Can't look Away: Attention control deficits predict Rumination, depression symptoms and depressive affect in daily Life

Background: Rumination and a reduced capacity to disengage attention as appropriate to context (attention control deficits) have each been implicated in the etiology and maintenance of depressive disorders. However, it remains unclear whether rumination is a mechanism by which attention control deficits predict depression, and whether these relations are observed outside of laboratory settings. We tested whether rumination mediates the effects of attention control deficits marked by slow disengagement from negative-valenced stimuli (sad faces) and fast disengagement from positive-valenced stimuli (happy faces) on depression symptoms and depressive affects in the daily lives of adults with various depression histories. Method: Forty-six participants (n=23 with histories of Major Depressive Disorder) completed a clinical evaluation, an eye-tracking task that indexed attention control, and a 7-day Ecological Momentary Assessment (EMA) follow-up during which Negative (NA) and Positive Affect (PA) were measured at times of peak distress that occurred in the hour preceding each EMA prompt. Results: Delayed disengagement from sad faces predicted elevated depression and NA levels, and low PA levels, independent of depression histories. Rumination mediated the effects of delayed disengagement from sad, and rapid disengagement from happy, faces on depression and NA levels. Effects of disengagement on rumination were maintained independent of depression levels. Limitations: Our sample size limited the detection of small statistical effects, and we could not clarify temporal relationships between attention control deficits and rumination. Conclusion: Our findings suggest that attention inflexibility and rumination persist independent of depressive states and should be targets of clinical intervention.