Abstract
This study examined concurrent and prospective associations between attentional biases for emotional images and relapse to depression. Previously depressed (n = 121) and never depressed (n = 28) women completed an eye-tracking task to measure attentional biases for emotional images (face images and naturalistic images) and were then followed for 6 months to assess for relapse to depression. Participants returned for a follow-up session that included the eye-tracking task after a relapse or after 6 months. Previously depressed women who experienced a relapse to depression during the study period showed the hypothesized pattern of decreased attention to positive images and increased attention to negative images, relative to previously depressed women who did not experience a relapse and never depressed women. This was true at the initial visit for naturalistic images and at the follow-up visit for both face and naturalistic images. Women who relapsed had greater attentional biases for some image types at the follow-up visit (when in a state of relapse) than the initial visit (when in a state of remission). Contrary to hypothesis, non-relapsed previously depressed women did not exhibit attentional biases for emotional images relative to never depressed women. Reduced attention to positive images prospectively predicted relapse to depression among the previously depressed women. The results clarify how attentional biases manifest and change from a remitted to relapsed state and provide preliminary evidence for reduced attention to positive information as a risk factor for depression recurrence.
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Notes
Three participants were missing eye tracking data for the face images and four participants were missing eye tracking data for the naturalistic images, resulting in samples sizes for the regression analyses of N = 118 and N = 117 for the face images and naturalistic images, respectively.
Previously depressed participants who dropped out or were lost to follow-up did not differ from those who attended both study visits on age or depression symptoms at the initial visit (BDI-II, PHQ-C, PHQ-L), all p > 0.10.
For the face image set, three participants from the non-relapsed group were missing data (due to technical issues with the eye-tracking system or calibration errors), resulting in a sample of 28 never depressed, 104 non-relapsed, and 14 relapsed participants for the analyses of dwell times for the face images. For the naturalistic image set, one participant from the never depressed group and four participants from the non-relapsed group were missing data (for the same reasons), resulting in a sample of 27 never depressed, 103 non-relapsed, and 14 relapsed participants for the analyses of dwell times for the naturalistic images.
Levene’s test of homogeneity of variances was significant for the happy faces, p < 0.05. The Brown-Forsythe robust test confirmed that the groups differed in their dwell times for happy faces, F(2, 69.29) = 9.87, p < 0.001.
Levene’s test of homogeneity of variances was significant for the positive images, p < .05. The Brown-Forsythe robust test confirmed that the groups differed in their dwell times for positive images, F(2, 56.67) = 5.41, p < .01.
We thank an anonymous reviewer for suggesting this possibility.
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Acknowledgements
We thank two anonymous reviewers for their excellent feedback and suggestions. This research was supported by the Canadian Institutes of Health Research (CIHR) and the Natural Sciences and Engineering Council of Canada (NSERC).
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Kristin Newman, Leanne Quigley, Amanda Fernandez, Keith Dobson, and Christopher Sears declare that they have no conflict of interest.
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Newman, K., Quigley, L., Fernandez, A. et al. Concurrent and Prospective Relations Between Attentional Biases for Emotional Images and Relapse to Depression. Cogn Ther Res 43, 893–909 (2019). https://doi.org/10.1007/s10608-019-10017-y
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DOI: https://doi.org/10.1007/s10608-019-10017-y