Biased attentional processing of positive stimuli in social anxiety disorder: an eye movement study

Despite the established relationship between social anxiety and attentional bias towards threat, a growing base of evidence suggests that social anxiety is additionally maintained by a deficit in the attentional processing of positive information. However, it remains unclear which component of attention is implicated in this deficit. Using eye movement-based measures and a novel attentional cuing methodology, the present study sought to investigate the presence of anxiety-linked bias in attentional engagement with, attentional disengagement from, and total fixation time to, socially relevant emotional stimuli in individuals diagnosed with social anxiety disorder, relative to non-socially anxious controls. Socially anxious individuals were found to exhibit faster attentional disengagement from positive stimuli, and reduced total fixation time to all emotional stimuli, relative to controls. Additionally for socially anxious individuals, lower total fixation times to positive stimuli were associated with higher levels of state anxiety. No differential pattern of engagement was evident between groups. We conclude that social anxiety is maintained in part by the aberrant processing of positive social stimuli.     

Evidence from the eyes: Threatening postures hold attention

Efficient detection of threat provides obvious survival advantages and has resulted in a fast and accurate threat-detection system. Although beneficial under normal circumstances, this system may become hypersensitive and cause threat-processing abnormalities. Past research has shown that anxious individuals have difficulty disengaging attention from threatening faces, but it is unknown whether other forms of threatening social stimuli also influence attentional orienting. Much like faces, human body postures are salient social stimuli, because they are informative of one’s emotional state and next likely action. Additionally, postures can convey such information in situations in which another’s facial expression is not easily visible. Here we investigated whether there is a threat-specific effect for high-anxious individuals, by measuring the time that it takes the eyes to leave the attended stimulus, a task-irrelevant body posture. The results showed that relative to nonthreating postures, threat-related postures hold attention in anxious individuals, providing further evidence of an anxiety-related attentional bias for threatening information. This is the first study to demonstrate that attentional disengagement from threatening postures is affected by emotional valence in those reporting anxiety.     

Attentional bias in high- and low-anxious individuals: evidence for threat-induced effects on engagement and disengagement

Attentional bias to threatening visual stimuli (words or pictures) is commonly present in anxious individuals, but not in non-anxious people. There is evidence to show that attentional bias to threat can be induced in all individuals when threat is imposed by threat not of symbolic nature, but by cues that predict aversive stimulation (loud noise or electric shock). However, it is not known whether attentional bias in such situations is still influenced by individual differences in anxiety. This question was addressed in two experiments using a spatial cuing task in which visual cues predicted the occurrence of an aversive event consisting of a loud human scream. Speeded attentional engagement to threat cues was positively correlated with trait anxiety in Experiment 1. Experiment 2 showed that speeded attentional engagement was present only in participants selected for high anxiety but not in low-anxious participants. In both experiments, slower disengagement from threat cues was found in all participants, irrespective of their trait anxiety levels.     

Attentional bias in high- and low-anxious individuals: Evidence for threat-induced effects on engagement and disengagement

Attentional bias to threatening visual stimuli (words or pictures) is commonly present in anxious individuals, but not in non-anxious people. There is evidence to show that attentional bias to threat can be induced in all individuals when threat is imposed by threat not of symbolic nature, but by cues that predict aversive stimulation (loud noise or electric shock). However, it is not known whether attentional bias in such situations is still influenced by individual differences in anxiety. This question was addressed in two experiments using a spatial cuing task in which visual cues predicted the occurrence of an aversive event consisting of a loud human scream. Speeded attentional engagement to threat cues was positively correlated with trait anxiety in Experiment 1. Experiment 2 showed that speeded attentional engagement was present only in participants selected for high anxiety but not in low-anxious participants. In both experiments, slower disengagement from threat cues was found in all participants, irrespective of their trait anxiety levels.     

Anxiety and Attention: Is There an Attentional Bias for Positive Emotional Stimuli?

Empirical research has shown that anxiety is associated with a systematic bias in the cognitive system. Anxious individuals (clinically anxious patients and normal individuals with high-trait anxiety) are characterized by a pattern of selective processing that favors the encoding of threatening information. Is this attentional bias specific to threat-related information, or does it operate for positive emotional stimuli? The research directly connected with the existence of an attentional bias for threat in anxiety was examined.     

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.     

Assessing the role of spatial engagement and disengagement of attention in anxiety-linked attentional bias: a critique of current paradigms and suggestions for future research directions

A considerable volume of research has demonstrated an anxiety-linked attentional bias characterized by selective processing of threat stimuli. The last decade has seen growing interest in identifying the precise attentional mechanisms which underlie such selective processing to advance both theoretical and etiological models of anxiety. This research has particularly focused on the roles of spatial engagement and disengagement of attention. The relative contribution of these attentional components to selective processing of threat in anxious individuals remains unclear however. Moreover, we argue here that many of the tasks employed to examine these mechanisms, may not be capable of indexing the attentional processes that they claim to measure. In this article, we provide a methodological review, critically evaluating the adequacy of previous tasks employed to measure biased attentional engagement and disengagement. Based on a number of concerns raised about the ability of such tasks to differentiate these component attentional processes, we detail three task criteria that we believe are essential to be confident that a task will accurately index biased attentional engagement with, and disengagement from threat in anxious participants.     

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.     

Intergenerational transmission of attentional bias and anxiety

Earlier evidence has revealed a bi‐directional causal relationship between anxiety and attention biases in adults and children. This study investigated the prospective and concurrent relations between anxiety and attentional bias in a sample of 89 families (mothers, fathers, and first‐born children). Parents’ and children's attentional bias was measured when children were 7.5 years old, using both a visual probe task and visual search task with angry versus happy facial expressions. Generalized and social anxiety symptoms in parents and children were measured when children were 4.5 and 7.5 years old. Anxiety in parents and children was prospectively (but not concurrently) related to their respective attentional biases to threat: All participants showed a larger attentional bias to threat in the visual search (but not in the visual probe) task if they were more anxious at the 4.5 (but not at the 7.5) year measurement. Moreover, parents’ anxiety levels were prospectively predictive of the visual search attentional bias of their children after controlling for child anxiety. More anxiety in mothers at 4.5 years was related to a faster detection of angry among happy faces, while more anxiety in fathers predicted a faster detection of happy among angry faces in children at 7.5 years. We found no direct association between parental and child attentional biases. Our study contributes to the recently emerging literature on attentional biases as a potential mechanism in the intergenerational transmission of anxiety by showing that parents’ anxiety rather than parents’ attentional bias contributes to the intergenerational transmission of risk for child anxiety.     

Attentional biases using the body in the crowd task: are angry body postures detected more rapidly?

Research using schematic faces has consistently demonstrated attentional biases towards threatening information (angry faces), which are accentuated for individuals with higher levels of anxiety. However, research has yet to reveal whether this is the case for other nonverbal channels of communication. In the research reported here, ninety-five undergraduates completed a body in the crowd task analogous to the face in the crowd task, to examine whether attentional biases for threat existed for schematic body postures. Participants demonstrated faster detection of threat. A discrepant angry posture in a neutral crowd was identified quicker than a discrepant happy posture in a neutral crowd. This effect was pronounced for individuals with higher self-reported levels of trait anxiety. Results also demonstrated evidence of delayed disengagement from threat. Individuals were slower (i.e., more distracted) by identical crowds of angry postures rather than happy or neutral crowds and were slower to detect a discrepant neutral posture among an angry crowd than neutral among a happy crowd. These findings are the first to establish threat biases using body postures in a visual search paradigm. The results are in accordance with previous research using schematic face stimuli. Theoretical and practical implications are discussed.     

Detection of emotional expressions in rapidly changing facial displays in high- and low-socially anxious women

Facial information and attention to facial displays are distributed over spatial as well as temporal domains. Thus far, research on selective attention to (dis)approving faces in the context of social anxiety has concentrated primarily on the spatial domain. Using a rapid serial visual presentation (RSVP) paradigm, the present study examined the temporal characteristics of visual attention for happy and angry faces in high- (n=16) and low-socially anxious individuals (n=17), to test whether also in the temporal domain socially anxious individuals are characterized by threat-confirming attentional biases. Results indicated that presenting angry faces as the first target (T1) did not aggravate the detection of the emotional expression of the second target (T2). Yet, participants generally showed superior detection of the emotional expression of T2, if T2 was an angry face. Casting doubt on the role of such attenuated attentional blink for angry faces in social anxiety, no evidence emerged to indicate that this effect was relatively strong in high-socially anxious individuals. Finally, the presentation of an angry face as T2 resulted in a relatively hampered identification of a happy-T1. Again, this "backward blink" was not especially pronounced in high-socially anxious individuals. The present anger superiority effects are consistent with evolutionary models stressing the importance of being especially vigilant for signals of dominance. Since the effects were not especially pronounced in high-anxious individuals, the present study adds to previous findings indicating that socially anxious individuals are not characterized by a bias in the (explicit) detection of emotional expressions [Philippot, P., & Douilliez, C. (2005). Social phobics do not misinterpret facial expression of emotion. Behaviour Research and Therapy, 43, 639-652].     

Attentional biases using the body in the crowd task: Are angry body postures detected more rapidly?

Research using schematic faces has consistently demonstrated attentional biases towards threatening information (angry faces), which are accentuated for individuals with higher levels of anxiety. However, research has yet to reveal whether this is the case for other nonverbal channels of communication. In the research reported here, ninety-five undergraduates completed a body in the crowd task analogous to the face in the crowd task, to examine whether attentional biases for threat existed for schematic body postures. Participants demonstrated faster detection of threat. A discrepant angry posture in a neutral crowd was identified quicker than a discrepant happy posture in a neutral crowd. This effect was pronounced for individuals with higher self-reported levels of trait anxiety. Results also demonstrated evidence of delayed disengagement from threat. Individuals were slower (i.e., more distracted) by identical crowds of angry postures rather than happy or neutral crowds and were slower to detect a discrepant neutral posture among an angry crowd than neutral among a happy crowd. These findings are the first to establish threat biases using body postures in a visual search paradigm. The results are in accordance with previous research using schematic face stimuli. Theoretical and practical implications are discussed.     

Components of attentional bias to threat in high trait anxiety: Facilitated engagement, impaired disengagement, and attentional avoidance

There is a wealth of evidence demonstrating enhanced attention to threat in high trait anxious individuals (HTA) compared with low trait anxious individuals (LTA). In two experiments, we investigated whether this attentional bias is related to facilitated attentional engagement to threat or difficulties disengaging attention from threat. HTA and LTA undergraduates performed a modified exogenous cueing task, in which the location of a target was correctly or incorrectly cued by neutral, highly and mildly threatening pictures. Results indicate that at 100 ms picture presentation, HTA individuals more strongly engaged their attention with and showed impaired disengagement from highly threatening pictures than LTA individuals. In addition, HTA individuals showed a stronger tendency to attentional avoidance of threat at the 200 and 500 ms picture presentation. These data provide evidence for differential patterns of anxiety-related biases in attentive processing of threat at early versus later stages of information processing.     

注意偏向训练对广泛性焦虑障碍负性情绪注意偏向的影响

采用改良的点探测任务,探讨了注意偏向训练能否改变GAD患者的负性情绪注意偏向并缓解其焦虑状态,及注意偏向训练的作用机制。结果发现,与控制组相比,训练组被试的负性注意偏向分数显著降低,具体表现为训练后训练组的负性注意解除能力显著高于控制组,两组被试的负性注意警觉在前后测均未有显著变化;注意偏向训练引起了GAD患者积极情绪的变化,缓解了状态焦虑。这证明了注意偏向训练对改变GAD患者负性情绪注意偏向及缓解其焦虑状态的有效性,并揭示这种改变主要是通过提升其对负性刺激的注意解除能力来实现的。     

Anxiety and speaking in people who stutter: An investigation using the emotional Stroop task

People with anxiety disorders show an attentional bias towards threat or negative emotion words. This exploratory study examined whether people who stutter (PWS), who can be anxious when speaking, show similar bias and whether reactions to threat words also influence speech motor planning and execution. Comparisons were made between 31 PWS and 31 fluent controls in a modified emotional Stroop task where, depending on a visual cue, participants named the colour of threat and neutral words at either a normal or fast articulation rate. In a manual version of the same task participants pressed the corresponding colour button with either a long or short duration. PWS but not controls were slower to respond to threat words than neutral words, however, this emotionality effect was only evident for verbal responding. Emotionality did not interact with speech rate, but the size of the emotionality effect among PWS did correlate with frequency of stuttering. Results suggest PWS show an attentional bias to threat words similar to that found in people with anxiety disorder. In addition, this bias appears to be contingent on engaging the speech production system as a response modality. No evidence was found to indicate that emotional reactivity during the Stroop task constrains or destabilises, perhaps via arousal mechanisms, speech motor adjustment or execution for PWS.Educational objectives: The reader will be able to: (1) explain the importance of cognitive aspects of anxiety, such as attentional biases, in the possible cause and/or maintenance of anxiety in people who stutter, (2) explain how the emotional Stroop task can be used as a measure of attentional bias to threat information, and (3) evaluate the findings with respect to the relationship between attentional bias to threat information and speech production in people who stutter.     

Impact of fearful expression on danger processing: The influence of the level of trait anxiety

Threat estimation is crucial for the adaptation of behavior to a dangerous situation. In anxiety, a bias to threat has been described as a core feature. Therefore, the sensitivity for threatening information in anxious individuals may have consequences for danger estimation. In this study, we used the affective priming paradigm to test the assumption that fearful expressions would facilitate danger detection in natural scenes in anxious individuals. Twenty-three high trait anxious individuals and 22 low trait anxious individuals participated in the study. They had to detect the potential threat of a target scene (neutral or threatening) following neutral or fearful face primes. High trait anxious participants detected threat more rapidly than low trait anxious participants, consistent with previous reports of emotional hypervigilance in anxiety. Furthermore, this effect was enhanced when the target scene followed a fearful expression: Only in anxious participants were reaction times shorter to detect danger following a fearful prime than a neutral prime. Our results tend to show that in anxiety, the hypervigilance to threat may be of an important value such as increasing the detection of a subsequent potential danger. Implication of attentional processes and attentional control is discussed.     

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.     

Selective attention and avoidance on a pictorial cueing task during stress in clinically anxious and depressed participants

Although it is well established that attentional biases exist in anxious populations, the specific components of visual orienting towards and away from emotional stimuli are not well delineated. The present study was designed to examine these processes. We used a modified spatial cueing task to assess the speed of engagement and disengagement from supraliminal and masked pictorial cues depicting threat, dysphoria, or neutral content in 36 clinically anxious, 41 depressed and 41 control participants. Participants were randomly assigned to a stress or neutral condition. During stress, anxious participants were slow to disengage from masked left hemifield pictures depicting threat or dysphoria, but were quick to disengage from supraliminal threat pictures. Information processing in anxious participants during stress was characterized by early selective attention of emotional stimuli, occurring prior to full conscious awareness, followed by effortful avoidance of threat. Depressed participants were distinct from the anxious group, displaying selective attention for stimuli depicting dysphoria, but not threat, during the neutral condition. In sum, attentional biases in clinical populations are associated with difficulties in the disengagement component of visual orienting. Further, a vigilant-avoidant pattern of attentional bias may represent a strategic attempt to compensate for the early activation of a fear response.     

Early attention processes and anxiety in children

It has been hypothesized that anxiety in children is associated with attentional bias in the early stages of information processing. Bias towards threat indicates the tendency of an individual to direct attention towards threatening information. The aim of the present study was to investigate whether high test-anxiety in a sample of nonreferred children is associated with attentional bias towards threat pictures, and if low test-anxiety is associated with attentional bias away from threat pictures. A probe-detection task was used with 44 10- to 13-yr.-old children. The overall analyses indicated the presence of an attentional bias away from threatening pictures in these nonreferred children. However, in relation to anxiety, the study did not confirm that high anxious children show an attentional bias towards threatening pictures or that low anxious children show an attentional bias away from threatening pictures. Yet, higher anxiety did seem to be associated with longer mean response times. These longer response times might originate from the interpretation of the nature of a stimulus as too threatening, compared to the actual threatening content, in the first stage of information processing. This finding could be useful to improve treatment methods aimed at anxiety symptoms during childhood.     

Influence of emotional task relevancy on the temporal dynamic of attentional bias in people with high-trait anxiety

ABSTRACT

It is unknown whether high-trait anxiety (HTA) individuals show facilitated attention or impaired attentional disengagement. In the present study, we have manipulated emotion and task relevance to explore the temporal dynamic of attentional bias in an HTA group via emotional attentional blink (EAB) and emotion-induced blindness (EIB). The results showed that the attentional blink effect was greater in the negative compared to neutral condition. When emotional stimulation was task-irrelevant at lag6, this enhanced effect was only present for the HTA group, indicating impaired attentional disengagement. However, when emotional stimulation was task-relevant at lag4, the enhanced attentional blink was absent for HTA but still present for LTA until lag8, suggesting facilitated attention for HTA. Thus, task relevancy of emotional distractor appears to influence attention biases in HTA individuals. In addition, individual characteristics modulate the magnitude and time window of the attentional blink in the context of EIB and EAB tasks.