Attentional biases to threat in social anxiety disorder: time to focus our attention elsewhere?

Background: Cognitive models propose that attentional biases to threat contribute to the maintenance of social anxiety disorder (SAD). However, the specific characteristics of such biases are still object to debate.

Objectives: The current study aimed to disentangle effects of trait and state social anxiety on attention allocation towards social stimuli.

Methods: Participants with SAD (n?=?67) and healthy controls (n?=?62) completed three visual search tasks while their eye movements were recorded. Half of the participants in each group were randomly assigned to a state anxiety induction.

Results: Contrary to our predictions, neither trait nor state social anxiety was associated with a facilitated attention to or a delayed disengagement from threat. However, participants with SAD did show reduced fixation durations for threatening stimuli, indicating an avoidance of threat. Induction of state anxiety led to an increased distractibility by threat.

Conclusions: We suggest that attention allocation in SAD is characterized by an avoidant rather than a vigilant attentional bias. Accordingly, our results contradict previous results that associate SAD with facilitated attention to threat and existing approaches to modify attentional biases, that aim to decrease attention towards threatening stimuli.     

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.     

Time course of attentional bias to emotional scenes in anxiety: Gaze direction and duration

Pictures of emotionally neutral, positive, and negative (threat‐ or harm‐related) scenes were presented for 3 seconds, paired with nonemotional control pictures. The eye fixations of high and low trait anxiety participants were monitored. Intensity of stimulus emotionality was varied, with two levels of perceptual salience for each picture (colour vs. greyscale). Regardless of perceptual salience, high anxiety was associated with preferential attention: (a) towards all types of emotional stimuli in initial orienting, as revealed by a higher probability of first fixation on the emotional picture than on the neutral picture of a pair; (b) towards positive and harm stimuli in a subsequent stage of early engagement, as shown by longer viewing times during the first 500 ms following onset of the pictures; and with (c) attention away from (i.e., avoidance) harm stimuli in a later phase, as indicated by shorter viewing times and lower frequency of fixation during the last 1000 ms of picture exposure. This suggests that the nature of the attentional bias varies as a function of the time course in the processing of emotional pictures.     

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.     

高焦虑个体对威胁性刺激的注意偏向特点*

采用点探测实验范式,将图片按照威胁性分为高威胁性和一般威胁性,探讨焦虑程度不同的个体对不同威胁性刺激的注意特点。采用状态-特质焦虑问卷从265个大学生中选取了33名高焦虑被试和31名对照组被试。结果发现：（1）高焦虑组个体对一般威胁性刺激有显著注意偏向,对高威胁性刺激有注意回避趋势;（2）对照组个体对一般威胁性刺激没有表现出注意偏向,对高威胁刺激有注意偏向趋势。结论：（1）即使是一般威胁性图片也能引起高焦虑被试的注意偏向 （2）高威胁性图片才能引起对照组个体产生注意偏向的趋势。     

刷微博，让焦虑的人更焦虑——特质焦虑对青少年注意情绪刺激的影响

采用自由观看眼动追踪范式,考察特质焦虑青少年在观看情绪面孔图片过程中的眼动轨迹。结果发现,高特质焦虑组对愤怒和恐惧面孔的首次注视到达时间（TFF）较快,首次注视持续时间（TFD）较短;低特质焦虑组对愤怒和恐惧面孔的TFF虽然稍早于平静面孔,但差异不显著。在刺激呈现1000ms之后,高特质焦虑组对愤怒和恐惧面孔的注视次数（FC）较多,平均注视持续时间（AFD）较短。低特质焦虑组对愤怒和恐惧面孔的FC较少,AFD较长;这就表明,高特质焦虑青少年在认知加工早期对威胁性刺激注意定向加速,没有注意解除困难,呈现“浅尝辄止”现象。而在认知加工晚期,他们则对威胁性刺激存在“反刍”现象。     

Watch out! Directional threat-related postures cue attention and the eyes

Previous work indicates that threatening facial expressions with averted eye gaze can act as a signal of imminent danger, enhancing attentional orienting in the gazed-at direction. However, this threat-related gaze-cueing effect is only present in individuals reporting high levels of anxiety. The present study used eye tracking to investigate whether additional directional social cues, such as averted angry and fearful human body postures, not only cue attention, but also the eyes. The data show that although body direction did not predict target location, anxious individuals made faster eye movements when fearful or angry postures were facing towards (congruent condition) rather than away (incongruent condition) from peripheral targets. Our results provide evidence for attentional cueing in response to threat-related directional body postures in those with anxiety. This suggests that for such individuals, attention is guided by threatening social stimuli in ways that can influence and bias eye movement behaviour.     

Effects of threat cues on attentional shifting, disengagement and response slowing in anxious individuals

According to cognitive models of anxiety, attentional biases for threat may cause or maintain anxiety states. Previous research using spatial cueing tasks has been interpreted in terms of difficulty in disengaging attention from threat in anxious individuals, as indicated by contrasts of response times (RTs) from threat cue versus neutral cue trials. However, on spatial cueing tasks, differences in RT between threat cue and neutral cue trials may stem from a slowing effect of threat on RT, as well as effects on allocation of visuospatial attention. The present study examined the effects of threat cues on both attentional cueing and response slowing. High and low anxious individuals completed a central cue task, which assessed threat-related response slowing, and a spatial cueing task, which assessed attentional biases for angry, happy and neutral faces. Results indicated that interpretation of the anxiety-related bias for threat depended on whether the effect of response slowing was taken into account. The study illustrates an important problem in using the modified spatial cueing task to assess components of threat-related attentional bias. As this experimental method may reflect both threat-related attentional cueing and response slowing effects, it cannot be assumed to provide pure measures of shift or disengagement components of attention bias.     

Time course of attentional bias to emotional scenes in anxiety: Gaze direction and duration

Pictures of emotionally neutral, positive, and negative (threat- or harm-related) scenes were presented for 3 seconds, paired with nonemotional control pictures. The eye fixations of high and low trait anxiety participants were monitored. Intensity of stimulus emotionality was varied, with two levels of perceptual salience for each picture (colour vs. greyscale). Regardless of perceptual salience, high anxiety was associated with preferential attention: (a) towards all types of emotional stimuli in initial orienting, as revealed by a higher probability of first fixation on the emotional picture than on the neutral picture of a pair; (b) towards positive and harm stimuli in a subsequent stage of early engagement, as shown by longer viewing times during the first 500 ms following onset of the pictures; and with (c) attention away from (i.e., avoidance) harm stimuli in a later phase, as indicated by shorter viewing times and lower frequency of fixation during the last 1000 ms of picture exposure. This suggests that the nature of the attentional bias varies as a function of the time course in the processing of emotional pictures.     

Processing efficiency in anxiety: Evidence from eye-movements during visual search

It is generally held that anxiety is characterized by an attentional bias for threatening information. In recent years there has been an important debate whether these biases reside at the level of attentional selection (threat detection) or attentional processing after threat detection (attentional disengagement). In a visual search task containing emotional facial expressions, eye-movements were examined before and after threat detection in high and low trait anxious individuals to further elucidate the temporal unfolding of attentional bias. Results indicated that high-anxious individuals neither showed facilitated orienting to threat nor impaired disengagement of visual attention from threat. Interestingly, the presence of threat in the visual search display was associated with increased decision times in high-anxious individuals. These results challenge some of the current views on attentional bias to threat but indicate that emotional information reduces processing efficiency in anxiety.     

Attention to Positive and Negative Social-Evaluative Words: Investigating the Effects of Social Anxiety,Trait Anxiety and Social Threat

The study investigated how attention to negative (threatening) and positive social-evaluative words is affected by social anxiety, trait anxiety and the expectation of social threat. High and low socially anxious individuals carried out a modified dot-probe task either while expecting to give a speech or under non-threatening conditions. High socially anxious individuals showed no significant attentional bias towards or away from social-evaluative words. This result significantly contrasted with an identical design that showed avoidance of emotional faces in high socially anxious participants drawn from the same population (Mansell et al ., 1999). Participants who expected to give a speech showed less attentional avoidance of negative and positive social-evaluative words. High trait anxiety was associated with selective attention to negative relative to positive social-evaluative words, consistent with earlier findings of attention to threat cues in high trait-anxious individuals. Implications for designing attention tasks and attentional bias across different dimensions of anxiety are discussed.     

对威胁刺激的注意偏向：注意定向加速还是注意解除困难？

对威胁刺激的注意偏向普遍存在。注意定向加速和注意解除困难在不同阶段对注意偏向产生影响。威胁刺激属性、呈现时间以及被试特征是重要的调节因素。以杏仁核为核心的杏仁核?前扣带回网络可能是注意定向加速的神经基础, 而以眶额叶为中心的前额叶皮层可能是注意解除的神经基础。未来还需要就注意定向加速与注意解除困难的关系、注意偏向的调节机制以及其神经基础做更深入的研究。     

The effects of trait and state anxiety on attention to emotional images: An eye-tracking study

Attentional biases for threatening stimuli have been implicated in the development of anxiety disorders. However, little is known about the relative influences of trait and state anxiety on attentional biases. This study examined the effects of trait and state anxiety on attention to emotional images. Low, mid, and high trait anxious participants completed two trial blocks of an eye-tracking task. Participants viewed image pairs consisting of one emotional (threatening or positive) and one neutral image while their eye movements were recorded. Between trial blocks, participants underwent an anxiety induction. Primary analyses examined the effects of trait and state anxiety on the proportion of viewing time on emotional versus neutral images. State anxiety was associated with increased attention to threatening images for participants, regardless of trait anxiety. Furthermore, when in a state of anxiety, relative to a baseline condition, durations of initial gaze and average fixation were longer on threat versus neutral images. These findings were specific to the threatening images; no anxiety-related differences in attention were found with the positive images. The implications of these results for future research, models of anxiety-related information processing, and clinical interventions for anxiety are discussed.     

Anxiety and attention to threatening pictures

Previous research using attentional search tasks has revealed an anxiety-related bias favouring attention to threatening words when they are presented simultaneously with emotionally neutral words. In Experiment 1, using a similar task, a related effect was found here with emotionally threatening pictures. When pictures were used as location cues in a second experiment, high-trait anxious individuals were slower than less anxious controls when responding to targets requiring attentional disengagement from threat, and they were slower in general with pictures judged to be highly threatening. In a third experiment using the same task but with a longer cue exposure, a related disengagement difficulty occurred across both groups, although the more general slowing with severe threat was again confined to the anxious group. We conclude that attentional bias involves both a specific difficulty in disengaging attention from the location of any threat and a more general interference effect that is related to threat level.     

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.     

Attentional bias towards emotional facial expressions in survivors of dating violence

This study identified components of attentional bias (e.g. attentional vigilance, attentional avoidance and difficulty with disengagement) that are critical characteristics of survivors of dating violence (DV). Eye movements were recorded to obtain accurate and continuous information regarding attention. DV survivors with high post-traumatic stress symptoms (DV-High PTSS group; n = 20) and low post-traumatic stress symptoms (DV-Low PTSS group; n = 22) and participants who had never experienced DV (NDV group; n = 21) were shown screens displaying emotional (angry, fearful and happy) faces paired with neutral faces and negative (angry and fearful) faces paired with happy faces for 10 s. The results indicate that the DV-High PTSS group spent longer dwelling on angry faces over time compared with the DV-Low PTSS and NDV groups. This result implies that the DV-High PTSS group focused on specific trauma-related stimuli but does not provide evidence of an attentional bias towards threatening stimuli in general.     

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.     

Attentive processing of threat and adult attachment: a dot-probe study

We examined selective attention to threat stimuli as a function of individual differences in adult attachment. Participants completed a dot-probe task in which a general threat word, attachment-related threat word, general positive or attachment-related positive word was presented together with a neutral word. Results showed that attachment anxiety and avoidance were associated with an attentional bias away from attachment threat words. This attentional avoidance effect was best predicted by the interaction between attachment anxiety and avoidance and not by their unique main effects. The findings are discussed in terms of attachment theory and its relation to attentional biases observed in psychopathology.     

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.