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Attention Biases in Previously Depressed Individuals: A Meta-Analysis and Implications for Depression Recurrence

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Abstract

Background

Depression is a severely disabling disorder, with high recurrence rates suggesting that depression-prone individuals may be characterized by stable vulnerability-factors. Cognitive theories of depression posit that aberrant negative and positive attention biases confer vulnerability for depression recurrence. Attention biases toward negative information and lack of bias toward positive information during depressive episodes have been widely documented. In contrast, the nature of attention biases following termination of a depressive episode has been more scantly studied. We conducted a systematic-review and meta-analyses of extant studies on attention biases in previously depressed participants.

Methods

Dysphoric and positive attention biases were compared in 13 studies contrasting previously and never depressed participants (ns = 1051 and 957, respectively) and six studies contrasting previously and currently depressed participants (ns = 397 and 217, respectively).

Results

Relative to never depressed, previously depressed participants showed a larger dysphoric bias (g = 0.29, 95% CI 0.08, 0.49) and a smaller positive bias (g = − 0.17, 95% CI − 0.33, − 0.01), whereas no difference was identified between previously and currently depressed participants.

Conclusions

These findings suggest that attention biases may be active even when depressive episodes recede, potentially reflecting risk-markers for depression recurrence that could serve as targets for preventative intervention. We also conclude that the limited number of studies available for meta-analysis may limit definitive conclusions. We hope that this first meta-analysis on attention biases following depressive episodes will inspire this much needed additional research.

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Data Availability

This meta-analysis was registered in the PROSPERO international prospective register of systematic reviews (registration ID: CRD42021233440). All data generated or analyzed in this meta-analysis are available in https://osf.io/46hrm/?view_only=86768c26f8444e9e9d7c2a2d655cf2d0.

Notes

  1. Subgroups moderator analyses can be conducted only if a sufficient number of studies are obtained for each of the moderator’s sub-categories (k ≥ 4; Fu et al., 2008).

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

Authors

Contributions

DSL and YBH: developed the study concept and study design. Data extraction and quality assessment were performed by DSL and ML. DSL: performed the data analysis and interpretation under the supervision of YBH. All authors drafted the manuscript and agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Dana Shamai-Leshem.

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Conflict of interest

Dana Shamai-Leshem, Marian Linetzky and Yair Bar-Haim declare that they have no conflict of interest.

Animal Rights

No animal studies were carried out for this study.

Informed Consent

No human subjects were involved in this review article.

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Supplementary Information

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Supplementary file1 (DOCX 223 KB)

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Cite this article

Shamai-Leshem, D., Linetzky, M. & Bar-Haim, Y. Attention Biases in Previously Depressed Individuals: A Meta-Analysis and Implications for Depression Recurrence. Cogn Ther Res 46, 1033–1048 (2022). https://doi.org/10.1007/s10608-022-10331-y

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  • DOI: https://doi.org/10.1007/s10608-022-10331-y

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