Negative information enhances the attentional blink in dysphoria

Comparing the Effects of Thought Suppression and Focused Distraction on Pain-Related Attentional Biases in Men and Women

Increasing attentional focus away from pain can affect pain experience, suggesting that cognitive strategies that move attentional allocation may be a moderator of pain. In a pre-post-design, the present study examined the effects of 2 cognitive strategies used in pain contexts, thought suppression and focused distraction, on subsequent pain-related attention. Thought suppression was hypothesized to increase pain-related attention, whereas focused distraction was expected to reduce it. Influences of both anxiety and sex were also considered, as secondary questions. 139 (86 women, 53 men) healthy, pain-free participants were randomly assigned to use either thought suppression or focused distraction during a mild cold pressor test (CPT). Pain-related attention was examined using a dot-probe and an attentional blink task, pre-and post-CPT. Questionnaires about relevant cognitive and emotional aspects, demographics, and pain were completed. Results showed no difference in the effect of the 2 pain inhibition strategies on pain-related attention. The hypothesized rebound effect in thought suppression on pain-related attention did not emerge. However, thought suppression showed a short-term benefit in comparison to focused distraction regarding reported pain and perceived threat during the cold pressor test. Few sex differences were found. Thus, the cognitive strategies affected pain outcomes, but did not influence pain-related attention. PERSPECTIVE: Cognitive strategies could help with pain through changing attention allocation. In this study, the effects of the 2 cognitive strategies thought suppression and focused distraction on pain-related attention in men and women were examined. Elucidating mechanisms that lie behind pain strategies that focus on changing attention may help improve treatments.

Training the attentional blink: subclinical depression decreases learning potential

The attentional blink (AB) reflects a temporal restriction of selective attention and is generally regarded as a very robust phenomenon. However, previous studies have found large individual differences in AB performance, and under some training conditions the AB can be reduced significantly. One factor that may account for individual differences in AB magnitude is the ability to accurately time attention. In the current study, we focus on the sensitivity for temporal information on the ability to control attention. Following a visual AB task, a time estimation task was presented in either the visual or auditory modality, followed by another visual AB task. It was found that the time estimation training in both the auditory and visual modality reduced AB magnitude. Although a reduction in AB magnitude was also observed when individuals were trained on a control task (either an auditory frequency or visual line length estimation task), the effect was significantly larger following the time estimation tasks. In addition, it was found that individuals who showed most improvement on the visual time estimation task, also showed the largest reduction in AB magnitude, which was not the case for individuals who were trained on the control tasks. Finally, a negative correlation was observed between depression scores (tested by Beck Depression Inventory-Short Form (BDI-SF) scores and the improvement in the AB and time estimation tasks. Our findings demonstrate clear links between timing ability and mechanisms to control attention and emotion.

Body Dissatisfaction Enhances Awareness and Facilitates the Consolidation of Body-Related Words During Rapid Serial Visual Presentation

Attentional biases have received considerable focus in research on cognitive biases and body dissatisfaction (BD). However, most work has focused on spatial allocation of attention. The current two experiments employed a rapid serial visual presentation (RSVP) task to investigate attention bias to body-related words in the temporal domain among young females with high and low BD. During this task, there were two targets presented in the same stimulus stream. The first target was defined as target one (T1) and the second was defined as target 2 (T2). Participants were asked to identify T2 while ignoring T1 in single task mode or identify both targets in the dual task mode. In the current study, Experiment 1 assessed the stimulus-driven attention of body-related stimuli. Participants were required to identify a target of neutral word (T2) as quickly and accurately as possible while ignoring the preceding target (T1) of neutral, fat-, or thin-related words. As expected, we observed spontaneous attentional blink (AB) effects elicited by both fat- and thin-related T1s among participants with high BD, suggesting enhanced awareness of body-related stimuli even when this information does not have to be identified. Such effects did not emerge among participants without BD. Experimental 2 investigated the goal-directed attention of body-related stimuli, during which participants needed to identify both the T1 and neutral T2. Participants with BD showed reduced AB effects after both fat- and thin-related T1, suggesting facilitated consolidation of body-related information in goal-directed attention among participants with BD. These findings have important clinical implications that it provided insight for creating more accurate attention bias modification (ABM) task aiming at reducing and preventing BD among young females.

Stressful Life Events, Cognitive Biases, and Symptoms of Depression in Young Adults

Although the link between stressful experiences and depression has been supported in numerous studies, the specific mechanisms of this relationship are still unclear. Cognitive theories of depression postulate that the influence of stress on depression may be modified by cognitive factors. The aim of the present study was to examine the interplay between negative life events, cognitive vulnerability factors, and depressive symptoms. It was hypothesized that the relationship between negative life events and symptoms of depression is shaped by rumination and cognitive biases. The study sample consisted of 108 young adults (19 men and 89 women; M = 20.31; SD = 1.84). Memory bias and attentional bias were assessed using the Attentional Blink Task and the Memory Task, respectively. Rumination and depressive symptoms were assessed via self-report questionnaires. Logistic regression and moderation analyses were conducted to examine the relationship between the study variables. Stressful life events, rumination and memory bias were found to be significantly related to depressive symptoms. Moderation analyses revealed that there is a positive relationship between negative life events and depressive symptoms but only among individuals characterized by an elevated level of rumination and among participants exhibiting negative attentional bias. The results provide further evidence for cognitive models of depression.

The influence of positive and negative affect on emotional attention

BACKGROUND AND OBJECTIVES

Mechanisms of engagement and disengagement of attention to emotional information are thought to contribute to the onset and maintenance of anxiety and depression, a conclusion based largely on findings in analogue subclinical samples. However, we argue that traditionally defined analogue samples can be misleading. Firstly, research has challenged the adequacy of conventional measures of subclinical traits by illustrating that supposedly distinct scales are highly inter-correlated and do not therefore measure independent constructs. Secondly, recent research in clinical groups has revealed results opposite to those expected from the analogue literature, suggesting speeded, rather than impaired, disengagement from threat.

METHODS

We present analogue findings, from a sample of 70 healthy participants, allowing a purer distinction between the phenomenology of anxiety versus depression using the orthogonal traits of positive and negative affect to classify individuals.

RESULTS

Using emotional peripheral cueing we found that, at short cue durations, dysphoric individuals' (those with low positive and high negative affect) attention to facial expressions was slowed by emotional compared to neutral invalid cues.

LIMITATIONS

Limitations included a small sample size and limited generalisability due to sampling from a student population.

CONCLUSIONS

The data suggest that, in line with the previous subclinical literature, dysphoric individuals are slow to disengage attention from emotional information at early stages of processing and are consistent with the possibility that patterns of orienting of attention might be qualitatively different in subclinical versus clinical populations.

Do arousal and valence have separable influences on attention across time?

Previous research has shown that emotions differentially influence attention across time, especially when the valence of the attended stimuli is congruent with the emotion of observer. Sadness produces a larger attentional blink while fear and happiness produce smaller attentional blinks. We report on four dual-task rapid serial visual presentation experiments in which participant emotion and the affective features of the first target (T1) were systematically varied to determine whether arousal and valence have unique and consistent influences on attention performance. All T1s connoted affect. Results showed that the emotional experience of negative affect with high arousal led to better second target (T2) detection than negative affect with low arousal. In conditions where positive affect was the experienced emotion, low arousal resulted in better T2 detection than high arousal. When participant arousal was held constant at a low level there were no differences in performance. When participant arousal was high, a cross-over effect was observed in which negative affect produced better performance than positive affect at early positions and negative affect produced better performance at late. The first targets in these experiments varied in arousal and valence to test for emotion congruent effects, but none were found. It was concluded that the experience of varied levels of arousal and types of valence do not have separable influences on attention across time. Rather, their influence is more consistent with emotion-specific mechanisms.

Reduced detection of positive expressions in major depression

In patients with depression, negative biases have been reported in various cognitive domains, but few studies have examined whether even detection is affected, i.e. are depressed patients more likely to detect the presence of negative stimuli? This study compared detection of sad and happy faces in patients (n=17) and healthy participants (n=18) using an attentional blink task. Patients with depression detected significantly fewer happy faces than matched healthy participants, but for sad faces the group difference was non-significant. The results suggest that depression may affect the detection of positive stimuli.

An fMRI study of cognitive control in problem gamers

A small proportion of video game players develop uncontrolled gaming behavior. A dysfunctional cognitive control circuit may explain this excessive behavior. Therefore, the current study investigated whether problem gamers are characterized by deficits in various aspects of cognitive control (inhibitory control, error processing, attentional control) by measuring brain activation using functional magnetic resonance imaging during Go-NoGo and Stroop task performance. In addition, both impulsivity and attentional control were measured using self-reports. Participants comprised 18 problem gamers who were compared with 16 matched casual gaming controls. Results indicate significantly increased self-reported impulsivity levels and decreased inhibitory control accompanied by reduced brain activation in the left inferior frontal gyrus (IFG) and right inferior parietal lobe (IPL) in problem gamers relative to controls. Significant hypoactivation in the left IFG in problem gamers was also observed during Stroop task performance, but groups did not differ on behavioral and self-reported measures of attentional control. No evidence was found for reduced error processing in problem gamers. In conclusion, the current study provides evidence for reduced inhibitory control in problem gamers, while attentional control and error processing were mostly intact. These findings implicate that reduced inhibitory control and elevated impulsivity may constitute a neurocognitive weakness in problem gamers.

Mood-specific effects in the allocation of attention across time

Participants completed single and dual rapid serial visual presentation (RSVP) tasks. Across five experiments, either the mood of the participant or valence of the target was manipulated to create pairings in which the critical target was either mood congruent or mood noncongruent. When the second target (T2) in an RSVP stream was congruent with the participant's mood, performance was enhanced. This was true for happy and sad moods and in single- and dual-task conditions. In contrast, the effects of congruence varied when the focus was on the first target (T1). When in a sad mood and having attended to a sad T1, detection of a neutral T2 was impaired, resulting in a stronger attentional blink (AB). There was no effect of stimulus-mood congruence for T1 when in a happy mood. It was concluded that mood-congruence is important for stimulus detection, but that sadness uniquely influences post-identification processing when attention is first focused on mood-congruent information.

Attention to memory: orienting attention to sound object representations

Despite a growing acceptance that attention and memory interact, and that attention can be focused on an active internal mental representation (i.e., reflective attention), there has been a paucity of work focusing on reflective attention to 'sound objects' (i.e., mental representations of actual sound sources in the environment). Further research on the dynamic interactions between auditory attention and memory, as well as its degree of neuroplasticity, is important for understanding how sound objects are represented, maintained, and accessed in the brain. This knowledge can then guide the development of training programs to help individuals with attention and memory problems. This review article focuses on attention to memory with an emphasis on behavioral and neuroimaging studies that have begun to explore the mechanisms that mediate reflective attentional orienting in vision and more recently, in audition. Reflective attention refers to situations in which attention is oriented toward internal representations rather than focused on external stimuli. We propose four general principles underlying attention to short-term memory. Furthermore, we suggest that mechanisms involved in orienting attention to visual object representations may also apply for orienting attention to sound object representations.

Genes for Emotion-Enhanced Remembering Are Linked to Enhanced Perceiving

Emotionally enhanced memory and susceptibility to intrusive memories after trauma have been linked to a deletion variant (i.e., a form of a gene in which certain amino acids are missing) of ADRA2B, the gene encoding subtype B of the α2-adrenergic receptor, which influences norepinephrine activity. We examined in 207 participants whether variations in this gene are responsible for individual differences in affective influences on initial encoding that alter perceptual awareness. We examined the attentional blink, an attentional impairment during rapid serial visual presentation, for negatively arousing, positively arousing, and neutral target words. Overall, the attentional blink was reduced for emotional targets for ADRA2B-deletion carriers and noncarriers alike, which reveals emotional sparing (i.e., reduction of the attentional impairment for words that are emotionally significant). However, deletion carriers demonstrated a further, more pronounced emotional sparing for negative targets. This finding demonstrates a contribution of genetics to individual differences in the emotional subjectivity of perception, which in turn may be linked to biases in later memory.

Prefrontal control of attention to threat

Attentional control refers to the regulatory processes that ensure that our actions are in accordance with our goals. Dual-system accounts view temperament as consisting of both individual variation in emotionality (e.g., trait anxiety) and variation in regulatory attentional mechanisms that act to modulate emotionality. Increasing evidence links trait variation in attentional control to clinical mood and anxiety disorder symptoms, independent of trait emotionality. Attentional biases to threat have been robustly linked to mood and anxiety disorders. However, the role of variation in attentional control in influencing such biases, and the neural underpinnings of trait variation in attentional control, are unknown. Here, we show that individual differences in trait attentional control, even when accounting for trait and state anxiety, are related to the magnitude of an attentional blink (AB) following threat-related targets. Moreover, we demonstrate that activity in dorso-lateral prefrontal cortex (DLPFC), is observed specifically in relation to control of attention over threatening stimuli, in line with neural theories of attentional control, such as guided activation theory. These results have key implications for neurocognitive theories of attentional bias and emotional resilience.

On the blink: the importance of target-distractor similarity in eliciting an attentional blink with faces

Temporal allocation of attention is often investigated with a paradigm in which two relevant target items are presented in a rapid sequence of irrelevant distractors. The term Attentional Blink (AB) denotes a transient impairment of awareness for the second of these two target items when presented close in time. Experimental studies reported that the AB is reduced when the second target is emotionally significant, suggesting a modulation of attention allocation. The aim of the present study was to systematically investigate the influence of target-distractor similarity on AB magnitude for faces with emotional expressions under conditions of limited attention in a series of six rapid serial visual presentation experiments. The task on the first target was either to discriminate the gender of a neutral face (Experiments 1, 3–6) or an indoor/outdoor visual scene (Experiment 2). The task on the second target required either the detection of emotional expressions (Experiments 1–5) or the detection of a face (Experiment 6). The AB was minimal or absent when targets could be easily discriminated from each other. Three successive experiments revealed that insufficient masking and target-distractor similarity could account for the observed immunity of faces against the AB in the first two experiments. An AB was present but not increased when the facial expression was irrelevant to the task suggesting that target-distractor similarity plays a more important role in eliciting an AB than the attentional set demanded by the specific task. In line with previous work, emotional faces were less affected by the AB.

Mood modulates auditory laterality of hemodynamic mismatch responses during dichotic listening

Hemodynamic mismatch responses can be elicited by deviant stimuli in a sequence of standard stimuli even during cognitive demanding tasks. Emotional context is known to modulate lateralized processing. Right-hemispheric negative emotion processing may bias attention to the right and enhance processing of right-ear stimuli. The present study examined the influence of induced mood on lateralized pre-attentive auditory processing of dichotic stimuli using functional magnetic resonance imaging (fMRI). Faces expressing emotions (sad/happy/neutral) were presented in a blocked design while a dichotic oddball sequence with consonant-vowel (CV) syllables in an event-related design was simultaneously administered. Twenty healthy participants were instructed to feel the emotion perceived on the images and to ignore the syllables. Deviant sounds reliably activated bilateral auditory cortices and confirmed attention effects by modulation of visual activity. Sad mood induction activated visual, limbic and right prefrontal areas. A lateralization effect of emotion-attention interaction was reflected in a stronger response to right-ear deviants in the right auditory cortex during sad mood. This imbalance of resources may be a neurophysiological correlate of laterality in sad mood and depression. Conceivably, the compensatory right-hemispheric enhancement of resources elicits increased ipsilateral processing.

Delayed attentional disengagement from sad face: a study of alpha rhythm by event-related desynchronization

This study investigated the influence of different emotional facial cues on the detection of subsequent visual digit targets presented after various cue-target intervals (CTIs). Behavioral results indicated that, compared to neutral faces, happy faces facilitated the response to subsequent tasks only after a short CTI (17 ms), while sad faces would slow or inhibit the processing of following tasks after different CTIs (17, 350, 1000, and 1500 ms). Event-related desynchronization of alpha rhythm (α-ERD) showed that the left frontal and parietal cortical areas were more prominently activated by emotional faces than by neutral ones. In particular, happy faces induced more activity in left frontal lobes, starting from the beginning of CTI (post-cue 0~400 ms), while sad faces induced stronger and longer activation during the middle of CTI (post-cue 400~800 ms). Such a later a-ERD in left frontal area suggested that the attentional disengagement was slowed by sad faces.

Disrupting the rhythm of depression using Mobile Cognitive Therapy for recurrent depression: randomized controlled trial design and protocol

BACKGROUND

Major depressive disorder (MDD) is projected to rank second on a list of 15 major diseases in terms of burden in 2030. The major contribution of MDD to disability and health care costs is largely due to its highly recurrent nature. Accordingly, efforts to reduce the disabling effects of this chronic condition should shift to preventing recurrence, especially in patients at high risk of recurrence. Given its high prevalence and the fact that interventions are necessary during the remitted phase, new approaches are needed to prevent relapse in depression.

METHODS/DESIGN

The best established effective and available psychological intervention is cognitive therapy. However, it is costly and not available for most patients. Therefore, we will compare the effectiveness and cost-effectiveness of self-management supported by online CT accompanied by SMS based tele-monitoring of depressive symptomatology, i.e. Mobile Cognitive Therapy (M-CT) versus treatment as us usual (TAU). Remitted patients (n = 268) with at least two previous depressive episodes will be recruited and randomized over (1) M-CT in addition to TAU versus (2) TAU alone, with follow-ups at 3, 12, and 24 months. Randomization will be stratified for number of previous episodes and type of treatment as usual. Primary outcome is time until relapse/recurrence over 24 months using DSM-IV-TR criteria as assessed by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID). For the economic evaluation the balance between costs and health outcomes will be compared across strategies using a societal perspective.

DISCUSSION

Internet-based interventions might be helpful in empowering patients to become their own disease managers in this lifelong recurrent disorder. This is, as far as we are aware of, the first study that examines the (cost) effectiveness of an E-mental health program using SMS monitoring of symptoms with therapist support to prevent relapse in remitted recurrently depressed patients.

TRIAL REGISTRATION

Netherlands Trial Register (NTR): NTR2503.

Disrupting the rhythm of depression: design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressants

BACKGROUND

Maintenance treatment with antidepressants is the leading strategy to prevent relapse and recurrence in patients with recurrent major depressive disorder (MDD) who have responded to acute treatment with antidepressants (AD). However, in clinical practice most patients (up to 70-80%) are not willing to take this medication after remission or take too low dosages. Moreover, as patients need to take medication for several years, it may not be the most cost-effective strategy. The best established effective and available alternative is brief cognitive therapy (CT). However, it is unclear whether brief CT while tapering antidepressants (AD) is an effective alternative for long term use of AD in recurrent depression. In addition, it is unclear whether the combination of AD to brief CT is beneficial.

METHODS/DESIGN

Therefore, we will compare the effectiveness and cost-effectiveness of brief CT while tapering AD to maintenance AD and the combination of CT with maintenance AD. In addition, we examine whether the prophylactic effect of CT was due to CT tackling illness related risk factors for recurrence such as residual symptoms or to its efficacy to modify presumed vulnerability factors of recurrence (e.g. rigid explicit and/or implicit dysfunctional attitudes). This is a multicenter RCT comparing the above treatment scenarios. Remitted patients on AD with at least two previous depressive episodes in the past five years (n = 276) will be recruited. The primary outcome is time related proportion of depression relapse/recurrence during minimal 15 months using DSM-IV-R criteria as assessed by the Structural Clinical Interview for Depression. Secondary outcome: economic evaluation (using a societal perspective) and number, duration and severity of relapses/recurrences.

DISCUSSION

This will be the first trial to investigate whether CT is effective in preventing relapse to depression in recurrent depression while tapering antidepressant treatment compared to antidepressant treatment alone and the combination of both. In addition, we explore explicit and implicit mediators of CT.

TRIAL REGISTRATION

Netherlands Trial Register (NTR): NTR1907.

Understanding vulnerability for depression from a cognitive neuroscience perspective: A reappraisal of attentional factors and a new conceptual framework

We propose a framework to understand increases in vulnerability for depression after recurrent episodes that links attention processes and schema activation to negative mood states, by integrating cognitive and neurobiological findings. Depression is characterized by a mood-congruent attentional bias at later stages of information processing. The basic idea of our framework is that decreased activity in prefrontal areas, mediated by the serotonin metabolism which the HPA axis controls, is associated with an impaired attenuation of subcortical regions, resulting in prolonged activation of the amygdala in response to stressors in the environment. Reduced prefrontal control in interaction with depressogenic schemas leads to impaired ability to exert attentional inhibitory control over negative elaborative processes such as rumination, leading in turn to sustained negative affect. These elaborative processes are triggered by the activation of negative schemas after confrontation with stressors. In our framework, attentional impairments are postulated as a crucial process in explaining the increasing vulnerability after depressive episodes, linking cognitive and biological vulnerability factors. We review the empirical data on the biological factors associated with the attentional impairments and detail how they are associated with rumination and mood regulation. The aim of our framework is to stimulate translational research.

Mood-congruent attention and memory bias in dysphoria: Exploring the coherence among information-processing biases

Recent studies indicate that depression is characterized by mood-congruent attention bias at later stages of information-processing. Moreover, depression has been associated with enhanced recall of negative information. The present study tested the coherence between attention and memory bias in dysphoria. Stable dysphoric (n = 41) and non-dysphoric (n = 41) undergraduates first performed a spatial cueing task that included negative, positive, and neutral words. Words were presented for 250 ms under conditions that allowed or prevented elaborate processing. Memory for the words presented in the cueing task was tested using incidental free recall. Dysphoric individuals exhibited an attention bias for negative words in the condition that allowed elaborate processing, with the attention bias for negative words predicting free recall of negative words. Results demonstrate the coherence of attention and memory bias in dysphoric individuals and provide suggestions on the influence of attention bias on further processing of negative material.