Attentional biases to emotional information in clinical depression: A systematic and meta-analytic review of eye tracking findings

Suslow, Thomas; Hußlack, Anja; Kersting, Anette; Bodenschatz, Charlott Maria

doi:10.1016/j.jad.2020.05.140

Cited by 101 publications

(71 citation statements)

References 60 publications

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“…However, selecting individuals with an initial attention bias requires psychometrically-validated tasks and metrics, a well-debated issue in this area of research (Parsons et al, 2019) . In addition, we used modestly longer presentation times for stimuli in ABMT, which more closely matches free-viewing paradigms and the biases observed in those studies (Suslow et al, 2020). Consequently, the maintenance and disengagement biases observed in depressed individuals may have been better engaged with this training format;…”

Section: Resultsmentioning

confidence: 70%

“…Empirical work has supported these assertions. Meta-analyses have found that depressed adults exhibit biased attention for negative stimuli and preferential gaze for sad stimuli compared to healthy control individuals (Armstrong & Olatunji, 2012;Peckham et al, 2010;Suslow et al, 2020) . These biases in depression likely reflect difficulties disengaging from sad stimuli (e.g., Sanchez et al, 2013) and relatively late stage attentional processes (1000 ms onwards; De Raedt & Koster, 2010) .…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Attention Bias Modification Training for Depressed Adults: A Randomized Clinical Trial

Hsu¹,

Shumake²,

Caffey³

et al. 2020

Preprint

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Background: This study examined the efficacy Attention Bias Modification Training (ABMT) for the treatment of depression. Methods: In this randomized clinical trial, 145 adults (77% female, 62% white) with at least moderate depression severity (i.e., self-reported Quick Inventory of Depressive Symptomatology (QIDS-SR) ≥ 13) and a negative attention bias were randomized to active ABMT, sham ABMT, or assessments only. Training consisted of two in-clinic and three (brief) at-home ABMT sessions per week for four weeks (2,224 training trials total). The pre-registered primary outcome was change in QIDS-SR. Secondary outcomes were the 17-item Hamilton Depression Rating Scale (HRSD) and anhedonic depression and anxious arousal from the Mood and Anxiety Symptom Questionnaire (MASQ). Primary and secondary outcomes were administered at baseline and four weekly assessments during ABMT. Results: Intent-to-treat analyses indicated that, relative to assessment only, active ABMT significantly reduced QIDS-SR and HRSD scores by an additional 0.62 ± 0.23 (p = .008, d = -0.57) and 0.74 ± 0.31 (p = .021, d = -0.49) points per week. Similar results were observed for active vs sham ABMT: a greater symptom reduction of 0.44 ± 0.24 QIDS-SR (p = .067, d = -0.41) and 0.69 ± 0.32 HRSD (p = .033, d = -0.42) points per week. Sham ABMT did not significantly differ from the assessment-only condition. No significant differences were observed for the MASQ scales.Conclusion: Depressed individuals with at least modest negative attentional bias benefitted from active ABMT.

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Section: Resultsmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Efficacy of Attention Bias Modification Training for Depressed Adults: A Randomized Clinical Trial

Hsu¹,

Shumake²,

Caffey³

et al. 2020

Preprint

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“…Previous research using free-viewing tasks found evidence for increased attentional maintenance on negative facial expressions and reduced maintenance on positive facial expressions in depressed compared to healthy individuals [4,[50][51][52]. These results have largely been interpreted as depression-related attentional biases when it comes to EFEs.…”

Section: Discussionmentioning

confidence: 93%

“…Depression has further been associated with changes in allocation of attention toward EFEs. A recent review and meta-analysis of eye-tracking studies that analyzed gaze behavior of depressed and healthy individuals found evidence for biased attention [4]. Most of these studies used free-viewing paradigms, in which participants are presented with multiple EFEs at a time and the instruction is to view the pictures freely.…”

Section: Introductionmentioning

confidence: 99%

Efficient visual search for facial emotions in patients with major depression

et al. 2021

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Background Major depressive disorder has been associated with specific attentional biases in processing emotional facial expressions: heightened attention for negative and decreased attention for positive faces. However, using visual search paradigms, previous reaction-time-based research failed, in general, to find evidence for increased spatial attention toward negative facial expressions and reduced spatial attention toward positive facial expressions in depressed individuals. Eye-tracking analyses allow for a more detailed examination of visual search processes over time during the perception of multiple stimuli and can provide more specific insights into the attentional processing of multiple emotional stimuli. Methods Gaze behavior of 38 clinically depressed individuals and 38 gender matched healthy controls was compared in a face-in-the-crowd task. Pictures of happy, angry, and neutral facial expressions were utilized as target and distractor stimuli. Four distinct measures of eye gaze served as dependent variables: (a) latency to the target face, (b) number of distractor faces fixated prior to fixating the target, (c) mean fixation time per distractor face before fixating the target and (d) mean fixation time on the target. Results Depressed and healthy individuals did not differ in their manual response times. Our eye-tracking data revealed no differences between study groups in attention guidance to emotional target faces as well as in the duration of attention allocation to emotional distractor and target faces. However, depressed individuals fixated fewer distractor faces before fixating the target than controls, regardless of valence of expressions. Conclusions Depressed individuals seem to process angry and happy expressions in crowds of faces mainly in the same way as healthy individuals. Our data indicate no biased attention guidance to emotional targets and no biased processing of angry and happy distractors and targets in depression during visual search. Under conditions of clear task demand depressed individuals seem to be able to allocate and guide their attention in crowds of angry and happy faces as efficiently as healthy individuals.

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“…Unipolar depression is characterized by dysfunctional affective and cognitive processing 4 , including reduced executive functioning 5 , biased emotional processing 6 , and impaired reward processing 7 . Correspondingly, individuals with UD show aberrant activation during tasks which recruit these processes, including activation in the striatum, hippocampus, amygdala, orbitofrontal cortex, prefrontal cortex, insula, cingulate, and occipital cortex [8][9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

Aberrant levels of cortical myelin distinguish individuals with unipolar depression from healthy controls

Baranger

Halchenko

Satz

et al. 2021

Preprint

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The association of unipolar depression (UD), relative to healthy controls (HC), with cortical myelin is underexplored, despite growing evidence of associations with white matter tract integrity. We characterized cortical myelin in the 360 Glasser atlas regions using the T1w/T2w ratio in 39 UD and 47 HC participants (ages=19-44, 75% female). A logistic elastic net regularized regression with nested cross-validation and a subsequent linear discriminant analysis conducted on held-out samples were used to classify UD vs. HC. True-label model performance was compared against permuted-label model performance. Cortical myelin distinguished UD from HC with 68% accuracy (p<0.001; sensitivity=63.8%, specificity=71.5%). Consistently selected regions were located in the orbitofrontal cortex, anterior cingulate, extended visual, and auditory cortices, and showed statistically significant both decreases and increases in myelin levels in UD vs. HC. The patterns of cortical myelin in these regions may be a biomarker of UD.

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Attentional biases to emotional information in clinical depression: A systematic and meta-analytic review of eye tracking findings

Cited by 101 publications

References 60 publications

Efficacy of Attention Bias Modification Training for Depressed Adults: A Randomized Clinical Trial

Efficacy of Attention Bias Modification Training for Depressed Adults: A Randomized Clinical Trial

Efficient visual search for facial emotions in patients with major depression

Aberrant levels of cortical myelin distinguish individuals with unipolar depression from healthy controls

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