Effects on Depressive Symptoms of a Web-Based Cognitive Bias Modification-Interpretation (CBM-I) Program for Emotion Recognition: A Randomised Controlled Trial

Abstract

Depression is a global problem, causing disability and economic burden. Many people currently do not obtain treatment. Development of more accessible, cost-effective treatments is essential. An identified mechanism by which depression treatments work is through modifying underlying negative cognitive biases, which mediate changes in mood. A specific negative information-processing bias in depression is a tendency to interpret ambiguous facial expressions as sad rather than happy. The emotion recognition task is a treatment paradigm developed as a cognitive bias modification intervention to target this emotion recognition bias. Previous studies showed promising signs that this novel intervention could modify biases in people with low mood outside of laboratory conditions and potential to increase positive affect within laboratory conditions. The current study built on these developments, aiming to investigate, using a randomised controlled trial with follow-up at 2 and 6 weeks, whether a web-based version of the emotion recognition task could reduce depressive symptoms in addition to modifying emotion recognition biases. An analogue sample of 124 participants with low mood was recruited. Evidence was found that the intervention modified participants’ biases, compared to the control group but there was no evidence of improvement in mood. Study limitations included a high rate of attrition and non-adherence to the intervention. Future recommendations include modifying the intervention to increase acceptability, investigating generalizability of increased positive bias to different stimuli, and identifying consistent reductions in symptoms of depression before examining its efficacy with a clinical population.