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Modulating cognitive bias in the context of depression: Mental imagery, emotion and behaviour

English title Modulating cognitive bias in the context of depression: Mental imagery, emotion and behaviour
Applicant Pictet Arnaud
Number 140104
Funding scheme Fellowships for prospective researchers
Research institution Departement of Psychiatry University of Oxford
Institution of higher education Institution abroad - IACH
Main discipline Psychology
Start/End 01.01.2012 - 31.12.2012
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All Disciplines (2)

Discipline
Psychology
Neurology, Psychiatry

Keywords (6)

widely accessible; Depression; positive mental imagery; evidence-based; treatment development; Internet-based intervention

Lay Summary (English)

Lead
Lay summary

Depression presents a global health problem, but current treatment provision is inadequate. There is therefore a need for development of new treatments, for example accessible via the internet. One potential target for novel treatments is the negative thinking style, or cognitive bias, that is found in depression, as this contributes to depressed mood. “Cognitive Bias Modification”, or CBM is a computerised procedure developed through basic experimental science that aims to modify these thinking styles. The new variant we are developing, called ‘OxIGen’ (Oxford Imagery Generation) uses ‘mental imagery’, which is  when you see with your mind’s eye or hear with your mind’s ear. Specifically, OxIGen requires you to imagine yourself in a number of situations presented, which all work out positively. As people with depression normally lack positive mental imagery about themselves this may be particularly helpful. There have been some preliminary published investigations of the precursors to OxIGen in depression, which suggest that it has the potential to be developed into a useful computerised treatment in the future. However, these preliminary studies have had a number of limitations, and the current project aims to develop and evaluate OxiGen further. Studies to date have had only small numbers of participants, a short time period of investigation, and used specialised software that is not easily accessible. This research therefore aims to take the investigation of this computerized cognitive bias modification task an important step further forward by investigating its impact over a longer time period, with a larger number of depressed individuals, and using a more accessible version of the program accessible over the internet. If we find that OxIGen is effective in modifying thinking style and thus improving mood in this study, we will then be able to develop it into an accessible treatment component for testing in future studies.

 

Direct link to Lay Summary Last update: 21.02.2013

Responsible applicant and co-applicants

Publications

Publication
Davies, C., Malik, A., Pictet, A., BlacIntrusive mental images after a positive film are dampened by a visuospatial task: Unhelpful in depression but helpful in m
Davies C., Malik A., Pictet A., Blackwell S.E., Holmes E.A. (2012), Davies, C., Malik, A., Pictet, A., BlacIntrusive mental images after a positive film are dampened by a visuospatial task: Unhelpful in depression but helpful in m, in Clinical Psychology % Psychotherapy, 19(4), 341-351.
The powerful impact of mental imagery in changing emotion
Pictet A., The powerful impact of mental imagery in changing emotion, in Hermans Rimé & Mesquita (ed.), Psychology Press, London, 187-194.

Abstract

This research study is designed to investigate the effects of an online computer program promoting positive mental imagery in depression. Depression presents a global health problem, with the World Health Organization ranking it as the leading cause of burden of all diseases in middle and high-income countries (World Health Organisation, 2004). Current treatments for depression are pharmacological or psychological. However, these approaches are proving to be inadequate given the scale of the problem. Concerns have been expressed about the effectiveness of anti-depressant medication, and evidence-based psychological therapies such as Cognitive Behavior Therapy (CBT) are resource-intensive to provide and difficult to access when delivered in the traditional face-to-face manner. Therefore we need to develop innovative treatments deliverable via computer or telephone if we are to tackle this global health problem (Marks & Cavanagh, 2009; Simon & Ludman, 2009). One possible candidate for novel treatment development is computerized “Cognitive Bias Modification” (CBM). People who are depressed tend to interpret information negatively - that is, they show a negative thinking style or ‘cognitive bias’(Butler & Mathews, 1983; Rude, Wenzlaff, Gibbs, Vane, & Whitney, 2002). These biases are thought to play a central role in depression, and thus are a key target for existing psychological treatments such as Cognitive Behaviour Therapy. Thus if it was possible to improve depressed mood by targeting and modifying these biases directly via a simple computer program this would open the door to a new generation of inexpensive accessible treatment options. The version of CBM that has been investigated in depression focuses on generating positive mental imagery - OxIGen (Blackwell & Holmes, 2010; Lang, Blackwell, Harmer, Davison, & Holmes, submitted; Pictet, Coughtrey, Mathews, & Holmes, 2011). In this procedure, individuals are repeatedly presented with ambiguous information (e.g. a description of a situation, or a picture), but then provided with a positive interpretation. Crucially, in the positive imagery generation tasks, participants have to imagine themselves in the scenarios presented. Generating this mental imagery has been shown to play a central role in the effectiveness of the components of OxIGen (Holmes, Lang, & Shah, 2009; Holmes, Mathews, Dalgleish, & Mackintosh, 2006).So far there have been two small studies investigating the effects of the components of OxIGen in depression (Blackwell & Holmes, 2010; Lang et al., submitted). These have both found significant effects of the CBM in reducing symptoms of depression and instilling a more positive cognitive bias amongst people with depression. However, despite these promising findings, these studies have some important limitations that the proposed research described here aims to answer.First, these studies used only small sample sizes. Second, the time scale of the studies was very brief. Participants only completed the CBM for one week, and were only followed up for two weeks after this. Third, the CBM ran via specialised laboratory software not suitable for widespread distribution, thus limiting its accessibility and usability. Fourth, the schedule of measurement did not allow important questions about the mechanisms of change to be addressed. This study aims to address these limitations by investigating the impact of a program derived from CBM:•With a larger sample of currently depressed individuals•Using a longer, more realistic intervention (delivered online over four weeks) and follow-up period (at one, three and six months)•Using the newly developed OxIGen program, delivered via the internet for widespread accessibility.•Incorporating an optional sub-study “Imagery and Behaviour Mechanisms” (IBM) specifically designed to address questions about mechanisms of change.Such a larger-scale rigorous study with an online OxIGen program will allow us to draw much stronger conclusions about its effects as a potential treatment option, and provide the data needed to develop it into an online intervention for testing in a full Randomized Controlled Trial (RCT).
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