{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T05:20:16Z","timestamp":1764998416730,"version":"3.46.0"},"reference-count":38,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82271543","8230229","82101566"],"award-info":[{"award-number":["82271543","8230229","82101566"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JEMR"],"abstract":"<jats:p>Major depressive disorder (MDD) represents a prevalent mental health condition characterized by prominent attentional biases, particularly toward negative stimuli. While extensive research has established the significance of negative attentional bias in depression, critical gaps remain in understanding the temporal dynamics and valence-specificity of these biases. This study employed eye-tracking technology to systematically examine the attentional processing of emotional faces (happy, fearful, sad) in MDD patients (n = 61) versus healthy controls (HC, n = 47), assessing both the initial orientation (initial gaze preference) and sustained attention (first dwell time). Key findings revealed the following: (1) while both groups showed an initial vigilance toward threatening faces (fearful\/sad), only MDD patients displayed an additional attentional capture by happy faces; (2) a significant emotion main effect (F (2, 216) = 10.19, p &lt; 0.001) indicated a stronger initial orientation to fearful versus happy faces, with Bayesian analyses (BF &lt; 0.3) confirming the absence of group differences; and (3) no group disparities emerged in sustained attentional maintenance (all ps &gt; 0.05). These results challenge conventional negativity-focused models by demonstrating valence-specific early-stage abnormalities in MDD, suggesting that depressive attentional dysfunction may be most pronounced during initial automatic processing rather than later strategic stages. The findings advance the theoretical understanding of attentional bias in depression while highlighting the need for stage-specific intervention approaches.<\/jats:p>","DOI":"10.3390\/jemr18060072","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T17:35:17Z","timestamp":1764956117000},"page":"72","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Initial and Sustained Attentional Bias Toward Emotional Faces in Patients with Major Depressive Disorder"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8910-5646","authenticated-orcid":false,"given":"Hanliang","family":"Wei","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453199, China"},{"name":"National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing 100191, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3576-0811","authenticated-orcid":false,"given":"Tak","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weijian","family":"Liu","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing 100191, China"},{"name":"Danish Research Centre for Magnetic Resonance, Department of Radiology and Nuclear Medicine, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0781-0247","authenticated-orcid":false,"given":"Waxun","family":"Su","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing 100875, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing 100875, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiandong","family":"Wang","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing 100875, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao","family":"Lin","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing 100191, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Li","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing 100191, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/S0140-6736(21)02141-3","article-title":"Time for united action on depression: A Lancet-World Psychiatric Association Commission","volume":"399","author":"Herrman","year":"2022","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1016\/j.cpr.2012.09.004","article-title":"Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis","volume":"32","author":"Armstrong","year":"2012","journal-title":"Clin. Psychol. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1007\/s10899-022-10161-3","article-title":"A Systematic Review of Eye-Tracking Studies of Gambling-Related Attentional Biases","volume":"39","author":"Takahashi","year":"2023","journal-title":"J. Gambl. Stud."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1080\/02699931.2020.1802228","article-title":"Attentional biases to emotional faces among women with a history of single episode versus recurrent major depression","volume":"35","author":"Foster","year":"2021","journal-title":"Cogn. Emot."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Ao, X., Mo, L., Wei, Z., Yu, W., Zhou, F., and Zhang, D. (2020). Negative Bias During Early Attentional Engagement in Major Depressive Disorder as Examined Using a Two-Stage Model: High Sensitivity to Sad but Bluntness to Happy Cues. Front. Hum. Neurosci., 14.","DOI":"10.3389\/fnhum.2020.593010"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/S2215-0366(20)30130-9","article-title":"Efficacy of cognitive bias modification interventions in anxiety and depressive disorders: A systematic review and network meta-analysis","volume":"7","author":"Fodor","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1037\/0021-843X.95.1.15","article-title":"Attentional bias in emotional disorders","volume":"95","author":"MacLeod","year":"1986","journal-title":"J. Abnorm. Psychol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e13058","DOI":"10.1111\/psyp.13058","article-title":"What does the dot-probe task measure? A reverse correlation analysis of electrocortical activity","volume":"55","author":"Thigpen","year":"2018","journal-title":"Psychophysiology"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Kappenman, E.S., Farrens, J.L., Luck, S.J., and Proudfit, G.H. (2014). Behavioral and ERP measures of attentional bias to threat in the dot-probe task: Poor reliability and lack of correlation with anxiety. Front. Psychol., 5.","DOI":"10.3389\/fpsyg.2014.01368"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Veerapa, E., Grandgenevre, P., El Fayoumi, M., Vinnac, B., Haelewyn, O., Szaffarczyk, S., Vaiva, G., and D\u2019Hondt, F. (2020). Attentional bias towards negative stimuli in healthy individuals and the effects of trait anxiety. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-68490-5"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.3758\/s13428-017-0946-y","article-title":"The reliability of eyetracking to assess attentional bias to threatening words in healthy individuals","volume":"50","author":"Skinner","year":"2018","journal-title":"Behav. Res. Methods"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"73","DOI":"10.5498\/wjp.v11.i3.73","article-title":"Using eye movements in the dot-probe paradigm to investigate attention bias in illness anxiety disorder","volume":"11","author":"Zhang","year":"2021","journal-title":"World J. Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1007\/s10608-013-9588-2","article-title":"Measuring attentional bias to threat: Reliability of dot probe and eye movement indices","volume":"38","author":"Waechter","year":"2014","journal-title":"Cogn. Ther. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1037\/abn0000184","article-title":"Unreliability as a threat to understanding psychopathology: The cautionary tale of attentional bias","volume":"125","author":"Rodebaugh","year":"2016","journal-title":"J. Abnorm. Psychol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.jbtep.2014.09.005","article-title":"Double attention bias for positive and negative emotional faces in clinical depression: Evidence from an eye-tracking study","volume":"46","author":"Duque","year":"2015","journal-title":"J. Behav. Ther. Exp. Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"103762","DOI":"10.1016\/j.brat.2020.103762","article-title":"Aberrant attentional bias to sad faces in depression and the role of stressful life events: Evidence from an eye-tracking paradigm","volume":"135","author":"Klawohn","year":"2020","journal-title":"Behav. Res. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.psychres.2019.02.076","article-title":"Biases in processing of mood-congruent facial expressions in depression","volume":"275","author":"Merzenich","year":"2019","journal-title":"Psychiatry Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1016\/j.brat.2008.07.004","article-title":"Time course of selective attention in clinically depressed young adults: An eye tracking study","volume":"46","author":"Kellough","year":"2008","journal-title":"Behav. Res. Ther."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1016\/j.jad.2020.05.140","article-title":"Attentional biases to emotional information in clinical depression: A systematic and meta-analytic review of eye tracking findings","volume":"274","author":"Suslow","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.jad.2018.05.047","article-title":"Free viewing of sad and happy faces in depression: A potential target for attention bias modification","volume":"238","author":"Lazarov","year":"2018","journal-title":"J. Affect. Disord."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.beth.2021.07.001","article-title":"Lack of an Attention Bias Away From Relatively Negative Faces in Dysphoria Is Not Related to Biased Emotion Identification","volume":"53","author":"Basel","year":"2022","journal-title":"Behav. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1177\/0300060516662134","article-title":"Alleviated negative rather than positive attentional bias in patients with depression in remission: An eye-tracking study","volume":"44","author":"Li","year":"2016","journal-title":"J. Int. Med. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1177\/0300060517708920","article-title":"Attentional bias scores in patients with depression and effects of age: A controlled, eye-tracking study","volume":"45","author":"Lu","year":"2017","journal-title":"J. Int. Med. Res."},{"key":"ref_24","first-page":"1049851","article-title":"Emotional Expression Processing and Depressive Symptomatology: Eye-Tracking Reveals Differential Importance of Lower and Middle Facial Areas of Interest","volume":"2020","author":"Hunter","year":"2020","journal-title":"Depress. Res. Treat."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1080\/10615806.2015.1101457","article-title":"Psychological, endocrine, and neural correlates of attentional bias in subclinical depression","volume":"29","author":"Dedovic","year":"2016","journal-title":"Anxiety Stress Coping"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1037\/emo0000944","article-title":"Positive emotion in daily life: Emotion regulation and depression","volume":"22","author":"Vanderlind","year":"2022","journal-title":"Emotion"},{"key":"ref_27","first-page":"249030","article-title":"Recognition of facial expressions in individuals with elevated levels of depressive symptoms: An eye-movement study","volume":"2012","author":"Wu","year":"2012","journal-title":"Depress. Res. Treat."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"Faul","year":"2007","journal-title":"Behav. Res. Methods"},{"key":"ref_29","first-page":"40","article-title":"Revision of the Chinese Facial Affective Picture System","volume":"25","author":"Gong","year":"2011","journal-title":"Chin. Ment. Health J."},{"key":"ref_30","first-page":"396","article-title":"Standardization and Assessment of College Students\u2019 Facial Expression of Emotion","volume":"13","author":"Wang","year":"2005","journal-title":"Chin. J. Clin. Psychol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"102377","DOI":"10.1016\/j.mex.2023.102377","article-title":"SHINE_color: Controlling low-level properties of colorful images","volume":"11","year":"2023","journal-title":"MethodsX"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Wang, Z. (2021). Eye-Tracking with Python and Pylink, Springer International Publishing.","DOI":"10.1007\/978-3-030-82635-2"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1037\/0021-843X.116.1.80","article-title":"Selective attention to emotional faces following recovery from depression","volume":"116","author":"Joormann","year":"2007","journal-title":"J. Abnorm. Psychol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Wang, S. (2025). Development of approach to an automated acquisition of static street view images using transformer architecture for analysis of Building characteristics. Sci. Rep., 15.","DOI":"10.1038\/s41598-025-14786-3"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1080\/02699930903407948","article-title":"Emotion regulation in depression: Relation to cognitive inhibition","volume":"24","author":"Joormann","year":"2010","journal-title":"Cogn. Emot."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.biopsych.2007.06.012","article-title":"Altered emotional interference processing in affective and cognitive-control brain circuitry in major depression","volume":"63","author":"Fales","year":"2008","journal-title":"Biol. Psychiatry"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.psychres.2016.07.004","article-title":"Social anxiety and perception of (un)trustworthiness in smiling faces","volume":"244","author":"Calvo","year":"2016","journal-title":"Psychiatry Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.tins.2011.11.005","article-title":"The neurobiology of anhedonia and other reward-related deficits","volume":"35","author":"Markou","year":"2012","journal-title":"Trends Neurosci."}],"container-title":["Journal of Eye Movement Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1995-8692\/18\/6\/72\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T05:17:32Z","timestamp":1764998252000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1995-8692\/18\/6\/72"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,1]]},"references-count":38,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["jemr18060072"],"URL":"https:\/\/doi.org\/10.3390\/jemr18060072","relation":{},"ISSN":["1995-8692"],"issn-type":[{"type":"electronic","value":"1995-8692"}],"subject":[],"published":{"date-parts":[[2025,12,1]]}}}