Relationship between change in social evaluation learning and mood in early antidepressant treatment: a prospective cohort study in primary care

Catherine Hobbs, Milly Beck, Faye Denham, Laura Pettit, Julian Faraway, Marcus R. Munafo, Jie Sui, David Kessler, Katherine S. Button

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Abstract

Background: Antidepressants are proposed to work by increasing sensitivity to positive versus negative information. Increasing positive affective learning within social contexts may help remediate negative self-schema. We investigated the association between change in biased learning of social evaluations about the self and others, and mood during early antidepressant treatment. Method: Prospective cohort assessing patients recruited from primary care in South West England at four timepoints over the first 8 weeks of antidepressant treatment (n = 29). At each timepoint, participants completed self-report measures of depression (Beck Depression Inventory II (BDI-II) and Patient Health Questionnaire 9 (PHQ-9)), anxiety (Generalised Anxiety Disorder Questionnaire 7 (GAD-7)), and a computerised task measuring learning of social evaluations about the self, a friend and a stranger. Results: We did not find evidence that learning about the self was associated with a reduction in PHQ-9 (b = 0.08, 95% CI: −0.05, 0.20, p = 0.239) or BDI-II scores (b = 0.10, 95% CI: −0.18, 0.38, p = 0.469). We found some weak evidence that increased positive learning about the friend was associated with a reduction in BDI-II scores (b = 0.30, 95% CI: −0.02, 0.62, p = 0.069). However, exploratory analyses indicated stronger evidence that increased positive learning about the self (b = 0.18, 95% CI: 0.07, 0.28, p = 0.002) and a friend (b = 0.22, 95% CI: 0.10, 0.35, p = 0.001) was associated with reductions in anxiety. Conclusions: Change in social evaluation learning was associated with a reduction in anxiety but not depression. Antidepressants may treat anxiety symptoms by remediating negative affective biases towards socially threatening information directed towards the self and close others. However, our findings are based on exploratory analyses within a small sample without a control group and are therefore at risk of type 1 errors and order effects. Further research with larger samples is required.

Original languageEnglish
Pages (from-to)303-312
JournalJournal of Psychopharmacology
Volume37
Issue number3
Early online date24 Aug 2022
DOIs
Publication statusPublished - 31 Mar 2023

Bibliographical note

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This work was supported in part by grant MR/N0137941/1 for the GW4 BIOMED MRC DTP, awarded to the Universities of Bath, Bristol, Cardiff and Exeter from the Medical Research Council (MRC)/UKRI. This study was also supported by service support costs provided by the NIHR Clinical Research Network West of England.

Keywords

  • Depression
  • antidepressants
  • emotional processing
  • self-schema
  • social cognition

ASJC Scopus subject areas

  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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