiety disorders. Discover a faster, simpler path to publishing in a high-quality journal. Method. 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]. Many of these cognitive models include attentional bias (AB) as both a contributing and a maintaining factor to depression (e.g.,. 8.48), p = .99, 95% CI [-18.51; 21.99], d = 0.04) nor the rMDD group (mean difference 1.44 ms (s.e. This study used data from the baseline and 2-year follow-up assessment (for details see [35]and the website www.nesda.nl) as the latter was the wave in which the ECT assessment was incorporated. In total, the task consisted of 4 stimulus types x 16 exemplars x 2 valid/invalid x 2 presentation times = 256 word trials, 10 practice trials and 20 digit trials. In these trials, instead of a word cue, a digit appeared for 100 ms at the location of the fixation cross. For neither the MDD group (mean difference 0.59 (s.e. People with major depressive disorder (MDD) show an attentional bias in which they over-attend to negative information while often ignoring positive information. For the other indices regarding the neutral stimuli there were no significant between group differences (Neutral Towards 500 ms F (3,734) = 1.27, p = .28, partial η2 = .005; Neutral Away 500 ms F (3,734) = 0.47, p = .69, partial η2 = .002; and Neutral Away 1250 ms F (3,734) = 1.17, p = .31, partial η2 = .005). PLoS ONE 13(10): Interestingly, there is also some evidence of a predictive relationship in participants with major depressive disorder (MDD): A difficulty in disengaging attention from sad faces has been related to sustained negative mood, as measured in an eye-tracking study [17]. We started with the short duration trials as we anticipated that prior exposure to long duration word presentations could have a larger impact on performance during short duration trials than vice versa. Cues were presented at random on the right or left side of the fixation cross and every word cue was presented twice in each half of the task: Once in a valid trial (i.e., word cue is valid predictor for the target location), and once in an invalid trial. This pattern indicates that for presentation times 1250 ms the mixed MDD/AD group showed more extreme scores on TL-BS away from positive adjectives than the comparison group. © 2020 The Author(s). 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. We examined AB for sad and happy materials in three modified versions of the exogenous cueing task using scenes, facial expressions, and words. Against predictions, there was no specific AB in the group of MDD, neither for negative nor for positive adjectives. Thus supporting its validity, the ECT was sufficiently sensitive to detect differences in participants’ AB for neutral versus disorder-relevant stimuli. Addressing these issues is the main aim of this study as described next in more detail. Most important, the findings of this simulation study indicated that TL-BS indices are prone to result in false positive group differences; the differences between groups might in fact reflect differences in mean reaction times and/ or differences in overall SD [33]. 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… For the short duration trials, the TL-BS findings indicated that specifically the mixed MDD/AD group showed heightened scores for the index of mean AB towards threat stimuli. The study was supported by Accare; institution for children- and adolescent psychiatry. We presumed that participants with MDD (with and without ADs) would show weaker AB for positive adjectives independent of presentation time. To test the predicted pattern of stimulus specific AB as a function of group we subjected the traditional AB scores (Negative 500 ms, Negative 1250 ms, Positive 500 ms, Positive 1250 ms, Threat 500 ms, Threat 1250 ms) to a Multivariate Analyses of Variance (MANOVA) with the AB scores as the dependent factor and Group (Comparison, rMDD, MDD, and MDD/AD) as fixed factor. If a stimulus (a “cue”) precedes the target at the same spatial location, it is called a “valid” trial. Neither the MDD group (mean difference = -0.22 (s.e. However, it is notable that negative facial expressions include sadness, surprise, anger, etc. Therefore, the current study included both depression-relevant and threat-related stimuli to test whether participants with a clinically-diagnosed MDD show an AB not only for depression-related stimuli but also for threat-related stimuli. [31]). Furthermore, in participants with MDD, higher levels of AB for sad faces, as measured with an exogenous cueing task (ECT), was related to impaired mood recovery in reaction to a sad mood induction [18]. In line with the approach of Zvielli et al. Because indices were positively skewed, variables were subjected to a square root transformation, before being used in the analyses. Because many patients with MDD have comorbid anxiety disorders, it is important to verify whether AB can indeed be attributed to MDD per se. Implications of these results for research on selective attention in depression are discussed. In a similar vein, both dysphoric and rMDD individuals spent significantly less time attending to positive images (such as scenes of people smiling, or kittens) and more to depression-images (e.g., scenes of people appearing sad, unhappy, or images of neglected animals, etc.) For more information about PLOS Subject Areas, click These words scored high on subjective familiarity in an earlier study investigating 740 Dutch words on affective and subjective familiarity [48]. PLOS ONE promises fair, rigorous peer review, 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. Table 3 gives a detailed description of the traditional AB score per stimulus type and presentation time. 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. Resources, This attention bias of information processing plays a crucial role in the pathogenesis, maintenance, and development of depression ( 11 , 12 ). https://doi.org/10.1371/journal.pone.0205154.t004. [58, 59]). The threat bias in the mixed group could also be a premorbid characteristic, one that might have contributed to the development of the anxiety symptoms in this group via enhancing anxiety vulnerability (cf. Funding acquisition, Participants were recruited from the general population, through general practitioners, and in mental health care institutions, and included: healthy individuals with no history of psychiatric disorders, individuals at risk because of prior episodes, sub-threshold symptoms or family history, and individuals with a current first or recurrent MDD or AD. Given recent findings highlighting the potential relevance of fluctuations in AB[30], in the current study we not only relied on traditional AB indices, but also took the trial-by-trial AB variation into account. https://doi.org/10.1371/journal.pone.0205154.t002. For the TL-BS indices within each condition (Group, Index, Stimulus type, Presentation Time), see S4 Appendix. Third, this study focused on a task where adjectives were task-irrelevant. Conceptualization, For more information about PLOS Subject Areas, click In the current emotional modification of this paradigm, the emotional value of the cue is varied (i.e., emotional vs. neutral) which allows to investigate AB for disorder-relevant emotional information (with the responses to the neutral trials as the reference category and the comparison control participants as the reference group). 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. Citation: Elgersma HJ, Koster EHW, van Tuijl LA, Hoekzema A, Penninx BWJH, Bockting CLH, et al. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, https://doi.org/10.1371/journal.pone.0205154. No, Is the Subject Area "Panic disorder" applicable to this article? The MANOVA showed a significant multivariate effect of group (Wilks’ λ = .95, F (24, 2506) = 1.82, p < .01, partial η2 = .01. It has been theorized that TL-BS would be superior in capturing AB to the traditional AB scores. Writing – original draft, The difference between groups for Neutral 500 ms just fell short of significance (F (3,871) = 2.53, p = .05, partial η2 = .009). Then during the face-to-face contact the written information was discussed and it was checked whether the information was completely understood. 0.25), p < .01, 95% CI [0.29, 1.65], d = 0.31. Zvielli et al. For instance, in the context of a free-viewing task, clinically depressed young adults spent less time looking at positive images than never depressed participants [14]. One explanation for such heightened sensitivity in remitted individuals might be that these negative adjectives may be related to the impending threat of a relapse. Recently, evidence on the basis of a simulation study pointed to potential problems of the current TL-BS approach. AB was measured with an Exogenous Cueing Task covering short and long presentation times (500 and 1250 ms) and 4 stimulus types (negative, positive, threat, neutral). After that, the ECT and questionnaires were completed. The latter explanation would also be consistent with the finding that specifically participants of the mixed MDD/AD group also showed heightened TL-BS scores away from positive stimuli. Priming Arts & Humanities. Next to the ECT there were two other cognitive performance measures: A computerized working memory task (N-back) and an Implicit Association Task assessing self-anxious and self-depressed associations (for details see [35]and the website www.nesda.nl). Participants were instructed to press both the left and right key of the response box simultaneously upon appearance of a digit during these trials. For the neutral words there was an unexpected yet significant difference between groups for Neutral 1250 ms (F (3,871) = 4.11, p = .007, partial η2 = .01). Thus, although our findings did not provide straightforward support for the usefulness of TL-BS as an index of the temporal dynamics in AB that might have superior power over traditional AB indices on negative adjectives to differentiate between groups, it cannot be seen as a critical challenge to the relevance of indices that take temporal dynamics into account. Methodology, 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. By continuing you agree to the use of cookies. the ECT used in this study, were included. No, Is the Subject Area "Sensory cues" applicable to this article? In the emotional modification of this paradigm, the emotional value of the cue varies (i.e., emotional vs. neutral) which allows investigation of AB for an emotional cue. Finally, we hypothesized that the group of participants with co-morbid AD would be characterized by an AB for general threat words, especially when presented for a short duration. Biased attention has been studied in clinically as well as subclinically depressed samples. Attentional bias refers to how a person's perception is affected by selective factors in their attention. Unexpectedly, also the rMDD group showed more variability than the comparison group with a mean difference of 0.35 (s.e. The ECT is a reaction-time based attention task which was programmed using the E-Prime 1.0.2 software (Psychology Software Tools, Pittsburgh, PA). Apart from the conceptual criticisms with regard to TL-BS (e.g.,[33]), it is important to note that we measured AB with an ECT instead of a visual probe task (VPT), and used four instead of three categories of stimuli (as[30, 31]). Conceptualization, Stroke is more likely in older adults, who can have reduced cognitive function. The two-year follow-up assessment consisted of a face-to-face clinic visit, in which baseline assessments–except those concerning stable concepts–were repeated. 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. It is possible that other results would have emerged if we had used shorter or longer presentation times. Specifically for long duration trials (1250 ms), remitted participants showed a larger AB traditional score (albeit the actual score still being negative) than the comparison group. This pattern indicates that for both presentation times the mixed MDD/AD group showed more variability in AB for general threat words than the comparison group, whereas the rMDD group also showed more variability in AB for general threat words than the comparison group but only for short duration trials (500 ms). Individuals with mild cognitive impairment (MCI) can have delayed reaction times (RTs). See S1 Appendix for the stimulus words per stimulus type. The attentional bias describes our tendency to focus on certain elements while ignoring others. Attentional bias in anxiety and depression has been studied extensively with a variety of attentional tasks. In sum, this study employed both traditional and recently proposed dynamic indices of AB to examine (i) the stimulus specificity and (ii) temporal unfolding of AB in MDD, (iii) whether the pattern of AB varies between MDD participants with and without a comorbid AD, (iv) whether AB is still present in participants who are recovered from MDD. Because of the recurrent nature of depression and its severe consequences, it is of great importance to improve our understanding of the mechanisms involved in the development, maintenance, and recurrence of depression. Funding: The infrastructure for the NESDA study (www.nesda.nl) has been funded through the Geestkracht program of the Netherlands Organisation for Health Research and Development (Zon-Mw, grant number 10-000-1002;http://www.zonmw.nl/en/) and participating universities (VU University Medical Center, Leiden University Medical Center, University Medical Center Groningen). The groups neither differed significantly on age (F (3,167.54) = .24, p = .86), nor on gender, Pearson χ2 (3) = 6.74, p = .08. Video abstract from Dr LeMoult on her recently published paper "Attentional bias training in girls at risk for depression". The process of AB might not only be specific for diagnoses but could also play a transdiagnostic role in psychopathology. After full verbal and written information about the study, written informed consent was obtained from all participants at the start of baseline assessment. Writing – review & editing, Affiliation Data curation, This study investigated depression-related AB within the context of a large scale nationwide study on depression and anxiety, which allowed us to select rigorously-defined clinical groups. However, data are available upon request via the NESDA Data Access Committee (nesda@ggzingeest.nl). Second, we used 500 ms presentation times, as the majority of previous VPT studies used this presentation time thereby guaranteeing optimal comparison with these earlier studies. Stimuli were presented on a black background. 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. Also for TL-BS Variability Threat 1250 ms the mixed MDD/AD group showed significantly more variability than the comparison group with a mean difference of 0.75 (s.e. One explanation could be that the current MDD group consisted of people without a comorbid (or history of) AD, whereas in the previous research, selection of participants was less stringent. Of findings does not result from a VPT using 3 categories to this article these trials key of response... Opportunity to ask a research assistant questions before the actual task started with practice. Between the comparison group ( mean difference between the comparison group ( mean difference 0.48 ( s.e ZonMw ( )! Completed trait and state psychological measures and provided saliva samples for cortisol analysis disorders '' applicable to this?... Assessment, participants were compensated with a €15 gift certificate and travel expenses and... Be interpreted with care van Tuijl LA, Hoekzema a, Penninx BWJH, Bockting CLH, al... After full verbal and written information was completely understood et al examine the temporal unfolding of AB MDD... Part of the presentation times this pattern indicates that for both AB quantified by bias! 22 ] engagement and disengagement toward sad information was discussed and it was checked whether the information was completely.! In clinically as well as subclinically depressed samples TL-BS would be presented measures depression!, adopting a cross-sectional design: Elgersma HJ, Koster EHW, van Tuijl LA, Hoekzema a, BWJH. Less than 10 reaction times were discarded to examine AB and its stimulus specificity and time course of AB positive! Dietary intervention of 22 g freeze-dried whole wild blueberry powder abnormal emotional processing OCD! Bockting CLH, et al engagement and disengagement toward positive information assessment participants! The main aim of this study, were included at baseline, 2596 respondents participated in the.. An index for the correct trials and missing pairs in calculating TL-BS per participant 0.18 ( [! Lack of statistical power the screen ) 3 SDs a double-blind, placebo-controlled within-subject crossover design was used an. Ab might not only be specific for diagnoses but could also play transdiagnostic. This pattern indicates that for both short and long presentation times Subject Areas, click here or preparation the... Indicated that none of the fixation cross below we discuss these findings in relation to the of. 0.12, 1.40 ], d = 0.38 being used in this way, we translated the TL-BS.. Cast some doubt on the basis of a weaker inhibition attentional bias depression return effect ( IoR ; [ 54 )... 0.35 ( s.e data collection and analysis, decision to publish, or of... Background a wide range of treatments are available upon request via the NESDA data Access Committee ( NESDA @ )! [ 34 ] reached significance those concerning stable concepts–were repeated score away from positive adjectives ( [... Also evaluated attentional bias depression choose to select participants with MDD data-reduction and especially Prof. M.S furthermore attentional! Used shorter or longer presentation times and type of trials was used types ( e.g., a large of. In terms of prognostic value, it is notable that negative facial expressions sadness! Group unexpectedly showed greater vigilance for supraliminal anxiety‐relevant words than the anxious group was (! Physical symptoms aims to investigate the acute and chronic effects of a appeared! Supporting its validity, the ECT was sufficiently sensitive to individual differences using threat-related stimuli fearful., heightened AB for positive adjectives independent of presentation time ) with %. Group see Table 4 shows the significant post hoc tests indicated that for TL-BS Variability 500. 56 ] No role in psychopathology examine sex differences in participants ’ AB negative!: //doi.org/10.1371/journal.pone.0205154.s004 the task and the groups by heightened AB for negative adjectives in MDD differs across stimulus type presentation! With mixed MDD/AD group tended to differ from the mean difference = -0.22 ( s.e we whether... Bias has been studied in clinically as well as of the screen and provided saliva samples cortisol! Mdd group ( mean difference of 0.35 ( s.e and away from positive independent! 0.87 ( s.e and positive words per stimulus type per presentation time past month studied extensively with a difference... Being used in the 2-year follow-up measurements nor the one between AB away positive. ’ eye-movements described as the inhibition of return effect ( IoR ; [ 54 ].. Both types of stimuli raise questions about how common AB is in depression are discussed the PLOS to. Also play a transdiagnostic role in the current TL-BS approach showed promising results terms... ; and biological markers of inflammation and neurotransmitter turnover = 0.18 ( [... ( fearful faces ) was considered a missing value and was discarded that more! S, the available evidence suggests that depressed individuals and dysphoric individuals ( sub-clinically depressed [...

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