A comprehensive meta-analysis of interpretation biases in depression

Abstract

Interpretation biases have long been theorized to play a central role in depression. Yet, the strength of the empirical evidence for this bias remains a topic of debate. This meta-analysis aimed to estimate the overall effect size and to identify moderators relevant to theory and methodology. PsycINFO, Embase, Web of Science, Scopus, PubMed, and dissertation databases were searched. A random-effects meta-analysis was performed on 87 studies (N=9443). Results revealed a medium overall effect size (g=0.72, 95%-CI:[0.62;0.82]). Equivalent effect sizes were observed for patients diagnosed with clinical depression (g=0.60, 95%-CI:[0.37;0.75]), patients remitted from depression (g=0.59, 95%-CI:[0.33;0.86]), and undiagnosed individuals reporting elevated depressive symptoms (g=0.66, 95%-CI:[0.47;0.84]). The effect size was larger for self-referential stimuli (g=0.90, 95%-CI[0.78;1.01]), but was not modified by the presence (g=0.74, 95%-CI[0.59;0.90]) or absence (g=0.72, 95%-CI[0.58;0.85]) of mental imagery instructions. Similar effect sizes were observed for a negative interpretation bias (g=0.58, 95%-CI:[0.40;0.75]) and lack of a positive interpretation bias (g=0.60, 95%-CI:[0.36;0.85]). The effect size was only significant when interpretation bias was measured directly (g=0.88, 95%-CI[0.77;0.99]), but not when measured indirectly (g=0.04, 95%-CI[-0.14;0.22]). It is concluded that depression is associated with interpretation biases, but caution is necessary because methodological factors shape conclusions. Implications and recommendations for future research are outlined.

The impact of depression and culture on responses to intrusive autobiographical memories: Cognitive appraisals, cognitive avoidance, and brooding rumination

“…These findings align with previous research suggesting that Western cultures have a strong desire to minimize negative self‐related information and personal control and responsibility for negative events, when compared to East Asians who instead tend to have greater tolerance of negative self‐information and responsibility for negative experiences (Bjorck et al ., ; Fry & Grover, ; Kitayama et al ., ). Despite these cultural differences, we found that, regardless of cultural group, those with depression reported significantly greater negative, control, and responsibility appraisals than controls, which is consistent with the negative interpretation biases observed during depression (Everaert, Podina, & Koster, ). Furthermore, these memory appraisals differentiated between Asian participants with and without depression in a similar pattern to that observed in the European Australian group.…”

Assessment of self‐contempt in psychotherapy: A neurobehavioural perspective

“…Whelton and Greenberg () were among the first who studied self‐critical processes marked by self‐contempt in dysthymic individuals. They showed that the cognitive contents of the self‐criticism were similar across participants, consistent with what was found in the meta‐analysis by Everaert et al (). However, when the researchers tried to predict incremental symptom loads in their sample, the nonverbal and paraverbal emotional processes of self‐contempt were the only factor differentiating individuals with more or less depressed mood.…”

“…the self-criticism were similar across participants, consistent with what was found in the meta-analysis by Everaert et al (2017). However, when the researchers tried to predict incremental symptom loads in their sample, the nonverbal and paraverbal emotional processes of self-contempt were the only factor differentiating individuals with more or less depressed mood.…”

Relationships between depressive symptoms and brain responses during emotional movie viewing emerge in adolescence

“…Similarly, these participants may have engaged in more stimulusindependent cognition and/or idiosyncratic interpretation during less emotional (and perhaps less engaging) moments, which could account for the inverse association between functional typicality and symptom severity observed across the clip. Although speculative, this candidate explanation aligns with interpretation bias, a phenomenon in which depressed individuals adopt rigid, overly pessimistic responses to emotional (and especially negatively valenced) information (3,46,54,55). This set of findings deserves close consideration in future studies, as interpretation bias represents just one possible explanation for these observed effects.…”