The relationship between change in social evaluation learning and mood in early antidepressant treatment: a prospective cohort study in primary care

Abstract

Background: It has been proposed that antidepressants operate by increasing sensitivity to positive versus negative information. Increasing positive affective learning within social contexts may play a key role in remediating negative self-schema. We investigated the association between change in biased learning of social evaluations about the self and others, and mood during early antidepressant treatment. Method: Prospective cohort assessing patients recruited from primary care sites in South West England at four timepoints over the first 8 weeks of antidepressant treatment. At each timepoint participants completed self-report measures of depression (BDI-II, PHQ-9), anxiety (GAD-7), and a computerised task measuring learning of social evaluations about the self, a friend, and a stranger. Results: We did not find evidence that learning about the self was associated with a reduction in PHQ-9 (b=0.08, 95%CI:-0.05,0.20, p=0.239) or BDI-II scores (b=0.10, 95%CI:-0.18,0.38, p=0.469). We found some weak evidence that increased positive learning about the friend was associated with a reduction in BDI-II scores (b=0.30, 95%CI:-0.02, 0.62, p=0.069). However, exploratory analyses indicated stronger evidence that increased positive learning about the self (b=0.18, 95% CI:0.07,0.28, p=0.002) and a friend (b=0.22, 95%CI:0.10,0.35, p=0.001) was associated with a reduction in anxiety.Conclusions: Change in social evaluation learning was more reliably associated with a reduction in anxiety rather than depression. Antidepressants may treat anxiety symptoms by remediating negative affective biases towards socially threatening information directed towards the self and close others. However, our findings are based on exploratory analyses within a small sample and require further replication.

Relationship between change in social evaluation learning and mood in early antidepressant treatment: A prospective cohort study in primary care

“…The study protocol was pre-registered on Open Science Framework (https://osf.io/z9p8a), where study materials are also available (https://osf.io/8a95j/). The data that support the findings of this study are openly available in the University of Bath Research Data Archive at https://doi.org/10.15125/BATH-01107 (Hobbs et al, 2022).…”