Is There a Negative Interpretation Bias in Depressed Patients? An Affective Startle Modulation Study

Abstract

Background/Aims: Scientists proposed that patients with depression favour negative interpretations when appraising ambiguity. As self-report measures seem prone to response bias, implicit measures of emotional valence should be additionally used. Methods: A total of 16 patients with depression and 19 controls underwent an acoustic imagery task comprising neutral and negative words, as well as ambiguous words that could be understood either way. Affective startle modulation and direct interrogation were used to assess implicit and explicit emotional valence, respectively. We expected a negative bias for ambiguous words in the patient group, resulting in augmented startle magnitudes and preference for negative interpretations of the ambiguous words in the interrogation. Results: Surprisingly, both groups preferred neutral interpretations and showed augmented startle magnitudes to ambiguous words. Furthermore, both groups displayed an emotional startle potentiation for negative words. Conclusion: In summary, our results do not confirm a negative interpretation bias or a blunted emotional response in patients with major depression. The mismatch between self-report and affective startle reaction to ambiguous targets might reflect defensive mobilization or attention effects.

Cognitive bias modification for depression

“…While early studies have provided mixed evidence for the existence of a depressive interpretation bias (selective generation and selection of negative rather than positive interpretations), recent studies have more consistently demonstrated its legitimacy using a broad range of assessment techniques ( [8,22,23), but see [24]). Accordingly, there has been a recent increase in studies investigating the potential of CBM techniques targeting appraisal processes (CBM-I) as an intervention for depression.…”