Attentional bias scores in patients with depression and effects of age: a controlled, eye-tracking study

Attentional Bias in Older Adults with Non-Clinical Depression: An Eye-Tracking Study

BACKGROUND

Cognitive models of depression assert that attentional biases play an important role in the maintenance of depression. However, few studies have explored attentional bias in depressed older adults, and no consistent conclusions have been reached.

METHODS

In the current study, we investigated attentional bias in older adults with non-clinical depression. Older adults aged over 60 with non-clinical depression and without depression were instructed to perform a free viewing task while their eye movements were tracked.

RESULTS

The results showed that, compared to older adults without depression, non-clinically depressed older adults had longer total fixation durations and a greater number of fixations on sad stimuli. Moreover, non-depressed older adults exhibited a preference for pleasant images, whereas this effect was not observed in older adults with non-clinical depression.

CONCLUSION

This study suggested that non-clinically depressed older adults have attentional bias, which is manifested as increased attention to sad stimuli and decreased attention to pleasant stimuli.The current study has functional and potential functional implications.

Negative emotional cues improve free recall of positive and neutral words in unmedicated patients with major depressive disorder

Individuals with major depressive disorder (MDD) exhibit attentional biases toward negative, mood-congruent stimuli while filtering out positive and neutral stimuli, resulting in memory biases to negative content. While attentional and memory biases in MDD have been extensively studied, the underlying mechanisms of these biases remain unclear. The current study investigates a novel model proposing that exposure to negative emotional cues triggers a transient "attentional window" in individuals with MDD, leading to heightened and deeper cognitive processing of any subsequent information, irrespective of its content. Forty-two unmedicated patients with MDD and no comorbid disorder and 41 healthy controls, completed six blocks of the emotional memory task, in which they were asked to watch a short video (negative, neutral, or positive valence) followed by a memory test on a list of neutral or positive valance words. Results indicated that participants with MDD, but not healthy controls, had better recall performance after a negative video compared to after neutral or positive videos, and that this effect occurred for both neutral and positive word-lists. These findings provide evidence that participants with MDD engage in deeper information processing following exposure to negative emotional stimuli. Potential clinical implications are discussed.

The neurophysiological consequences of racism-related stressors in Black Americans

Racism-related stressors, from experiences of both implicit and explicit racial discrimination to systemic socioeconomic disadvantage, have a cumulative impact on Black Americans' health. The present narrative review synthesizes peripheral (neuroendocrine and inflammation markers), psychophysiological (heart-rate variability, skin conductance), and neuroimaging (structural and functional) findings that demonstrate unique associations with racism-related stress. Emerging evidence reveals how racism-related stressors contribute to differential physiological and neural responses and may have distinct impacts on regions involved with threat and social processing. Ultimately, the neurophysiological effects of racism-related stress may confer biological susceptibility to stress and trauma-related disorders. We note critical gaps in the literature on the neurophysiological impact of racism-related stress and outline additional research that is needed on the multifactorial interactions between racism and mental health. A clearer understanding of the interactions between racism-related stress, neurophysiology, and stress- and trauma-related disorders is critical for preventative efforts, biomarker discovery, and selection of effective clinical treatments for Black Americans.

Eye-tracking evidence of a relationship between attentional bias for emotional faces and depression severity in patients with treatment-resistant depression

In a retrospective study, 54 patients with treatment-resistant major depressive disorder (TRD) completed a free-viewing task in which they had to freely explore pairs of faces (an emotional face (happy or sad) opposite to a neutral face). Attentional bias to emotional faces was calculated for early and sustained attention. We observed a significant negative correlation between depression severity as measured by the 10-item Montgomery-Åsberg Depression Rating Scale (MADRS) and sustained attention to happy faces. In addition, we observed a positive correlation between depression severity and sustained attention to sad faces. No significant correlation between depression severity and early attention was found for either happy or sad faces. Although conclusions from the current study are limited by the lack of comparison with a control group, the eye-tracking free-viewing task appears to be a relevant, accessible and easy-to-use tool for measuring depression severity through emotional attentional biases in TRD.

Deployment of attention to facial expressions varies as a function of emotional quality-but not in alexithymic individuals

Background

Alexithymia is a risk factor for emotional disorders and is characterized by differences in automatic and controlled emotion processing. The multi-stimulus free-viewing task has been used to detect increased negative and reduced positive attentional biases in depression and anxiety. In the present eye-tracking study, we examined whether lexical emotional priming directs attention toward emotion-congruent facial expressions and whether alexithymia is related to impairments in lexical priming and spontaneous attention deployment during multiple face perception.

Materials and methods

A free-viewing task with happy, fearful, angry, and neutral faces shown simultaneously was administered to 32 alexithymic and 46 non-alexithymic individuals along with measures of negative affect and intelligence. Face presentation was preceded by masked emotion words. Indices of initial orienting and maintenance of attention were analyzed as a function of prime or target category and study group.

Results

Time to first fixation was not affected by prime category or study group. Analysis of fixation duration yielded a three-way interaction. Alexithymic individuals exhibited no prime or target category effect, whereas non-alexithymic individuals showed a main effect of target condition, fixating happy faces longer than neutral and angry faces and fearful faces longer than angry faces.

Discussion

Our results show evidence of attentional biases for positive and fearful social information in non-alexithymic individuals, but not in alexithymic individuals. The lack of spontaneous attentional preference for these social stimuli in alexithymia might contribute to a vulnerability for developing emotional disorders. Our data also suggest that briefly presented emotion words may not facilitate gaze orientation toward emotion-congruent stimuli.

Clinically elevated depression scores do not produce negative attentional biases in caregivers of autistic children

Objective

Depression scores in caregivers of autistic children often fall in the clinical range. The attention of clinically depressed individuals tends to be biased toward negatively toned information. Whether caring for an autistic child might also be characterized by a negative attentional bias was explored here.

Methods

A sample of N = 98 (57 caregivers and 41 controls) completed questionnaires assessing depressive symptoms. Orienting attention to (i.e., vigilance), and shifting attention away from (i.e., disengagement), negative information was assessed via an online version of the emotional face dot probe task.

Results

Mean depression scores in caregivers, falling in the borderline clinical range, were significantly higher compared with controls. Groups, however, were indistinguishable with respect to vigilance and disengagement, and these attentional indices were unrelated to depression scores.

Conclusion

Caring for an autistic child, while associated with borderline clinical depression scores, was not characterized by a negative attentional bias. Findings are discussed in the context of methodological shortcomings and recommendations for future research.

Current development of biosensing technologies towards diagnosis of mental diseases

The biosensor is an instrument that converts the concentration of biomarkers into electrical signals for detection. Biosensing technology is non-invasive, lightweight, automated, and biocompatible in nature. These features have significantly advanced medical diagnosis, particularly in the diagnosis of mental disorder in recent years. The traditional method of diagnosing mental disorders is time-intensive, expensive, and subject to individual interpretation. It involves a combination of the clinical experience by the psychiatrist and the physical symptoms and self-reported scales provided by the patient. Biosensors on the other hand can objectively and continually detect disease states by monitoring abnormal data in biomarkers. Hence, this paper reviews the application of biosensors in the detection of mental diseases, and the diagnostic methods are divided into five sub-themes of biosensors based on vision, EEG signal, EOG signal, and multi-signal. A prospective application in clinical diagnosis is also discussed.

Emotional stimulation processing characteristics in depression: Meta-analysis of eye tracking findings

Objective

To systematically evaluate the attentional bias in patients with depression toward emotional stimuli and to explore eye movement indicators and potential regulatory variables that can distinguish such patients from healthy individuals.

Methods

Case-control studies regarding eye-tracking in major depressive disorder published in PubMed, Web of Science, ScienceDirect, The Cochrane Library, EBSCOhost, Embase, China National Knowledge Infrastructure, Wanfang, and VIP databases from database initiation until March 12, 2022 were included in the present meta-analysis. Two researchers independently screened the literature and performed data extraction. The quality of the literature was assessed using the Newcastle-Ottawa quality assessment scale.RevMan 5.4 software was used for Meta-analysis.

Results

Overall, 14 studies were included, including 1,167 participants (N _depression = 474; N _healthy = 693). We found that (1) fixation duration was significantly lower for positive emotional stimuli in the depression group than that in the healthy group; however, for negative stimuli, the fixation duration was significantly more in the depression group than in the healthy group. No significant difference was observed in terms of neutral emotional stimuli between groups. (2) Patients with depression exhibited a significantly lower fixation count for positive emotional stimuli than healthy individuals, whereas the fixation count for negative emotional stimuli was significantly higher in the depression group than in the healthy group. No significant difference was found for neutral emotional stimuli between groups. (3) No significant difference was detected in terms of the first fixation duration of the positive, negative, and neutral emotional stimuli between groups. (4) subgroup analysis indicated that age effected fixation duration for positive emotional stimuli. In addition, age and the type of negative emotional picture (sad, dysphoric, threat, anger) effected fixation duration for negative emotional stimuli.

Conclusion

Our research supports that patients with depression exhibit a negative attention bias toward emotional stimuli, and the fixation duration and fixation counts may be used as auxiliary objective indicators for depression screening.

Intact face detection in young patients with major depressive disorder revealed by the face-specific N170 component

It is unclear whether the face perceptual processing, especially the perceptual computation in early stages of processing faces, impaired in young patients with major depressive disorder (MDD). In this study, the face perception was investigated by analyzing the early ERP components in response to upright and inverted faces versus objects. Across all conditions, both the P1 and the N170 components were similar in MDD patients versus in the controls, regardless of latencies or amplitudes. Faces elicited larger N170 than objects (N170 face effect) and inverted faces elicited higher and delayed N170 (N170 inversion effect); however, none of these effects were modulated by depression. These findings suggest that there is intact perceptual mechanism of processing faces in young MDD patients, relying primarily on global/configural information versus non-face objects.

Comparing emotional working memory in adolescents and young adults with and without depressive symptoms: developmental and psychopathological differences

Depressive symptoms are associated with working memory impairments. Yet, comparative studies examining working memory across the developmental spectrum in depressed and non depressed cohorts are lacking. This study examined emotional working memory in 74 adolescents (mean age = 14; 21 with depressive symptoms) and 92 adults (mean age = 22; 36 with depressive symptoms). Participants completed two versions of an emotional face n-back task, and either paid attention to the valence of the emotion or the gender. Both tasks were completed at low load (0-back) and high load (2-back). In the high load condition, healthy adolescents showed a bias towards positive faces, both speeding up reaction times (RTs) when emotion was task relevant but slowing RTs when they were task irrelevant. This interaction was neither significant in adolescents with depressive symptoms nor in young adults. Depressive symptoms did not influence RTs in low load. The results indicate that adolescents with depressive symptoms might lack the bias towards positive affective material at high load WM task present in healthy adolescents.

Looks interesting: Attention allocation in depression when using a news website - An eye tracking study

BACKGROUND

Eye-tracking-based attention research has shown attentional biases toward dysphoric and away from positive stimuli in depression. However, most research used prototypical stimuli (co-presented contrasting emotional faces/pictures), less reflective of real-life situations. The current study addressed this limitation by examining participants' attentional allocation patterns while freely viewing a news website containing dysphoric and positive news articles.

METHODS

Participants with high levels of depression (HD; n = 30) and with minimal levels of depression (MD; n = 30) freely viewed a fictitious news website for 3.5 min, containing six articles (picture + text) with dysphoric content and six with positive content. Gaze patterns on corresponding areas of interest (AOIs) were compared. Following the task, participants rated each article's valence, authenticity, and interest.

RESULTS

Compared to MD participants, HD participants spent more time dwelling on dysphoric articles and less time dwelling on positive articles. Within group analyses showed that while HD participants spent more time dwelling on dysphoric compared to positive articles, MD participants showed no preference, allocating their attention equally to both article types. Echoing within-group gaze patterns, HD participants rated the dysphoric articles as being more interesting than the positive articles, while MD participants rated both types of articles as being equally interesting.

CONCLUSION

Attentional biases in depression were also evident when using a more ecologically valid task such as viewing a news website, manifesting as increase attention allocation to dysphoric over positive content. This attention pattern may be related to corresponding differences in the level of interest participants found in each article type.

Lack of an Attention Bias Away From Relatively Negative Faces in Dysphoria Is Not Related to Biased Emotion Identification

Eye-tracking-based attention research has consistently shown a lack of a normative attentional bias away from dysphoric face stimuli in depression, characterizing the attention system of non-depressed individuals. However, this more equal attention allocation pattern could also be related to biased emotion identification, namely, an inclination of depressed individuals to attribute negative emotions to non-negative stimuli when processing mood-congruent stimuli. Here, we examined emotion identification as a possible mechanism associated with attention allocation when processing emotional faces in depression. Attention allocation and emotion identification of participants with high (HD; n = 30) and low (LD; n = 30) levels of depression symptoms were assessed using two corresponding tasks previously shown to yield significant findings in depression, using the same face stimuli (sad, happy, and neutral faces) across both tasks. We examined group differences on each task and possible between-task associations. Results showed that while LD participants dwelled longer on relatively positive faces compared with relatively negative faces on the attention allocation task, HD participants showed no such bias, dwelling equally on both. Trait anxiety did not affect these results. No group differences were noted for emotion identification, and no between-task associations emerged. Present results suggest that depression is characterized by a lack of a general attention bias toward relatively positive faces over relatively negative faces, which is not related to a corresponding bias in emotion identification.

Attentional Processing and Interpretative Bias in Functional Neurological Disorder

OBJECTIVE

Altered attentional processing (automatically attending to negative or illness-relevant information) and interpretative biases (interpreting ambiguous information as negative or illness relevant) may be mechanistically involved in functional neurological disorder (FND). Common mechanisms between FND and chronic fatigue syndrome (CFS) have been proposed but not compared experimentally.

METHODS

We compared the cognitive task performance of FND, CFS, and healthy control (HC) groups. The tasks assessed attentional bias toward illness-relevant stimuli (visual probe task), attentional control (attention network task), and somatic interpretations (interpretative bias task), alongside self-reported depression, anxiety, fatigue, and general health.

RESULTS

Thirty-seven participants diagnosed with FND, 52 participants diagnosed with CFS, and 51 HC participants were included. Although participants with CFS showed attentional bias for illness-relevant stimuli relative to HC (t = -3.13, p = .002, d = 0.624), individuals with FND did not (t = -1.59, p = .118, d = 0.379). Both the FND (t = 3.08, p = .003, d = 0.759) and CFS (t = 2.74, p = .007, d = 0.548) groups displayed worse attentional control than did the HC group. Similarly, the FND (t = 3.63, p < .001, d = 0.801) and CFS groups (t = 4.58, p < .001, d = 0.909) showed more somatic interpretative bias than did the HC group.

CONCLUSIONS

Similar attentional control deficits and somatic interpretative bias in individuals with FND and CFS support potential shared mechanisms underlying symptoms. Interpretative bias toward somatic and illness-relevant stimuli in functional disorders may prove a therapeutic target.

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

BACKGROUND

In the last decade, eye-tracking technology has been increasingly used to investigate attention orientation in depression. The aim of the current review was to summarize the available eye-tracking research specifying the effects of clinical depression on early and late attention allocation during visual perception of emotional material.

METHODS

The literature search identified sixteen relevant publications, including twelve free-viewing studies in which multiple stimulus arrays with images (scenarios) or faces were administered. Meta-analyses were conducted to evaluate the impact of acute depression on attentional maintenance during free viewing as a function of type and emotional quality of stimulus material.

RESULTS

Moderate (to large) differences were observed between depressed and healthy individuals in maintained attention to dysphoric images (Hedges' g = .66) and sad faces (g = .58). Moderate group differences were also revealed for maintained attention to positive images (g = -.51) and happy faces (g = -.54). Age of patients explained between study variance in effect sizes for attention to happy faces. No group differences in initial attention orientation were found.

LIMITATIONS

The number of free-viewing studies based on images was low (n=4).

CONCLUSIONS

Our results suggest that clinical depression is characterized by medium-sized increases of attention maintenance for dysphoric and medium-sized decreases for positive stimuli compared to healthy individuals. Therefore, both alterations represent equally important targets for attention modification programs. Depressed patients seem not to manifest abnormalities in early orienting to emotional stimuli. Differences between patients and healthy subjects in attention to positive stimuli may diminish with age.

Disease Classification Based on Eye Movement Features With Decision Tree and Random Forest

Medical research shows that eye movement disorders are related to many kinds of neurological diseases. Eye movement characteristics can be used as biomarkers of Parkinson's disease, Alzheimer's disease (AD), schizophrenia, and other diseases. However, due to the unknown medical mechanism of some diseases, it is difficult to establish an intuitive correspondence between eye movement characteristics and diseases. In this paper, we propose a disease classification method based on decision tree and random forest (RF). First, a variety of experimental schemes are designed to obtain eye movement images, and information such as pupil position and area is extracted as original features. Second, with the original features as training samples, the long short-term memory (LSTM) network is used to build classifiers, and the classification results of the samples are regarded as the evolutionary features. After that, multiple decision trees are built according to the C4.5 rules based on the evolutionary features. Finally, a RF is constructed with these decision trees, and the results of disease classification are determined by voting. Experiments show that the RF method has good robustness and its classification accuracy is significantly better than the performance of previous classifiers. This study shows that the application of advanced artificial intelligence (AI) technology in the pathological analysis of eye movement has obvious advantages and good prospects.

Eye Tracking as a Tool to Identify Mood in Aphasia: A Feasibility Study

Background. Persons with aphasia often present with low mood/depression, which can negatively affect their quality of life. The validity and reliability of existing depression measures for aphasia have been called into question. Eye tracking in nonstroke populations is reliable in identifying low mood/depression. Depressed persons are biased to negative emotions compared with nondepressed persons and have an absence of bias to positive emotions. However, nondepressed persons may be biased to positive emotions. Objective. To examine the feasibility of using eye tracking to measure mood in persons with aphasia. Methods. We recruited 22 persons with chronic aphasia and 12 healthy controls. Participants completed 2 self-report measures of mood. They also viewed faces that showed happy, sad, and neutral facial expressions during eye tracking. We analyzed 2 eye tracking indices: initial gaze orientation and gaze maintenance to happy, sad, and neutral faces. Results. For initial gaze orientation, participants with aphasia fixated faster on emotional faces compared with healthy controls but directed their gaze less often to happy faces compared with healthy controls. For gaze maintenance components, the duration of first fixation and total fixation duration were shorter on sad faces for participants with aphasia compared with healthy controls. Conclusion. Use of eye tracking with faces representing different mood states is feasible in persons with aphasia. Although there were some similarities, participants with aphasia had different gaze patterns to emotional faces compared with healthy controls. Further research is needed to establish whether this is a valid and reliable method of mood assessment.

An Improved Classification Model for Depression Detection Using EEG and Eye Tracking Data

At present, depression has become a main health burden in the world. However, there are many problems with the diagnosis of depression, such as low patient cooperation, subjective bias and low accuracy. Therefore, reliable and objective evaluation method is needed to achieve effective depression detection. Electroencephalogram (EEG) and eye movements (EMs) data have been widely used for depression detection due to their advantages of easy recording and non-invasion. This research proposes a content based ensemble method (CBEM) to promote the depression detection accuracy, both static and dynamic CBEM were discussed. In the proposed model, EEG or EMs dataset was divided into subsets by the context of the experiments, and then a majority vote strategy was used to determine the subjects' label. The validation of the method is testified on two datasets which included free viewing eye tracking and resting-state EEG, and these two datasets have 36,34 subjects respectively. For these two datasets, CBEM achieves accuracies of 82.5% and 92.65% respectively. The results show that CBEM outperforms traditional classification methods. Our findings provide an effective solution for promoting the accuracy of depression identification, and provide an effective method for identificationof depression, which in the future could be used for the auxiliary diagnosis of depression.

Attentional bias for emotional faces in depressed and non-depressed individuals: an eye-tracking study

Current assessment tools for clinicians in mental health evaluation relies mostly on patient self-report and clinician's judgement. Recent studies suggest that affective disorders are correlated to attentional bias for visual information. This study used eye-tracking technology to measure attentional bias for faces in depressed and non-depressed individuals. The experiment was based on a free-viewing task of pair of faces including 4 types of expressions: neutral, sad, happy and angry. 69 individuals took part in this study. All the participants completed the Beck Depression Inventory II (BDI-II) to evaluate the severity of depressive symptoms. The attention indexes were total time for eye events, total fixation duration, ratio of total fixation and eye events, and fixation duration on each face. The results showed that depressed individuals have a significant (p = 0.005) difference in the total time of eye events (302.4±41.2) compared to non-depressed individuals (331.5±39.3) and revealed a tendency to disengage from emotional stimuli with differences in the total fixation in pair of faces. The study demonstrated that the use of eye-tracking is a valuable tool to asses attentional bias and important technology that could be used to improve diagnosis technics.

Depressive Symptoms in Late Pregnancy Disrupt Attentional Processing of Negative-Positive Emotion: An Eye-Movement Study

This study investigated biases for negative-positive information in component processes of visual attention (initial shift vs. maintenance of gaze) among women in late pregnancy with or without depressive symptoms. Eye movements were recorded while participants viewed a series of picture pairs depicting negative, positive, and neutral scenes. Initial orienting (latency and percentage of first fixation) and gaze duration were computed. Compared with neutral pictures, the group with major depressive symptoms (MDS) were less able to sense the positive emotion-related pictures and were over-responsive to negative emotion-related pictures. The group with suspicious depressive symptoms (SDS) had an attention bias toward both positive and negative emotion-related pictures. The group with no depressive symptoms (NDS) had an attention bias toward positive emotion-related pictures and had an initial attention avoidance tendency for negative emotion-related pictures. The initial gaze direction bias score for negative emotion-related pictures was positively correlated with the severity of depressive symptoms. Therefore, women with a risk of perinatal depression have a significant bias toward negative stimuli. Hypervigilant emotion processing during pregnancy may increase a woman's susceptibility to depression during late pregnancy. Attention away from negative information or attention toward positive information may provide a way of buffering emotional responses.

Free viewing of sad and happy faces in depression: A potential target for attention bias modification

BACKGROUND

Identification of reliable targets for therapeutic interventions is essential for developing evidence-based therapies. Attention biases toward negative-valenced information and lack of protective positive bias toward positive-valenced stimuli have been implicated in depression. However, extant research has typically used tasks with narrow stimuli arrays and unknown or poor psychometric properties. Here, we recorded eye-tracking data of depressed and non-depressed participants during a free viewing task to address these limitations.

METHODS

Patients with major depressive disorder (MDD; n = 20) and undergraduate students with high (n = 23) and low (n = 20) levels of depression freely viewed 60 different face-based matrices for six seconds each. Each matrix included eight sad and eight happy facial expressions. Gaze patterns on sad and happy areas of interest (AOIs) were explored. Internal consistency for the entire sample and one-week test-retest reliability in the student sub-sample were assessed.

RESULTS

Compared to undergraduates with low levels of depression, patients with MDD and students with high levels of depression dwelled significantly longer on sad faces. Results also showed a significantly longer dwell time on the happy AOI relative to the sad AOI only in the low depression group. The two depressed groups dwelled equally on the two AOIs. The task demonstrated high internal consistency and acceptable one-week test-retest reliability.

LIMITATIONS

Only sad and happy facial expressions were used. Relative small sample size.

CONCLUSION

Relative to non-depressed participants, depressed participants showed prolonged dwelling on sad faces and lack of bias toward happy faces. These biases present viable targets for gaze-contingent attention bias modification therapy.

Sex differences in default mode and dorsal attention network engagement

Focusing on sex differences is necessary to fully understand basic neurobiological processes such as the engagement of large-scale brain networks involved in attention. Prior work suggests that women show enhanced attention during tasks of reward/punishment relative to men. Yet, sex differences in the engagement of neural networks sub serving internal and external focus has been unexplored in regard to reward and punishment. Using data from a large sample (n = 190) of healthy participants from the Human Connectome Project, we investigated sex differences in default mode network (DMN), dorsal attention network (DAN), and frontal parietal network (FPN) activation during exposure to reward and punishment. To determine if sex differences are specific to valenced stimuli, we analyzed network activation during working memory. Results indicate that, relative to men, women have increased suppression of the DMN and greater activation of the DAN during exposure to reward and punishment. Given the relative roles of these networks in internal (DMN) and external (DAN) attention, this pattern of activation suggests that women have enhanced external attention to reward and punishment. In contrast, there were no sex differences in network activation during working memory, indicating that this sex difference is specific to the processing of reward and punishment. These findings suggest a neurobiological explanation for prior work showing women have greater sensitivity to reward/punishment and are more prone to psychiatric disorders characterized by enhanced attention to such stimuli. Furthermore, given the large sample from the Human Connectome Project, the current findings provide general implications for the study of sex as a biological variable in investigation of reward processes.