Not all Cognitions and Emotions are Created Equal. Uncovering Negative Biases Impact on Anxiety and Depression Disorders

Human decision-making shows systematic simplifications and deviations from the tenets of rationality (‘heuristics’) that may lead to suboptimal decisional outcomes (‘cognitive biases’) (Korteling et al, 2018).

Different cognitive heuristics and cognitive biases may contribute in varying degrees to differences in perception of incoming information. This blog aims to illuminate these differences between individuals with anxiety and depression.

Why is this an important discussion?

Adept use of social information, such as for establishing social bonds, social communication, risk perception, and collaborative strategies is evolutionarily adaptive. This means that it helped our ancestors survive and over time these helpful traits are passed on. Developmentally, this ability evolves across different domains including cognitive (thinking), emotional (affective) and psychomotor (physical), and is individually different.

Individual difference means not everyone uniformly perceives and responds or pays attention to all social information in the same way. Highlighting the existence of variations in cognitive processing. Researchers have delved into the role of cognitive heuristics and biases in shaping these differences. Cognitive heuristics are mental shortcuts that the brain employs to streamline judgement and decision-making, often leading to efficient but sometimes biased and inaccurate outcomes.

Cognitive biases represent systematic errors in judgment or decision-making that deviate from what might be considered normative. This can lead to perceptual distortion, illogical interpretation, or what is broadly referred to as "thinking errors." Researchers explore how these cognitive biases and cognitive heuristics manifest in real-world scenarios and the potential impact on individuals' decision and choice outcomes.

For example, the anchoring and adjustment heuristic can lead to misestimating numerical values due to overreliance on available information in memory recall without proper adjustment. Another example is the framing effect bias, which can influence how we respond to choices based on whether outcomes are framed as gains or losses. Would you prefer a chocolate bar with only 30% sugar or a chocolate bar with 70% less sugar?

Psychological cognitive biases include negativity bias, which favours negative information compared to positive or neutral, and is a predilection of human evolutionary advantage. Interpretive bias is a systematic tendency to interpret ambiguous or uncertain information in a particular way, potentially deviating from a neutral interpretation. The inclination toward negativity can shape the interpretation of ambiguous stimuli, leaning towards more negative explanations. These biases may work in conjunction with attentional bias, selective focus on specific information, influenced by emotions or experiences.

Overconfidence in predictions may result from focusing on specific information and undervaluing alternatives. Overvaluing readily available information becomes a compatible experience, and so more heuristically activated again in the future. Dominance of biases like negativity and attentional bias can distort preconceptions and shape habits. This may create psychological blindspots, limiting consideration of alternatives and blocking contradictory information in decision-making.

Understanding how the brain predicts and uses heuristics in social information processing provides insights into the cognitive mechanisms of social cognition. It illuminates how individuals swiftly decide, form expectations, and adapt heuristics through ongoing social interactions. Recognising the link between predictive processing, heuristics, psychological cognitive biases and mood disorders, informs efforts to understand better social cognitive challenges in conditions like depression and anxiety.

More About Negative Cognitive Bias

Cognitive biases are common mental patterns that can lead to 'thinking errors’, combined with cognitive heuristics, which can underlie systematic errors in what we pay attention to, and how we process incoming information and sort through memories, beliefs, attitudes and preconceptions in making judgements and decisions.

In attentional shifts—whether it's automatic and stimulus-driven or intentional and goal-driven—cognitive bias plays a crucial role in shaping perception, memory, and controlling eye movements. The effect of traits for anxiety and depression is an increased propensity for asymmetry in attention toward negative stimuli.

This bias or imbalance in how an individual's attention is directed implies that there's a disproportionate allocation of attentional resources toward negative stimuli which carry a negative emotional tone, leading to an increased sensitivity to, and retention of, unfavourable information. Consequently, comparatively less attention is given to neutral or positive stimuli.

Negative affective bias, by comparison, involves not only attention but also extends to the processing and retention of information. It means that individuals may not only selectively focus on negative aspects but also encode and more readily remember and recall information with a negative emotional tone.

These negative cognitive biases can contribute to an overarching negative orientation in how individuals perceive and respond to their surroundings and are amplified in anxiety and depression phenotypes. This, in turn, can influence thinking that can negatively distort predictions, judgments, decision-making, and emotional and physiological responses.

How might negative cognitive biases bias anxiety and depression phenotypes and how might they differ between the two?

Negative Bias in Anxiety Disorders

Attention is a multifaceted cognitive process involving the interplay of multiple brain regions, that involves the selective concentration of mental resources on specific stimuli or tasks, filtering out irrelevant information and focusing on what is important in a given context.

Attentional bias in anxiety disorders, selectively attends to external threat-based cues, with a tendency to interpret ambiguous events negatively (Beck, 1967). Moreover, attentional bias in anxiety disorders is a ‘mode of cognitive processing that facilitates a negative appraisal, with heightened attention toward threat vigilance’ (Lichtenstein-Vidne et al, 2016).

This can sustain anxiety phenotypes like worry, intrusive rumination, and physical symptoms. There is evidence suggesting a link between these anxiety traits and variations in gene expression, indicating a genetic predisposition to anxiety. However, the specifics of this genetic predisposition and the degree to which it influences anxiety are not yet fully understood.

In anxiety disorder, implicit memory (unconscious and automatic) primes or influences incoming stimuli and links them to biased representations in long-term memory that are oriented toward threats (Williams et al 1988, 1997). This facilitates the adoption of the ‘threat processing mode’, contributing to susceptibility to anxiety disorders (Mathews, 1990).

This creates a vicious cycle, illustrating the reciprocal relationship between cause and effect in an 'anxiety trait.' This contrasts with individuals not experiencing anxiety, whose cognitive bias tends to default to ignoring or redirecting attention away from threatening information.

Mogg and Bradley (1998) proposed attentional biases in anxiety, as being evaluated from a ‘cognitive-motivational perspective’. This is where anxious phenotypes have a reduced ability to evaluate threats, alongside negative biased attention. They proposed that ‘everyone orients to stimuli that are judged significantly threatening’, whereas anxious individuals may evaluate all stimuli as threatening, due to their heightened anxious state.

Phobic fear is an example of this, or a disposition to a heightened anxious state, whereby an individual’s unconscious prioritised attention toward danger and threat stimuli perpetuates the phobia. This amplifies the encoding in memory of threatening material, which then reciprocates heightened fear levels on recall of the memory (Mineka & Sutton, 1992).

Bower’s ‘Network Theory’ on the other hand proposes that the disposition of a phobic to anticipate worry actually makes ‘worry congruent material’ more accessible (Bower, 1981). William’s and colleagues’ (date) termed this ‘unconscious automatic priming’ (the idea that exposure to one stimulus may influence a response to a subsequent stimulus, without conscious guidance or intention)  further biases the processing of the same or related threatening material.

Negative Bias in Depression

Anxiety is often comorbid or concurrent with depression, however attentional bias in depression trait uses explicit memory (specific event or factual information). Rather than implicit memory, directing attention toward predominantly (negative) mood-congruent material, encoding and recalling negative over positive memories (Clark and Teasdale, 1982, Teasdale and Fogarty, 1979).

This combined with a ‘slower recall of positive memories’ (Teasdale & Fogarty, 1979), and the ‘triggering of unpleasant memories quicker’ (Lloyd and Lishman, 1975) can lead to chronicity of depression. It also perpetuates achieving the attentional ‘goal’ of corroborating negative self-reference. That self-perpetuates an anxious mood state and this is known to correlate with depression severity.

An example of this is depressive rumination, whereby rumination is conceptualised as an inability to effectively address or resolve a particular concern or issue. Watkins (2008) described it as a "response to a failure to progress satisfactorily towards a goal"; a method of ‘memory rehearsal’ that is never completed but continues in rumination”. Matthews and Wells (2004) discussed ‘self-regulatory dysfunction’, where repetitive thoughts are generated by attempts to cope with self-discrepancy.

However, in anxiety trait, this type of rumination has an implicit goal; believing in, anticipating or reacting to a mood state of heightened threat. Consequently, attention becomes intuitively focused on this, along with associated symptoms of distress (Disner et al, 2011).

This is termed maladaptive thinking, prevalent in both depression and anxiety, often linked to individual beliefs and assumptions. Within this cognitive framework, early adverse events in childhood may play a role in forming and sustaining what is referred to as "dysfunctional schemas."

Schemas delineate between two types of informational knowledge: beliefs and assumptions. Beliefs, considered core constructs, are perceived as unconditional truths. Assumptions, on the other hand, are seen as conditional, representing eventualities between events and self-appraisals, including expectations, but are grounded in beliefs. 

The attentive biases within these schemas are purported to be specific to each disorder. In depression, unconditional beliefs focus on self-referenced statements (e.g., 'I am useless'), while in anxiety, conditional assumptions revolve around 'if-then' intentions (e.g., 'if I see a shadow in the dark, then it's probably something bad'). This poses a risk of inaccuracy.

In Summary

Negative biases, sustain differences in anxiety and depressive disorders. Negative attentional bias underpins an anxious phenotype, with a threat-based mode of cognitive processing or thinking, involving heightened attention toward threat and danger vigilance. This can be reinforced by unconscious automatic priming of incoming stimuli, which gives priority to screening for threat-based representations in long-term memory, holding in place the vulnerability to anxiety disorders. 

Negative attentional bias vulnerability differs in the depression phenotype, in using explicit memory or intentional conscious recollection of personal experiences – episodic, and factual semantic information. Directing attention toward predominantly negative mood-congruent material, slower recall of positive memories and triggering unpleasant memories quicker. 

This can lead to chronicity of depression and corroborate the negative self-reference that perpetuates a depressive predisposition and also correlates with depression severity. Navigating cognitive biases, particularly in the context of anxiety and depression disorders, can present unique challenges for individuals facing severe mental health issues. In severe cases, the ability to actively engage in cognitive strategies and balanced perspectives may be compromised.

Addressing cognitive biases often involves a comprehensive approach, including therapeutic interventions, medication, and support tailored to the severity of the individual's mental health condition. It's essential to recognize that managing cognitive biases may vary based on the individual's mental health status, and professional guidance is crucial for those dealing with anxiety and depression disorders.

The content of the blog is evidence-based and designed to stimulate discussions and explorations of emerging research. However, it does not represent official advice or exhaustive factual claims and includes a perspective in choosing this particular topic of interest. The goal is to offer readers valuable insights while respecting the boundaries of objectivity. Readers of course consider multiple sources when forming opinions.