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Covariation bias in depression - a predictor of treatment response?

Journal of Neural Transmission volume 126, pages 1653–1665 (2019)Cite this article

Abstract

Covariation bias, defined as an overestimation of the relationship between fear-relevant stimuli and aversive consequences, is a well-investigated cognitive bias in anxiety disorders. As patients with affective disorders also show biased information processing, the aim of the present study was to investigate whether depressed patients also display a covariation bias between negative stimuli and aversive consequences. Covariation estimates of 62 inpatients with a current severe depressive episode were assessed at admission (n = 31) or after 6 weeks of treatment (n = 31) and were compared in a between-group design with 31 age- and sex-matched healthy controls. All participants showed a covariation bias for the relationship between negative stimuli and aversive consequences. Moreover, covariation bias at admission was significantly associated with various clinician- and self-reported dimensional measures of treatment response assessed 6 weeks later (Global Assessment of Functioning, Clinical Global Impression Scale, and Beck Depression Inventory), i.e., patients with a stronger bias showed greater impairment after 6 weeks of treatment. Categorical analyses revealed that overall, treatment non-responders—but not responders—were characterized by a covariation bias. The naturalistic study design without standardized pharmacological and psychotherapeutic treatments is a central limitation. We conclude that the covariation bias may constitute a possible marker in the field of emotional information processing in the search for effective predictors of therapy outcome.

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Funding

This work was supported by a grant from the Interdisciplinary Center for Clinical Research (IZKF), University of Wuerzburg (N-258 to LH), and from the German Research Foundation DFG, SFB-TRR-58, projects B01 to PP and project B05, and DFG project 378414384 to JW.

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Affiliations

  1. Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany

    Saskia Stonawski, Catherina Wurst, Jannika Reitz, Leif Hommers & Andreas Menke

  2. Department of Biological Psychology, Clinical Psychology and Psychotherapy, Center of Mental Health, University of Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany

    Julian Wiemer & Paul Pauli

  3. Interdisciplinary Center for Clinical Research, University Hospital of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany

    Leif Hommers & Andreas Menke

  4. Comprehensive Hearth Failure Center (CHFC), University Hospital of Würzburg, Am Schwarzenberg 15, 97078, Würzburg, Germany

    Leif Hommers & Andreas Menke

  5. Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, Hauptstr. 5, 79104, Freiburg, Germany

    Katharina Domschke & Miriam A. Schiele

Authors
  1. Saskia Stonawski
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  2. Julian Wiemer
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  3. Catherina Wurst
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  4. Jannika Reitz
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  5. Leif Hommers
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  6. Andreas Menke
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  7. Katharina Domschke
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  8. Miriam A. Schiele
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  9. Paul Pauli
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Correspondence to Paul Pauli.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Appendix

Appendix

See Table 4.

Table 4 IAPS slides used in the experimental task
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Stonawski, S., Wiemer, J., Wurst, C. et al. Covariation bias in depression - a predictor of treatment response?. J Neural Transm 126, 1653–1665 (2019). https://doi.org/10.1007/s00702-019-02091-z

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  • DOI: https://doi.org/10.1007/s00702-019-02091-z

Keywords

  • Covariation bias
  • Affective disorders
  • Severe depressive episode
  • Treatment response