Emotionally biased cognitive processes: the weakest link predicts prospective changes in depressive symptom severity

Emotional biases in attention, interpretation, and memory are predictive of future depressive symptoms. However, it remains unknown how these cognitive biases combine to predict depressive symptoms in the long-term. This study tested the predictive value of two integrative approaches that model relations between cognitive biases, namely the additive (i.e., cognitive biases have a cumulative effect) vs. the weakest link (i.e., the dominant bias is important) model. We also tested whether these integrative models interacted with perceived stress to predict prospective changes in depressive symptom severity. At Time 1, participants completed measures of depressive symptom severity and emotional biases in attention, interpretation, and memory. At Time 2, one year later, participants (n=53) were reassessed to determine depressive symptoms and perceived stress. Results revealed that the weakest link model had incremental validity over the additive model in predicting prospective changes in depressive symptoms, though both models explained a significant proportion of variance in the change in depressive symptoms from Time 1 to Time 2. None of the integrative models interacted with perceived stress to predict changes in depressive symptomatology. These findings suggest that the best cognitive marker of the evolution in depressive symptoms is the cognitive process that is dominantly biased toward negative material, which operates independent from experienced stress. This highlights the importance of considering idiographic cognitive profiles with multiple cognitive processes for understanding and modifying effects of cognitive biases in depression