The Compilation And Application Of Interpretation Bias Assessment Tools In Depression

Object and significanceDepression is a common psychiatric disorder with a global point prevalence rate of4.7%.Depression not only has a high morbidity and functional disability rate,but also brings about dramatic disease burdens to the sufferers and society.The economic cost s to the whole Chinese society is over 52.3 billion yuan a year.Personally,patients fall into economic woes due to the loss of productivity,and the high medical costs and the good-will care impose heavy burden to the suffering families as well.Depression along with other serious physical or mental disorders causes the deterioration of patients'disease,which along with high suicide risk caused by depression greatly increases mortality and has great negative impact on suffering families and society.Dep ression tends to be more and more popular following with increasing survival pressure caused by rapid urbanization,along with people's emphasis on mental and physical health.Depression has become a hot issue that people now pay close attention to and a m ajor public health concern.While the mechanism of depression is still not clear,psychologists believe that cognitive factors play extremely important role in the onset and maintenance of depression.Researchers began to pay much attention to cognitive bi as components,since Beck firstly put forward the concept of negative cognitive bias.Recently,interpretation bias in the study of depression has gotten more and more attention,which is a systematic emotional tendency when people analyze ambiguity,and generally considered as the core cognitive factor of depression.On one hand,because our research on depressive interpretation bias started late,especially lack of standardized assessment tools,it is urgent to develop a standardized measurement of depression in China.On the other hand,reported conflicting results on study of interpretation bias,especially on the relationship between negative and positive interpretation bias,encourage us to develop suitable depressive interpretation bias measurement tools for Chinese population.Ambiguous materials are usually used in such research which involve semantic and nonverbal ambiguity.Semantic ambiguity involves words,sentences and paragraphs among which the inductive effect of paragraph is much more better.Furthermore,narrative short-form animations are more vivid than text in presenting the same content,so we developed the Similarity Rating Task Questionnaire which presents ambiguous scenario in animation.As to nonverbal ambiguity,facial expression is most commonly used,among which the dynamic facial expression is closer to nature than the static.However,few standardized dynamic Chinese facial expressions are available,so we developed the Micro-Morphing Chinese Facial Expression Series System.Additionally,previous studies often used one certain type of ambiguity as the research material,which may be one of the reasons for the inconsistent results or failing in comprehensively understanding the common features of interpretation bias in depression.In general,we decided to use two distinct measurement tools to check the interpretation bias in depression to make a comprehensive analysis.SubjectIn the revision of the Similarity Rating Task Questionnaire?Chinese version?,91and 112 valid cases were obtained through the screening of ambiguity paragraphs.477subjects were selected for the reliability and validity test study,and 404 valid cases were obtained.102 valid cases were obtained in the compilation of the Similari ty Rating Task Questionnaire?Multimedia Version?.The Micro-Morphing Chinese Facial Expression Series uses 20 performers'expressions,and 71 valid cases?among 84 raters?were obtained after stability screening.In the study of the characteristic of interp retation bias in depression,27 patients with episodic depression?22 valid?,25 patients with remission depression?19 valid?,21 first-degree relatives of depression,and 27 healthy controls were obtained.?1?The revision of the Similarity Rating Task Questionnaire?Chinese version?:?1?57 paragraphs were selected after translating and adjusting scenario paragraphs in the CBMerrors training programs,and 8 were screened out;?2?10 paragraphs of the Similarity Rating Task?English version?,8 paragraphs screened out from the CBMerrors training programs and 2 paragraphs complied by our research group according to our national culture and customs were selected in the second screening stage of survey,and14 paragraphs were screened out eventually;?3?Neutral comprehension questions and disambiguating sentences for rating were compiled according to the format of the Similarity Rating Task?English version?;?4?477 cases?404 valid?were recruited in testing the Similarity Rating Task Questionnaire?Chinese version?for the purpose of reliability and validity test.?2?The compilation of the Similarity Rating Task Questionnaire?Multimedia Version?:?1?To adapt all ambiguity scenario paragraphs in the Similarity Rating Task Questionnaire?Chinese version?to narrative short-form animations which last 15 seconds per paragraph;?2?The text content was presented by audio in sync with the animation video;?3?The research group and the video team discussed many times to ensure the consistency of the animations with the original texts;?4?102 valid cases were recruited to test the reliability and validity.?3?The establishment of the Micro-Morphing Chinese Facial Expression Series System:?1?20 performers?male:female=1:1?were recruited to perform facial expressions;?2?Primary screening of photos was implemented by the shooting crew,secondary screening was implemented by other members in our research group,and 1133expression pictures were screened out finally;?3?All pictures are processed into the same sized black-and-white pictures which only display the face?not including hair,ears,neck,etc.?;?4?84 raters were recruited to assess the valence,arousal,dominance and expressional type of the 1133 pictures.?4?The study of the characteristics of interpretation bias in depression:?1?All participants had a short interview with psychiatrist to confirm grouping;?2?All participants read and signed the informed consent,along with submitting the general information;?3?The participants were asked to perform the BDI-II,the Negative Cognitive Processing Bias Questionnaire and the S-TDEP.?4?The participants were asked to perform the Similarity Rating Task Questionnaire?Multimedia Version?and the Morphing Facial Expression Identification Task,order of task presentation was counterbalanced across participants.The total time for each participant was 40-90minutes.Results?1?The Similarity Rating Task Questionnaire?Chinese version?:Cronbach?=0.613,split-half reliability=0.617.5 factors were extracted by exploratory factor analysis,which cumulative contribution rate was 52.67%.The confirmatory factor analysis showed that the five-factor model fitted well.The criterion validity was good according to CES-D,which showed the significant correlation between them?r=-0.224,p<0.01?.?2?The Similarity Rating Task Questionnaire?Multimedia version?:Cronbach?=0.820,split-half reliability=0.767.Validity test showed that total score and each factor were significantly related to CES-D(r_total=0.493,r_{depressive affect}=0.460,r_{positive affect}=0.307,rsomatic complaint=0.340,rinterpersonal relation=0.399),and to NCPBQ?rtotal=0.493,rattention bias=0.362,rmemory bias=0.303,rinterpretation bias=0.408,rrumination bias=0.562?.In particular,the negative interpretation bias factor was significantly correlated with the 5 factors in our questionnaire?r₁=0.318,r₂=0.362,r₃=0.296,r₄=0.232,r₅=0.279?.There was an extremely significant correlation between the multimedia version and the verbal version?r=0.817,p<0.01?.?3?The Micro-Morphing Chinese Facial Expression Series System contains 78series of different emotional types,and each series includes the same person's calm expression and a specific expression.There are 20 series belong to positive expression,all of which are pictures of calm and happy expressions.There are 44 series belong to negative expression,including 15 series of calm-anger expression,18 series of calm-sadness expression,1 series of calm-fear expression,and 10 series of calm-disgust expression.There were also 14 calm-surprise expression.There are 603 pictures in total.?4?The study of the characteristics of interpretation bias in depression showed that concerning semantic ambiguity?1?positive and negative interpretation bias are two independent components rather than two sides of interpretation bias;?2?positive interpretation bias is more sensitive than the negative one.As to nonverbal ambiguity,the relative interpretation bias is a more sensitive index:?1?The lower the difference of positive and negative expression recognition accuracy is,the more relative interpretation bias inclines to negative interpretation bias,which may indicate the onset of dep ression;?2?The threshold ratio of different valence can be used as an objective index for the improvement of depression symptoms.Conclusion?1?Both the Chinese version and multimedia version of the Similarity R ating Task Questionnaire are good at reliability and validity for measuring the degree of depression interpretation bias,and the multimedia version is better than the Chinese verbal version.?2?The Micro-Morphing Chinese Facial Expression Series System is a standardized emotional research material using Chinese faces,which is characterized by providing different types of emotional images of the same performer.It provides reliable original material of morphing paradigm.?3?The increase of negative interpretation bias and the lack of positive interpretation are two independent components rather than two side of interpretation bias in depression.Relative interpretation bias Score is a more sensitive index indicating development of depression.