In this study, we tested the robustness of these earlier findings by comparing a large group of rMDD to never-depressed individuals with regard to their AB for positive and negative adjectives, as well as for general threat words. Overall, the researchers found that anxious individuals were significantly slower to respond to the target image when the distracting images were negative as opposed to when they were positive or neutral. 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. Interestingly, the results of this re-analysis showed that rMDD participants were characterized by higher levels of TL-BS, specifically increased variability, than non-depressed individuals. © 2020 The Author(s). 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. Median scores were computed for the different presentation times and type of trials (valid/invalid), for all stimulus types. During each trial, a white fixation cross was presented in the center of the screen. A Monte Carlo simulation study demonstrated that TL-BS indices could be prone to result in false positive group differences; the differences between groups might in fact reflect differences in mean RT and or differences in overall SD [33]. We replaced these outliers with the group mean for that index plus (or minus) 3 SDs. Priming Arts & Humanities. Importantly, previously depressed individuals spent more time looking at anxiety-relevant images during a free-viewing task (such as scenes of people being threatened with weapons, people with physical injuries, dangerous situations) than never depressed individuals [23]. The same fixed random order of trials was used for all participants to make the design more sensitive to individual differences. From a theoretical point of view, because individuals with depression did not exhibit AB, our results also seemingly challenge the claim that AB figures prominently in the maintenance of depression. 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. The current findings provide preliminary evidence indicating that individuals who were remitted from MDD show an AB for negative adjectives and seem more sensitive for general threat stimuli. Below we discuss these findings in relation to the key issues that this study aimed to address. 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. It seems plausible that the mixed results of AB studies in participants with MDD, rMDD and/or the mixed participants can be untangled using the temporal dynamics of AB. Non-response was considered a missing value and was discarded. Against predictions, there was no specific AB in the group of MDD, neither for negative nor for positive adjectives. Department of Research Support, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands, Roles For the other indices of threat stimuli there were no significant between group differences (Threat Away 500 ms F (3,734) = .62, p = .60 partial η2 = .003; Threat Towards 1250 ms F (3,734) = 1.89, p = .13, partial η2 = .008). Our results raise questions about how common AB is in depression. Where this bias occurs In addition, there are several important questions regarding AB that remain. 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). 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.) In addition, we included positive stimuli to test whether AB in MDD is not only characterized by enhanced attention for negative information but also an attenuated bias for positive information. Earlier research provided evidence indicating that it may be critical to take the time course of AB into consideration when examining the relevance of AB in the context of depression. However, findings concerning the presence of these biases in depression are mixed. [58, 59]). Bonferroni adjusted post hoc tests indicated that for TL-BS Variability Neutral 500 ms none of the groups differences were significant. After that, the ECT and questionnaires were completed. All other mean differences between groups were not statistically significant. Depression is associated with an increased focus on negative interpretations of events and negative biases in attention and memory. Implications of these results for research on selective attention in depression are discussed. Per presentation time and per stimulus type (e.g., positive), we calculated for each participant (i) the mean TL-BS Towards (the mean of the TL-BS scores that were higher than 0 ms indicating attention towards the stimuli [i.e., invalid trial RT was higher than valid trial RT]), (ii) mean TL-BS Away (the mean of the TL-BS scores that were lower than 0 indicating attention away from the stimuli [i.e., valid trial RT was higher than invalid trial RT]), (iii) the peak TL-BS Towards (maximum TL-BS indicating an AB toward target stimuli [i.e., invalid trial RT was higher than valid trial RT]), (iv) peak TL-BS Away (minimum TL-BS indicating attention away from target stimuli [i.e., valid trial RT was higher than invalid trial RT]), and (v) variability (reflects the degree of stability or temporal variability in the expression of attention toward and/or away over time, calculated by the standard deviation of TL-BS). Copyright © 2020 Elsevier B.V. or its licensors or contributors. In the process of translating we had to make pragmatic choices which might have been suboptimal; more generally the current task was not optimally suited to examine the relevance of TL-BS indices. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Attentional biases in depression: Relation to disorder severity, rumination, and anhedonia. For the correct trials and missing pairs in calculating TL-BS per stimulus type per presentation time, see S3 Appendix. 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]. In addition, many factors apart from AB may contribute to the development of MDD. The current study concerns secondary analyses and the number of participants available for the current analyses was thus not based on the initial power analysis that determined the sample size of the cohort that was included in NESDA. Data Availability: According to European law (AVG) data contain potentially identifying or sensitive patient information are restricted; our data involving clinical participants are not freely available in the manuscript, supplemental files, or in a public repository. The study was supported by ZonMw (OOG) (Grant 100000–2035). Yes We use cookies to help provide and enhance our service and tailor content and ads. Zvielli et al. Keywords: Attentional bias modification, Depression, Clinical trial Background A wide range of treatments are available for depression. Software, As such, a given trial was included in maximally two pairs maximum. here. Together the current pattern of findings regarding the threat trials is consistent with -and complements- previous studies showing that participants with AD are characterized by an AB for disorder-specific threat stimuli [53]. 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. The aims of attentional bias modification is to reduce anxiety by attenuating bias towards threatening information. In this way we were able to examine whether the pattern of AB in pure MDD participants differed from that in individuals with comorbid AD. This pattern indicates that for both presentation times the mixed MDD/AD group showed more variability on positive word trials than the comparison group. Whether Obsessive Compulsive Disorder (OCD) is associated with an increased attentional bias to emotive stimuli remains controversial. This study was conducted as part of the Netherlands Study of Depression and Anxiety (NESDA) [34], an ongoing multi-centre, longitudinal cohort study designed to examine the long-term course and consequences of anxiety and depressive disorders. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Attentional bias to negative information has been considered as a vulnerability factor for depression, enhancing susceptibility and maintenance of this disorder. The third aim of this study relates to the observation that MDD and AD often co-occur[26]. No, Is the Subject Area "Reaction time" applicable to this article? Validation, Because many patients with MDD have comorbid anxiety disorders, it is important to verify whether AB can indeed be attributed to MDD per se. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, https://doi.org/10.1371/journal.pone.0205154. In this way, we computed time series of TL-BS per participant. The MANOVA showed a significant multivariate effect of group (Wilks’ λ = .88, F (48, 2139) = 1.83, p < .001, partial η2 = .03). ; it was found that depression-related sad faces could well induce negative attentional bias in depression patients [1,28], whereas the threat stimuli associated 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. The groups neither differed significantly on age (F (3,167.54) = .24, p = .86), nor on gender, Pearson χ2 (3) = 6.74, p = .08. The mean of the median reaction times per stimulus type and the cue validity effects are displayed in Table 2 as a function of trial type (valid vs. invalid; short vs. long duration) and group. 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]. 0.25), p < .01, 95% CI [0.29, 1.65], d = 0.31. This prediction is based on the hypothesis that AB is a stable vulnerability factor that renders individuals vulnerable for the development of depression. 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). 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. Bayes factors analyses revealed that the present pattern of findings does not result from a lack of statistical power. To examine whether in line with predictions, the effect of group was mainly due to more extreme AB for threat in the mixed MDD/AD group we used Dunnett’s method for multiple comparisons (two sided). See S1 Appendix for the stimulus words per stimulus type. Objective To compare the attentional bias of depressed patients and non-depressed control subjects and examine the effects of age using eye-tracking technology in a free-viewing set of tasks. No, Is the Subject Area "Attention" applicable to this article? Investigation, The assessments started with the CIDI-interview. Table 4 shows the significant post hoc contrasts for the analyses of the traditional AB scores as well as of the TL-BS indices. 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. A similar pattern has been found in dysphoric individuals (sub-clinically depressed) [15, 16]. Copyright: © 2018 Elgersma et al. Trial types (e.g., a positive valid trial with 500 ms presentation time) with 40% errors or more were also excluded. After completing the assessment, participants were compensated with a €15 gift certificate and travel expenses. Formal analysis, With the advent of attentional bias modification techniques (Mathews & MacLeod, 2002), it became possible to modify attentional bias experimentally. We investigated both stimulus specificity and time course of AB in these groups, adopting a cross-sectional design. Bonferrroni adjustedpost hoc between group tests indicated that for the 1250 ms trials specifically the rMDD group showed a higher (less negative) AB score for negative adjectives than the comparison group without (a history of) MDD/AD (mean difference 9.07 ms (s.e. 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]. By continuing you agree to the use of cookies. Although there is evidence that attentional biases can be responsive to medications in nonclinical populations (e.g., [36], it has been argued that within the context of clinical populations differences in AB are due to improved clinical status rather than to a medical treatment effect per se [37]. In support of the view that AB in MDD is not merely due to comorbid anxiety disorders, one of the studies that was included in this meta-analysis showed that MDD participants with no comorbid panic disorder or social phobia (n = 88) displayed a stronger AB for sad faces (within the context of a visual probe study with happy, sad, and angry faces) than participants with only social phobia (n = 35) and participants without MDD or social phobia (n = 55) [13]. Several limitations of this study need to be considered. The mixed MDD/AD group showed a higher trial-level AB score away from positive adjectives (1250 ms) than the comparisons. This pattern of findings with regard to the threat stimuli is consistent with a vigilance-avoidance pattern that has been previously reported in the context of threat scenes (e.g., [57]). Statistical analyses were run on 96.24% of the data. The funding was given to the NESDA consortium. There was converging evidence indicating that individuals with mixed MDD/AD showed an AB for general threat words that reflected a vigilance-avoidance pattern. Although, the overall pattern as a function of group was quite similar for both types of indices there were also some notable exceptions: The AB for negative stimuli in rMDD that was only evident for the traditional index whereas the AB away from positive stimuli in the mixed group and the biases for threat stimuli were only evident for the TL-BS. Thus supporting its validity, the ECT was sufficiently sensitive to detect differences in participants’ AB for neutral versus disorder-relevant stimuli. [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 two-year follow-up assessment consisted of a face-to-face clinic visit, in which baseline assessments–except those concerning stable concepts–were repeated. We computed trial-level bias scores (TL-BS) based on the computational methodology of Zvielli et al. The main results using traditional AB scores were: (i) compared to those without a history of MDD or AD, there was no evidence for a difference in AB towards negative adjectives or away from positive adjectives in strictly defined clinical groups of MDD participants with or without a comorbid AD; (ii) specifically for longer duration trials (1250 ms), rMDD individuals showed higher (less negative) AB scores for negative adjectives than the no AD/MDD comparison group. Click through the PLOS taxonomy to find articles in your field. On the remaining trials, the preceding stimulus is presented at the opposite spatial location of the target and thus invalidly cues the target’s location (“invalid” trials). In addition, the mixed MDD/AD group showed higher and more variable trial-level AB scores away from short and towards longer presented general threat words together with a non-significant tendency to show less negative traditional AB scores for threat trials (500 ms) than the comparison group. This attentional bias feeds, reinforces, and prolongs depressive thought patterns, and serves as an underlying risk factor for depressive symptom onset and relapse. This is known as the inhibition of return effect (IoR;[54]). Validation, Writing – original draft, This involved a comparison of the AB index between each of the (sub)clinical groups and the comparison group [56]. 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. There has been empirical evidence supporting this assumption in recent studies[30, 31], and this was the reason why we calculated AB as a stable factor using the traditional AB score and as a temporal dynamic factor, using TL-BS. 0.16), p = .21, 95% CI [-0.27; 1.49], d = 0.13) showed significantly stronger variability than the comparison group. People with major depressive disorder (MDD) show an attentional bias in which they over-attend to negative information while often ignoring positive information. Thus, the current results for a well-defined clinical group of participants with MDD selected from a large multi-center sample did not corroborate previous research using a similar ECT in high versus low dysphoric students [24]. According to cognitive models of depression, selective attentional biases (ABs) for mood-congruent information are core vulnerability factors of depression maintenance. Such attentional bias occurs for both pictorial emo- tional stimuli [18, 20] and emotional words, and is related to maladaptive forms of emotional regulation in depression, such as increased rumination [22, 23] and a reduced use of reappraisal strategies [24, 25]. Stroke is more likely in older adults, who can have reduced cognitive function. 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. 0.32), p < .01, 95% CI [0.26; 1.83], d = 0.36. 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. were more revealing of attentional bias than were emotional words and scene images [27]. Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands, Roles 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). The instructions were presented on the computer and the task started with 10 practice trials. Depressive symptoms were assessed using the 30-item Inventory of Depressive Symptoms Self-Report version (IDS-SR) [40]. Data curation, Attentional disengagement toward sad information was not associated with brooding. [30], we calculated 5 indices of TL-BS based on the derived pairings for each stimulus type per 2 presentation times (40 TL-BS indices in total) which indicated individual differences in phasic bursts or “peaks” of AB expression, mean levels of TL-BS toward and away from target stimuli, and degree of TL-BS variability over time across the spectrum of AB (away, towards, or both). Stimuli were presented on a black background. 0.35), p = .42, 95% CI [-0.36; 1.34], d = 0.24) did not differ significantly from the comparison group. If a stimulus (a “cue”) precedes the target at the same spatial location, it is called a “valid” trial. 0.21), p < .001, 95% CI [0.23; 1.27], d = 0.40. To test whether differences in AB would be most pronounced when stimuli would be presented for a longer duration as was found in previous analogue research (e.g., [24]), we also included trials with 1250 ms presentation time. Data curation, Writing – review & editing, Affiliation 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]. 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. Supervision, 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. A study testing AB in dysphoric vs. non-dysphoric students showed that the AB for negative adjectives was especially prominent during relatively long presentation times (1500 ms), and absent during relatively short presentation times (250 ms) [24]. Writing – review & editing, Affiliation This attention bias of information processing plays a crucial role in the pathogenesis, maintenance, and development of depression (11, 12). In contrast to our hypotheses, there were no ABs for negative or positive information, regardless of the task and the groups. Data curation, Cues were 16 generally threatening words, 16 neutral words, 16 negative adjectives, and 16 positive adjectives (see Table 1). Methods: Attentional bias toward happy and sad faces in healthy (N = 26) and subclinically depressed individuals (N = 22) was assessed via a neuroimaging dot-probe attention task. 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). 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]. Participants were then given the opportunity to ask a research assistant questions before the actual task started. Table 6 gives a detailed description of the TL-BS indices Mean and Variability scores per stimulus type and presentation time. Baseline assessments started in September 2004. Only a few studies have looked at AB for threatening information in MDD. Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium, Roles Together, this pattern indicates that the mixed MDD/AD group showed larger AB scores towards shortly presented threat words as well as larger AB scores away from longer presented threat words than the comparison group. They were asked to ignore any other information that would be presented. The fourth aim of this study was to investigate AB in remitted depressed (rMDD) participants. 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]. 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. Writing – review & editing. 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]. Moreover, the traditional AB-index reflects differential responding to emotional versus neutral cue words, whereas the current TL-BS indices reflect differential responding to validly and invalidly cued trials for each of the cue word types separately. In line with this view, both currently depressed and rMDD individuals selectively attended to sad faces when measured with a dot-probe task [29], whereas healthy comparisons avoided sad faces and oriented toward the happy faces. The study was supported by Accare; institution for children- and adolescent psychiatry. We computed separate indices of AB for each of the presentation times (500 and 1250 ms). Because these processes might play a different role in MDD, it would be interesting in future research to use a task that is especially designed for this (e.g., the Attentional Response to Distal vs. Proximal Emotional Information) [60]. 3.35), p = .04, 95% CI [0.20, 17.93], d = 0.20) (see also Table 4 for all significant between group contrasts). This study aimed to examine the impact of oxytocin on attentional processes to social faces representing anger, disgust, and happiness in patients with anorexia nervosa. For all other AB scores there was no statistically significant between group difference; AB Negative 500 ms (F (3, 853) = 1.66, p = .17, partial η2 = .006), AB Positive 500 ms (F (3,853) = 0.86, p = .45, partial η2 = .003), AB Positive 1250 ms (F (3, 853) = 0.99, p = .39, partial η2 = .003), Threat 1250 ms (F (3, 853) = 1.63, p = .18, partial η2 = .006). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. https://doi.org/10.1371/journal.pone.0205154.t002. It focuses on possible attentional biases in depression, and whether such biases constitute a cognitive vulnerability factor to suffer from the disorder or, on the contrary, they reflect a feature associated exclusively with the clinical level of depression. If a participant gave the wrong number, also a rectangle with the words “missed digit!” in capitals appeared in the middle of the screen. The traditional AB scores were calculated using the formula suggested by Mogg et al.,[53]: Attentional bias score (AB score) = (median RT invalid emotional cue–median RT valid emotional cue)–(median RT invalid neutral cue–median RT valid neutral cue). In these trials, instead of a word cue, a digit appeared for 100 ms at the location of the fixation cross. To examine whether in line with predictions, the effect of group for the Threat AB score Presentation Time 500 ms that just fell short of the conventional level of significance was mainly due to more extreme AB for threat in the mixed MDD/AD group, we used Dunnett’s method (two sided) for multiple comparisons. However, systematic reviews point to limited efficacy in terms of remission, response rates and long-term effects for both pharmacological [1] … Methodology, Method. Fourth, some of the observed effects had a small effect size and might not easily replicate in smaller samples and some of the groups were relatively small, which implied that for some between group contrasts (e.g., MDD vs. comparison) the statistical power was insufficient to reliably detect differences in AB with moderate or small effect sizes.
Devilbiss Starting Line Cup, Basil Leaf Edge Curling Up, Light Mountain Natural Hair Color How To Use, Para 3 Lightweight Mods, How To Grow Jasmine From Cuttings In Tamil, Tactical Knives Australia, Garnier Color Sensation Snow Day Cocoa, Whirlpool Dryer Not Heating, Neutrons In Re-185, Arctic Fox Fun Facts, Scholar Of The Lost Trove Edh,