Patterns of perceptual asymmetry in depression and anxiety: Implications for neuropsychological models of emotion and psychopathology.

More than 1,000 university undergraduates were simultaneously classified as either high or low depressed and high or low anxious and given a face-processing task that typically elicits a left hemispatial bias. Depression and anxiety were associated with opposing biases in perceptual asymmetry scores. In particular, high-depressed students had smaller left hemispatial biases than low-depressed students, whereas high-anxious students had larger left hemispatial biases than low-anxious students. The results suggest that depression and anxiety may be associated with different patterns of asymmetric hemispheric function. Because the rate of comorbidity of depression and anxiety in the population is high, these findings confirm the importance of separating anxiety and depression when examining the relationship among patterns of brain activity, emotion, and psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Investigating models of affect: Relationships among EEG alpha asymmetry, depression, and anxiety.

The approach-withdrawal and valence-arousal models both predict that depressive and anxious profiles will be associated with relatively reduced left frontal and increased right frontal activity respectively, while the valence-arousal model also proposes a dissociation by lower and higher right parietotemporal activity, respectively. Recent work further suggests that subtypes of anxiety disorders may be characterized by distinctive patterns of activity depending on their type of arousal (anxious arousal/apprehension). The aim of this study was to investigate the relationships among nonclinical depression/anxiety and lateralized frontal/parietotemporal activity by categorizing participants (N = 428) on the basis of both negative mood and alpha EEG. Key findings include: (i) greater right frontal lateralization in anxious participants, symmetrical frontal activity in depressed/comorbid, and left frontal lateralization in healthy controls; (ii) right frontal lateralization in anxious arousal participants, left frontal and right parietotemporal lateralization in anxious apprehension; (iii) bilateral increase in frontal and increased right parietotemporal activity in depressed/comorbid participants. Findings support predictions for frontal but not posterior regions. Grouping on the basis of EEG may not be reciprocally predictive of negative mood groupings, suggesting involvement of additional factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Selective attention to affective stimuli and clinical depression among youths: Role of anxiety and specificity of emotion.

Cognitive models of psychopathology posit that the content or focus of information-processing biases (e.g., attentional biases) is disorder specific: Depression is hypothesized to be characterized by attentional biases specifically for depression-relevant stimuli (e.g., sad facial expressions), whereas anxiety should relate particularly to attentional biases to threat-relevant stimuli (e.g., angry faces). However, little research has investigated this specificity hypothesis and none with a sample of youths. The present study examined attentional biases to emotional faces (sad, angry, and happy compared with neutral) in groups of pure depressed, pure anxious, comorbid depressed and anxious, and control youths (ages 9–17 years; N = 161). Consistent with cognitive models, pure depressed and pure anxious youths exhibited attentional biases specifically to sad and angry faces, respectively, whereas comorbid youths exhibited attentional biases to both facial expressions. In addition, control youths exhibited attentional avoidance of sad faces, and comorbid boys avoided happy faces. Overall, findings suggest that cognitive biases and processing of particular emotional information are specific to pure clinical depression and anxiety, and results inform etiological models of potentially specific processes that are associated with internalizing disorders among youths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Discriminating patterns of emotions in 10- and 11-yr-old children's anxiety and depression.

Evaluated emotional variables in the discrimination and prediction of anxiety and depression in 280 5th and 6th graders. Ss and teachers completed inventories assessing the Ss' emotions, anxiety level, and depression level twice, 4 mo apart. The battery included the Trait scale of the State-Trait Anxiety Inventory for Children and the Children's Depression Inventory. Results indicate that distinct patterns of emotional variables are involved in anxiety and depression syndromes, and these patterns confirm the hypotheses based on differential emotions theory. An attempt to predict future depression was successful when based on the Ss' self-reported emotions but not when based on the teachers' ratings of the Ss' emotions. It is concluded that the latter may have been due to the high stability (Time 1/Time 2 correlation) of the depression measure over the 4-mo interval. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective test of an integrative interpersonal theory of depression: A naturalistic study of college roommates.

This study tested an integrated interpersonal theory of depression, which combines J. C. Coyne's (1976) interpersonal theory of depression with work on the interplay between self-enhancement and self-consistency theory. Students' (targets') and their same-gender roommates' appraisals of each other, depression and anxiety levels, reassurance seeking, and negative feedback seeking were assessed at Time 1 (T1), and again at Time 2 (T2), 3 wks later. Consistent with the theoretical integration (1) depressed targets reported engaging in more negative feedback seeking than nondepressed targets, and tended to report seeking more reassurance than nondepressed targets at T1; (2) for male (but not female) targets, the combination of negative feedback seeking, high reassurance seeking, and depression at T1 predicted T1 to T2 increases in rejection by roommates; and (3) rejection effects applied to depressive symptoms, but not anxious symptoms or anhedonic mood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns of regional brain activity differentiate types of anxiety.

Previous studies have reported hemispheric asymmetries in brain activity in anxiety, but the direction of asymmetry has been inconsistent. A distinction between anxious apprehension (e.g., worry) and anxious arousal (e.g., panic), as types of anxiety, may account for some of the discrepancies. To test this proposition, the authors selected participants with self-reported anxious apprehension and experimentally manipulated anxious arousal. Regional brain activity was examined by recording electroencephalograms during rest and during an emotional narrative task designed to elicit anxious arousal. Overall, anxious participants showed a larger asymmetry in favor of the left hemisphere than did controls. In contrast, during the task, anxious participants showed a selective increase in right parietal activity. The results support the hypothesis that anxious apprehension and anxious arousal are associated with different patterns of regional brain activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Regional brain asymmetries in major depression with or without an anxiety disorder: a quantitative electroencephalographic study

Studies of brain activity in affective disorders need to distinguish between effects of depression and anxiety because of the substantial comorbidity of these disorders. Based on a model of asymmetric hemispheric activity in depression and anxiety, it was predicted that anxious and nonanxious depressed patients would differ on electroencephalographic (EEG) measures of parietotemporal activity. Resting EEG (eyes closed and eyes open) was recorded from 44 unmedicated outpatients having a unipolar major depressive disorder (19 with and 25 without an anxiety disorder), and 26 normal controls using 30 scalp electrodes (13 homologous pairs over the two hemispheres and four midline sites). As predicted, depressed patients with an anxiety disorder differed from those without an anxiety disorder in alpha asymmetry. Nonanxious depressed patients showed an alpha asymmetry indicative of less activation over right than left posterior sites, whereas anxious depressed patients showed evidence of greater activation over right than left anterior and posterior sites. The findings are discussed in terms of a model in which specific symptom features of depression and anxiety are related to different patterns of regional brain activity.     

Vulnerability to depressive symptomatology: A prospective test of the diathesis-stress and causal mediation components of the hopelessness theory of depression.

The diathesis-stress and causal mediation components of the hopelessness theory of depression (L. Y. Abramson et al, 1989) were tested using a prospective methodology. Measures of the 3 vulnerability factors posited by the theory (cognitive diatheses about cause, consequences, and self) were completed by 152 Ss at Time (T) 1. Ss completed measures of depressive symptoms, anxious symptoms, and hopelessness at T1 and again at T2, 5 wks later. Naturally occurring stressors were assessed at T2 (covering the T1–T2 interval). Consistent with the diathesis-stress component, each Cognitive Diathesis?×?Stress (CD?×?S) interaction predicted onset of depressive symptoms from T1 to T2. In contrast, the CD?×?S interactions predicted neither state nor trait anxiety. In addition, 2 of the 3 CD?×?S interactions (those involving cause and self, but not consequences) were partially mediated by hopelessness. Implications for future work on the hopelessness theory of depression are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Generalized self-efficacy, self-esteem, and negative affect.

In order to help resolve the ongoing debate about the relationship between and the functions of self-esteem and generalized self-efficacy (GSE), the authors tested the hypotheses that GSE predicts future self-esteem and that self-esteem predicts unique incremental variance in future negative affect. Measures of these three constructs were administered to two samples of undergraduates (N = 160 and N = 75) twice over five-six weeks. Time 1 GSE accounted for significant variance in Time 2 self-esteem in both studies, 1.6% of the variance in Study 1 and 4.6% of the variance in Study 2, after controlling for Time 1 self-esteem. Time 1 self-esteem did not predict Time 2 GSE in either study. Self-esteem accounted for significant variance in negative affect in Study 1. Results suggest that GSE and self-esteem are distinct, that GSE may play a role in the development of self-esteem, and that self-esteem may help shape negative affect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression and anxious apprehension distinguish frontocingulate cortical activity during top-down attentional control.

A network consisting of left dorsolateral prefrontal cortex (LDLPFC) and dorsal anterior cingulate cortex (dACC) has been implicated in top-down attentional control. Few studies have systematically investigated how this network is altered in psychopathology, despite evidence that depression and anxiety are associated with attentional control impairments. Functional MRI and dense-array event-related brain potential (ERP) data were collected in separate sessions from 100 participants during a color–word Stroop task. Functional MRI results guided ERP source modeling to characterize the time course of activity in LDLPFC (300–440 ms) and dACC (520–680 ms). At low levels of depression, LDLPFC activity was indirectly related to Stroop interference and only via dACC activity. In contrast, at high levels of depression, dACC did not play an intervening role, and increased LDLPFC activity was directly related to decreased Stroop interference. Specific to high levels of anxious apprehension, higher dACC activity was related to more Stroop interference. Results indicate that depression and anxious apprehension modulate temporally and functionally distinct aspects of the frontocingulate network involved in top-down attention control. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Perfectionism and depression: Longitudinal assessment of a specific vulnerability hypothesis.

The authors tested whether perfectionism dimensions interact with specific stress to predict depression over time. A sample of 103 current and former patients completed measures of perfectionism and depression at Time 1 and measures of stress and depression 4 months later. After controlling for Time 1 depression, self-oriented perfectionism interacted only with achievement stress to predict Time 2 depression. Socially prescribed perfectionism did not interact with achievement or social stress to predict Time 2 depression, but it did predict Time 2 depression as a main effect. The results provide support for the contention that perfectionism dimensions are involved in vulnerability to depression over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term stability of depression, anxiety, and stress syndromes.

At Time 1, 3,540 participants completed the Depression Anxiety Stress Scales (DASS). At Time 2, 3 to 8 years later, the DASS was readministered to 882 of these participants. There was strong evidence for selective stability of the syndromes of depression, anxiety, and stress. Each Time 2 scale was best predicted by the same scale at Time 1, with no significant increase in prediction from the other 2 Time 1 scales. Stability of the 3 syndromes did not vary systematically over the intervals studied. The results support the longitudinal stability of depression, anxiety, and stress and, in particular, draw attention to the distinction between anxiety symptoms and tension–stress symptoms. The results were interpreted as supporting the existence of syndrome-specific vulnerabilities, over and above a primary general vulnerability to emotional distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A meta-analysis of the effect of cognitive bias modification on anxiety and depression.

Cognitive biases have been theorized to play a critical role in the onset and maintenance of anxiety and depression. Cognitive bias modification (CBM), an experimental paradigm that uses training to induce maladaptive or adaptive cognitive biases, was developed to test these causal models. Although CBM has generated considerable interest in the past decade, both as an experimental paradigm and as a form of treatment, there have been no quantitative reviews of the effect of CBM on anxiety and depression. This meta-analysis of 45 studies (2,591 participants) assessed the effect of CBM on cognitive biases and on anxiety and depression. CBM had a medium effect on biases (g = 0.49) that was stronger for interpretation (g = 0.81) than for attention (g = 0.29) biases. CBM further had a small effect on anxiety and depression (g = 0.13), although this effect was reliable only when symptoms were assessed after participants experienced a stressor (g = 0.23). When anxiety and depression were examined separately, CBM significantly modified anxiety but not depression. There was a nonsignificant trend toward a larger effect for studies including multiple training sessions. These findings are broadly consistent with cognitive theories of anxiety and depression that propose an interactive effect of cognitive biases and stressors on these symptoms. However, the small effect sizes observed here suggest that this effect may be more modest than previously believed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Hemispheric laterality and memory bias for threat in anxiety disorder.

Examined auditory perceptual asymmetries and explicit memory biases for threat in patients with panic disorder and generalized anxiety disorder relative to healthy control Ss. They did not find a greater explicit memory bias for threat in the anxiety patients. However, explicit memory biases for threat were associated with perceptual asymmetry scores; patients with a greater right-ear (left hemisphere) advantage exhibited an explicit memory bias for threat material, whereas patients with a lower right-ear advantage displayed apparent cognitive avoidance of threat material. Memory for threat words was unrelated to perceptual asymmetry in healthy control Ss. These findings suggest that neuropsychological variables may partly determine the degree to which anxiety patients process threatening stimuli. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comorbidity of anxiety and depression in children and adolescents.

Anxiety and depression in children and adolescents are reviewed, including differential diagnosis, assessment of symptoms, family history data, developmental features, and clinical correlates. Findings indicate that 15.9% to 61.9% of children identified as anxious or depressed have comorbid anxiety and depressive disorders and that measures of anxiety and depression are highly correlated. Family history data are inconclusive. Differences emerged among children with anxiety, depression, or both disorders. Anxious children were distinguishable from the other 2 groups in that they showed less depressive symptomatology and tended to be younger. The concurrently depressed and anxious group tended to be older and more symptomatic. In this group, the anxiety symptoms tended to predate the depressive symptoms. Findings are discussed in the context of a proposed developmental sequence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpretive biases for one's own behavior and physiology in high-trait-anxious individuals and repressors.

The experiments reported here were designed to test predictions from a cognitive theory of personality proposed by M. W. Eysenck (1997). According to that theory, many of the observed differences between individuals high in trait anxiety and repressors (individuals low in trait anxiety and high in social desirability) depend on underlying individual differences in cognitive biases. It follows from the theory that high-anxious individuals should have an interpretive bias for their own behavior in social situations, that is, they exaggerate how anxious it is. In contrast, repressors should have an opposite interpretive bias for their own behavior, that is, they underestimate how anxious it is. Evidence consistent with these predictions was obtained in Experiments 1 and 2. Implications of these findings for cognitive theories of personality are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attention biases to threat and behavioral inhibition in early childhood shape adolescent social withdrawal.

Behavioral inhibition (BI) is a temperament characterized in young children by a heightened sensitivity to novelty, social withdrawal, and anxious behaviors. For many children, these social difficulties dissipate over time. For others, patterns of social withdrawal continue into adolescence. Over time, attention biases to threat may influence the stability of BI and its association with social withdrawal, ultimately modulating the risk for anxiety disorders in BI children. However, we know relatively little about the cognitive processes that accompany BI and shape later socioemotional functioning. We examined the relations among BI in childhood, attention biases to threat in adolescence, and adolescent social withdrawal in a longitudinal study (N = 126, Mean age = 15 years). As has been reported in anxious adults, adolescents who were behaviorally inhibited as toddlers and young children showed heightened attention bias to threat. In addition, attention bias to threat moderated the relation between childhood BI and adolescent social withdrawal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Overt and covert attention and vibrotactile reaction times: Gaze direction, spatial compatibility and hemispatial asymmetry.

Performed 2 vibrotactile reaction time (RT) experiments, using 32 strongly dextral undergraduates to determine if (1) Ss attention toward/away from the operating hand effected RT and (2) there was an interaction with hand-hemispace and spatial compatibility. In Exp I, 16 Ss were administered a 250 Hz vibratory stimulus to the forefinger of a hand and were required to depress a switch as soon as the stimulus was felt. Hemispace of the stimulated hand was varied and head turns were recorded. In Exp II, 16 Ss were presented with stimuli to the left and the right hand and Ss looked at 1 hand for a block of trials. Results suggest that vibrotactile asymmetries may stem from differences in ability to hold covert attention in a number of spatial locations. It is suggested that overt and covert attention play different mediating roles in performance asymmetries, both at the hemispatial level and in classical anatomical connectivity paradigms of visual field and ear of entry. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anger style, psychopathology, and regional brain activity.

Depression and anxiety often involve high levels of trait anger and disturbances in anger expression. Reported anger experience and outward anger expression have recently been associated with left-biased asymmetry of frontal cortical activity, assumed to reflect approach motivation. However, different styles of anger expression could presumably involve different brain mechanisms and/or interact with psychopathology to produce various patterns of brain asymmetry. The present study explored these issues by comparing resting regional electroencephalographic activity in participants high in trait anger who differed in anger expression style (high anger-in, high anger-out, both) and participants low in trait anger, with depression and anxiety systematically assessed. Trait anger, not anger-in or anger-out, predicted left-biased asymmetry at medial frontal EEG sites. The anger-in group reported higher levels of anxious apprehension than did the anger-out group. Furthermore, anxious apprehension moderated the relationship between trait anger, anger-in, and asymmetry in favor of the left hemisphere. Results suggest that motivational direction is not always the driving force behind the relationship of anger and left frontal asymmetry. Findings also support a distinction between anxious apprehension and anxious arousal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical risk factors for the generation of life events in major depression.

This study examines the relationship of anxiety disorder and dysthymia comorbidity to the generation of life events prior to major depression episode onset in a cross-sectional community sample of 76 women. Those with comorbid anxiety and dysthymia experienced higher rates of events that were at least partly dependent on their own behavior but did not differ from those without these clinical risk factors on independent life events outside of their control. This relationship remained significant even after controlling for overall severity of depression and demographic covariates. The implications of these results for understanding the increased rates of major depression onset and recurrence among those with comorbid anxiety and dysthymia are discussed as avenues of future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)