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Emotional recognition training modifies neural response to emotional faces but does not improve mood in healthy volunteers with high levels of depressive symptoms

Published online by Cambridge University Press:  17 February 2020

Ian S. Penton-Voak Open the ORCID record for Ian S. Penton-Voak [Opens in a new window] ,
Sally Adams ,
Katherine S. Button ,
Meg Fluharty ,
Michael Dalili ,
Michael Browning ,
Emily A. Holmes ,
Catherine J. Harmer  and
Marcus R. Munafò
Ian S. Penton-Voak*
Affiliation:
School of Experimental Psychology, University of Bristol, Bristol, UK National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
Sally Adams
Affiliation:
Department of Psychology, University of Bath, Bath, UK
Katherine S. Button
Affiliation:
Department of Psychology, University of Bath, Bath, UK
Meg Fluharty
Affiliation:
School of Experimental Psychology, University of Bristol, Bristol, UK
Michael Dalili
Affiliation:
School of Social and Community Medicine, University of Bristol, Bristol, UK
Michael Browning
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK NIHR Oxford Health Biomedical Research Centre, Oxford, UK
Emily A. Holmes
Affiliation:
Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Solna, Sweden
Catherine J. Harmer
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK NIHR Oxford Health Biomedical Research Centre, Oxford, UK
Marcus R. Munafò
Affiliation:
School of Experimental Psychology, University of Bristol, Bristol, UK National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK UK Centre for Tobacco and Alcohol Studies, University of Bristol, Bristol, UK
*
Author for correspondence: Ian S. Penton-Voak, E-mail: [email protected]
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Abstract

Background

There is demand for new, effective and scalable treatments for depression, and development of new forms of cognitive bias modification (CBM) of negative emotional processing biases has been suggested as possible interventions to meet this need.

Methods

We report two double blind RCTs, in which volunteers with high levels of depressive symptoms (Beck Depression Inventory ii (BDI-ii) > 14) completed a brief course of emotion recognition training (a novel form of CBM using faces) or sham training. In Study 1 (N = 36), participants completed a post-training emotion recognition task whilst undergoing functional magnetic resonance imaging to investigate neural correlates of CBM. In Study 2 (N = 190), measures of mood were assessed post-training, and at 2-week and 6-week follow-up.

Results

In both studies, CBM resulted in an initial change in emotion recognition bias, which (in Study 2) persisted for 6 weeks after the end of training. In Study 1, CBM resulted in increases neural activation to happy faces, with this effect driven by an increase in neural activity in the medial prefrontal cortex and bilateral amygdala. In Study 2, CBM did not lead to a reduction in depressive symptoms on the BDI-ii, or on related measures of mood, motivation and persistence, or depressive interpretation bias at either 2 or 6-week follow-ups.

Conclusions

CBM of emotion recognition has effects on neural activity that are similar in some respects to those induced by Selective Serotonin Reuptake Inhibitors (SSRI) administration (Study 1), but we find no evidence that this had any later effect on self-reported mood in an analogue sample of non-clinical volunteers with low mood (Study 2).

Keywords

cognitive bias modificationdepressionemotion recognitionfacial expressioninterpretative biaslow mood
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 7 , May 2021 , pp. 1211 - 1219
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Copyright
Copyright © Cambridge University Press 2020

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References

Adams, S., Penton-Voak, I. S., Harmer, C. J., Holmes, E. A., & Munafo, M. R. (2013). Effects of emotion recognition training on mood among individuals with high levels of depressive symptoms: Study protocol for a randomised controlled trial. Trials, 14, 161.CrossRefGoogle ScholarPubMed
Altman, E. G., Hedeker, D., Peterson, J. L., & Davis, J. M. (1997). The Altman Self-Rating Mania Scale. Biological Psychiatry, 42, 948–955.CrossRefGoogle ScholarPubMed
Beck, A. T., Brown, G., Epstein, N., & Steer, R. A. (1988). An inventory for measuring clinical anxiety – psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897.CrossRefGoogle ScholarPubMed
Beck, A.T., Steer, R.A., & Brown, G.K. (1996). Manual for the beck depression inventory-II. San Antonio, TX: Psychological Corporation.Google Scholar
Cotter, J., Granger, K., Backx, R., Hobbs, M., Looi, C. Y., & Barnett, J. H. (2018). Social cognitive dysfunction as a clinical marker: A systematic review of meta-analyses across 30 clinical conditions. Neuroscience and Biobehavioral Reviews, 84, 92–99.CrossRefGoogle ScholarPubMed
Cristea, I. A., Kok, R. N., & Cuijpers, P. (2015). Efficacy of cognitive bias modification interventions in anxiety and depression: Meta-analysis. British Journal of Psychiatry, 206, 7–16.CrossRefGoogle ScholarPubMed
Dalili, M. N., Penton-Voak, I. S., Harmer, C. J., & Munafo, M. R. (2015). Meta-analysis of emotion recognition deficits in major depressive disorder. Psychological Medicine, 45, 1135–1144.CrossRefGoogle ScholarPubMed
Dalili, M. N., Schofield-Toloza, L., Munafo, M. R., & Penton-Voak, I. S. (2017). Emotion recognition training using composite faces generalises across identities but not all emotions. Cognition & Emotion, 31, 858–867.CrossRefGoogle Scholar
Davidson, R. J., Jackson, D. C., & Kalin, N. H. (2000). Emotion, plasticity, context, and regulation: Perspectives from affective neuroscience. Psychological Bulletin, 126, 890–909.CrossRefGoogle ScholarPubMed
Disner, S. G., Beevers, C. G., Haigh, E. A. P., & Beck, A. T. (2011). Neural mechanisms of the cognitive model of depression. Nature Reviews Neuroscience, 12, 467–477.CrossRefGoogle ScholarPubMed
Drevets, W. C. (2001). Neuroimaging and neuropathological studies of depression: Implications for the cognitive-emotional features of mood disorders. Current Opinion in Neurobiology, 11, 240–249.CrossRefGoogle ScholarPubMed
Godlewska, B. R., Norbury, R., Selvaraj, S., Cowen, P. J., & Harmer, C. J. (2012). Short-term SSRI treatment normalises amygdala hyperactivity in depressed patients. Psychological Medicine, 42, 2609–2617.CrossRefGoogle ScholarPubMed
Grafton, B., Macleod, C., Rudaizky, D., Holmes, E. A., Salemink, E., Fox, E., & Notebaert, L. (2017). Confusing procedures with process when appraising the impact of cognitive bias modification on emotional vulnerability. British Journal of Psychiatry, 211, 266–271.CrossRefGoogle ScholarPubMed
Griffiths, S., Jarrold, C., Penton-Voak, I. S., & Munafo, M. R. (2015). Feedback training induces a bias for detecting happiness or fear in facial expressions that generalises to a novel task. Psychiatry Research, 230, 951–957.CrossRefGoogle ScholarPubMed
Grimm, S., Boesiger, P., Beck, J., Schuepbach, D., Bermpohl, F., Walter, M., … Northoff, G. (2009). Altered negative BOLD responses in the default-mode network during emotion processing in depressed subjects. Neuropsychopharmacology, 34, 932–943.CrossRefGoogle ScholarPubMed
Hamilton, J. P., Etkin, A., Furman, D. J., Lemus, M. G., Johnson, R. F., & Gotlib, I. H. (2012). Functional neuroimaging of major depressive disorder: A meta-analysis and new integration of baseline activation and neural response data. American Journal of Psychiatry, 169, 693–703.CrossRefGoogle ScholarPubMed
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology Neurosurgery and Psychiatry, 23, 56–62.CrossRefGoogle ScholarPubMed
Harmer, C. J., Mackay, C. E., Reid, C. B., Cowen, P. J., & Goodwin, G. M. (2006). Antidepressant drug treatment modifies the neural processing of nonconscious threat cues. Biological Psychiatry, 59, 816–820.CrossRefGoogle ScholarPubMed
Harmer, C. J., Goodwin, G. M., & Cowen, P. J. (2009). Why do antidepressants take so long to work? A cognitive neuropsychological model of antidepressant drug action. British Journal of Psychiatry, 195, 102–108.CrossRefGoogle Scholar
Hirsch, C. R., Clark, D. M., & Mathews, A. (2006). Imagery and interpretations in social phobia: Support for the combined cognitive biases hypothesis. Behavior Therapy, 37, 223–236.CrossRefGoogle ScholarPubMed
Holmes, E. A., Ghaderi, A., Harmer, C. J., Ramchandani, P. G., Cuijpers, P., Morrison, A. P., … Craske, M. G. (2018). The Lancet Psychiatry Commission on psychological treatments research in tomorrow's science. The Lancet. Psychiatry, 5, 237–286.CrossRefGoogle ScholarPubMed
Keedwell, P. A., Andrew, C., Williams, S. C. R., Brammer, M. J., & Phillips, M. L. (2005). The neural correlates of anhedonia in major depressive disorder. Biological Psychiatry, 58, 843–853.CrossRefGoogle ScholarPubMed
Lemogne, C., Le Bastard, G., Mayberg, H., Volle, E., Bergouignan, L., Lehericy, S., … Fossati, P. (2009). In search of the depressive self: Extended medial prefrontal network during self-referential processing in major depression. Social Cognitive and Affective Neuroscience, 4, 305–312.CrossRefGoogle ScholarPubMed
Lewis, G., Pelosi, A. J., Araya, R., & Dunn, G. (1992). Measuring psychiatric disorder in the community – a standardized assessment for use by lay interviewers. Psychological Medicine, 22, 465–486.CrossRefGoogle ScholarPubMed
Nelson, H. E. (1982). The national adult reading test (NART): Test manual. Windsor: NFER-Nelson.Google Scholar
Penton-Voak, I. S., Bate, H., Lewis, G., & Munafo, M. R. (2012). Effects of emotion perception training on mood in undergraduate students: Randomised controlled trial. British Journal of Psychiatry, 201, 71–72.CrossRefGoogle ScholarPubMed
Penton-Voak, I. S., Munafo, M. R., & Looi, C. Y. (2017). Biased facial-emotion perception in mental health disorders: A possible target for psychological intervention? Current Directions in Psychological Science, 26, 294–301.CrossRefGoogle Scholar
Penton-Voak, I. S., Thomas, J., Gage, S. H., Mcmurran, M., Mcdonald, S., & Munafo, M. R. (2013). Increasing recognition of happiness in ambiguous facial expressions reduces anger and aggressive behavior. Psychological Science, 24, 688–697.CrossRefGoogle ScholarPubMed
Peters, S. E., Lumsden, J., Peh, O. H., Penton-Voak, I. S., Munafo, M. R., & Robinson, O. J. (2017). Cognitive bias modification for facial interpretation: A randomized controlled trial of transfer to self-report and cognitive measures in a healthy sample. Royal Society Open Science, 4, 170681.CrossRefGoogle Scholar
Pictet, A., Coughtrey, A. E., Mathews, A., & Holmes, E. A. (2011). Fishing for happiness: The effects of generating positive imagery on mood and behaviour. Behaviour Research and Therapy, 49, 885–891.CrossRefGoogle ScholarPubMed
Price, J. L., & Drevets, W. C. (2010). Neurocircuitry of mood disorders. Neuropsychopharmacology, 35, 192–216.CrossRefGoogle ScholarPubMed
Rawdon, C., Murphy, D., Motyer, G., Munafo, M. R., Penton-Voak, I., & Fitzgerald, A. (2018). An investigation of emotion recognition training to reduce symptoms of social anxiety in adolescence. Psychiatry Research, 263, 257–267.CrossRefGoogle ScholarPubMed
Renner, F., Siep, N., Lobbestael, J., Arntz, A., Peeters, F., & Huibers, M. J. H. (2015). Neural correlates of self-referential processing and implicit self-associations in chronic depression. Journal of Affective Disorders, 186, 40–47.CrossRefGoogle ScholarPubMed
Rude, S. S., Wenzlaff, R. M., Gibbs, B., Vane, J., & Whitney, T. (2002). Negative processing biases predict subsequent depressive symptoms. Cognition & Emotion, 16, 423–440.CrossRefGoogle Scholar
Sander, D., Grafman, J., & Zalla, T. (2003). The human amygdala: An evolved system for relevance detection. Reviews in the Neurosciences, 14, 303–316.CrossRefGoogle ScholarPubMed
Santos, A., Mier, D., Kirsch, P., & Meyer-Lindenberg, A. (2011). Evidence for a general face salience signal in human amygdala. Neuroimage, 54, 3111–3116.CrossRefGoogle ScholarPubMed
Tottenham, N., Tanaka, J. W., Leon, A. C., Mccarry, T., Nurse, M., Hare, T. A., … Nelson, C. (2009). The NimStim set of facial expressions: Judgments from untrained research participants. Psychiatry Research, 168, 242–249.CrossRefGoogle ScholarPubMed
Warren, M. B., Pringle, A., & Harmer, C. J. (2015). A neurocognitive model for understanding treatment action in depression. Philosophical Transactions of the Royal Society B: Biological Sciences, 370, 12.CrossRefGoogle ScholarPubMed
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect – the PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070.CrossRefGoogle ScholarPubMed
Yoshimura, S., Okamoto, Y., Onoda, K., Matsunaga, M., Ueda, K., Suzuki, S., & Yamawaki, S. (2010). Rostral anterior cingulate cortex activity mediates the relationship between the depressive symptoms and the medial prefrontal cortex activity. Journal of Affective Disorders, 122, 76–85.CrossRefGoogle ScholarPubMed
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