Investigating Emotion Recognition Biases as a Target for Intervention in Anxiety and Depression

  • Steph Suddell

Student thesis: Doctoral ThesisDoctor of Philosophy (PhD)


Individuals with anxiety and depression display negative biases in their interpretation of emotional information. Neurocognitive models posit that these biases are causally related to the onset and maintenance of symptoms. This reasoning has led to the development of several cognitive bias modification techniques as a potential treatment for emotional disorders. However, to date, these interventions have had limited success. This may in part be due to previous research being hindered by small sample sizes and the use of methods which prevent causal inference.

This thesis has two overarching aims: to investigate the role that emotion recognition biases play in anxiety and depression, and to evaluate emotional bias training as an intervention for anxiety and depression. During my PhD, I used a range of observational, experimental, and genetic methods to strengthen causal inference. First, I conducted a cohort study using data from the Avon Longitudinal Study of Parents and Children. Second, I conducted genetic analyses in the same sample, applying Mendelian randomisation to investigate causal pathways. Third, I investigated whether interpretation biases are present in the appraisal of more complex social stimuli in an online cross-sectional study. Finally, I present the results of two randomised controlled trials of emotional bias training in two populations: a general population sample and a sample of individuals currently taking antidepressants.

Overall, I found evidence that both anxiety and depressive symptoms are associated with negative interpretation biases in the appraisal of social stimuli. There was particularly strong evidence for a relationship between depressive symptoms and a bias towards recognising sad facial expressions. Evidence for this relationship being causal was inconsistent, as emotional bias training targeting biases towards sadness had little impact on mood outcomes. However, there was some evidence that emotional bias training may be beneficial for specific subpopulations. Future research should adopt a transdiagnostic approach, to identify how subtle changes in bias relate to symptoms of emotional disorder.
Date of Award2 Dec 2021
Original languageEnglish
Awarding Institution
  • The University of Bristol
SupervisorIan S Penton-Voak (Supervisor) & Marcus R Munafo (Supervisor)

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