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Cited by 378Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesNeural and Behavioral Psychology StudiesPsychological Treatments and Assessments

A comprehensive meta-analysis of interpretation biases in depression

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Everaert, Jonas, Podina, Ioana R., Koster, Ernst H.W.·2017·Clinical Psychology Review
DOI 10.1016/j.cpr.2017.09.005
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Abstract

Interpretation biases have long been theorized to play a central role in depression. Yet, the strength of the empirical evidence for this bias remains a topic of debate. This meta-analysis aimed to estimate the overall effect size and to identify moderators relevant to theory and methodology. PsycINFO, Embase, Web of Science, Scopus, PubMed, and dissertation databases were searched. A random-effects meta-analysis was performed on 87 studies (N=9443). Results revealed a medium overall effect size (g=0.72, 95%-CI:[0.62;0.82]). Equivalent effect sizes were observed for patients diagnosed with clinical depression (g=0.60, 95%-CI:[0.37;0.75]), patients remitted from depression (g=0.59, 95%-CI:[0.33;0.86]), and undiagnosed individuals reporting elevated depressive symptoms (g=0.66, 95%-CI:[0.47;0.84]). The effect size was larger for self-referential stimuli (g=0.90, 95%-CI[0.78;1.01]), but was not modified by the presence (g=0.74, 95%-CI[0.59;0.90]) or absence (g=0.72, 95%-CI[0.58;0.85]) of mental imagery instructions. Similar effect sizes were observed for a negative interpretation bias (g=0.58, 95%-CI:[0.40;0.75]) and lack of a positive interpretation bias (g=0.60, 95%-CI:[0.36;0.85]). The effect size was only significant when interpretation bias was measured directly (g=0.88, 95%-CI[0.77;0.99]), but not when measured indirectly (g=0.04, 95%-CI[-0.14;0.22]). It is concluded that depression is associated with interpretation biases, but caution is necessary because methodological factors shape conclusions. Implications and recommendations for future research are outlined.

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  • The linkage across negative beliefs, subsequent psychopathology, and examining and restructuring these beliefs to reduce depression is well established.

    “This linkage across negative beliefs, subsequent psychopathology, and examining and restructuring these beliefs to reduce depression is well established (e.g., Everaert et al., 2017; Diehle et al., 2014).”

    From I've Seen Enough: Measuring the Toll of Content Moderation on Mental Health (2025) · cites this paper as Everaert et al., 2017

    Theoretical models of interpretation biases in depression (page unavailable) link negative beliefs and interpretations to worsening depressive mood. But Clinical status of depression says prospective studies are still needed to establish whether biases precede depression, and Clinical implications says training may have limited effects on mental health. The paper therefore does not establish the claimed sequence or that examining and restructuring beliefs reduces depression. (LLM, conf=0.87)

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Research works printed but not linked: 2

  1. Dickson, D. A. (2015). Investigating the role of cognitive biases as a risk factor for depression (Dissertation Abstracts International). Dissertation Abstracts International: Section B: The Sciences and Engineering.
  2. H. Gotlib & C. L. Hammen (Eds.), Handbook of depression (pp. 60-92). New York: The Guilford Press.

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Authors
Everaert, J., Podina, I. R., & Koster, E. H. W.
Affiliations
  • Ghent University (BE)
  • University of Bucharest (RO)
Corresponding author
Everaert, Jonas
ORCID
Venue
Clinical Psychology Review
Publisher
Elsevier BV
Published
2017-12
Volume
58
Pages
33-48
ISSN
0272-7358 (ISSN-L)
DOI
10.1016/j.cpr.2017.09.005
OpenAlex
W2756528888
Cited by
378
References
133
Citations by year
2026: 59 · 2025: 35 · 2024: 41 · 2023: 49 · 2022: 42 · 2021: 34 · 2020: 79 · 2019: 28 · 2018: 10 · 2017: 1
FWCI
5.10
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Psychology Review (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
Funders
  • Yale University
  • Universiteit Gent
  • Universitatea din București
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
  • Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
Keywords
interpretation bias, depression, cognitive biases, negative interpretation bias, mental imagery, depression remission, depressive symptoms
MeSH terms
Depression, Depressive Disorder, Humans, Thinking

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