Cognitive neuropsychological theory: Reconciliation of psychological and biological approaches for depression

Godlewska, Beata R.

doi:10.1016/j.pharmthera.2018.12.010

Cited by 10 publications

(8 citation statements)

References 122 publications

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“…For example, another large study used change in facial emotion recognition in an algorithm to predict antidepressant response, but adding word categorisation or recall did not improve predictions (Browning et al, 2019 ). Facial emotion recognition tasks may be particularly sensitive to changes in emotional processing because the ability to recognise human emotions is fundamental to social interactions (Godlewska, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

The effect of sertraline on emotional processing: secondary analyses of the PANDA randomised controlled trial

et al. 2021

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Background According to the cognitive neuropsychological model, antidepressants reduce symptoms of depression and anxiety by increasing positive relative to negative information processing. Most studies of whether antidepressants alter emotional processing use small samples of healthy individuals, which lead to low statistical power and selection bias and are difficult to generalise to clinical practice. We tested whether the selective serotonin reuptake inhibitor (SSRI) sertraline altered recall of positive and negative information in a large randomised controlled trial (RCT) of patients with depressive symptoms recruited from primary care. Methods The PANDA trial was a pragmatic multicentre double-blind RCT comparing sertraline with placebo. Memory for personality descriptors was tested at baseline and 2 and 6 weeks after randomisation using a computerised emotional categorisation task followed by a free recall. We measured the number of positive and negative words correctly recalled (hits). Poisson mixed models were used to analyse longitudinal associations between treatment allocation and hits. Results A total of 576 participants (88% of those randomised) completed the recall task at 2 and 6 weeks. We found no evidence that positive or negative hits differed according to treatment allocation at 2 or 6 weeks (adjusted positive hits ratio = 0.97, 95% CI 0.90–1.05, p = 0.52; adjusted negative hits ratio = 0.99, 95% CI 0.90–1.08, p = 0.76). Conclusions In the largest individual placebo-controlled trial of an antidepressant not funded by the pharmaceutical industry, we found no evidence that sertraline altered positive or negative recall early in treatment. These findings challenge some assumptions of the cognitive neuropsychological model of antidepressant action.

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Section: Discussionmentioning

confidence: 99%

The effect of sertraline on emotional processing: secondary analyses of the PANDA randomised controlled trial

et al. 2021

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“…The cognitive neuropsychological hypothesis of antidepressant action (Harmer et al, 2009b, Godlewska, 2018) was developed in an attempt to understand a puzzling phenomenon of the delay in the appearance of the clear clinical effect of antidepressant drugs (ADs), which characterizes the majority of currently used antidepressant medications. This is counterintuitive as although the molecular, cellular and chemical effects occur very quickly after a drug gets administered, within the course of hours, symptomatic improvement is rarely seen before 1 week (Taylor 2007), with clear and sustained effects often not evident until 4-6 weeks of administration (Mitchell 2006;Frazer and Benmansour 2002).…”

Section: The Cognitive Neuropsychological Hypothesis Of Antidepressanmentioning

confidence: 99%

“…These studies have important implications for the CNP theory. For example, they facilitated a hypothesis regarding the mode of action of new fast-acting antidepressant drugs, discussed in more detail below (Stuart et al 2015, Godlewska 2018.…”

Section: Testing the Validity Of The Cognitive Neuropsychological Hypmentioning

confidence: 99%

Cognitive neuropsychological theory of antidepressant action: a modern-day approach to depression and its treatment

Godlewska

Harmer

2020

Psychopharmacology

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Depression is a leading cause of disability worldwide and improving its treatment is a core research priority for future programmes. A change in the view of psychological and biological processes, from seeing them as separate to complementing one another, has introduced new perspectives on pathological mechanisms of depression and treatment mode of action. This review presents a theoretical model that incorporated this novel approach, the cognitive neuropsychological hypothesis of antidepressant action. This model proposes that antidepressant treatments decrease the negative bias in the processing of emotionally salient information early in the course of antidepressant treatment, which leads to the clinically significant mood improvement later in treatment. The paper discusses the role of negative affective biases in the development of depression and response to antidepressant treatments. It also discusses whether the model can be applied to other antidepressant interventions and its potential translational value, including treatment choice, prediction of response and drug development.

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“…4-6 weeks) treatment, this delay in antidepressant action seems to be counterintuitive, as the molecular, cellular and chemical effects occur very quickly after a drug is administered, and recent studies have demonstrated that beneficial effects on biased cognition are evident even after the first dose. The cognitive neuropsychological theory of antidepressant action [107,108] was developed in an attempt to understand this potential paradox and states that the induction of a more positive way of processing environmental stimuli (positive bias) leads to cognitive and psychological reconsolidation [107]. This theory is consistent with cognitive models of depression, which emphasize the importance of correcting negative biases in information processing in the successful treatment of this disorder [23,109].…”

Section: Implications For Treatmentmentioning

confidence: 85%

Neuromolecular Underpinnings of Negative Cognitive Bias in Depression

Noworyta-Sokołowska

Cieślik

Ryguła

2021

Cells

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This selective review aims to summarize the recent advances in understanding the neuromolecular underpinnings of biased cognition in depressive disorder. We begin by considering the cognitive correlates of depressed mood and the key brain systems implicated in its development. We then review the core findings across two domains of biased cognitive function in depression: pessimistic judgment bias and abnormal response to negative feedback. In considering their underlying substrates, we focus on the neurochemical mechanisms identified by genetic, molecular and pharmacological challenge studies. We conclude by discussing experimental approaches to the treatment of depression, which are derived largely from an improved understanding of its cognitive substrates.

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Cognitive neuropsychological theory: Reconciliation of psychological and biological approaches for depression

Cited by 10 publications

References 122 publications

The effect of sertraline on emotional processing: secondary analyses of the PANDA randomised controlled trial

The effect of sertraline on emotional processing: secondary analyses of the PANDA randomised controlled trial

Cognitive neuropsychological theory of antidepressant action: a modern-day approach to depression and its treatment

Neuromolecular Underpinnings of Negative Cognitive Bias in Depression

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