Attentional bias to threat in clinical anxiety states

Abstract

Attentional responses to threat stimuli were assessed in anxious patients, normal controls, and subjects who had recovered from a clinical anxiety state. The main aims of the study were: (1) to replicate MacLeod, Mathews, and Tata's (1986) finding of an attentional bias to threat in currently anxious patients compared with normal control subjects; (2) to assess whether the bias is related to the predominant worries of anxious patients; and (3) to investigate whether the bias is present in recovered anxious patients. The original finding of an anxiety-related attentional bias was replicated. The results indicated that the extent to which anxious patients selectively attended to social threat words was associated with the seventy of their social worries. The attentional responses of the recovered anxious group were not significantly differentiated from those of the currently anxious or normal control groups.     

Bias in interpretation of ambiguous sentences related to threat in anxiety

In the 1st of 2 experiments, currently clinically anxious, recovered clinically anxious, and normal control subjects were presented with a mixture of unambiguous and ambiguous sentences; both threatening and nonthreatening interpretations were possible for the latter. A subsequent recognition-memory test indicated that the currently anxious subjects were more likely than normal control and recovered anxious subjects to interpret the ambiguous sentences in a threatening fashion rather than in a nonthreatening fashion. This suggests that the biased interpretation of ambiguity found in currently anxious subjects reflected their anxious mood state. A 2nd experiment established that the difference in interpretative processes between currently anxious and control subjects was not due to response bias and that the interpretative bias was a reasonably general one.     

Selective processing of threat cues in anxiety states: a replication

A replication of Mathews and MacLeod's (Behav. Res. Ther. 23, 563-569, 1985) study, using a modified Stroop task, confirmed that threat words selectively interfere with the colour-naming performance of generally anxious patients, compared with normal controls. Clearer evidence was obtained of a highly specific interference effect of threat words that were congruent with the predominant worries reported by anxious patients. However, there was no evidence of a subsequent recognition memory bias for the threat words in anxious Ss. These results are discussed in relation to findings from other recent experiments investigating attentional and memory biases for threat-related information in anxiety states, and their implications for cognitive theories of anxiety are considered.     

Anxiety and the spelling and use in sentences of threat/neutral homophones

The disambiguation of threat/neutral homophones was investigated in high- and low-trait anxiety subjects who had been exposed to either a positive or a negative mood manipulation procedure. Subjects were required first to spell each auditorily presented word and second, to generate and speak a sentence using the word. Difference indices were calculated for the spelling and the sentence usage data, i.e. the number of threat minus neutral interpretations. Examination of these indices revealed that subjects exposed to the negative mood manipulation procedure produced relatively more threat than neutral interpretations (for both spelling and sentence usage) than did subjects exposed to the positive mood manipulation procedure. Multiple regression analyses revealed that both the trait anxiety and mood manipulation variables contributed significantly to the prediction of the difference index on the spelling task. In the analysis of the use of homophones in sentences, only the mood manipulation variable contributed significantly to the prediction of the difference index on the sentence usage task.     

Selective orienting of attention to masked threat faces in social anxiety

The aims of the study were two-fold: to examine whether previous evidence of a pre-attentive bias for masked threat faces in anxious individuals could be replicated, and to assess the relationship between the predicted bias and measures of trait and social anxiety. Pairs of face stimuli were briefly displayed and masked in a modified version of the visual probe task. Results indicated that high anxious individuals were faster to respond to probes occurring in the spatial location of masked threat rather than neutral faces; consistent with their attention being automatically captured by sub-threshold threat cues. Furthermore, this vigilance effect for masked threat faces appeared to be primarily a function of social anxiety and social avoidance, rather than trait anxiety. It was also more apparent when threat faces were presented in the left visual field, suggestive of right hemisphere involvement.     

Physical abuse amplifies attention to threat and increases anxiety in children

Two experiments using event-related potentials (ERPs) examined the extent to which early traumatic experiences affect children's ability to regulate voluntary and involuntary attention to threat. The authors presented physically abused and nonabused comparison children with conflicting auditory and visual emotion cues, posed by children's mothers or a stranger, to examine the effect of emotion, modality, and poser familiarity on attention regulation. Relative to controls, abused children overattended to task-relevant visual and auditory anger cues. They also attended more to task-irrelevant auditory anger cues. Furthermore, the degree of attention allocated to threat statistically mediated the relationship between physical abuse and child-reported anxiety. These findings indicate that extreme emotional experiences may promote vulnerability for anxiety by influencing the development of attention regulation abilities.     

Spiritual issues in anxiety states

This overview points to large areas of human concern that cannot be bounded by the biomedical, behavioral, and narrowly cognitive approaches that characterize current understanding and treatment of anxiety disorders. I look at some aspects of existential, wholistic, and transpersonal psychology that I have found especially useful in enhancing therapy of the anxiety spectrum.     

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.     

Bodily states of anxiety: the movement from somatic states to thought

My paper attempts to stimulate thought about the relationship between physical and mental 'states of anxiety' by looking at some experiences in the consulting room, particularly at those moments when shifts from predominantly somatic to predominantly psychic forms of representation appeared to be taking place. These experiences are considered in conjunction with some of the ideas of Jung, Fordham, Bion, Winnicott, Meltzer and others relevant to the body-mind question. I conclude with some imaginative speculations.     

Anticipation of interoceptive threat in highly anxiety sensitive persons

Anticipatory anxiety plays a major role in the etiology of panic disorder. Although anticipatory anxiety elicited by expectation of interoceptive cues is specifically relevant for panic patients, it has rarely been studied. Using a population analogue in high fear of such interoceptive arousal sensations (highly anxiety sensitive persons) we evaluated a new experimental paradigm to assess anticipatory anxiety during anticipation of interoceptive (somatic sensations evoked by hyperventilation) and exteroceptive (electric shock) threat. Symptom reports, autonomic arousal, and defensive response mobilization (startle eyeblink response) were monitored during threat and matched safe conditions in 26 highly anxiety sensitive persons and 22 controls. The anticipation of exteroceptive threat led to a defensive and autonomic mobilization as indexed by a potentiation of the startle response and an increase in skin conductance level in both experimental groups. During interoceptive threat, however, only highly anxiety sensitive persons but not the controls exhibited a startle response potentiation as well as autonomic activation. The anticipation of a hyperventilation procedure thus seems a valid paradigm to investigate anticipatory anxiety elicited by interoceptive cues in the clinical context.     

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.     

A list of English homophones

A list of 382 sets of English heterographic homophones compiled from Collins Dictionary of the English Language (1979).¹     

Conscious intrusion of threat information via unconscious priming in anxiety

Preferential processing of threat has been implicated in the development and perpetuation of anxiety. We investigated threat processing and anxiety using a subliminal priming paradigm. People with high or low trait anxiety viewed masked, briefly presented words, and then took an exclusion-completion test in which three-letter stems were to be completed without using recently perceived words. Completion rates were greater for words viewed subliminally compared to a baseline estimate. In addition, unconscious priming was greater for threat than for neutral words in the high-trait-anxiety group, and for neutral than for threat words in the low-trait-anxiety group. Enhanced unconscious priming of threat completions among anxious individuals may model intrusions in anxiety, when unconscious processing breaks into consciousness in the form of threat-related intrusive thoughts.     

Test anxiety,evaluative stress,and susceptibility to distraction from threat

Examinations are perhaps one of the main methods of assessment in education. Unfortunately, there are some individuals who are so fearful of such events that performance is impaired. Test anxiety is believed to be the trait that predisposes individuals to react negatively to examinations and tests. One way in which it is believed that test anxiety affects performance is by increasing susceptibility to distraction from task‐irrelevant material. However, few studies have directly investigated this impairment. An experiment was therefore conducted to investigate susceptibility to distraction in high and low test‐anxious students. The task used was based on one developed by Mathews, May, Mogg and Eysenck (1990), which distinguishes between focused attention and selective search. In order to determine whether a specific susceptibility to distraction exists, the distractors were varied in terms of valence and relevance to examinations. Since test anxiety is a situation‐specific trait, an evaluation‐related stressor was used to trigger test‐anxious reactions. A specific susceptibility to distraction from threat was found amongst high test‐anxious participants who received the evaluation‐related stressor. However, this effect was only found when participants were using focused attention. This suggests that the disturbed performance often found to be associated with test anxiety might be due to an inability to ignore threatening material when attempting to focus attentional resources. These results are discussed in light of current theories of test anxiety and implications for educational practice. Copyright © 2001 John Wiley & Sons, Ltd.     

Selective attention to threat: A test of two cognitive models of anxiety

Two experiments evaluated differential predictions from two cognitive formulations of anxiety. According to one view, attentional biases for threat reflect vulnerability to anxiety; and as threat inputs increase, high trait anxious individuals should become more vigilant, and low trait individuals more avoidant, of threat (Williams, Watts, MacLeod, & Mathews, 1988, 1997). However, according to a “cognitive-motivational” view, trait anxiety influences the appraisal of stimulus threat value, rather than the direction of attentional bias, and both high and low trait anxious individuals should exhibit greater vigilance for high rather than mild threat stimuli (Mogg & Bradley, 1998). To test these predictions, two experiments examined the effect of manipulating stimulus threat value on the direction of attentional bias. The stimuli included high threat and mild threat pictorial scenes presented in a probe detection task. Results from both studies indicated a significant main effect of stimulus threat value on attentional bias, as there was increased vigilance or reduced avoidance of threat, as threat value increased. This effect was found even within low trait anxious individuals, consistent with the “cognitive-motivational” view. Theoretical and clinical implications are discussed.