Attention Biases in Previously Depressed Individuals: A Meta-Analysis and Implications for Depression Recurrence

Background: Depression is a severely disabling disorder, with high recurrence rates suggesting that depression-prone individuals may be characterized by stable vulnerability-factors. Cognitive theories of depression posit that aberrant negative and positive attention biases confer vulnerability for depression recurrence. Attention biases toward negative information and lack of bias toward positive information during depressive episodes have been widely documented. In contrast, the nature of attention biases following termination of a depressive episode has been more scantly studied. We conducted a systematic-review and meta-analyses of extant studies on attention biases in previously depressed participants. Methods: Dysphoric and positive attention biases were compared in 13 studies contrasting previously and never depressed participants (ns = 1051 and 957, respectively) and six studies contrasting previously and currently depressed participants (ns = 397 and 217, respectively). Results: Relative to never depressed, previously depressed participants showed a larger dysphoric bias (g = 0.29, 95% CI 0.08, 0.49) and a smaller positive bias (g = − 0.17, 95% CI − 0.33, − 0.01), whereas no difference was identified between previously and currently depressed participants. Conclusions: These findings suggest that attention biases may be active even when depressive episodes recede, potentially reflecting risk-markers for depression recurrence that could serve as targets for preventative intervention. We also conclude that the limited number of studies available for meta-analysis may limit definitive conclusions. We hope that this first meta-analysis on attention biases following depressive episodes will inspire this much needed additional research.