Positivity Training: Effects of a Bias Modification Training on Emotion Processing in Major Depression and healthy Controls

• Applicants: Professor Dr. Thomas Frodl; Privatdozent Dr. Bernhard W. Müller
• Subject Area: Biological Psychiatry ; Clinical Psychiatry, Psychotherapy, Child and Adolescent Psychiatry
• Term: from 2022 to 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 507720021

• Final Report Year: 2025

Final Report Abstract

In people with depression, negative schemata influence information processing not only by directing attention to negative events, but also by altering the processing of positive events. In a previous study, we were able to show using a dot probe task that training to implicitly focus on positive events reduced depressive symptoms. Early posterior negativity (EPN) derived from EEG has been shown in recent studies to be sensitive to early, automated emotion processing. Most recently, it has been shown that patients with major depression show reduced EPN for faces with positive emotions compared to control subjects. In this experimental, randomised, single-blind study, we therefore investigated the effects of app-based positivity training compared to control training on changes in information processing in 120 outpatients with depressive disorder and 120 healthy subjects. Over a period of two weeks, the participants independently completed ten units of app-based positivity training based on a dot probe task, each unit lasting 25 minutes. Clinical and EEG measures were examined before and after the training. A clinical follow-up supplemented the assessment of the intervention effects. The primary outcome criterion was the change in EPN in the processing of positive stimuli. During the positivity training the EPN of patients increased (towards negative amplitudes), while the EPN decreased during the control training. Thus, we were able to confirm the hypothesis that positivity training can alter automated processing of positive stimuli in depression in particular. Positivity training also normalized the topographical bias of EEG activity with increased parietal alpha activity. Our study was the first to investigate the effects of cognitive positivity training on EPN and EEG oscillations. These results suggest that positive stimuli play a decisive role in attention and emotion processing. In addition, EEG measures in particular appear to be sensitive markers that can reflect therapy and disease progression effects and may be suitable for early prediction of response to therapy.

Publications

• Effects of a Cognitive Bias Modification Training on Resting State EEG Microstates in Patients with MDD and Healthy Controls. (2024). EPA-Congress (Poster)
  Kesik, J.; Kratochwil, Z.; Keskin-Gökcelli, D.; Müller, B. & Frodl, T.
  
• Effects of a cognitive bias modification training on resting state EEG oscillations in patients with major depressive disorder and healthy controls. Clinical Neurophysiology, 159, e14.
  Kesik, J.; Kratochwil, Z.; Keskin-Gökcelli, D.; Heckelmann, J.; Müller, B. & Frodl, T.
  
• Effekte eines Kognitiven-Bias-Modifikationstrainings auf Oszillationen in Ruhe-EEGs bei Patienten mit Major Depression und gesunden Kontrollen. (2024). DGPPN-Kongress (Poster)
  Kesik, J., Kratochwil, Z., Keskin- Gökcelli, D., Heckelmann, J., Müller, J. & Frodl, T.
  
• Untersuchung der frontalen Alpha-Aktivität und der parietalen Alpha 1- und Beta 2-Aktivitäten in Ruhe-EEGs bei Patienten mit Major Depression und gesunden Kontrollen. (2024). DGBP e.V. und AGNP e.V Jahreskongress (Poster)
  Kesik, J., Kratochwil, Z., Keskin-Gökcelli, D., Heckelmann, J., Müller, J. & Frodl, T.