Interpreting ambiguous emotional information: Convergence among interpretation bias measures and unique relations with depression severity

Hypnotically enhancing behavioral activation in the treatment of depression

Depressive disorders are common conditions associated with high personal and economic burdens. The best treatment outcomes occur in patients receiving both psychotherapy and antidepressant medications. Behavioral activation is one approach within the most widely available and studied psychotherapy frameworks (cognitive behavioral therapy, CBT) utilized for depression, and is effective in treating depression even in isolation from the rest of the CBT approach. Many hypnosis treatments for depression have been developed to incorporate various CBT techniques, including behavioral activation. However, research regarding the applications of hypnosis to facilitate behavioral activation has been slow to emerge. Addressing this relative gap in the literature may be possible through a broader review of the relevant literature. There is quality evidence speaking to the efficacy of diverse clinician-guided visualization or imagery exercises in the treatment of depression by means of behavioral activation. While not explicitly hypnosis, the similarities of these interventions to more typical hypnosis interventions are highly salient. Clinicians and researchers interested in hypnosis's applications to treating depression would benefit from adopting a more comprehensive consideration of the relevant literature.

Dissociation of Implicit and Explicit Interpretation Bias: The Role of Depressive Symptoms and Negative Cognitive Schemata

A negative interpretation bias appears to depend on several depression-related state and trait characteristics, most notably depressive symptoms, negative mood, and negative cognitive schemas. While empirical findings for explicitly assessed interpretation bias are rather consistent, implicit measures have revealed heterogeneous results. In this context, we present two studies investigating the relationship between implicit and explicit interpretation bias and depression- and anxiety-related state and trait variables. In the first study, we conducted an implicit ambiguous cue-conditioning task (ACCT) with 113 young, healthy individuals. In the second study, we utilized an explicit ambiguous social situations task (DUCTUS) with 113 young, healthy individuals. Additionally, a subsample of 46 participants completed both the ACCT and DUCTUS tasks to directly relate the two bias scores obtained from the implicit and explicit assessment methods, respectively. In the first study, regression analysis revealed no significant predictors for the implicit interpretation bias. However, in the second study, the explicit negative interpretation bias was significantly predicted by female gender, depressive symptoms, and dysfunctional cognitive schemas. For the subsample that completed both tasks, we observed no significant correlation between the two bias scores obtained from the ACCT and DUCTUS. These results suggest that implicit and explicit interpretation biases are differently associated with depression-related trait and state characteristics, indicating that they represent different aspects of biased information processing.

Negative interpretation bias as a clinical marker and a scar of depression: New insights from a large-scale study of the scrambled sentence task in formerly, subclinically and clinically depressed individuals

Negative interpretation biases are thought to be clinical markers of depression and risk factors for its recurrence that would remain active after remission. Evidence on the conditions under which negative interpretation biases are active after remission is still unclear, and further studies are required to clarify whether negative interpretation biases are equivalent in magnitude at different depression conditions. A large-scale study of the Scrambled Sentence Task (SST) was conducted (639 participants), where different depression and never-depressed samples were compared in their performance in the SST through three experiments (i.e., formerly - Studies 1 and 2 -, subclinically - Study 2 - and clinically depressed individuals - Study 3 -). Cognitive load manipulations were used while completing the task. Formerly compared to never-depressed individuals showed higher negative interpretation biases at conditions of cognitive load only (Study 1). Formerly and subclinically depressed showed equivalent biases compared to never-depressed individuals (Study 2). Negative interpretation biases were further supported for clinically depressed (Study 3). Comparative analyses showed that both formerly and subclinically differed from clinically depressed individuals in their negative bias magnitude. These results prove the utility of the SST to detect negative interpretation biases in different depression conditions, including those recovered from depression. Results further show that negative bias magnitudes tend to decrease after remission but remain at subclinical levels, potentially conferring risk for depression recurrence.

Development and psychometric evaluation of a scrambled sentences test specifically for worry in individuals with generalised anxiety disorder

The tendency to draw negative conclusions from ambiguous information (interpretation bias) is prevalent across emotional disorders and plays a key role in the development and maintenance of pathological worry and anxious mood. Assessing interpretation bias using valid and reliable measures is central to empirical research. A commonly used measure of interpretation bias is the scrambled sentences test (SST), originally relating to depression. Given the association between interpretation bias and worry, we aimed to develop and psychometrically evaluate a new version of the SST with items pertaining to common worry domains for use in worry and anxiety research. In Studies 1-3 (analogue samples, combined N = 288), the new worry SST showed excellent construct validity (moderate-to-strong associations with worry and anxiety-related measures), and reliability (split-half and test-retest reliability). We confirmed construct validity in Study 4 (N = 215 individuals with generalised anxiety disorder). Furthermore, we demonstrated version specificity in analogue and clinical samples: the worry SST was associated with trait worry but not trait rumination, while the original depression SST largely showed the opposite pattern. Overall, the new worry SST is a psychometrically robust measure that may be especially useful for research into cognitive processes underpinning worry and anxiety.

Scrambled but valid? The scrambled sentences task as a measure of interpretation biases in psychopathology: A systematic review and meta-analysis

The Scrambled Sentences Task (SST) is frequently used to assess interpretation biases (IBs). However, neither the range of its applications nor the quality of the empirical evidence it provides has been systematically examined. This systematic review investigates the types of samples and disorders in which the SST has been applied and evaluates its psychometric properties via a meta-analysis. The databases PubMed and EBSCOhost (including PsycINFO, PsycARTICLES, PSYNDEX, MEDLINE) were examined (last search: September 2021) and 93 studies from 91 manuscripts were included. Results showed that the SST has been applied predominantly in unselected samples or those with elevated levels of subsyndromal symptoms, with about a third of the studies employing the SST in a clinical population. While the SST was initially developed to assess depression-related IBs, it has now been extended to other disorders, in particular anxiety disorders. Results of the meta-analyses indicated good convergent validity and reliability across disorders, albeit in the context of substantial heterogeneity. Findings concerning divergent validity were mixed with high correlations across disorders between the SST and trait anxiety in particular, questioning its specificity. Future research should consider developing standardized SST versions and investigating its relationships with other measures of IB.

Disentangling the mediating role of modifying interpretation bias on emotional distress using a novel cognitive bias modification program

BACKGROUND

Negative interpretation bias is a potential risk factor for emotional disorders. In this study, we tested a clinically inspired 4-session online Cognitive Bias Modification-Interpretation (CBM-I_Clin) program to modify negative interpretation biases.

METHODS

We randomized one hundred and twenty-one volunteer young adults (Mean age = 21.6 years, SD = 3.5; 85 % women) with varying levels of emotional distress to either an experimental or waitlist control group. Mediation analyses were used to disentangle the associations between the intervention, changes in interpretation biases (assessed by both a self-report and an experimental task), and changes in measures of cognitive vulnerability and symptoms of depression and anxiety.

RESULTS

The results showed that the CBM-I_Clin could change negative interpretation biases. Also, it had a direct effect on the change in negative memory bias, an indirect effect on the change in depression symptoms via the change in interpretation bias, and both direct and indirect effects on the change in self-reported dysfunctional attitudes.

LIMITATIONS

The study included a non-clinical sample of participants and it did not control for some potential confounding factors (e.g., attentional disorders). Furthermore, participants' engagement during the sessions at home was not supervised.

CONCLUSIONS

The CBM-I_Clin is a potential tool to prevent and intervene in emotional disorders in young adults and could complement other traditional CBM procedures or clinical interventions.