Reaction to Negative Imagery Suppressed by Depression in Anxiety-Related Disorders
April 21, 2021

By Louise Gagnon

Patients with anxiety had more negative ratings of negative imagery, after controlling for depression, according to a study presented at the Virtual 2021 Annual Meeting of the Anxiety and Depression Association of American (ADAA).

“We know that individuals with anxiety and depression suffer from intrusive negative imagery,” explained Annmarie MacNamara, PhD, Texas A&M University, College Station, Texas. “We also know that anxiety and depression are highly comorbid and both are characterised by high levels of negative imagery.”

The researchers sought to look at links between depression, generalised anxiety disorder (GAD), social anxiety disorder, and electrocortical and subjective responses to negative imagery.

The study involved 57 individuals (39 females) who had varying levels of anxiety and depressive disorders. Subjects completed an imagery paradigm, and they underwent electroencephalography (EEG) to determine EEG responses to imagery. Specifically, EEG late positive potential (LPP) toward imagery was captured.

Subjects were exposed to a neutral scenario, where they were informed that they woke up and had breakfast, and a negative scenario, where they were informed that a close friend falls to the floor and is unable to breathe.

The investigators used the Structured Clinical Interview for DSM-5 to check for depression, and the Depression, Anxiety and Stress Scale and the Social Phobia Inventory to screen for and measure the severity of social anxiety disorder.

Multiple regression was used to examine suppressor effects and parse out and control for overlap in anxiety and depression.

Individuals who were more depressed showed reduced electrocortical processing of negative imagery (Dx, beta = -0.30, P = .018; Sx, beta = -0.35, P = .008), as well as less negative ratings of negative imagery (Sx, beta=0.28; P = .050).

Individuals who had GAD showed heightened electrocortical processing of negative imagery, but only when controlling for depression (Dx, beta = 0.26, P = .047). Additionally, individuals with greater social anxiety rated negative imagery more negatively, when controlling for depression (Sx, beta = -0.33, P = .045).

“When we controlled for other diagnoses, we saw that depression is linked to smaller LPPs to negative imagery,” said Dr. MacNamara. “We saw that GAD is associated with larger LPPs.”

Dr. MacNamara speculates that depression may be leading to an emotionally blunted response, which is why it is key to parse out the respective impacts of anxiety and depression to stimuli.

“This research highlights that there are important distinctions between different dimensions of distress-based psychopathology,” he said.

[Presentation title: S1-245 Negative Imagery in the Internalizing Disorders: An Event-Related Potential Study]