Anne-Wil Kruijt

Cognitive Reactivity, Implicit Associations, and the Incidence of Depression: A Two-Year Prospective Study

Background Cognitive reactivity to sad mood is a vulnerability marker of depression. Implicit self-depressed associations are related to depression status and reduced remission probability. It is unknown whether these cognitive vulnerabilities precede the first onset of depression. Aim To test the predictive value of cognitive reactivity and implicit self-depressed associations for the incidence of depressive disorders. Methods Prospective cohort study of 834 never-depressed individuals, followed over a two-year period. The predictive value of cognitive reactivity and implicit self-depressed associations for the onset of depressive disorders was assessed using binomial logistic regression. The multivariate model corrected for baseline levels of subclinical depressive symptoms, neuroticism, for the presence of a history of anxiety disorders, for family history of depressive or anxiety disorders, and for the incidence of negative life events. Results As single predictors, both cognitive reactivity and implicit self-depressed associations were significantly associated with depression incidence. In the multivariate model, cognitive reactivity was significantly associated with depression incidence, together with baseline depressive symptoms and the number of negative life events, whereas implicit self-depressed associations were not. Conclusion Cognitive reactivity to sad mood is associated with the incidence of depressive disorders, also when various other depression-related variables are controlled for. Implicit self-depressed associations predicted depression incidence in a bivariate test, but not when controlling for other predictors.

Relationships among 5-HTT Genotype, Life Events and Gender in the Recognition of Facial Emotions

Accumulating evidence has shown that a polymorphism in the promoter region of the serotonin-transporter (5-HTTLPR) modulates neural activation during the perceptual processing of emotional facial expressions. Furthermore, behavioral research has shown that attentional bias for negative information is increased in s allele carriers. We examined the interactions among 5-HTTLPR (including SNP rs25531), life events and gender on the detection of facial emotions. We found a main effect of genotype, as well as moderating effects of childhood emotional abuse (CEA) and recent life events (RLE). S homozygous participants recognized negative facial expressions at a lower intensity than the other genotype groups. This effect was more evident in female participants and in participants who had experienced life events. The 5-HTTLPR genotype affects facial emotional perception, a process which is linked to a neurobiological response to threat and vulnerability to emotional disorders.

The effects of a visual search attentional bias modification paradigm on attentional bias in dysphoric individuals.

BACKGROUND AND OBJECTIVESnAttentional Bias Modification (ABM) may constitute a new type of treatment for affective disorders. ABM refers to computerized training programs that have been developed based on laboratory findings in experimental psychology. Meta-analyses have reported moderate effect sizes in anxiety disorders. Two small studies have also claimed an effect in dysphoria. Furthermore, a series of studies in individuals with low self-esteem has shown that they benefit from a single session of an ABM variant based on a visual search task. The current study tested the working mechanism of visual search ABM in dysphoria.nnnMETHODSnForty dysphoric individuals engaged in a single session of ABM training or control training. Attentional bias for positive and negative facial expressions was assessed pre- and post training. Positive and negative mood states were assessed throughout the procedure.nnnRESULTSnAttentional training had no effect on attentional bias. Positive and negative mood states were not differentially affected by training condition.nnnLIMITATIONSnSmall treatment effects may have gone undetected and there are some methodological differences with prior research.nnnCONCLUSIONnWe found no evidence that engaging in a single session of a visual search ABM modifies attentional biases for happy, sad or disgusted facial expressions.

Capturing dynamics of biased attention: are new attention variability measures the way forward?

Background New indices, calculated on data from the widely used Dot Probe Task, were recently proposed to capture variability in biased attention allocation. We observed that it remains unclear which data pattern is meant to be indicative of dynamic bias and thus to be captured by these indices. Moreover, we hypothesized that the new indices are sensitive to SD differences at the response time (RT) level in the absence of bias. Method Randomly generated datasets were analyzed to assess properties of the Attention Bias Variability (ABV) and Trial Level Bias Score (TL-BS) indices. Sensitivity to creating differences in 1) RT standard deviation, 2) mean RT, and 3) bias magnitude were assessed. In addition, two possible definitions of dynamic attention bias were explored by creating differences in 4) frequency of bias switching, and 5) bias magnitude in the presence of constant switching. Results ABV and TL-BS indices were found highly sensitive to increasing SD at the response time level, insensitive to increasing bias, linearly sensitive to increasing bias magnitude in the presence of bias switches, and non-linearly sensitive to increasing the frequency of bias switches. The ABV index was also found responsive to increasing mean response times in the absence of bias. Conclusion Recently proposed DPT derived variability indices cannot uncouple measurement error from bias variability. Significant group differences may be observed even if there is no bias present in any individual dataset. This renders the new indices in their current form unfit for empirical purposes. Our discussion focuses on fostering debate and ideas for new research to validate the potentially very important notion of biased attention being dynamic.

The influence of worry and avoidance on the Iowa Gambling Task

BACKGROUNDnIt has been proposed that worry in individuals with Generalized Anxiety Disorder may be reinforced by a positive effect of worry on decision making, as reflected by a steeper learning curve on the Iowa Gambling Task (IGT). We hypothesized that this apparent positive effect of worry is dependent on the IGT parameters, in particular the absence of an opportunity to avoid decisions.nnnOBJECTIVEn(1) To replicate previous findings on the effect of worry on IGT performance. (2) To examine the influence of avoidance opportunity on IGT performance. We hypothesized that the positive effect of worry on learning would be abolished or reversed by the opportunity to avoid.nnnMETHODnA standard IGT and a new IGT version that includes a pass (avoidance) option were completed by 78 and 79 participants, respectively.nnnRESULTSnA beneficial effect of worry on learning in the standard version of the IGT was not observed. In the pass version of the IGT, worry status and avoidance were negatively associated with performance. Worry was not related, however, to pass usage. The hypothesized mediating effect of avoidance was non-significant.nnnLIMITATIONSnIt is unclear to what extent these findings generalize to real-life decision making and how clinical status affects results.nnnCONCLUSIONnThe possibility to avoid a decision results in poorer IGT performance in high relative to low trait worriers. Possible explanations for these findings are discussed.

A Multiple Case Series Analysis of Six Variants of Attentional Bias Modification for Depression

Background. Attention bias modification (ABM) is a new treatment for affective disorders. A meta-analysis of ABM for anxiety disorders showed that the effect size may be large but the number of studies is low. The working mechanism is still unclear, and little is known about the optimal treatment parameters. ABM for depression is much less studied. A few studies claimed positive effects but the sample sizes are low. Furthermore, the treatment parameters varied widely and differed from the anxiety literature. Aim. To select the most promising version of ABM for depression for further evaluation in clinical trials. Methods. Multiple case series design. We tested six versions of ABM that varied on stimulus duration and training direction. Thirty students with mild to moderate symptoms of depression underwent four sessions of ABM. Change of attentional bias was measured during each session. Generalization of treatment effects and the role of awareness of receiving training were also investigated. Results. None of the investigated versions of ABM had a consistent effect on attentional bias. Changes of attentional bias in individual participants the effects did not generalize to untrained stimuli. Conclusion. It is unlikely that any of these ABM versions will have a specific effect on symptoms in controlled studies.

The 5-HTTLPR polymorphism, early and recent life stress, and cognitive endophenotypes of depression

Studies associating interactions of 5-HTTLPR and life adversities with depression have yielded equivocal results. Studying endophenotypes may constitute a more powerful approach. In the current study, it was assessed whether interactions of 5-HTTLPR with childhood emotional abuse (CEA) and recent negative life events (RNLE) affect possible cognitive endophenotypes of depression, namely, attention-allocation bias and the ability to recognise others mind states in 215 young adults of North-West European descent. The ability to classify others negative mind states was found to be increased with increasing RNLE in carriers of low-expressing Serotonin Transporter Linked Polymorphic Region (5-HTTLPR) alleles. Carriers of two low-expressing alleles also preferentially oriented attention towards negative information. Gene-environment interactions were not observed for attention allocation bias. No effects involving CEA were observed. These results suggest that low-expressing 5-HTTLPR alleles may confer increased risk for depression through enhanced recognition of negative facial expressions following RNLE.