Not all Cognitions 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 what we pay attention to, perception, and translation of incoming information from others and our world. This blog aims to raise awareness about some of these cognitive differences in individuals with anxiety and depression, and their impact.
Why is this an important discussion?
Neurocognition encompasses the mental processes that underlie human thinking. Neurocognitive domains have been variously categorised by different research. The DSM-5 or Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition used by clinicians, categorises neurocognitive functions into six key domains: Perceptual Motor Function, Executive Function, Language, Complex Attention, Learning and Memory, and Social Cognition. In this blog, we will focus on social cognition.
Social cognition refers to the mental operations underlying social interactions, which include recognising and considering the emotions, beliefs, intentions, and behaviours of the self and others (or theory of mind), required for interpreting and predicting social behaviours and situations. This includes our ability to recognise social cues, express empathy, read facial expressions, motivate ourselves, and control our desires to act on impulse. It also includes insight.
For decades, researchers across various disciplines, have explored social cognition. One example is The Social Information Processing (SIP) model, developed by Crick and Dodge in 1994, that provides a framework for understanding how children process social information, which in turn influences their social interactions and behaviours. Rooted in psychology, the SIP model describes a dynamic and cyclical process, wherein prior experiences can influence future processing, following six sequential steps:
1. Encoding of Cues or selectively paying attention to social cues - verbal and non-verbal information involving alertness, selectivity and vigilance, filtering relevant cues while ignoring irrelevant ones. Example: A child in a playground hears another child laughing and encodes this as either friendly or not.
2. Interpretation of Cues or what happened and why - meaning is attributed to the encoded social cues, including making attributions about others intentions which may be biased. Example: the child interprets the laughing as mocking (could be right or could be a negative bias).
3. Clarification of Goals or what you wish to achieve in response - desired outcome in the social situation. Example: sets an intent for an anti-social response where the ambiguous laugh has been interpreted as aggressive.
4. Response Access / Construction or generation of possible responses - based on memory of past experiences and learned behaviours. Example: the child decides to retaliate.
5. Response Decision or selecting the best option - considering all the factors (consequences, will it work, social norms). Example: the child considers whether responding aggressively will make things worse or solve the issue of mocking.
6. Behavioural Enactment or the chosen response is carried out in the social situation - effectiveness depends on social skills, communication ability and emotional regulation. Example: the child decides to walk away from the so-called provocation to avoid escalation.
Each step can overlap, occur simultaneously, or be skipped under certain conditions. They differentiate between real-time processing and retrieval of long-term memories, as it explains how immediate social perceptions and historical social experiences play roles in shaping one's social behaviour in the present moment. This nuanced understanding helps illustrate the dynamic and sometimes non-linear nature of social cognition, highlighting that responses in social situations are not just reactions to the present but also reflections of past interactions.
Albert Bandura's Social Cognitive Theory (SCT) does not have steps in the same sequential manner as the SIP model. Instead, SCT is built around core concepts that interact in dynamic and reciprocal ways intended as a broad framework that applies to individuals across all age groups and provides insights into how experiences shape cognitive and behavioural patterns, and how beliefs and attitudes can influence behaviours in social settings. Here’s a breakdown of SCT main elements:
Reciprocal Determinism: This is the central concept of SCT and posits that behaviour, personal factors (like cognitions, emotions, and biological events), and environmental influences or our social setting all interact and influence each other. Unlike a step-based model, this concept suggests a more fluid and continuous interaction between these factors.
Behavioral Capability: This refers to a person’s ability to perform a behaviour through essential knowledge and skills. This capability ensures that individuals know how to perform certain behaviours and understand the steps needed to execute them effectively.
Observational Learning (Modelling): People can learn by observing others. In the context of social cognition, this means that individuals can learn social behaviours by watching how others behave in social settings.
Reinforcements: This involves the response consequences that influence the likelihood of a behaviour being repeated. Positive and negative reinforcements can affect how individuals perceive and engage in social interactions.
Expectations: These are the anticipated consequences of a behaviour, which influence behavioral engagements. For instance, if someone expects a negative outcome from a social interaction, they may be less likely to engage in it.
Self-Efficacy: This is the belief in one's capabilities to organise and execute the courses of action required to manage prospective situations. In social settings, high self-efficacy can enhance the likelihood of engaging in social interactions, while low self-efficacy, possibly exacerbated by anxiety or depression, might deter someone from participating.
Emotional Coping Responses: This refers to the strategies individuals use to deal with emotional stimuli. People with anxiety or depression may have different coping responses that can affect their social interactions, for example.
Within the framework of the SIP model or SCT model or indeed any social cognitive model, cognitive heuristics and cognitive biases have been considered as universal features of neurocognition. “Heuristics are the ‘shortcuts’ that humans use to reduce task complexity in judgment and choice, and biases are the resulting gaps between normative behaviour and the heuristically determined behaviour.” (Gonzalez (2017, p. 251).
What do we mean by cognitive biases? Here are some examples:
Encoding and Attention:
Availability bias: Individuals may be more likely to notice and focus on information that is readily available in their memory, leading to biased interpretations of social cues based on their recent experiences.
Primacy effect: The first impression or piece of information received about someone may disproportionately influence how they are perceived.
Interpretation and Attribution:
Fundamental attribution error: The tendency to attribute others' behaviours to internal factors (like personality) rather than external situational factors, potentially leading to misinterpretations of intentions.
Confirmation bias: People may selectively interpret information to confirm their existing beliefs about someone or something, leading to biased judgments.
Actor-observer bias: Individuals may explain their own behaviour based on situational factors while attributing others' behaviour to internal factors.
Response Generation and Decision Making:
Anchoring bias: When making a decision, individuals may overly rely on the first piece of information they receive from memory, influencing their subsequent responses.
Representativeness heuristic: People may categorise others based on stereotypes or limited information, potentially leading to inaccurate judgments about them and their behaviour.
Overconfidence bias: Individuals may overestimate their ability to accurately interpret social cues, leading to potentially inappropriate responses.
Overvaluing selected information from past memories, above readily available information from any particular social setting, can become a compatible experience for some people, and so more heuristically activated again in the future. This may create psychological blindspots, limiting consideration of alternatives, and blocking contradictory information in decision-making.
Understanding how the brain predicts, using heuristics and applying biases, provides an insight into our individual social cognition. It illuminates how individuals swiftly decide, form expectations, and adapt heuristics and biases, through ongoing social interactions, and how internal or innate and external environments may impact our responses.
Recognising the link between the brain’s predictive processing, heuristics, and cognitive biases raises an important question. How might these processes differ in individuals with depression and anxiety disorders? Here we briefly explore how negative cognitive biases can shape perception, thought patterns and emotional responses in these disorders, potentially contributing to their persistence and severity.
More About Negative Cognitive Bias
Cognitive biases are common mental patterns that can lead to 'thinking errors.' When combined with cognitive heuristics, they can contribute to systematic distortions in what we pay attention to, memory retrieval, and perception. These biases shape our beliefs, attitudes, and preconceptions, influencing how we make judgments and decisions, and ultimately our behaviour and actions.
In paying attention, attentional shifts, whether automatic and stimulus-driven by what we are paying attention to, or intentional and goal-directed, play a crucial role in cognitive processing. Individuals with traits associated with anxiety and depression, shaped by genes and experience, may exhibit a heightened asymmetry in attention toward negative stimuli.
This imbalance in attentional allocation, results in a disproportionate focus on stimuli with a ‘negative emotional tone’, increasing sensitivity to, and retention of, negative information. As a consequence, neutral or positive stimuli receive comparatively less attention, posing a negative affective bias.
Negative affective bias means that individuals not only selectively attend to negative aspects of their environment but also encode, recall memories and more readily remember information with a negative emotional tone, or the affective quality or emotional valence of a stimulus that evokes unpleasant or distressing emotions.
How might negative affective bias fit the SIP model?
1. Encoding and Attention (Step 1) – Which cues are noticed?
Availability bias → Individuals may focus on recent negative experiences, leading them to encode and attend to negative social cues disproportionately.
Primacy effect → First impressions stick, which can lead to long-term biased encoding of social cues, even if later evidence contradicts them.
2. Interpretation and Attribution (Step 2) – What does this cue mean?
Fundamental attribution error → A person may assume negative intent behind someone’s actions instead of considering external factors.
Confirmation bias → A person interprets social cues in a way that aligns with their pre-existing negative beliefs (e.g., assuming someone is always rude based on one past interaction).
Actor-observer bias → Individuals excuse their own negative behavior due to circumstances but judge others harshly for the same actions.
3. Clarification of Goals (Step 3) – What do I want to achieve?
Negative bias is less relevant here since this step is about setting a desired outcome, but prior negative interpretations from Step 2 could shape whether someone seeks revenge, avoidance, or conflict resolution.
4. Response Generation and Decision Making (Steps 4 & 5) – What are my options and which response should I choose?
Anchoring bias → A person may over-rely on their initial negative interpretation, shaping their response selection.
Representativeness heuristic → People may rely on stereotypes to predict behaviour, which can lead to misguided responses in social interactions.
Overconfidence bias → Someone might believe they are reading the situation correctly, even when their perception is negatively biased.
Such negative cognitive biases can contribute to a persistent negative orientation in how individuals perceive and respond to their surroundings. These biases can be particularly pronounced in anxiety and depression disorders, and the nature and extent of these biases varies across individuals with anxiety and depression, influencing cognitive processing in distinct ways.
Negative Bias in Anxiety Disorders
Attention is a domain of neurocognition, 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 to the individual 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).
Research indicates that anxiety traits such as worry, intrusive rumination, and physical symptoms like pain can be sustained by genetic predispositions. Variations in gene expression, particularly in genes regulating neurotransmitter systems like serotonin, have been linked to anxiety phenotypes or traits. However, the precise mechanisms and the extent of genetic influence on anxiety disorders are not yet fully understood (Gottschalk and Domschke, 2017)
In anxiety disorder, implicit memory (unconscious and automatic) can prime or influence 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).
Anxiety can perpetuate a vicious cycle, illustrating a reciprocal relationship between heightened threat perception and increased anxiety. This contrasts with individuals not experiencing anxiety, who typically exhibit a more balanced assessment of threatening information, allowing them to respond without undue fear or avoidance.
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 biasing the processing of the same or related threatening material.
Negative Bias in Depression
Anxiety is often comorbid or co-occurring 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 different mood disorders. 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 prediction inaccuracies.
In Summary
Negative biases can shape and sustain differences in neurocognition in everyday life across different settings, with distinct implications when examined in the context of social cognition in anxiety and depression disorders:
Negative attentional bias can underpin anxious traits with a threat-based mode of cognitive processing or thinking, involving heightened attention toward threat and danger vigilance in social settings. 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 or traits, 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 in anxiety and depression presents unique challenges, particularly when these biases become deeply ingrained in cognitive or thinking patterns. In more severe cases, the ability to engage in cognitive strategies that promote balanced thinking may be impaired.
Addressing these biases often involves a combination of therapeutic interventions, medication, and tailored support, depending on the type and severity of the mood disorder. Recognising that the impact of cognitive biases varies across individuals, highlights the importance of professional guidance in seeking to manage anxiety and depression disorders effectively.
The content of the blog is designed to stimulate discussions and explorations of emerging research. It does not represent official advice or exhaustive factual claims and is one perspective in 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.