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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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Authors: Everaert, J., Podina, I. R., & Koster, E. H. W.
Affiliations: Ghent University (BE)
University of Bucharest (RO)
Corresponding author: Everaert, Jonas
ORCID: Everaert, Jonas
Podina, Ioana R.
Koster, Ernst H.W.
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: hybrid
doi.org
Licence: other-oa
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
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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A comprehensive meta-analysis of interpretation biases in depression

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