Emotional recognition training modifies neural response to emotional faces but does not improve mood in healthy volunteers with high levels of depressive symptoms

Abstract

Background There is demand for new, effective and scalable treatments for depression, and development of new forms of cognitive bias modification (CBM) of negative emotional processing biases has been suggested as possible interventions to meet this need. Methods We report two double blind RCTs, in which volunteers with high levels of depressive symptoms (Beck Depression Inventory ii (BDI-ii) > 14) completed a brief course of emotion recognition training (a novel form of CBM using faces) or sham training. In Study 1 (N = 36), participants completed a post-training emotion recognition task whilst undergoing functional magnetic resonance imaging to investigate neural correlates of CBM. In Study 2 (N = 190), measures of mood were assessed post-training, and at 2-week and 6-week follow-up. Results In both studies, CBM resulted in an initial change in emotion recognition bias, which (in Study 2) persisted for 6 weeks after the end of training. In Study 1, CBM resulted in increases neural activation to happy faces, with this effect driven by an increase in neural activity in the medial prefrontal cortex and bilateral amygdala. In Study 2, CBM did not lead to a reduction in depressive symptoms on the BDI-ii, or on related measures of mood, motivation and persistence, or depressive interpretation bias at either 2 or 6-week follow-ups. Conclusions CBM of emotion recognition has effects on neural activity that are similar in some respects to those induced by Selective Serotonin Reuptake Inhibitors (SSRI) administration (Study 1), but we find no evidence that this had any later effect on self-reported mood in an analogue sample of non-clinical volunteers with low mood (Study 2).

Emotional bias training as a treatment for anxiety and depression: Evidence from experimental medicine studies in healthy and medicated samples

“…Here we report two studies that investigated the effectiveness of EBT when remotely delivered as a digital therapeutic, in both healthy participants and individuals currently taking SSRIs for anxiety or depression. In both, EBT was successful in producing lasting positive changes in facial emotion perception, with effects comparable to those found in laboratory-based studies (Penton-Voak et al, 2012, 2020. These changes have previously been shown to transfer to novel faces (Dalili et al, 2017), suggesting that a short course of EBT has the potential to influence participants' wider social encounters.…”

“…A recent neuroimaging study found that EBT alters emotional processing by increasing neural activation in response to happy facial expression (Penton-Voak et al, 2020). After five sessions, participants showed increased activity in the medial prefrontal cortex and bilateral amygdala when viewing a novel set of happy faces.…”

Emotion processing in depression and anxiety disorders in older adults: systematic review

“…Indeed, packages of emotion recognition training are being developed to address this issue (e.g. the study by Penton-Voak et al 78 ).…”

Examining the bidirectional association between emotion recognition and social autistic traits using observational and genetic analyses

“…However, the direction of effect is unclear; social autistic traits may contribute to deficits in emotion recognition, or these deficits may contribute to, or exacerbate social autistic traits. Since emotion recognition is a potentially modifiable target (Penton‐Voak et al., 2020 ; Penton‐Voak, Bate, Lewis, & Munafò, 2012 ; Rawdon et al., 2018 ), a better understanding of its relationship with ASD and social autistic traits, including the direction of association, may help inform management and treatment of ASD.…”