Posted 04.15.2020 | by AMRA

People with major depressive disorder (MDD) show an attentional bias in which they over-attend to negative information while often ignoring positive information. This attentional bias feeds, reinforces, and prolongs depressive thought patterns, and serves as an underlying risk factor for depressive symptom onset and relapse.

Mindfulness-Based Cognitive Therapy (MBCT) is an approach to psychotherapy that combines features of mindfulness meditation and cognitive behavioral therapy. The program has been shown to effectively reduce the odds of depressive relapse among people with MDD. Less is known about the efficacy of the program for alleviating current depressive symptoms.

Holas et al. [Mindfulness] conducted a randomized controlled trial to test if MBCT reduces attentional bias and depressive symptoms in patients with current MDD.

The researchers randomly assigned 53 adults with untreated current major depressive episodes (100% Polish Caucasian; 74% female; average age = 35 years) to an 8-week MBCT program or a wait-list control. Participants completed a self-report measure of depressive symptoms (CESD) and were assessed on an eye movement tracking task, measuring attentional bias immediately before and after the intervention period.

In that task, participants viewed slides with sad, angry, happy, and neutral faces in each of the four quadrants of the slide while their eye movements and fixations were recorded in milliseconds. This enabled researchers to calculate the relative amount of time participants spent gazing at each of the different faces.

The results showed that MBCT affected how long participants gazed at the various faces. Participants in the MBCT group significantly increased the amount of time they gazed at happy faces from pretest to posttest (ηp2=.23) and decreased their gaze at sad (ηp2=.09) and angry (ηp2=.14 ) faces, whereas controls showed no changes on these measures.

At pretest, the MBCT group gazed at the happy faces an average of 2.234 seconds and at posttest they gazed at the them for 2.965 seconds. At pretest MBCT participants spent 27% of their time per slide gazing at happy faces, and at posttest 35% of their time. In addition, the MBCT group gazed significantly longer at happy faces (ηp2=.25) and shorter at sad faces (ηp2=.18) than controls at posttest.

MBCT participants also reported significantly fewer depressive symptoms after intervention (ηp2=.15) than controls.

This study finds that MBCT significantly decreases depression-related attentional bias as well as current self-reported depressive symptoms immediately following intervention. These findings are important because attentional bias is thought to be an underlying risk factor in initiating and prolonging recurring depressive states. The eye fixation measure is a particularly good measure of attentional bias because it reflects behavior largely outside of conscious control.

Additionally, the findings support the utility of MBCT in treating people who are currently depressed, extending previous research findings focused on the prevention of depression relapse in people who are already recovered. The study implications are limited by the absence of an active comparator group and longer-term follow-up.

Reference:

Holas, P., Krejtz, I., Wisiecka, K., Rusanowska, M., & Nezlek, J. B. (2020). Modification of attentional bias to emotional faces following mindfulness-based cognitive therapy in people with a current depression. Mindfulness.

[Link to study]