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Stroke is more likely in older adults, who can have reduced cognitive function. Keywords: Attentional bias modification, Depression, Clinical trial Background A wide range of treatments are available for depression. A few additional assessments, e.g. Yet, a recent analogue study showed that participants who reported both symptoms of anxiety and depression displayed an AB for emotional words, whereas participants who only reported heightened symptoms of depression did not [27]. Formal analysis, Neither the association between AB toward negative information and brooding nor the one between AB away from positive stimuli and anhedonia was significant. The difference between groups for Neutral 500 ms just fell short of significance (F (3,871) = 2.53, p = .05, partial η2 = .009). 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. 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). For the neutral words there was an unexpected yet significant difference between groups regarding TL-BS Neutral Towards 1250 ms, F (3,734) = 4.58, p = .003, partial η2 = .01. 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. Visualization, Bonferrroni adjusted post hoc tests tests indicated that none of the between group contrasts were statistically significant. All other mean differences between groups were not statistically significant. Unexpectedly, the group of remitted participants also showed evidence for a threat bias as indexed by heightened variability in AB for general threat words (1250 ms trials). See Table 5 for zero-order correlations. ... Attentional Bias Medicine & Life Sciences. Controls, non-depressed and depressed OCD patients … Methodology, We examined AB for sad and happy materials in three modified versions of the exogenous cueing task using scenes, facial expressions, and words. Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands, We compared three groups based on a semi-structured diagnostic interview and a depressive symptoms scale (BDI-II): 34 individuals with major depressive disorder (clinically depressed); 35 with a dysphoric mood but without the criteria of major depressive disorder (i.e., subclinically depressed), and 26 never been depressed individuals. than never depressed individuals [23]. 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. 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). e0205154. This study examined attentional bias to OC-relevant scenes using a visual search task. To the extent that one is willing to see less IoR (and thus less bias away from negative stimuli) as a stronger inclination to dwell on negative stimuli (cf. Writing – original draft, This attention bias of information processing plays a crucial role in the pathogenesis, maintenance, and development of depression (11, 12). [30]to examine the temporal dynamics of AB. For both short and long presentation times, participants were generally faster on invalid than on valid trials. Copyright: © 2018 Elgersma et al. 0.25), p < .01, 95% CI [0.29, 1.65], d = 0.31. All in all, the findings do not corroborate the view that an AB towards negative or away from positive adjectives is critically involved in currently depressed individuals. Cognitive theories emphasize the role biased processing of affective information has in the development and maintenance of depression [6, 7, 8, 9, 10]. Bonferrroni controlled post hoc between group contrasts indicated that for TL-BS Mean Positive 1250 ms Away the mean difference between the mixed MDD/AD group and the comparison group was 0.97 (s.e. No, Is the Subject Area "Anxiety disorders" applicable to this article? This involved a comparison of the AB index between each of the (sub)clinical groups and the comparison group [56]. The groups neither differed significantly on age (F (3,167.54) = .24, p = .86), nor on gender, Pearson χ2 (3) = 6.74, p = .08. 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. The third aim of this study relates to the observation that MDD and AD often co-occur[26]. Post-stroke depression increases the likelihood of adverse physical symptoms. Only for this AB index, the effect of group was significant (F (3,853) = 3.51, p = .01, partial η2 = .01). 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]. Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands, Roles Methodology, Because many patients with MDD have comorbid anxiety disorders, it is important to verify whether AB can indeed be attributed to MDD per se. There was a non-significant trend for AB Threat 500 ms (F (3, 853) = 2.32, p = .07, partial η2 = .008). Attentional bias refers to how a person's perception is affected by selective factors in their attention. According to cognitive models of depression, selective attentional biases (ABs) for mood-congruent information are core vulnerability factors of depression maintenance. The assessments at baseline and follow-up were largely similar; they lasted between 3 and 5 hours and were conducted on one day. It would be important for future research to test whether attentional biases for negative adjectives and/or general threat stimuli are predictive for the recurrence of depression. In contrast to our hypotheses, there were no ABs for negative or positive information, regardless of the task and the groups. Attentional disengagement toward sad information was not associated with brooding. This study aims to investigate the acute and chronic effects of a dietary intervention of 22 g freeze-dried whole wild blueberry powder. Competing interests: The authors have declared that no competing interests exist. The negative and positive adjectives were selected from trait self-descriptors of depressive and manic persons, which were used in a study on AB in depression [47]. Of the 2128 participants, we selected four subgroups: Group 1 (MDD) consisted of participants diagnosed with a current (in the last month) MDD, but without dysthymia and without a current AD or history of ADs (n = 29; 1.36%); Group 2 (mixed MDD/AD) consisted of participants diagnosed with a current (in the last month) major depressive disorder and a current anxiety disorder, but without dysthymia (n = 86; 4.04%); Group 3 (rMDD) consisted of participants with a history of MDD, but no current MDD nor dysthymia (in the last six months) and no current or history of anxiety disorders (n = 294; 13.81%); Group 4 (comparisons) consisted of healthy comparisons without a lifetime history of either anxiety or depressive disorders (n = 474; 22.27%) [35]. However, it is notable that negative facial expressions include sadness, surprise, anger, etc. When a participant gave a wrong response, a red rectangle with the word wrong in capitals appeared for 500 ms in the middle of the screen. 0.41), p = .95, 95% CI [-0.81; 1.18], d = 0.08) nor the rMDD group (mean difference 0.28 (s.e. Attentional bias in anxiety and depression has been studied extensively with a variety of attentional tasks. https://doi.org/10.1371/journal.pone.0205154.t005. The target was presented until a response was made. The mixed MDD/AD group showed a higher trial-level AB score away from positive adjectives (1250 ms) than the comparisons. In line with the approach of Zvielli et al. Stroebe for her helpful comments and suggestions. Neither the MDD group (mean difference 0.18 (s.e. 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. Whether Obsessive Compulsive Disorder (OCD) is associated with an increased attentional bias to emotive stimuli remains controversial. In addition, for both presentation times the mixed MDD/AD group showed more variability in AB scores for general threat words than the comparison group which may be interpreted as further evidence for a heightened sensitivity for threat stimuli (cf. Zvielli et al. Previously depressed individuals and dysphoric individuals spent less time looking at positive images than never-depressed persons. Neither the MDD group (mean difference = -0.22 (s.e. 0.52), p = .96, 95% CI [-1.47; 1.01], d = 0.07) nor the rMDD group (mean difference 0.18 (s.e. https://doi.org/10.1371/journal.pone.0205154.t006. Negative attentional bias in depression — the tendency of depressed individuals to focus on negative stimuli and thoughts more than healthy individuals — has been the subject of research spanning multiple decades, much of it seeking to explain why the bias is not always observed [1, 2, 3]. 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 hypothesized that rMDD individuals may still be characterized by an AB towards negative and away from positive stimuli. To stay as close to the concept of TL-BS Variability as possible, we eventually decided to use the standard deviation of TL-BSs to index variability in TL-BS. 0.13), p < .03, 95% CI [0.02; 0.68], d = 0.18 (see Table 4). At baseline, a total of 748 (25.1% of the total sample) respondents were using antidepressants [34]. 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. Writing – review & editing, Affiliation Data were drawn from the large scale Netherlands Study of Depression and Anxiety (NESDA), from which we selected all participants with pure current MDD without a history of AD (n = 29), all participants with current MDD and co-morbid AD(s) (n = 86), all remitted MDD participants (n = 294), and a comparison group without (a history of) MDD or ADs (n = 474). Citation: Elgersma HJ, Koster EHW, van Tuijl LA, Hoekzema A, Penninx BWJH, Bockting CLH, et al. were more revealing of attentional bias than were emotional words and scene images [27]. 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 outcomes include measures of depression, anxiety, and anhedonia; cognitive tests; and biological markers of inflammation and neurotransmitter turnover. Such heightened sensitivity for negative stimuli might well lower the threshold for entering a negative spiral ending up in the recurrence of depression. Accordingly, a large body of literature has examined threat-related attentional bias in relation to symptoms of anxiety and depression. 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. © 2020 The Author(s). 0.25), p < .01, 95% CI [0.27; 1.49], d = 0.38. Directly after responding, the next trial started. For the correct trials and missing pairs in calculating TL-BS per stimulus type per presentation time, see S3 Appendix. Attentional biases may explain an individual's failure to consider alternative possibilities when occupied with an existing train of thought. Cues were 16 generally threatening words, 16 neutral words, 16 negative adjectives, and 16 positive adjectives (see Table 1). During each trial, a white fixation cross was presented in the center of the screen. 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. Several limitations of this study need to be considered. Discover a faster, simpler path to publishing in a high-quality journal. All other between group contrasts for AB Negative 1250 ms did not reach significance. Methods Patients with major depressive disorder (MDD) and non-depressed control subjects completed an eye-tracking task to assess attention of processing negative, positive and neutral facial expressions. Both traditional and trial level (dynamic) AB scores failed to show an AB for negative adjectives in participants with MDD or mixed MDD/AD. here. In addition, an earlier study using a visual probe task depicting words, found that participants who were diagnosed with Dysthymia or MDD showed an AB for socially threatening words [19]. 0.37), p = .29, 95% CI [-.29; 1.49], d = 0.29) nor the rMDD group (mean difference 0.20 (s.e. 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. 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. Conceptualization, Thus supporting its validity, the ECT was sufficiently sensitive to detect differences in participants’ AB for neutral versus disorder-relevant stimuli. 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. 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. An incorrect response was also discarded. This study was designed to examine selective processing of emotional information in depression. Taken together, the available evidence suggests that depressed individuals are characterized by heightened AB for negative information and lowered AB for positive information. Data curation, Trial types (e.g., a positive valid trial with 500 ms presentation time) with 40% errors or more were also excluded. Table 6 gives a detailed description of the TL-BS indices Mean and Variability scores per stimulus type and presentation time. 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]. For the positive adjectives the between subject tests indicated a significant difference between groups for Positive Towards 500 ms F (3,734) = 3.74, p = .01, partial η2 = .01; Positive Towards 1250 ms F (3,734) = 3.04, p = .02, partial η2 = .01, and for Positive Away 1250 ms F (3,734) = 6.21, p < .001, partial η2 = .02. To the extent that these factors do not exert their influence via attentional bias, this may have reduced the sensitivity of the current study to find between group differences in AB. [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). Against predictions, there was no specific AB in the group of MDD, neither for negative nor for positive adjectives. Each trial started with the presentation of the fixation cross and the two placeholders for 500 ms. Next, a word cue was presented in the left or right placeholder, for 500 ms (short presentation time) or 1250 ms (long presentation time). It is noteworthy, though, that the current sample size is an improvement on many of the previous studies. We examined attentional bias (AB) for negative and positive adjectives and general threat words in strictly-defined clinical groups of participants with pure Major Depressive Disorder (MDD) without a history of anxiety disorders (AD), mixed MDD and AD, and remitted participants. In this way, we computed time series of TL-BS per participant. Resources, 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. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, https://doi.org/10.1371/journal.pone.0205154. Negative attentional bias has been well established in depression. Given the stimulus onset asynchrony used in the current study (500 and 1250 ms), negative cue validity effects were to be expected. 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. 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]. We matched each invalid trial with a subsequently presented valid trial (thus, in a single direction from the beginning to the end of the task), temporally as close as possible and no further than 9 trials away from each other, for each stimulus type. Baseline assessments started in September 2004. Interestingly, the rMDD group showed reduced inhibition of return for negative adjectives (and thus less bias away from negative adjectives) than the comparison group as reflected in higher (less negative) traditional AB scores than the comparison group. Supervision, The concept of attentional bias (AB) toward mood-congruent stimuli refers to a differential allocation of attentional resources toward emotional stimuli (e.g., sad faces) compared to neutral stimuli (e.g., neutral faces…

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