Is there a mutual relationship between opposite attentional biases underlying anxiety?

Current models that account for attentional processes in anxiety have proposed that high-trait anxious individuals are characterized by a hypervigilant-avoidant pattern of attentional biases to threat. We adopted a laboratory conditioning procedure to induce concomitant hypervigilance and avoidance to threat, emphasizing a putative relationship between lower-level reactive and upper-level controlled attentional mechanisms as the core account of attentional processes involved in the development and maintenance of anxiety. Eighty high- and low-trait anxious participants underwent Pavlovian conditioning to a human face. Eye tracking was used to monitor attentional changes to the conditioned stimulus (CS+) face and the neutral stimulus (CS?) face, presented at 200, 500, and 800 ms durations. The high-anxious participants developed the expected attentional bias toward the CS+ at 200 ms presentation time and attentional avoidance at 500 and 800 ms durations. Hypervigilance to aversive stimuli at 200 ms and later avoidance to the same stimuli at 500 and 800 ms were associated with higher levels of galvanic skin conductance to the CS+. The low-anxious individuals developed the opposite attentional pattern with an initial tendency to orient attention away from the aversive stimuli in the 200 ms condition and to orient attention toward aversive stimuli in the remaining time. The differential modulation between hypervigilance and avoidance elicited in the two groups by the conditioning procedure suggests that vulnerability to anxiety is characterized by a latent relationship between diverse attentional mechanisms. Within this relationship, hypervigilance and avoidance to threat operate at different stages of information processing suggesting fuzzy boundaries between early reactive and later-strategic processing of threat. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

To look or not to look: An eye movement study of hypervigilance during change detection in high and low spider fearful students.

Previous eye movement studies of attentional bias in spider fear reported inconsistent results with respect to early attentional capture, suggesting that overt attentional capture only reliably occurs under specific circumstances. In addition, none of these studies explored covert attention. The present study examined attentional bias in spider phobia using a change detection paradigm that was expected to provide good conditions for documenting attentional capture. In contrast to our expectations, eye movement data showed that all participants' first fixations were fastest on general negative targets, whereas participants' first fixations on spider targets were slower in the spider fearful than in the nonfearful group. In addition, spider fearful participants made more nontarget fixations before fixating on a spider target than did nonfearful participants. Thus, we found that participants' overt attention was more quickly focused on general negative targets, whereas covert attentional processes enabled initial avoidance of fear-relevant (i.e. spider) stimuli. The present findings have important implications for research on attention and fear as they indicate that fearful individuals are not characterized by static attentional orienting toward threat but, under certain conditions, may avert attention from threat automatically. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Biases in eye movements to threatening facial expressions in generalized anxiety disorder and depressive disorder.

The study investigated biases in selective attention to emotional face stimuli in generalized anxiety disorder (GAD) and depressive disorder, using a modified probe detection task. There were 4 face types: threatening, sad, happy, and neutral. Measures of attentional bias included (a) the direction and latency of the initial eye movement in response to the faces and (b) manual reaction time (RT) to probes replacing the face stimuli 1,000 ms after their onset. Results showed that individuals with GAD (without depressive disorder) were more likely to look first toward threat faces rather than neutral faces compared with normal controls and those with depressive disorder. They also shifted their gaze more quickly toward threat faces, rather than away from them, relative to the other two groups. There were no significant findings from the manual RT data. Implications of the results for recent theories of clinical anxiety and depression are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Orienting and maintenance of gaze to facial expressions in social anxiety.

In 2 experiments, the authors tested predictions from cognitive models of social anxiety regarding attentional biases for social and nonsocial cues by monitoring eye movements to pictures of faces and objects in high social anxiety (HSA) and low social anxiety (LSA) individuals. Under no-stress conditions (Experiment 1), HSA individuals initially directed their gaze toward neutral faces, relative to objects, more often than did LSA participants. However, under social-evaluative stress (Experiment 2), HSA individuals showed reduced biases in initial orienting and maintenance of gaze on faces (cf. objects) compared with the LSA group. HSA individuals were also relatively quicker to look at emotional faces than neutral faces but looked at emotional faces for less time, compared with LSA individuals, consistent with a vigilant-avoidant pattern of bias. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attentional Biases to Internal and External Sources of Potential Threat in Social Anxiety.

D. M. Clark and A. Wells (1995) proposed that a shift of attention inward toward interoceptive information is a central feature of social phobia. However, few studies have examined attentional biases toward internal physiological cues in social phobia. The current experiment assessed whether socially anxious individuals exhibit an attentional bias (a) toward cues for an internal source of potential threat (heart-rate information), (b) toward cues for an external source of potential threat (threatening faces) or (c) both. Ninety-one participants who were selected to form extreme groups based on a social anxiety screening measure performed a dot-probe task to assess location of attention. Results showed that socially anxious participants exhibited an attentional bias toward cues of internal, but not external, sources of potential threat. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conditioning-induced attentional bias for face stimuli measured with the emotional Stroop task.

People with anxiety disorder display attentional bias toward threat-related objects. Using classical fear conditioning, the authors investigated the possible source of such bias in normal participants. Following differential fear conditioning in which an angry face of either male or female (conditioned stimulus: CS+) was paired with mild electric fingershock (unconditioned stimulus: US) but the angry face of the other gender and all other facial expressions unpaired (CS-), an emotional Stroop task was administered. In the Stroop task, participants were required to identify the color of the facial stimuli (red, green, blue, or yellow). Response latency was significantly longer for the CS+ angry face than the other unpaired facial stimuli (CS-). Furthermore, this acquired attentional bias was positively correlated with the level of trait-anxiety measured before the conditioning and the degree of self-reported aversiveness of the US. Our results demonstrated that attentional bias could be induced in normal individuals through a simple associative learning procedure, and the acquisition is modulated by the level of trait anxiety and the level of perceived fear of the aversive US. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attentional bias to pictures of fear-relevant animals in a dot probe task.

Attentional bias to fear-relevant animals was assessed in 69 participants not preselected on self-reported anxiety with the use of a dot probe task showing pictures of snakes, spiders, mushrooms, and flowers. Probes that replaced the fear-relevant stimuli (snakes and spiders) were found faster than probes that replaced the non-fear-relevant stimuli, indicating an attentional bias in the entire sample. The bias was not correlated with self-reported state or trait anxiety or with general fearfulness. Participants reporting higher levels of spider fear showed an enhanced bias to spiders, but the bias remained significant in low scorers. The bias to snake pictures was not related to snake fear and was significant in high and low scorers. These results indicate preferential processing of fear-relevant stimuli in an unselected sample. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The reduction of anxiety vulnerability through the modification of attentional bias: A real-world study using a home-based cognitive bias modification procedure.

Recent laboratory work suggests that biased attentional responding to negative information causally impacts anxiety reactivity to a contrived laboratory stressor. However, it remains unknown whether such attentional bias contributes to real-world anxiety vulnerability. In the present study, the authors addressed this issue by experimentally inducing biased attentional response to emotionally negative stimuli, using a home-based attentional training program and then examining the influence of this attentional manipulation on trait anxiety scores and on state anxiety responses to a subsequent stressful life event. The attentional bias modification procedure was effective in inducing attentional avoidance of negative information. Furthermore, this attentional manipulation served to reduce trait anxiety scores and to attenuate state anxiety responses to the subsequent naturalistic stressor. These findings support the hypotheses that biased attentional responding to emotionally negative information contributes causally to real-world anxiety vulnerability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Phobia-related cognitive bias for pictorial and linguistic stimuli.

The purpose of this study was to examine whether anxiety-related cognitive bias for threat is stronger for threatening pictures than for threatening words. Spider-phobic participants (n?=?31 ) and control participants (n?=?33) performed a pictorial and linguistic spider Stroop task. Spider-phobic participants showed a marked bias for threat. However, this bias was similar for pictures and for words, although the spider-phobic group evaluated the pictures as being more aversive. The results suggest that automatic processing of threatening information in people with phobias is triggered in an on-off fashion, independent of subjective threat of the stimuli. This lack of distinction in automatic processing of weak and strong predictors of danger may be fundamental to the irrational nature of anxiety disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contrasting two accounts of anxiety-linked attentional bias: Selective attention to varying levels of stimulus threat intensity.

Previous research has established that clinical anxiety patients and nonclinical populations with high levels of anxiety vulnerability characteristically orient attention toward moderately threatening stimuli. In contrast, populations with low levels of anxiety vulnerability typically orient attention away from such stimuli. The differing experimental predictions generated by 2 classes of hypothetical explanation for this anxiety-linked attentional discrepancy were tested, using attentional probe methodology to compare the attentional responses of high and low trait anxious individuals to facial stimuli of differing threat intensities. The results support the view that all individuals orient attention away from mildly threatening stimuli and toward strongly threatening stimuli, with differences in anxiety vulnerability reflecting the intensity of stimulus threat required to elicit the attentional vigilance response. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anxiety-related attentional biases and their regulation by attentional control.

This study examined the role of self-reported attentional control in regulating attentional biases related to trait anxiety. Simple detection targets were preceded by cues labeling potential target locations as threatening (likely to result in negative feedback) or safe (likely to result in positive feedback). Trait anxious participants showed an early attentional bias favoring the threatening location 250 ms after the cue and a late bias favoring the safe location 500 ms after the cue. The anxiety-related threat bias was moderated by attentional control at the 500-ms delay: Anxious participants with poor attentional control still showed the threat bias, whereas those with good control were better able to shift from the threatening location. Thus, skilled control of voluntary attention may allow anxious persons to limit the impact of threatening information. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of stress and anxiety on the processing of threat stimuli.

Two experiments extended the work of C. MacLeod and A. Mathews (see record 1989-23867-001) and examined whether a cognitive bias for threat information is a function of state or trait anxiety. Color-naming and attention deployment tasks were used to assess the effects of a stress manipulation procedure on attentional responses in high and low trait anxious Ss. Ss under high stress selectively allocated processing resources toward threat stimuli, irrespective of their trait anxiety level. There was no consistent evidence of a cognitive bias associated with trait anxiety, and the effect of the stress manipulation did not apppear to be mediated by state anxiety. It was suggested that trait factors do not modify attentional biases associated with acute stress but may influence such biases when stress is prolonged. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Speeded Detection and Increased Distraction in Fear of Spiders: Evidence From Eye Movements.

Anxiety patients exhibit attentional biases toward threat, which have often been demonstrated as increased distractibility by threatening stimuli. In contrast, speeded detection of threat has rarely been shown. Therefore, the authors studied both phenomena in 3 versions of a visual search task while eye movements were recorded continuously. Spider-fearful individuals and nonanxious control participants participated in a target search task, an odd-one-out search task, and a category search task. Evidence for disorder-specific increased distraction by threat was found in all tasks, whereas speeded threat detection did not occur in the target search task. The implications of these findings for cognitive theories of anxiety are discussed, particularly in relation to the concept of disengagement from threat. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attentional retraining procedures: Manipulating early or late components of attentional bias?

According to cognitive models of anxiety disorders, attentional bias for threatening information is a vulnerability factor to the etiology and maintenance of anxiety. A recently developed methodology to reduce attentional bias has been found to reduce emotional reactivity and anxiety. The present study aimed at identifying the effects of this attentional bias reduction on early and later stages of threat processing. Undergraduates were allocated to an attentional bias reduction (n = 23) versus control condition (n = 25). It was found that attentional bias reduction influenced late but not early stages of threat processing. This finding is of theoretical importance in relation to studies on the causal role of attentional bias and emotional reactivity. Moreover, the present findings also bear relevance to the clinical application of attentional retraining procedures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical implications of attentional bias in anxiety disorders: An integrative literature review.

Research on information processing biases has been motivated by the hope that it would lead to new and more efficient psychotherapeutic interventions. The literature is abundant with empirical data of attentional biases toward threat stimuli in anxiety disorders. This article aims to review the existing literature on the topic of attentional bias in anxiety disorders and discuss important implications for clinical practice. We adopted an integrative approach to link research data on attentional bias, information processing, and cognitive accounts (automaticity and controllability) with clinical practice in cognitive-behavioral therapy. It is important to develop and apply therapeutic interventions that can effectively reduce negative attentional biases while treating the main problems associated with anxiety disorders. However, it remains to be seen whether cognitive therapy interventions targeting more voluntary, strategic information processing can have a positive impact on automatic, involuntary processing involved in attentional biases. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Information-Processing Biases in Young Adults From Bereaved and Divorced Families.

Parental loss or divorce is associated with increased risk for affective disorders, potentially because of dysfunctional information processing. This study evaluated attentional biases to threat or loss-related cues in young adults from divorced, parental-loss, or intact families. Participants from intact families showed avoidance of supraliminal threat and loss cues, whereas those from divorced families showed vigilance toward loss cues. Those from bereaved families showed no pattern of bias. Abuse and poor family relationships were associated independently with vigilance toward negative cues. After controlling for abuse, group differences in threat bias were no longer apparent. Results suggest that parental death or divorce may increase risk of affective disorder owing to the loss of a "protective bias" away from negative stimuli. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anxiety meets fear in perception of dynamic expressive gaze.

This study investigated in 2 experiments whether reflexive cuing of attention that occurs after perception of a gaze cue is greater for fearful than for happy faces in normal participants, as hypothesized from a social neuroscience perspective. To increase neuroecological validity, dynamic stimulus presentation was used to display faces that simultaneously morphed from a neutral expression into a happy or fearful one and shifted eye gaze from the center to the periphery. Shifts of attention resulting from a natural fearful gaze were expected to be related to participants' anxiety traits, in agreement with the often found increased selective attention to threat in anxious participants. Both hypotheses were confirmed: Fearful faces induced stronger gaze cuing than happy faces, and the strength of this cuing effect was correlated to participants' anxiety levels. These results suggest a neural network, which integrates the processing of gaze, expression, and emotional states to adaptively prime vigilance under threatening circumstances. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prepared for the worst: Readiness to acquire threat bias and susceptibility to elevate trait anxiety.

Although people differ in their susceptibility to elevate trait anxiety in response to extended stress, little is known about the cognitive substrate of this particular individual difference. We report three studies designed to evaluate the hypothesis that individual differences in readiness to acquire an attentional bias toward threat cues, in response to a contingency that makes the acquisition of such a bias adaptive, underlie individual differences in susceptibility to elevate trait anxiety in response to extended stress. Our findings confirm that the ease with which such a threat bias can be transiently evoked by experimental conditions that encourage its acquisition predicts the degree to which trait anxiety later becomes elevated by extended exposure to a mild stressor. Furthermore, this reflects the fact that such early measures of attentional bias plasticity predict the later naturalistic acquisition of attentional bias in response to subsequent stress, which in turn is associated with a consequent increase in trait anxiety level. These findings are consistent with our proposed account of individual differences in susceptibility to elevate trait anxiety in response to stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Looking happy: The experimental manipulation of a positive visual attention bias.

Individuals with a positive visual attention bias may use their gaze to regulate their emotions while under stress. The current study experimentally trained differential biases in participants' (N = 55) attention toward positive or neutral information. In each training trial, one positive and one neutral word were presented and then a visual target appeared consistently in the location of the positive or neutral words. Participants were instructed to make a simple perceptual discrimination response to the target. Immediately before and after attentional training, participants were exposed to a stress task consisting of viewing a series of extremely negative images while having their eyes tracked. Visual fixation time to negative images, assessed with an eye tracker, served as an indicator of using gaze to successfully regulate emotion. Those participants experimentally trained to selectively attend to affectively positive information looked significantly less at the negative images in the visual stress task following the attentional training, thus demonstrating a learned aversion to negative stimuli. Participants trained toward neutral information did not show this biased gaze pattern. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Malleability of attentional bias for positive emotional information and anxiety vulnerability.

Recent research supports a causal link between attentional bias for negative emotional information and anxiety vulnerability. However, little is known about the role of positive emotional processing in modulating anxiety reactivity to stress. In the current study, we used an attentional training paradigm designed to experimentally manipulate the processing of positive emotional cues. Participants were randomly assigned to complete a computerized probe detection task designed to induce selective processing of positive stimuli or to a sham condition. Following training, participants were exposed to a laboratory stressor (i.e., videotaped speech), and state anxiety and positive affect in response to the stressor were assessed. Results revealed that individual variability in the capacity to develop an attentional bias for positive information following training predicted subsequent emotional responses to the stressor. Moreover, individual differences in social anxiety, but not depression, moderated the effects of the attentional manipulation, such that, higher levels of social anxiety were associated with diminished attentional allocation toward positive cues. The current findings point to the potential value of considering the role of positive emotional processing in anxiety vulnerability. (PsycINFO Database Record (c) 2011 APA, all rights reserved)