Attentional Disengagement Deficits Predict Brooding, but Not Reflection, Over a One-Year Period

Shifting away from negative inferences affects rumination and mood

In three studies, we examined the effect of shifting from a negative to a positive inference for a negative personal event, on mood, state rumination, and next-day inferences, and assessed whether trait brooding moderates these effects. Participants described a personal event and made two inferences for it. Studies 1 and 2 showed that instructing participants to shift from a negative to a positive inference, improved mood and decreased state rumination, compared to a no-shift condition. Lasting effects of this shift were observed on the next day, but not among high brooders. In Study 3, trait brooding was associated with less shifting from a negative to a positive inference, when participants were free to make any inference following a negative one. These findings highlight the benefits of shifting from negative to positive inferences for mood and state rumination. We also discuss the potential of shifting for brooders, who do not shift spontaneously but can do so with guidance, offering a potential intervention to enhance emotion regulation.

Rumination in patients with major depressive disorder before and after antidepressant treatment

BACKGROUND

Rumination is a maladaptive response to distress characteristic of Major Depressive Disorder (MDD). It is unclear to what degree rumination is associated with depression severity prior to treatment and how it responds to antidepressant treatment. Therefore, we evaluated the association between rumination and depression severity in 92 untreated patients with MDD and explored the changes in rumination after initiation of antidepressant medication.

METHOD

We measured rumination using the Rumination Response Scale (RRS) and depression severity with the Hamilton Depression Rating Scale (HDRS17 or HDRS6) before and after initiation of 12 weeks of antidepressant treatment. The association between RRS and pre-treatment HDRS17 was evaluated using a linear regression model. RRS at week 4, 8, and 12 across treatment response categories (remission vs. non-response) were evaluated using a mixed effect model.

RESULTS

RRS was positively associated with depression severity prior to treatment at a trend level (p = 0.06). After initiation of treatment RRS decreased significantly (p < 0.0001) and remitters exhibited lower rumination compared to non-responders at week 4 (p = 0.03), 8 (p = 0.01), and 12 (p = 0.007).

LIMITATIONS

The study had no placebo group.

CONCLUSIONS

Although pre-treatment rumination did not significantly associate with depressive symptoms, rumination was closely connected to change in depressive symptoms. Tormented patients could be reassured that rumination symptoms may be alleviated over the course of antidepressant treatment.

Free-viewing gaze patterns reveal a mood-congruency bias in MDD during an affective fMRI/eye-tracking task

Major depressive disorder (MDD) has been related to abnormal amygdala activity during emotional face processing. However, a recent large-scale study (n = 28,638) found no such correlation, which is probably due to the low precision of fMRI measurements. To address this issue, we used simultaneous fMRI and eye-tracking measurements during a commonly employed emotional face recognition task. Eye-tracking provide high-precision data, which can be used to enrich and potentially stabilize fMRI readouts. With the behavioral response, we additionally divided the active task period into a task-related and a free-viewing phase to explore the gaze patterns of MDD patients and healthy controls (HC) and compare their respective neural correlates. Our analysis showed that a mood-congruency attentional bias could be detected in MDD compared to healthy controls during the free-viewing phase but without parallel amygdala disruption. Moreover, the neural correlates of gaze patterns reflected more prefrontal fMRI activity in the free-viewing than the task-related phase. Taken together, spontaneous emotional processing in free viewing might lead to a more pronounced mood-congruency bias in MDD, which indicates that combined fMRI with eye-tracking measurement could be beneficial for our understanding of the underlying psychopathology of MDD in different emotional processing phases.Trial Registration: The BeCOME study is registered on ClinicalTrials (gov: NCT03984084) by the Max Planck Institute of Psychiatry in Munich, Germany.

Cognitive predictors of stress-induced mood malleability in depression

BACKGROUND & OBJECTIVES

Basic attentional control, negative biases in attention and interpretation, and rumination are all cognitive processes associated with depression; however, less is known about their predictive role in depressive mood reactivity and -recovery in response to stress, and their relation to severity of depression.

DESIGN & METHODS

We experimentally induced stress based on an autobiographical imagery script in a sample of 92 participants with Major Depressive Disorder with or without comorbid anxiety disorders. We used simple regression analysis for investigating the roles of state- and trait rumination, attentional networks, and attentional and interpretation biases for predicting stress-induced depressive mood reactivity and -recovery, respectively, and whether they in parallel mediated the association between cognitive processes and depression severity.

RESULTS

Stress-induced depressive mood reactivity was predicted by better orienting ability and more state rumination. Better recovery was predicted by better orienting efficiency and lower negative interpretation bias. Furthermore, the relation between state rumination and depression severity was partially mediated by depressive mood reactivity, however limited by the lack of temporal precedence in the analysis.

CONCLUSIONS

We characterized the relation between cognitive processes and mood malleability in response to stress. Findings could refine theoretical models of depression if causality is established.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT04137367.

The age-Related Positivity Effect and Emotion Regulation: Assessing Downstream Affective Outcomes

While substantial literature suggests that positive preferences are in the service of emotion regulation pursuits, little evidence has directly linked positivity "processes" with well-being "outcomes." The current study examined age-related differences in negative gaze preferences and how such preferences are related to subsequent regulatory outcomes. Participants were 79 older adults and 72 younger adults. They first provided a baseline mood assessment, which was followed by a standardized emotional video clip for three minutes during which visual fixation preferences were recorded via an eye tracker. Mood was again assessed after the film, which was followed by a standardized video recovery task, and completion of a recovery mood measure. Older adults fixated less on negative portions of the emotional video clip relative to younger adults, indicative of an age-related positivity effect. The indirect effect of age on mood recovery through fixation was not supported.

State and Trait Rumination Effects on Overt Attention to Reminders of Errors in a Challenging General Knowledge Retrieval Task

Rumination is a recurrent and repetitive manner of thinking that can be triggered by blockage of personally relevant goals, creating a temporary state of abstract and evaluative self-focus. Particularly when focused on passive “brooding” over one’s problems and feelings, however, rumination can increase negative affect, interfere with problem-solving, and, through a negative feedback cycle, become a chronic trait-like style of responding to personal challenges, particularly in women. Given the pervasiveness of rumination and its potential impact on cognitive processes and emotional states, the present study asks how it impacts attention to feedback that either reminds individuals of goal-state discrepancies (reminders of errors) or could help to remediate them (corrective information). Using eye-tracking, we examined both state and trait rumination effects on overt measures of attention [first fixation duration (FFD) and total fixation duration (TFD)] during simultaneous presentation of these two types of feedback following failed attempts to answer challenging verbal general knowledge questions (average accuracy ∼30%). After a pre-induction baseline, we induced either a state of rumination using a series of writing exercises centered on the description of an unresolved academic concern or a state of distraction by centering writing on the description of a neutral school day. Within our women-only sample, the Rumination condition, which writing analysis showed was dominated by moody brooding, resulted in some evidence for increased initial dwell time (FFD) on reminders of incorrect answers, while the Distraction condition, which did not elicit any rumination during writing, resulted in increased FFD on the correct answer. Trait brooding augmented the expression of the more negative, moody brooding content in the writing samples of both Induction conditions, but only influenced TFD measures of gaze duration and only during the pre-induction baseline, suggesting that once the inductions activated rumination or distraction states, these suppressed the trait effects in this sample. These results provide some support for attentional-bias models of rumination (attentional scope model, impaired disengagement hypothesis) and have implications for how even temporary states of rumination or distraction might impact processing of academic feedback under conditions of challenge and failure.

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.