Memory-based attentional biases: Anxiety is linked to threat avoidance

The purpose of the present research was to examine if anxiety is linked to a memory-based attentional bias, in which attention to threat is thought to depend on implicit learning. Memory-based attentional biases were defined and also demonstrated in two experiments. A total of 168 university students were shown a pair of faces that varied in their emotional $ content (angry, neutral, and happy), with each type of emotion being consistently preceded by a particular neutral cue face, appearing in the same position. Eye movements were measured during these cue faces and during the emotional faces. The results of two experiments indicated that anxiety was connected with a tendency to avert one's gaze from the positions of angry faces to the positions of happy faces, before these were shown on the screen. This, in turn, caused a reduced perception of angry relative to happy faces. In Experiment 2, participants were also not aware of having a memory-based attentional bias.     

Anxiety sensitivity, conscious awareness and selective attentional biases in children

The current study investigated whether physical anxiety sensitivity (AS) is associated with selective attentional biases to affective stimuli in children. The dot-probe paradigm was used to examine the deployment of attention towards words pertaining to anxiety symptomatology, socially threatening words, and positive words, in samples of 8-10-year-old children. Word pairs were presented under both masked and unmasked conditions. Irrespective of masking, children high in physical AS displayed an attentional vigilance for emotional words relative to neutral words, whereas those low in physical AS displayed a relative avoidance of such material. The results of this study are interesting as they not only suggest the presence of automatic AS-related biases in childhood, but that this is a general emotionality bias rather than one related to specific anxiety-related stimuli.     

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.     

Attentional biases for threat after fear-related autobiographical recall

Background : Previous studies suggested that affective state could enhance stimulus salience and modulate attention allocation for mood-congruent information, but contrasting data have been reported on the effects of mood induction on attentional biases for threat (ABTs) in non-clinical individuals.

Objective : We aimed to assess whether laboratory-induced negative mood can increase individuals’ tendency to allocate attention on threatening stimuli, thus determining a difficulty in attentional disengagement from threat. We also aimed at assessing whether level of trait anxiety could modulate the effect of mood induction on attentional biases.

Methods : We used an autobiographical episode recall procedure for mood induction (fear, happiness and neutral episode recall), and an exogenous cueing task with threatening and non-threatening images to assess attentional biases in 120 undergraduate students.

Results: Participants showed a significant difficulty in disengaging attention from threat after recalling fear-related episodes, independently from their trait anxiety level.

Conclusions: These findings clarify that the ABTs are not exclusive to anxiety disorders or high trait anxiety individuals, and could also arise in non-clinical individuals in a fearful context.     

Anxiety sensitivity cognitive concerns drive the relation between anxiety sensitivity and symptoms of depression

Depression is typically treated as a homogeneous construct despite evidence for distinct cognitive, affective, and somatic symptom dimensions. Anxiety sensitivity (AS; the fear of consequences of anxiety symptoms) is a cognitive risk factor implicated in the development of depressive symptoms. However, it is unclear how lower order AS dimensions (i.e. physical, cognitive, and social concerns) relate to depressive symptom factors. Confirmatory factor analysis, followed by structural equation modeling, were conducted to examine the factor structure of depression and to then examine the relations between these factors and the lower order factors of AS. This study was conducted in a sample of 374 adults (M age = 35.5, 54.3% female) with elevated levels of psychopathology (89.2% meeting criteria for at least one DSM-5 diagnosis, 25.6% primary depressive disorder). In this study a two-factor model of depression, composed of Cognitive and Affective/Somatic factors, was superior to one- and three-factor solutions. AS cognitive concerns were related to both cognitive and affective/somatic symptoms of depression. Neither of the other AS dimensions was related to depression symptom dimensions. These findings provide a better understanding of the relations between AS and depression symptoms.     

Anxiety sensitivity: the role of conscious awareness and selective attentional bias to physical threat

Selective attentional biases were examined amongst individuals varying in levels of physical anxiety sensitivity. The dot-probe paradigm was used to examine attention towards anxiety symptomatology, social threat and positive words. Stimuli were presented above (unmasked) and below (masked) the level of conscious awareness. High physical anxiety sensitivity was associated with attentional vigilance for anxiety symptomatology words in both unmasked and masked conditions. For positive words, however, those high in anxiety sensitivity were found to avoid such stimuli when they were masked, whereas they exhibited a relative vigilance when unmasked. If the differences between awareness conditions are reliable, then the impact of the automatic vigilance for threat might be modified by conscious attempts to direct attention towards other types of stimuli.     

The threat of appearing prejudiced and race-based attentional biases

The current work tested whether external motivation to respond without prejudice toward Blacks is associated with biased patterns of selective attention that reflect a threat response to Black individuals. In a dot-probe attentional bias paradigm, White participants with low and high external motivation to respond without prejudice toward Blacks (i.e., low-EM and high-EM individuals, respectively) were presented with pairs of White and Black male faces that bore either neutral or happy facial expressions; on each trial, the faces were displayed for either 30 ms or 450 ms. The findings were consistent with those of previous research on threat and attention: High-EM participants revealed an attentional bias toward neutral Black faces presented for 30 ms, but an attentional bias away from neutral Black faces presented for 450 ms. These attentional biases were eliminated, however, when the faces displayed happy expressions. These findings suggest that high levels of external motivation to avoid prejudice result in anxious arousal in response to Black individuals, and that this response affects even basic attentional processes.     

Anxiety and cognitive inhibition

In 3 experiments, the authors investigated whether anxiety proneness is associated with impaired inhibitory processing. Participants made speeded decisions requiring inhibition of threatening or neutral meanings of ambiguous words, which were inappropriate in their current context. In Experiment 1 there were no differences found in inhibitory processing associated with anxiety. However, in Experiment 2, when the capacity for controlled processing was reduced by imposition of a mental load, anxious individuals showed a response pattern consistent with a general impairment of inhibitory processing. In Experiment 3, a group who had experienced a traumatic event also showed evidence of impaired inhibition, despite the absence of additional load. Thus anxiety proneness is associated with a general deficit of inhibitory processing, but this may be revealed only under conditions that limit the availability of controlled processing resources.     

Eye movements reveal mechanisms underlying attentional biases towards threat

Mechanisms underlying attentional biases towards threat (ABTs), such as attentional avoidance and difficulty of disengagement, are still unclear. To address this issue, we recorded participants' eye movements during a dot detection task in which threatening or neutral stimuli served as peripheral cues. We evaluated response times (RTs) in trials where participants looked at the central fixation cross (not at the cues), as they were required, and number and duration of (unwanted) fixations towards threatening or neutral cues; in all analyses trait anxiety was treated as a covariate. Difficulty in attentional disengagement (longer RTs) was found when peripheral threatening stimuli were presented for 100?ms. Moreover, we observed significantly shorter (unwanted) fixations on threatening than on neutral peripheral stimuli, compatible with an avoidance bias, for longer presentation times. These findings demonstrate that, independent of trait anxiety levels, disengagement bias occurs without eye movements, whereas eye movements are implied in threat avoidance.     

Anxiety and the allocation of attention to threat

Using a probe detection technique we have recently demonstrated that anxious subjects consistently deploy attention towards threat-related stimuli, whereas non-anxious controls tend to move attention away from such material (MacLeod, Mathews, & Tata, 1986).

The current study employed the same paradigm but attempted to distinguish the role of trait and state anxiety by testing high- and low-trait students when state anxiety was relatively low (12 weeks before a major examination) and again when it was relatively high (one week before this examination). High-trait subjects alone tended to shift attention towards generally threatening material on both test occasions. Results for examination-related stimuli were more complex. Increased proximity to the examination was associated with an increase in attentional bias towards such threat stimuli in high-trait subjects, but with increased attentional avoidance of such stimuli in low-trait subjects. It is suggested that the attentional response to currently relevant stress-related stimuli may be associated with neither trait nor state anxiety alone, but with an interactive function involving both these variables. These results are discussed in relation to existing models of emotion and cognition, and alternative interpretations of the findings are considered.     

Facial affect processing and depression susceptibility: cognitive biases and cognitive neuroscience

Facial affect processing is essential to social development and functioning and is particularly relevant to models of depression. Although cognitive and interpersonal theories have long described different pathways to depression, cognitive-interpersonal and evolutionary social risk models of depression focus on the interrelation of interpersonal experience, cognition, and social behavior. We therefore review the burgeoning depressive facial affect processing literature and examine its potential for integrating disciplines, theories, and research. In particular, we evaluate studies in which information processing or cognitive neuroscience paradigms were used to assess facial affect processing in depressed and depression-susceptible populations. Most studies have assessed and supported cognitive models. This research suggests that depressed and depression-vulnerable groups show abnormal facial affect interpretation, attention, and memory, although findings vary based on depression severity, comorbid anxiety, or length of time faces are viewed. Facial affect processing biases appear to correspond with distinct neural activity patterns and increased depressive emotion and thought. Biases typically emerge in depressed moods but are occasionally found in the absence of such moods. Indirect evidence suggests that childhood neglect might cultivate abnormal facial affect processing, which can impede social functioning in ways consistent with cognitive-interpersonal and interpersonal models. However, reviewed studies provide mixed support for the social risk model prediction that depressive states prompt cognitive hypervigilance to social threat information. We recommend prospective interdisciplinary research examining whether facial affect processing abnormalities promote-or are promoted by-depressogenic attachment experiences, negative thinking, and social dysfunction.     

Anxiety sensitivity and risk-taking behavior

High trait anxiety has been linked with risk-avoidant decision-making, though little is known regarding the specific facets of anxiety contributing to this negative association. Anxiety sensitivity (AS), a transdiagnostic vulnerability factor for anxiety-related pathology, may be particularly relevant to risk decision-making given that risk-taking behaviors generate heightened somatic arousal and produce many of the sensations feared by individuals with high AS. Two studies were conducted to investigate the relation between AS and risk decision-making. In the first study, 268 undergraduate students completed a series of questionnaires that included measures of AS and gambling behaviors. Significant negative correlations were observed between AS and several gambling-related risk-taking activities, and hierarchical multiple regression analyses indicated that AS scores added significant incremental validity in predicting risk-taking over and above demographic variables, negative affect, and trait anxiety. In the second study, 43 participants who had screened for high (n = 20) or low (n = 23) AS completed the Iowa gambling task, a behavioral measure of risk-taking. Results indicated that, when placed under conditions of risk, individuals with high AS engaged in significantly less risk-taking than their low AS counterparts. The implications of these findings and potential directions for future research are discussed.     

Anxiety sensitivity and obsessive--compulsive disorder

Anxiety sensitivity (AS), a cognitive risk factor for anxiety disorders, was evaluated in a homogeneous obsessive-compulsive disorder (OCD) sample. A total of 280 individuals with OCD completed measures. Evaluation of the Anxiety Sensitivity Index revealed a latent structure that was congruent with previous studies showing a single higher order and three lower order factors, although greater variance was accounted for by the general factor than in a previous study. AS was significantly associated with OCD symptom severity after controlling for other putative cognitive risk factors, although the additional variance explained was small. Variability in the relationship of AS to OCD symptom severity was found across OCD symptom subgroups. Results suggest that AS might be an important aspect of OCD-relevant cognition for specific OCD subgroups, and the need for experimental evaluation is discussed.     

Anxiety sensitivity taxonicity: a concurrent test of cognitive vulnerability for post-traumatic stress symptomatology among young adults

This study evaluated the anxiety sensitivity taxon using the 16-item Anxiety Sensitivity Index in relation to 2 criteria relevant to post-traumatic stress disorder; post-traumatic stress disorder symptom severity as indexed by the Post-Traumatic Diagnostic Scale, and post-traumatic cognitions as indexed by the Post-Traumatic Cognitions Inventory. Taxometric analyses of data collected from 331 young adults indicated that the latent structure of anxiety sensitivity was taxonic with an estimated base-rate range of 11-12%. As predicted, an 8-item Anxiety Sensitivity Index Taxon Scale accounted for significant variance above and beyond that accounted for by negative affectivity and the full-scale Anxiety Sensitivity Index total score in terms of both criteria. Moreover, after accounting for variance explained by the full-scale Anxiety Sensitivity Index total score and negative affectivity, the sum score for the 8 Anxiety Sensitivity Index items not included in the Anxiety Sensitivity Index Taxon Scale was associated with significant variance in these same dependent measures, but the relation was in the opposite direction to that predicted by theory. These findings are discussed in terms of theoretical and clinical implications for the study of anxiety sensitivity and post-traumatic stress disorder vulnerability.     

Anxiety sensitivity and nonclinical panic attacks

The present study examined anxiety sensitivity in relation to trait anxiety and the occurrence of nonclinical panic attacks in 265 subjects. Fifty percent of high anxiety sensitivity subjects reported panic attacks (both cued and spontaneous) in the past year. In addition, almost 42% of subjects with high anxiety sensitivity but no history of panic reported a high level of trait anxiety concerning physical danger. The results suggest that anxiety sensitivity is frequently not independent of other forms of anxiety.     

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.