Academic journal article Cognitive, Affective and Behavioral Neuroscience

Training Attention Improves Decision Making in Individuals with Elevated Self-Reported Depressive Symptoms

Academic journal article Cognitive, Affective and Behavioral Neuroscience

Training Attention Improves Decision Making in Individuals with Elevated Self-Reported Depressive Symptoms

Article excerpt

Published online: 7 November 2013

© Psychonomic Society, Inc. 2013

Abstract Depression is often characterized by attentional biases toward negative items and away from positive items, which likely affects reward and punishment processing. Recent work has reported that training attention away from negative stimuli reduced this bias and reduced depressive symptoms. However, the effect of attention training on subsequent learning has yet to be explored. In the present study, participants were required to learn to maximize reward during decision making. Undergraduates with elevated self-reported depressive symptoms received attention training toward positive stimuli priortoperformingthedecision-makingtask(n = 20; active training). The active-training group was compared to two other groups: undergraduates with elevated self-reported depressive symptoms who received placebo training (n =22;placebo training) and a control group with low levels of depressive symptoms (n = 33; nondepressive control). The placebotraining depressive group performed worse and switched between options more than did the nondepressive controls on the reward maximization task. However, depressives that received active training performed as well as the nondepressive controls. Computational modeling indicated that the placebotrained group learned more from negative than from positive prediction errors, leading to more frequent switching. The nondepressive control and active-training depressive groups showed similar learning from positive and negative prediction errors, leading to less-frequent switching and better performance. Our results indicate that individuals with elevated depressive symptoms are impaired at reward maximization, but that the deficit can be improved with attention training toward positive stimuli.

Keywords Depression · Decision making · Computational modeling · Reflexive processing · Reward · Punishment

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Depression is a common, recurrent, and impairing condition that predicts negative life events, including future suicide attempts, interpersonal problems, unemployment, and substance abuse (Kessler et al., 2003; Kessler & Walters, 1998). The World Health Organization has reported that approximately 120 million people currently suffer from depression, and many more have elevated depressive symptoms. Furthermore, adults with elevated depressive symptoms, even in the absence of major depressive disorder, have poor physical, social, and role functioning as compared to a demographically similar group without a chronic health condition. The well-being and psychosocial functioning of individuals with elevated depressive symptoms is comparable to that of people with major chronic medical conditions, such as hypertension, diabetes, and arthritis (K. B. Wells & Trust, 1989).

Cognitive theories of depression (e.g., Beck, 1976; Teasdale, 1988) argue that a contributing factor to depression is an attentional bias for depression-relevant themes. Depressed individuals focus attention on negative selfreferent thoughts and exhibit enhanced effortful recall of negatively valenced material (Mathews & MacLeod, 2005). Supporting this, several studies have documented a negative attentional bias in depression (Mogg & Bradley, 2005). In addition, depression is also associated with the absence of a positive attentional bias. That is, nondepressed individuals typically have an attentional bias toward positive stimuli relative to neutral stimuli, which is often lacking among depressives (Ellis, Beevers, & Wells, 2011;Gotlib& Krasnoperova, 1998; Sears, Thomas, LeHuquet, & Johnson, 2010). Thus, depression involves biased attention toward negative stimuli and the absence of a bias toward positive stimuli.

Depression is also associated with decreased sensitivity to reward (i.e., Henriques, Glowacki, & Davidson, 1994; Pizzagalli et al., 2009) and decision-making deficits (Beevers et al. …

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