Attention bias for social threat in youth with tic disorders: Links with tic severity and social anxiety

Many individuals with Tourette syndrome and chronic tic disorders (TS/CTDs) report poor social functioning and comorbid social anxiety. Yet limited research has investigated the role of cognitive factors that highlight social threats in youth with TS/CTD, and whether these biases underlie tic severity and co-occurring social anxiety. This study examined whether selective attention to social threat is enhanced young people with TS/CTDs compared to healthy controls, and whether attention biases are associated with tic severity and social anxiety. Twenty seven young people with TS/CTDs and 25 matched control participants completed an experimental measure of attention bias toward/away from threat stimuli. A clinician-rated interview measuring tic severity/impairment (YGTSS Total Score) and questionnaire measures of social anxiety were completed by participants and their parents. Young people with TS/CTD showed an attention bias to social threat words (relative to benign words) compared to controls but no such bias for social threat faces. Attention bias for social threat words was associated with increasing YGTSS Total Score and parent-reported social anxiety in the TS/CTDs group. Mediation analysis revealed a significant indirect path between YGTSS Total Score and social anxiety, via attention to social threat. Tentatively, these associations appeared to be driven by impairment rather than tic severity scores. Preliminary data suggests that youth with TS/CTD have enhanced attention to threat, compared to controls, and this is associated with impairment and social anxiety. Attention to threat could offer a cognitive mechanism connecting impairment and social anxiety, and so be a valuable trans-diagnostic treatment target.     

Threat interpretation bias as a vulnerability factor in childhood anxiety disorders

The present study examined threat interpretation biases in children 7-12 years of age with separation, social and generalised anxiety disorders (N=15), non-anxious offspring at risk due to parental anxiety (N=16) and non-anxious controls of non-anxious parents (N=14). Children provided interpretations of ambiguous situations to assess cognitive, emotional and behavioural responses. In comparison with non-anxious control children and at-risk children who did not differ from each other, anxious children reported stronger negative emotion and less ability to influence ambiguous situations. These results suggest that threat interpretation bias may be a cognitive factor associated with ongoing childhood anxiety but not a vulnerability factor associated with parental anxiety.     

Anxiety sensitivity and attentional bias to threat interact to prospectively predict anxiety

The purpose of the present study was to examine anxiety sensitivity, attentional bias to threat (ABT), and the aggregate influence of these constructs as prospective predictors of anxiety. Participants (N = 176) completed a baseline assessment session which included the completion of self-report measures of anxiety and anxiety sensitivity, as well as an eye-tracking task in which eye movements were recorded during the viewing of neutral and threat images. Measures of anxiety and anxiety sensitivity were completed again as part of an online questionnaire battery at a 1-year follow-up session. As predicted, baseline anxiety sensitivity and ABT predicted anxiety at 1-year follow-up even after accounting for baseline anxiety. However, these main effects were qualified by a significant interaction effect such that those high in anxiety sensitivity at baseline reported relatively higher anxiety at the 1-year follow-up, but only if they also exhibited higher levels of ABT at baseline. Results suggest that individuals with this combination of vulnerability factors (high levels of both anxiety sensitivity and ABT) may be at particularly high risk for developing anxiety and may benefit from preemptive efforts to reduce ABT.     

Depression and anxiety symptoms following cancer diagnosis: a cross-sectional study

Introduction: The aims of the present study were to assess demographic and clinical characteristics of patients after receiving a cancer diagnosis, and to determine possible risk factors for anxiety and depression. Methods: All consecutive patients aged 18 or above, were assessed before starting intravenous chemotherapy for the first time with the Hospital Anxiety and Depression Scale (HADS), the Distress Thermometer, and a Visual Analog Scale for pain. Demographic and clinical data were also collected. Results: The patients assessed (n = 270) had a mean age of 59.4 (SD = 11.8) years, and 50.7% were women. Tumours were more frequently colorectal (27.2%), lung (18.8%) and breast (17.6%), and 68.9% were stages 3 or 4. A HADS Anxiety score ≥8 was present in 30% of the patients, a Depression score ≥8 in 24.1%, and a Distress score ≥4 in 44.4%. Independent risk factors for HADS Depression score ≥8 were being a woman (OR = 2.45; p = 0.004), being older (OR = 1.04; p = 0.005), and cancer stage 3–4 (OR = 2.24; p = 0.023) in the multivariable analysis; for Anxiety ≥8 they were being a woman (OR = 2.47; p = 0.002), having a past psychiatric consultation (OR = 2.83; p = 0.029), and cancer stage 3–4 (OR = 1.90; p = 0.047). Conclusion: These results suggest the need for greater awareness and a differentiated approach to patients at increased risk of anxiety and depression in the early stages of treatment and before starting chemotherapy.     

高功能自闭症个体对威胁性情绪面孔的注意偏向

高功能自闭症(High-Functioning Autism, HFA)个体智力正常, 但也面临着严重的社会功能障碍。对威胁性情绪面孔的注意偏向与HFA个体社会功能的发展密切相关。梳理相关研究发现, HFA个体在自动加工阶段和情绪目标参与阶段, 不存在威胁性情绪面孔注意偏向; 而在任务与情绪无关的控制加工阶段, 存在威胁性情绪面孔注意偏向。针对HFA个体威胁性情绪面孔注意偏向的理论解释主要有杏仁核理论、强烈世界理论和执行功能理论等。神经生理机制方面, HFA个体对威胁性情绪面孔的注意偏向可能与其异常的皮下及皮层通路功能有关, 同时可能会受5-羟色胺系统基因及催产素水平等的影响。未来研究可在综合考虑研究方法及个体因素的基础上, 进一步探究其加工特征及神经生物机制, 着力开发科学有效的干预策略。     

Attentional bias to respiratory- and anxiety-related threat in children with asthma

This study investigated attentional biases in children with asthma. The study aimed at testing whether children with asthma are vigilant to asthma and/or anxiety cues. Thirty-six children (18 with asthma and 18 healthy controls) aged 9–12 completed a computerised dot probe task designed to measure attentional bias to three different categories of words: asthma, anxiety symptom and general negative emotion. Main caregiver anxiety was also assessed, as was frequency of inhaler use for those with asthma. Children with asthma showed an attentional bias towards asthma words but not anxiety or general negative emotion words. Children without asthma showed no significant attentional biases to any word categories. Caregiver anxiety was correlated with asthma word attentional bias in the asthma group. The findings indicate that attentional bias is present in children with asthma. Further research is required to ascertain if this exacerbates or maintains health-related problems.     

Trait anxiety, defensiveness and selective processing of threat: an investigation using two measures of attentional bias

Attentional biases for threat were examined in a non-clinical sample (N=60), with each participant tested on both the modified Stroop colour-naming and dot probe tasks. Three groups were selected on the basis of trait anxiety and social desirability scale (SDS) scores: “low anxiety” (LA: low trait, low SDS), “repressor” (REP: low trait, high SDS) and “high anxiety” (HA: high trait, low SDS). Results from the colour-naming task suggested that high levels of defensiveness (in combination with low trait anxiety) were associated with greater avoidance of threat. The REP group showed less interference in colour-naming threat than neutral words; whereas the HA group showed increased interference due to threat words. On the dot probe task, there was a general tendency for this non-clinical sample as a whole to show avoidance of social threat relative to neutral words, but there was no bias for physical threat words. Avoidance of social threat was significant only within the REP group. No relationships were found between the measures of cognitive bias from the two tasks, suggesting different underlying mechanisms. Results are discussed in relation to previous findings and theoretical views of the effects of anxiety and defensiveness on the processing of threat.     

Attentional bias toward fear-related stimuli: an investigation with nonselected children and adults and children with anxiety disorders

Research investigating anxiety-related attentional bias for emotional information in anxious and nonanxious children has been equivocal with regard to whether a bias for fear-related stimuli is unique to anxious children or is common to children in general. Moreover, recent cognitive theories have proposed that an attentional bias for objectively threatening stimuli may be common to all individuals, with this effect enhanced in anxious individuals. The current study investigated whether an attentional bias toward fear-related pictures could be found in nonselected children (n=105) and adults (n=47) and whether a sample of clinically anxious children (n=23) displayed an attentional bias for fear-related pictures over and above that expected for nonselected children. Participants completed a dot-probe task that employed fear-related, neutral, and pleasant pictures. As expected, both adults and children showed a stronger attentional bias toward fear-related pictures than toward pleasant pictures. Consistent with some findings in the childhood domain, the extent of the attentional bias toward fear-related pictures did not differ significantly between anxious children and nonselected children. However, compared with nonselected children, anxious children showed a stronger attentional bias overall toward affective picture stimuli.     

Effect of a positive emotional state on interpretation bias for threat in children with anxiety disorders

The authors examined the effect of a positive emotional state on interpretation bias for threat in children with anxiety disorders. Participants were 34 children with anxiety disorders and 34 children without any psychological disorders who were randomly assigned to either a positive or neutral emotion induction condition. Consistent with the broaden-and-build theory, children with anxiety disorders exhibited an interpretation bias for threat, but not when they were in a positive emotional state. Furthermore, results indicated that positive emotional state made a unique prediction of interpretation bias score, whereas state anxiety did not. Findings are discussed with reference to theory, clinical implications, and suggestions for future research.     

Affective forecasting and self-rated symptoms of depression,anxiety, and hypomania: Evidence for a dysphoric forecasting bias

Emerging research has examined individual differences in affective forecasting; however, we are aware of no published study to date linking psychopathology symptoms to affective forecasting problems. Pitting cognitive theory against depressive realism theory, we examined whether dysphoria was associated with negatively biased affective forecasts or greater accuracy. Participants (n=325) supplied predicted and actual emotional reactions for three days surrounding an emotionally evocative relational event, Valentine's Day. Predictions were made a month prior to the holiday. Consistent with cognitive theory, we found evidence for a dysphoric forecasting bias—the tendency of individuals in dysphoric states to overpredict negative emotional reactions to future events. The dysphoric forecasting bias was robust across ratings of positive and negative affect, forecasts for pleasant and unpleasant scenarios, continuous and categorical operationalisations of dysphoria, and three time points of observation. Similar biases were not observed in analyses examining the independent effects of anxiety and hypomania. Findings provide empirical evidence for the long-assumed influence of depressive symptoms on future expectations. The present investigation has implications for affective forecasting studies examining information-processing constructs, decision making, and broader domains of psychopathology.     

Experimental modification of interpretation bias in socially anxious children: Changes in interpretation, anticipated interpersonal anxiety, and social anxiety symptoms

We report on an experimental manipulation of interpretation bias in socially anxious youths. A non-clinical sample of 10–11-year-olds selected for high social anxiety was trained over three sessions to endorse benign rather than negative interpretations of potentially threatening social scenarios. This group was subsequently less likely to endorse negative interpretations of new ambiguous social situations than children in a test–retest condition. Children who received interpretation training also showed reduced trait social anxiety and reported significantly less anxiety about an anticipated interpersonal encounter, compared with the control group.     

手机成瘾与抑郁：社交焦虑和负性情绪信息注意偏向的多重中介作用

为考察手机成瘾与抑郁的关系, 研究同时整合情绪和认知两方面因素, 探讨了社交焦虑和负性情绪信息注意偏向在手机成瘾和抑郁之间的多重中介作用。研究1共有545名大学生完成了大学生手机成瘾倾向量表、贝克抑郁量表和社会交往焦虑量表。研究2选取51名大学生采用问卷法和2(配对面孔表情的情绪类型: 负性、中性) × 2(探测点位置: 与负性情绪面孔表情同侧、与负性情绪面孔表情异侧)的被试内实验设计。结果表明: (1)手机成瘾、社交焦虑和抑郁两两间存在显著正相关, 且社交焦虑在手机成瘾和抑郁之间起完全中介作用; (2)社交焦虑和负性情绪信息注意偏向在手机成瘾与抑郁的关系中起链式中介作用, 而负性情绪信息注意偏向在手机成瘾与抑郁间的单独中介效应不显著。具体而言, 手机成瘾通过两条路径影响抑郁: 一是社交焦虑的单独中介作用; 二是社交焦虑→负性情绪信息注意偏向的链式中介作用。     

Inhibition of Internal Attention to Positive and Negative Representations in Dysphoria

We developed the Internal–External Attention‐Switching Task, which measures the ability to inhibit internal attention and the ability to remove inhibition of internal attention. The Internal–External Attention‐Switching Task was administered to a sample of dysphoric and non‐dysphoric undergraduate or graduate students (N = 44). Difficulty in both inhibition of internal attention to negative representation and removal of this inhibition were shown to be general. Importantly, however, dysphoric individuals could not maintain internal attention or remove inhibition of internal attention to positive representations as easily as non‐dysphoric individuals could. Therefore, reduced attention to positive representations in dysphoric individuals may enable maintenance of their depressive mood.     

Attention to faces and gaze-following in social anxiety: preliminary evidence from a naturalistic eye-tracking investigation

Social attentional biases are a core component of social anxiety disorder, but research has not yet determined their direction due to methodological limitations. Here we present preliminary findings from a novel, dynamic eye-tracking paradigm allowing spatial–temporal measurement of attention and gaze-following, a mechanism previously unexplored in social anxiety. 105 participants took part, with those high (N?=?27) and low (N?=?25) in social anxiety traits (HSA and LSA respectively) entered into the analyses. Participants watched a video of an emotionally-neutral social scene, where two actors periodically shifted their gaze towards the periphery. HSA participants looked more at the actors’ faces during the initial 2s than the LSA group but there were no group differences in proportion of first fixations to the face or latency to first fixate the face, although HSA individuals’ first fixations to the face were shorter. No further differences in eye movements were found, nor in gaze-following behaviour, although these null effects could potentially result from the relatively small sample. Findings suggest attention is biased towards faces in HSA individuals during initial scene inspection, but that overt gaze-following may be impervious to individual differences in social anxiety. Future research should seek to replicate these effects.     

Effect of cognitive bias modification-memory on depressive symptoms and autobiographical memory bias: two independent studies in high-ruminating and dysphoric samples

Memory bias is a risk factor for depression. In two independent studies, the efficacy of one CBM-Memory session on negative memory bias and depressive symptoms was tested in vulnerable samples. We compared positive to neutral (control) CBM-Memory trainings in highly-ruminating individuals (N?=?101) and individuals with elevated depressive symptoms (N?=?100). In both studies, participants studied positive, neutral, and negative Swahili words paired with their translations. In five study–test blocks, they were then prompted to retrieve either only the positive or neutral translations. Immediately following the training and one week later, we tested cued recall of all translations and autobiographical memory bias; and also measured mood, depressive symptoms, and rumination. Retrieval practice resulted in training-congruent recall both immediately after and one week after the training. Overall, there was no differential decrease in symptoms or difference in autobiographical memory bias between the training conditions. In the dysphoric but not in the high-ruminating sample, the positive training resulted in positive autobiographical bias only in dysphoric individuals with positive pre-existing bias.

We conclude that one session of positive retrieval-based CBM-Memory may not be enough to yield symptom change and affect autobiographical memory bias in vulnerable individuals.     

婴幼儿面孔注意偏向：先天倾向与发展轨迹——来自正常和孤独症婴幼儿的证据

正常发展(Typically developing, TD)婴儿的先天面孔注意倾向稳定地存在于不同发展阶段不同刺激情景中, 且在生命第一年内呈现短暂下降后快速增强的发展趋势。TD婴幼儿的视觉注意在第4至6周之间发生由皮下控制向皮层控制的关键性转变之后, 伴随面孔视觉经验的不断积累, 逐渐形成的面孔特异性皮层网络对面孔的优先选择性反应逐渐增强。而孤独症谱系(Autism Spectrum Disorder, ASD)婴幼儿具备初始的面孔注意先天倾向, 但在面孔皮层发育关键期内逐渐偏离正常轨道, 在1岁左右表现出面孔注意障碍。该群体先天的感知注意损伤或社会动机缺失可能导致其在关键性转变期内的面孔视觉经验输入不足, 进而阻碍面孔特异性皮层网络的正常发展。未来研究可考虑采用生物遗传学方法和近红外脑成像技术探索新生儿面孔注意先天倾向的起源, 系统考察社会场景中感知觉特征和社会性特征对ASD高危婴儿面孔注意发展轨迹尤其是关键性转变期的影响作用。     

Spatial affect learning restricted in major depression relative to anxiety disorders and healthy controls

Detecting and learning the location of unpleasant or pleasant scenarios, or spatial affect learning, is an essential skill that safeguards well-being (Crawford & Cacioppo, 2002). Potentially altered by psychiatric illness, this skill has yet to be measured in adults with and without major depressive disorder (MDD) and anxiety disorders (AD). This study enrolled 199 adults diagnosed with MDD and AD (n=53), MDD (n=47), AD (n=54), and no disorders (n=45). Measures included clinical interviews, self-reports, and a validated spatial affect task using affective pictures (IAPS; Lang, Bradley, & Cuthbert, 2005). Participants with MDD showed impaired spatial affect learning of negative stimuli and irrelevant learning of pleasant pictures compared with non-depressed adults. Adults with MDD may use a “GOOD is UP” heuristic reflected by their impaired learning of the opposite correlation (i.e., “BAD is UP”) and performance in the pleasant version of the task.     

The moderating role of emotional stability in the relationship between exposure to violence and anxiety and depression

This study investigated the associations among exposure to violence, emotional stability, and psychological symptoms. The moderating role of emotional stability in the relationship between exposure to violence and anxiety and depression was examined in a sample of 482 high school students in Hong Kong. Results showed that both witnessing violence and low levels of emotional stability were positively associated with symptoms of anxiety and depression. Low levels of emotional stability exacerbated the relation between witnessing violence and symptoms of anxiety and depression; the opposite pattern was found among adolescents with high levels of emotional stability. This study sheds light on the role of emotional stability in ameliorating the detrimental effects of witnessing violence on symptoms of anxiety and depression among adolescents. Findings of this study also have implications for the development of emotionally healthy personalities.     

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.     

The role of extinction and reinstatement in attentional bias to threat: a conditioning approach

We investigated the effects of extinction and reinstatement on attentional bias to fear-conditioned signals in healthy individuals using an emotional modification of a spatial cueing paradigm. Spatial cues were emotionally modulated using differential conditioning. The CS+ was sometimes followed by an aversive electrocutaneous stimulus (UCS), whereas the CS- was never followed by the UCS. During a subsequent extinction phase no UCS was presented anymore. The reinstatement phase started with one or four unpredicted UCS-only trials for half of the participants (reinstatement group). For the other half there were no additional UCS presentations (control group). We found that attention was biased to threat signals during acquisition. This biased attention largely disappeared during extinction. During the reinstatement phase attentional bias to threat signals re-emerged in the reinstatement group, but not in the control group.