An Eye-Tracking Study of Attention Biases in Children at High Familial Risk for Depression and Their Parents with Depression.

Attention biases (AB) are a core component of cognitive models of depression yet it is unclear what role they play in the transgenerational transmission of depression. 44 children (9-14 years) with a high familial risk of depression (HR) were compared on multiple measures of AB with 36 children with a low familial risk of depression (LR). Their parents: 44 adults with a history of depression (HD) and 36 adults with no history of psychiatric disorder (ND) were also compared. There was no evidence of group differences in AB; neither between the HR and LR children, nor between HD and ND parents. There was no evidence of a correlation between parent and child AB. The internal consistency of the tasks varied greatly. The Dot-Probe Task showed unacceptable reliability whereas the behavioral index of the Visual-Search Task and an eye-tracking index of the Passive-Viewing Task showed better reliability. There was little correlation between the AB tasks and the tasks showed minimal convergence with symptoms of depression or anxiety. The null-findings of the current study contradict our expectations and much of the previous literature. They may be due to the poor psychometric properties associated with some of the AB indices, the unreliability of AB in general, or the relatively modest sample size. The poor reliability of the tasks in our sample suggest caution should be taken when interpreting the positive findings of previous studies which have used similar methods and populations.

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.

Context matters: The role of subjective arousal during Attentional Bias Modification targeting socially anxious students.

BACKGROUND AND OBJECTIVES: Attentional Bias Modification (ABM) paradigms targeting anxiety aim to reduce attentional biases for threatening stimuli and thereby reduce anxiety. Based on cognitive theories of performance and learning, elevated levels of arousal during ABM might enhance its effectiveness by making training more engaging and activating fear schemas. This study investigated whether elevated levels of arousal during ABM would increase its effectiveness in reducing attentional bias, stress reactivity, and post-event processing. METHOD: We randomly assigned 79 high socially anxious students to a session of ABM or control training preceded by either a social stress or control induction to manipulate arousal. Training outcomes were attentional bias, stress reactivity, and post-event processing. Subjective arousal was assessed before, during, and after training. RESULTS: Results indicated that ABM was not successful in reducing attentional bias, stress reactivity or post-event processing, and that the effects of ABM were not moderated by subjective arousal. There was a trend towards ABM being more effective than control training in reducing attentional bias directly after training when participants were more aroused. However, this effect was not maintained one day after the training. LIMITATIONS: The arousal manipulation did not result in significant between-group differences in subjective arousal. CONCLUSIONS: This study did not provide support for the moderating role of arousal in ABM training effects. Replications with more effective mood induction procedures and more power are needed as a trend finding was observed suggesting that higher levels of arousal improved the direct ABM effects on attentional bias.

Imagine the bright side of life: A randomized controlled trial of two types of interpretation bias modification procedure targeting adolescent anxiety and depression.

INTRODUCTION: Anxiety and depression are highly prevalent during adolescence and characterized by negative interpretation biases. Cognitive bias modification of interpretations (CBM-I) may reduce such biases and improve emotional functioning. However, as findings have been mixed and the traditional scenario training is experienced as relatively boring, a picture-based type of training might be more engaging and effective. METHODS: The current study investigated short- and long-term effects (up to 6 months) and users' experience of two types of CBM-I procedure in adolescents with heightened symptoms of anxiety or depression (N = 119, aged 12-18 year). Participants were randomized to eight online sessions of text-based scenario training, picture-word imagery training, or neutral control training. RESULTS: No significant group differences were observed on primary or secondary emotional outcomes. A decrease in anxiety and depressive symptoms, and improvements in emotional resilience were observed, irrespective of condition. Scenario training marginally reduced negative interpretation bias on a closely matched assessment task, while no such effects were found on a different task, nor for the picture-word or control group. Subjective evaluations of all training paradigms were relatively negative and the imagery component appeared particularly difficult for adolescents with higher symptom levels. CONCLUSIONS: The current results question the preventive efficacy and feasibility of both CBM-I procedures as implemented here in adolescents.

Online visual search attentional bias modification for adolescents with heightened anxiety and depressive symptoms: A randomized controlled trial.

Anxiety and depression, which are highly prevalent in adolescence, are both characterized by a negative attentional bias. As Attentional Bias Modification (ABM) can reduce such a bias, and might also affect emotional reactivity, it could be a promising early intervention. However, a growing number of studies also report comparable improvements in both active and placebo groups. The current study investigated the effects of eight online sessions of visual search (VS) ABM compared to both a VS placebo-training and a no-training control group in adolescents with heightened symptoms of anxiety and/or depression (n = 108). Attention bias, interpretation bias, and stress-reactivity were assessed pre- and post-training. Primary outcomes of anxiety and depressive symptoms, and secondary measures of emotional resilience were assessed pre- and post-training and at three and six months follow-up. Results revealed that VS training reduced attentional bias compared to both control groups, with stronger effects for participants who completed more training sessions. Irrespective of training condition, an overall reduction in symptoms of anxiety and depression and an increase in emotional resilience were observed up to six months later. The training was evaluated relatively negatively. Results suggest that online ABM as employed in the current study has no added value as an early intervention in adolescents with heightened symptoms.

Online attentional bias modification training targeting anxiety and depression in unselected adolescents: Short- and long-term effects of a randomized controlled trial.

Based on information processing models of anxiety and depression, we investigated the efficacy of multiple sessions of online attentional bias modification training to reduce attentional bias and symptoms of anxiety and depression, and to increase emotional resilience in youth. Unselected adolescents (N = 340, age: 11-18 years) were randomly allocated to eight sessions of a dot-probe, or a visual search-based attentional training, or one of two corresponding placebo control conditions. Cognitive and emotional measures were assessed pre- and post-training; emotional outcome measures also at three, six and twelve months follow-up. Only visual search training enhanced attention for positive information, and this effect was stronger for participants who completed more training sessions. Symptoms of anxiety and depression reduced, whereas emotional resilience improved. However, these effects were not especially pronounced in the active conditions. Thus, this large-scale randomized controlled study provided no support for the efficacy of the current online attentional bias modification training as a preventive intervention to reduce symptoms of anxiety or depression or to increase emotional resilience in unselected adolescents. However, the absence of biased attention related to symptomatology at baseline, and the large drop-out rates at follow-up preclude strong conclusions.

Implicit alcohol-relaxation associations in frequently drinking adolescents with high levels of neuroticism.

INTRODUCTION: Most individuals start drinking during adolescence, a period in which automatically activated or implicit cognitive processes play an important role in drinking behavior. The aim of this study was to examine personality-related antecedents of implicit associations between alcohol and positive or negative reinforcement motives in adolescents. It was hypothesized that frequent alcohol consumption in combination with specific personality traits (neuroticism for negative reinforcement and extraversion for positive reinforcement) could predict specific implicit alcohol-relaxation and arousal associations. METHODS: Participants completed a brief Big Five Questionnaire and alcohol use questions at T1. Approximately eight months later (T2), two Brief Implicit Association Tests were completed to assess alcohol-relaxation (negative reinforcement, n=222) and alcohol-arousal (positive reinforcement, n=248) associations. RESULTS: Results indicated that frequently drinking adolescents who scored high on neuroticism had the strongest alcohol-relaxation associations eight months later. No significant predictors were observed for alcohol-arousal associations. CONCLUSIONS: The current study identified precursors of strong implicit alcohol-relaxation associations (i.e., high levels of neuroticism in combination with frequent alcohol consumption) which can inform future prevention and intervention studies.

Visual search attentional bias modification reduced social phobia in adolescents.

BACKGROUND AND OBJECTIVES: An attentional bias for negative information plays an important role in the development and maintenance of (social) anxiety and depression, which are highly prevalent in adolescence. Attention Bias Modification (ABM) might be an interesting tool in the prevention of emotional disorders. The current study investigated whether visual search ABM might affect attentional bias and emotional functioning in adolescents. METHODS: A visual search task was used as a training paradigm; participants (n = 16 adolescents, aged 13-16) had to repeatedly identify the only smiling face in a 4 × 4 matrix of negative emotional faces, while participants in the control condition (n = 16) were randomly allocated to one of three placebo training versions. An assessment version of the task was developed to directly test whether attentional bias changed due to the training. Self-reported anxiety and depressive symptoms and self-esteem were measured pre- and post-training. RESULTS: After two sessions of training, the ABM group showed a significant decrease in attentional bias for negative information and self-reported social phobia, while the control group did not. There were no effects of training on depressive mood or self-esteem. LIMITATIONS: No correlation between attentional bias and social phobia was found, which raises questions about the validity of the attentional bias assessment task. Also, the small sample size precludes strong conclusions. CONCLUSIONS: Visual search ABM might be beneficial in changing attentional bias and social phobia in adolescents, but further research with larger sample sizes and longer follow-up is needed.

Autobiographical memories become less vivid and emotional after eye movements.

OBJECTIVES: To test (1) whether eye movements during retrieval of emotional memories are followed by less vividness and less emotionality of future recollections, (2) whether this effect, if present, is stronger than the effects of a control activity (finger tapping), (3) whether the alleged effects of tapping and eye movements are stronger than a no-movement, control condition (mere imagery), (4) whether reductions in vividness and emotionality after eye movements (and finger tapping) are specific to negative memories or also occur in the case of positive memories. METHOD: Sixty healthy volunteers recalled either positive or negative memories and scored the vividness and emotionality of the recollections. Next, memories were recalled whilst the participant was performing rapid eye movements, finger tapping, or not performing a dual task. Then participants were asked to recall the event again and to rate its vividness and emotionality. RESULTS: Compared to finger tapping and the no-dual-task condition, recollections after eye movements made future recollections less vivid. After eye movements, but not after the other interventions, negative memories became less negative, and positive memories became less positive. CONCLUSION: The findings show that eye movements not only reduce vividness and emotionality of memories during the eye moving, but also affect future recollections, during which no eye movements are made. Some theoretical explanations are discussed. As to clinical implications, it is suggested that if there is a role for eye-movement-based treatments, it is very limited.