Biased Executive Control of Emotional Information in Remitted Depression: A Meta-Analytic Review

Cognitive theories of depression posit that maladaptive information processing increases the risk for depression recurrence. There is increasing theoretical and empirical support for the executive control of emotional information as a vulnerability factor for chronic depression. In particular, biased executive control characterized by reduced processing of positive relative to negative material in working memory may increase the risk for future depressive episodes. Understanding the executive control of emotional information in depression is crucial because biases in executive control may underlie information processing biases. Furthermore, studies that examined biases in remission allow for the identification of potential risk factors for recurrence, which is critical given the recurring nature of depression. In this investigation, findings from behavioral studies that compared the executive control of emotional information between people with remitted major depressive disorder (rMDD) and healthy people were examined. Response times (RTs) and error rates were examined as outcome variables, and aspects of clinical features, participant characteristics, and study design were examined as moderating variables. Of the 767 articles retrieved through databases and hand searches, 33 articles met the inclusion criteria. A total of 1457 rMDD participants and 1144 healthy control participants were included in the analyses. Significant differences (small effect sizes) were observed for the difference score between negative and positive trial RTs between the two groups and between the negative and positive trial RTs within each group. Specifically, the difference in RTs between negative and positive stimuli was larger in participants with rMDD than in healthy control participants. Furthermore, both the rMDD group and the healthy control group were slower to process negative than positive stimuli, but this difference was magnified in the rMDD group. Such patterns of executive control bias may lead to preferential processing of negative over positive information in working memory. This imbalance may then lead to other negative information processing biases and emotion dysregulation, thereby increasing the risk for depression recurrence. Implications, limitations, and future directions are discussed.