Interpretation bias characterizes trait rumination

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.

Wellness of patients with chronic pain is not only about pain intensity

OBJECTIVE

Attaining good outcomes in the management of chronic pain remains a clinical challenge. This study aimed to investigate the relationships between - and the contribution of - pain and related conditions to the wellness of these patients.

DESIGN

A secondary analysis of database of patients with chronic pain treated with medical cannabis (MC) to carry out a one-year prospective follow-up study was conducted. Questionnaires were completed before (T₀ ), six (T₆ ), and twelve (T₁₂ ) months after MC initiation. Data included patients' demographics and questionnaires related to three latent factors: pain intensity measures, related conditions (catastrophizing, sleep disturbance, anxiety, and depression), and wellness parameters (quality-of-life, disability, subjective-health-state). Weighted average of the observed variables (WOBs) were calculated for each latent factor. Longitudinal structural equation modeling (SEM) and mediation analyses were performed to identify predictors and interrelations between the WOBs, respectively.

RESULTS

Participants included 510 patients. All variables were significantly improved from T₀ to T₆ and T₁₂ . SEM revealed that related conditions, and to a lesser extent pain, predicted wellness at T₀ , T₆ , and T₁₂ (related conditions: β₀  = 0.55, p < 0.001; β₆  = 0.54, p < 0.001; and β₁₂  = 0.51, p < 0.001; pain: β₀  = 0.42, p < 0.001; β₆  = 0.18, p < 0.001; and β₁₂  = 0.25, p < 0.001). Mediation analyses demonstrated that the effect of WOB-related conditions was greater than WOB-pain on wellness.

CONCLUSION

Wellness of patients with chronic pain can be determined not only by pain itself but even more so by the severity of related conditions. Thus, considering a broad spectrum of pain measures and related conditions seems relevant for improving the wellness of patients with chronic pain.

Social anxiety and rumination in the context of the revised reinforcement sensitivity theory and the mediation model of social anxiety

The aim of this study was to examine the relationship between temperament, ruminative thought style and social anxiety using latent variable modeling. Before examining the integrated model that specifies the relations between the constructs, relevant measurement issues were examined. The study was conducted on a heterogeneous sample from the general population that included 1,029 participants (62.1% female) aged 19 to 79. The findings show that the Behavioural Inhibition System is the most important vulnerability factor for the development of social anxiety, and it has both a direct effect and an indirect one through the ruminative thought style. Also, Freeze has an additional contribution to the increased experience of social anxiety. The Behavioural Approach System has complex effects on social anxiety ? with a direct protective effect, and indirectly ? with a facilitation of the ruminative thought style. Thus, BAS can also act as a risk factor. The findings support the revised Reinforcement Sensitivity Theory and provide a basis for the extension of the Kimbrel?s Mediation Model of Social Anxiety.

An Online Assessment to Evaluate the Role of Cognitive Biases and Emotion Regulation Strategies for Mental Health During the COVID-19 Lockdown of 2020: Structural Equation Modeling Study

BACKGROUND

Extant research supports causal roles of cognitive biases in stress regulation under experimental conditions. However, their contribution to psychological adjustment in the face of ecological major stressors has been largely unstudied.

OBJECTIVE

We developed a novel online method for the ecological examination of attention and interpretation biases during major stress (ie, the COVID-19 lockdown in March/April 2020) and tested their relations with the use of emotion regulation strategies (ie, reappraisal and rumination) to account for individual differences in psychological adjustment to major COVID-19-related stressors (ie, low depression and anxiety, and high well-being and resilience).

METHODS

Participants completed an online protocol evaluating the psychological impact of COVID-19-related stressors and the use of emotion regulation strategies in response to them, during the initial weeks of the lockdown of March/April 2020. They also completed a new online cognitive task designed to remotely assess attention and interpretation biases for negative information. The psychometric properties of the online cognitive bias assessments were very good, supporting their feasibility for ecological evaluation.

RESULTS

Structural equation models showed that negative interpretation bias was a direct predictor of worst psychological adjustment (higher depression and anxiety, and lower well-being and resilience; χ²₉=7.57; root mean square error of approximation=0.000). Further, rumination mediated the influence of interpretation bias in anxiety (P=.045; 95% CI 0.03-3.25) and resilience (P=.001; 95% CI -6.34 to -1.65), whereas reappraisal acted as a mediator of the influence of both attention (P=.047; 95% CI -38.71 to -0.16) and interpretation biases (P=.04; 95% CI -5.25 to -0.12) in well-being.

CONCLUSIONS

This research highlights the relevance of individual processes of attention and interpretation during periods of adversity and identifies modifiable protective factors that can be targeted through online interventions.

Emotion Regulation as a Mediator in the Relationship Between Cognitive Biases and Depressive Symptoms in Depressed, At-risk and Healthy Children and Adolescents

Contemporary cognitive models of depression propose that cognitive biases for negative information at the level of attention (attention biases; AB) and interpretation (interpretation biases; IB) increase depression risk by promoting maladaptive emotion regulation (ER). So far, empirical support testing interactions between these variables is restricted to non-clinical and clinical adult samples. The aim of the current study was to extend these findings to a sample of children and adolescents. This cross-sectional study included 109 children aged 9–14 years who completed behavioural measures of AB (passive-viewing task) and IB (scrambled sentences task) as well as self-report measures of ER and depressive symptoms. In order to maximize the variance in these outcomes we included participants with a clinical diagnosis of depression as well as non-depressed youth with an elevated familial risk of depression and non-depressed youth with a low familial risk of depression. Path model analysis indicated that all variables (AB, IB, adaptive and maladaptive ER) had a direct effect on depressive symptoms. IB and AB also had significant indirect effects on depressive symptoms via maladaptive and adaptive ER. These findings provide initial support for the role of ER as a mediator between cognitive biases and depressive symptoms and provide the foundations for future experimental and longitudinal studies. In contrast to studies in adult samples, both adaptive as well as maladaptive ER mediated the effect of cognitive biases on depressive symptoms. This suggests potentially developmental differences in the role of ER across the lifespan.

When negative interpretations persist, positive emotions don't! Inflexible negative interpretations encourage depression and social anxiety by dampening positive emotions

Research on emotion regulation difficulties has been instrumental in understanding hallmark features of depression and social anxiety. Yet, the cognitive mechanisms that give rise to maladaptive patterns of emotion regulation strategy use remain underspecified. This investigation examined the association of negative interpretation inflexibility and interpretation biases with the use of common emotion regulation strategies in response to negative and positive emotional experiences (repetitive negative thinking, positive reappraisal, and dampening). Study 1 (N = 250) found that inflexibility in revising negative interpretations in response to disconfirmatory positive information was related to the dampening of positive emotions, but not to repetitive negative thinking or positive reappraisal. Importantly, dampening mediated the relation between inflexible negative interpretations and symptoms of both depression and social anxiety. This mediation model was further supported by the data from Study 2 (N = 294). Across both studies, negative interpretation bias was related to repetitive negative thinking and dampening, whereas positive interpretation bias was related to positive reappraisal. Collectively, these results suggest that both interpretation inflexibility and interpretation biases may contribute to difficulties in emotion regulation related to depression and social anxiety.

Hostile attribution bias and angry rumination: A longitudinal study of undergraduate students

Angry rumination and hostile attribution bias are important cognitive factors of aggression. Although prior theoretical models of aggression suggest that aggressive cognitive factors may influence each other, there are no studies examining the longitudinal relationship between angry rumination and hostile attribution bias. The present study used cross-lagged structural equation modeling to explore the longitudinal mutual relationship between hostile attribution bias and angry rumination; 941 undergraduate students (38.5% male) completed questionnaires assessing the variables at two time points. The results indicate that hostile attribution bias showed a small but statistically significant effect on angry rumination 6 months later, and angry rumination showed a quite small but marginally significant effect on hostile attribution bias across time. The present study supports the idea that hostile attribution bias influences angry rumination, and argue that the relationship between angry rumination and hostile attribution bias may be mutual. Additionally, the results suggest that there may be a causal relation of different aggression-related cognitive factors.

A Systematic Review of Experimental Paradigms for Exploring Biased Interpretation of Ambiguous Information with Emotional and Neutral Associations

Interpretation biases have been extensively explored in a range of populations, including patients with anxiety and depressive disorders where they have been argued to influence the onset and maintenance of such conditions. Other populations in which interpretation biases have been explored include patients with chronic pain, anorexia nervosa, and alcohol dependency among others, although this literature is more limited. In this research, stimuli with threatening/emotional and neutral meanings are presented, with participant responses indicative of ambiguity resolution. A large number of paradigms have been designed and implemented in the exploration of interpretation biases, some varying in minor features only. This article provides a review of experimental paradigms available for exploring interpretation biases, with the aim to stimulate and inform the design of future research exploring cognitive biases across a range of populations. A systematic search of the experimental literature was conducted in Medline, PsychINFO, Web of Science, CINAHL, and Cochrane Library databases. Search terms were information, stimuli, and ambiguous intersected with the terms interpretation and bias*. Forty-five paradigms were found, categorized into those using ambiguous words, ambiguous images, and ambiguous scenarios. The key features, strengths and limitations of the paradigms identified are discussed.

Annual Research Review: Transdiagnostic neuroscience of child and adolescent mental disorders--differentiating decision making in attention-deficit/hyperactivity disorder, conduct disorder, depression, and anxiety

BACKGROUND

Ineffective decision making is a major source of everyday functional impairment and reduced quality of life for young people with mental disorders. However, very little is known about what distinguishes decision making by individuals with different disorders or the neuropsychological processes or brain systems underlying these. This is the focus of the current review.

SCOPE AND METHODOLOGY

We first propose a neuroeconomic model of the decision-making process with separate stages for the prechoice evaluation of expected utility of future options; choice execution and postchoice management; the appraisal of outcome against expectation; and the updating of value estimates to guide future decisions. According to the proposed model, decision making is mediated by neuropsychological processes operating within three domains: (a) self-referential processes involved in autobiographical reflection on past, and prospection about future, experiences; (b) executive functions, such as working memory, inhibition, and planning, that regulate the implementation of decisions; and (c) processes involved in value estimation and outcome appraisal and learning. These processes are underpinned by the interplay of multiple brain networks, especially medial and lateralized cortical components of the default mode network, dorsal corticostriatal circuits underpinning higher order cognitive and behavioral control, and ventral frontostriatal circuits, connecting to brain regions implicated in emotion processing, that control valuation and learning processes.

FINDINGS AND CONCLUSION

Based on clinical insights and considering each of the decision-making stages in turn, we outline disorder-specific hypotheses about impaired decision making in four childhood disorders: attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), depression, and anxiety. We hypothesize that decision making in ADHD is deficient (i.e. inefficient, insufficiently reflective, and inconsistent) and impulsive (biased toward immediate over delayed alternatives). In CD, it is reckless and insensitive to negative consequences. In depression, it is disengaged, perseverative, and pessimistic, while in anxiety, it is hesitant, risk-averse, and self-deprecating. A survey of current empirical indications related to these disorder-specific hypotheses highlights the limited and fragmentary nature of the evidence base and illustrates the need for a major research initiative in decision making in childhood disorders. The final section highlights a number of important additional general themes that need to be considered in future research.

Mapping the interplay among cognitive biases, emotion regulation, and depressive symptoms

Cognitive biases and emotion regulation (ER) difficulties have been instrumental in understanding hallmark features of depression. However, little is known about the interplay among these important risk factors to depression. This cross-sectional study investigated how multiple cognitive biases modulate the habitual use of ER processes and how ER habits subsequently regulate depressive symptoms. All participants first executed a computerised version of the scrambled sentences test (interpretation bias measure) while their eye movements were registered (attention bias measure) and then completed questionnaires assessing positive reappraisal, brooding, and depressive symptoms. Path and bootstrapping analyses supported both direct effects of cognitive biases on depressive symptoms and indirect effects via the use of brooding and via the use of reappraisal that was in turn related to the use of brooding. These findings help to formulate a better understanding of how cognitive biases and ER habits interact to maintain depressive symptoms.

Attention bias modification via single-session dot-probe training: Failures to replicate

BACKGROUND AND OBJECTIVES

Across three experiments we investigated transfer effects of single-session attention bias modification via dot-probe training.

METHODS

In experiment 1, participants received training either toward or away from negative images or no-training, and transfer to an affective task-switching task was examined. In two other experiments, participants were trained to orient attention toward either positive or negative words (experiment 2a) or facial expressions (experiment 2b), and transfer to an interpretation bias task was examined.

RESULTS

In all experiments, the dot-probe training procedure did not effectively modify biases in attention allocation at the training condition level, but produced a large variability in individual attention bias acquisition within and across conditions. Individual differences in pre-training attention bias and attention bias acquisition were not related to performance on the affective task-switching task or the interpretation tasks.

LIMITATIONS

The present investigations are limited by the lack of effectiveness of ABM at the condition level, the order in which transfer tasks were administered, and the restricted range of affective symptoms that could moderate training and transfer effects.

CONCLUSIONS

The findings from three experiments provided no evidence for single-session dot-probe ABM procedures to effectively manipulate attention bias toward negative, away from negative, or toward positive stimuli at a training condition level. At the individual differences level of analysis, again no evidence was found for transfer of attention training. The observations invite further empirical scrutiny into factors that moderate attentional plasticity in response to dot-probe ABM procedures to optimize the conditions for effective implementation and transfer of training.

Rumination: Cognitive consequences of training to inhibit the negative

BACKGROUND AND OBJECTIVES

To explore cognitive factors in ruminative thinking, we assessed the effect of a single-session of inhibition training on subsequent biases in attention and interpretation.

METHODS

We randomly assigned participants to either inhibit or attend to negative stimuli. Inhibition was assessed by using assessment trials embedded throughout the training, and interpretation bias was assessed following the training.

RESULTS

Trait rumination moderated training effects on both measures. Low ruminators in the inhibition-training condition maintained their level of inhibition of negative stimuli, but those in the attention-training condition showed a non-significant trend for decreased inhibition. Participants also showed a transfer-congruent tendency in interpretation bias, with reduced bias by those trained to inhibit negative stimuli, compared to those trained to attend to negative stimuli. In contrast, high ruminators in the inhibition training condition showed a training-incongruent decrease in inhibition of negative stimuli, but no change in inhibition when trained to attend to negative stimuli. No effects of the training on interpretation bias were observed among high ruminators. Finally, the training did not affect subsequent measures of mood or state rumination, even when trait rumination scores were taken into account.

LIMITATIONS

This study used a single session of inhibition training rather than a multi-session training, and this may explain the null effects among high ruminators.

CONCLUSIONS

Findings highlight the critical role that trait rumination plays in moderating the effect of inhibition training. Our results suggest that inhibition training may provide an effective technique to change inhibition bias and later interpretation bias.

If I only knew why: the relationship between brooding, beliefs about rumination, and perceptions of treatments

People who tend to engage in brooding, the maladaptive subtype of rumination, are at risk to develop depression. Brooders often endorse metacognitive beliefs that self-focused ruminative thinking is beneficial. In the current study, we examined whether brooding and positive beliefs about rumination are associated with perceptions of and preferences for treatments for depression. Participants (N=118) read descriptions of two different clusters of treatments for depression, Insight-Oriented (IO) treatments and Activation-Oriented (AO) treatments. They then rated treatment efficacy and credibility and completed self-report measures of rumination (including brooding and reflection subscales), beliefs about rumination, and depression. Brooding and metacognitive positive beliefs about rumination were associated with positive perceptions of IO (but not AO) treatments. Positive beliefs about rumination contributed to the prediction of perceptions of IO treatments (but not AO treatments) beyond the effect of brooding. We discuss the implications of these findings for individuals' decision-making processes regarding which type of treatment to seek.