12 Attentional bias toward threat-related stimuli has been reported in Generalised Anxiety Disorder (GAD), when using a dot probe task. For example, in facial expression recognition (FER) tasks, evidence suggests that individuals with social anxiety are not significantly different from healthy controls in identifying facial expressions, 10, 11 but show a tendency to misidentify neutral facial expressions as angry. In younger adults with anxiety disorders, there is the tendency for a bias toward threat-related stimuli, which is hypothesised to maintain a heightened sense of threat. 7, 8 In more complex social processing, examined with the Reading the Mind in the Eyes Task (RMET) and other complex tasks, people with depression perform significantly worse than control participants. 6 In addition, there is a bias in individuals with depression toward perceiving positive (happy), neutral or ambiguous facial expressions as more negative or less happy, compared with those in healthy control groups. For example, using a dot probe task, several studies have shown a bias toward sad faces compared with neutral faces in patients experiencing a major depressive episode. 4, 5 Multiple paradigms have been used to investigate emotion processing, and several, when studied in groups of younger individuals with depression, show differences broadly supporting the cognitive neuropsychological theory. Antidepressants may reverse this bias relatively quickly, but it takes some time for this change to be translated, via improved social interactions, into a reduction in depressive symptoms. 3 These biases may play a role in precipitating depression, maintaining depression and conferring susceptibility to relapse. It is suggested that those who are more vulnerable to depression tend to perceive social cues as more negative and attend to, and recall more, negative information. The cognitive neuropsychological hypothesis of depression 2 posits that in depression there is both behavioural and neurocircuitry evidence of a bias toward negative emotional stimuli. Further, emotional material can impair efficient cognitive processing by inducing biases in attention or decision-making, and by interfering with efficient cognitive processing, thereby impairing other aspects of cognition.Emotion Processing in Depression Difficulties in social situations and avoidance of these, in the context of mental disorders, may maintain clinical levels of distress in patients and hinder attempts to treat their disorder. Interpretation of affective information is vital to these interactions as it influences emotional states and governs behavioural responses in social situations. 1 Being able to undertake these functions efficiently is an important part of interpersonal relationships and social interactions. Emotional cognition involves a range of functions, including ‘perceiving, interpreting, managing, and generating responses to socially relevant stimuli, such as intentions and behaviour of others’.
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