A comprehensive meta-analysis of interpretation biases in depression. (December 2017)

• Record Type: Journal Article
• Authors: Everaert, Jonas; Podina, Ioana R.; Koster, Ernst H.W.
• Is Part Of: Clinical psychology review. Volume 58(2017)
• Page Start: 33
• Page End: 48
• Publication Date: 2017-12
• Subjects: Interpretation bias -- Cognitive bias -- Depression -- Meta-analysis -- Review; Clinical psychology -- Periodicals; Psychology, Pathological -- Periodicals; Psychotherapy -- Periodicals; Psychology, Clinical -- Periodicals; Electronic journals; 616.89
• DOI: 10.1016/j.cpr.2017.09.005
• Languages: English
• ISSNs: 0272-7358

Abstract

Abstract: Interpretation biases have long been theorized to play a central role in depression. Yet, the strength of the empirical evidence for this bias remains a topic of debate. This meta-analysis aimed to estimate the overall effect size and to identify moderators relevant to theory and methodology. PsycINFO, Embase, Web of Science, Scopus, PubMed, and dissertation databases were searched. A random-effects meta-analysis was performed on 87 studies ( N = 9443). Results revealed a medium overall effect size (g = 0.72, 95%-CI:[0.62;0.82]). Equivalent effect sizes were observed for patients diagnosed with clinical depression (g = 0.60, 95%-CI:[0.37;0.75]), patients remitted from depression (g = 0.59, 95%-CI:[0.33;0.86]), and undiagnosed individuals reporting elevated depressive symptoms (g = 0.66, 95%-CI:[0.47;0.84]). The effect size was larger for self-referential stimuli (g = 0.90, 95%-CI[0.78;1.01]), but was not modified by the presence (g = 0.74, 95%-CI[0.59;0.90]) or absence (g = 0.72, 95%-CI[0.58;0.85]) of mental imagery instructions. Similar effect sizes were observed for a negative interpretation bias (g = 0.58, 95%-CI:[0.40;0.75]) and lack of a positive interpretation bias (g = 0.60, 95%-CI:[0.36;0.85]). The effect size was only significant when interpretation bias was measured directly (g = 0.88, 95%-CI[0.77;0.99]), but not when measured indirectly (g = 0.04, 95%-CI[− 0.14;0.22]). It is concluded that depression is associated with interpretation biases, but caution is necessary because methodological factors shape conclusions. Implications and recommendations for future research are outlined. Highlights: A meta-analysis on interpretation biases in depression was conducted Results revealed a medium overall effect size (ES) Clinical status or mental imagery instructions were not significant moderators Self-reference of stimuli and measurement method were significant moderators Theoretical and clinical implications with future directions are provided