Mapping the interplay among cognitive biases, emotion regulation, and depressive symptoms

ABSTRACT

Cognitive biases and emotion regulation (ER) difficulties have been instrumental in understanding hallmark features of depression. However, little is known about the interplay among these important risk factors to depression. This cross-sectional study investigated how multiple cognitive biases modulate the habitual use of ER processes and how ER habits subsequently regulate depressive symptoms. All participants first executed a computerised version of the scrambled sentences test (interpretation bias measure) while their eye movements were registered (attention bias measure) and then completed questionnaires assessing positive reappraisal, brooding, and depressive symptoms. Path and bootstrapping analyses supported both direct effects of cognitive biases on depressive symptoms and indirect effects via the use of brooding and via the use of reappraisal that was in turn related to the use of brooding. These findings help to formulate a better understanding of how cognitive biases and ER habits interact to maintain depressive symptoms.

KEYWORDS:

• Attention bias
• interpretation bias
• positive reappraisal
• brooding
• depressive symptoms

Acknowledgements

The authors thank Alvaro Sanchez for his comments on an earlier draft of this manuscript.

Notes

1. Reflection, the second subtype of rumination, refers to repetitive thinking focused on one's problems and has long been considered as an adaptive form of rumination. However, current evidence regarding its adaptive nature is mixed (Nolen-Hoeksema et al., 2008). To ensure theory-driven and evidence-based path model building in the present study, we focused only on empirically supported pathogenic difficulties in emotion regulation in depression.

2. Word length: M negative words = 8.79 (SD negative words = 1.71), M positive words = 8.58 (SD positive words = 1.97); Word frequency (log frequency per million): M negative words = 1.02 (SD negative words = 0.47), M positive words = 1.04 (SD positive words = 0.62).

3. The analyses using fixation times led to similar results and conclusions. The results are available upon request.

4. In addition to the measures reported in this article, the participants completed two cognitive control tasks (affective shifting task, emotional n-back task) after the cognitive biases assessment and before the questionnaires. The results on the relations among cognitive control components and cognitive biases are reported elsewhere.

5. Analyses exploring gender differences in the modelled relations among cognitive biases, emotion regulation, and depressive symptoms showed that the results remained unchanged when male participants were excluded.