On the relationship between self-focused attention and psychological disorder: a critical reappraisal.

A recent review of the literature on the role of self-focused attention in psychological dysfunction (Ingram, 1990) is critically examined. This article (a) reexamines the evidence relevant to Ingram's proposal that self-awareness is a nonspecific factor involved in virtually all forms of psychopathology and argues that this conclusion is not warranted by the existing evidence; (b) takes issue with his premise that the fact that self-awareness is associated with a variety of psychological dysfunctions poses a conceptual dilemma; (c) corrects several important inaccuracies and mischaracterizations in his presentation of Carver and Scheier's (1981) cybernetic control theory and Pyszczynski and Greenberg's (1987) self-regulatory perseveration theory; and (d) critiques the "self-absorption" model that he proposed as an alternative to extant theories and concludes that this conceptualization does not add to the understanding of either self-awareness processes or psychopathology.     

Prospective Associations Between Sleep Disturbance and Repetitive Negative Thinking: The Mediating Roles of Focusing and Shifting Attentional Control

Although considerable evidence has linked sleep disturbance to symptoms of psychopathology, including repetitive negative thinking, few studies have examined how sleep disturbance may predict repetitive negative thinking over time. Further, no study to date has examined specific mechanisms that may account for this relationship. The present study sought to address these gaps in the literature by testing focusing and shifting attentional control as two potential mediators of the relationship between sleep disturbance and repetitive negative thinking over a 6-month period. A final sample of 445 unselected community participants completed measures of sleep disturbance and repetitive negative thinking at Time 1, measures of focusing and shifting attentional control 3 months later, and measures of repetitive negative thinking again 6 months later. Results revealed that focusing, but not shifting, attentional control mediated the relationship between sleep disturbance and repetitive negative thinking, specifically, worry, rumination, and obsessions. These findings provide preliminary evidence for focusing attentional control as a candidate mechanism that may explain the causal role of sleep disturbance in the development of repetitive negative thinking observed in various disorders.     

Flanker recall and the flanker validity effect may reflect different attentional processes

High flanker recall in the correlated flanker task suggests a failure of selective attention. We used a dissociation approach to examine the role of attentional processing of the flankers’ identities in the flanker validity effect (FVE). In three experiments, flanker recall decreased as flanker duration decreased, but the FVE was not affected by flanker duration. Masking also produced a dissociation, in that masking decreased flanker recall but the FVE was not affected. Examination of on-line flanker identification suggested that flanker recall was an adequate measure of attentional processing of the flankers’ identities on most trials. The results suggest that attentional processing of the flankers’ identities is not related to the magnitude of the FVE and is not necessary for it to obtain. Because there is a failure of selective attention, the dissociations suggest that flanker recall and the FVE may reflect different attentional processes.     

Flanker recall and the flanker validity effect may reflect different attentional processes.

High flanker recall in the correlated flanker task suggests a failure of selective attention. We used a dissociation approach to examine the role of attentional processing of the flankers' identities in the flanker validity effect (FVE). In three experiments, flanker recall decreased as flanker duration decreased, but the FVE was not affected by flanker duration. Masking also produced a dissociation, in that masking decreased flanker recall but the FVE was not affected. Examination of on-line flanker identification suggested that flanker recall was an adequate measure of attentional processing of the flankers' identities on most trials. The results suggest that attentional processing of the flankers' identities is not related to the magnitude of the FVE and is not necessary for it to obtain. Because there is a failure of selective attention, the dissociations suggest that flanker recall and the FVE may reflect different attentional processes.     

The Roles of Persistence and Perseveration in Psychopathology

Two constructs were hypothesized to be of importance in psychological disorders: persistence (the ability to keep going to reach a goal, even when the task is difficult or drawn out) and perseveration (the tendency to continue a behavior, even when it ceases to be effective or rewarding). These are contrasted with perfectionism (having high standards for oneself or others). A measure was developed to address these constructs (the Persistence, Perseveration and Perfectionism Questionnaire; PPPQ). The PPPQ was administered to 325 nonclinical participants, alongside a measure of psychological disturbance. Factor analysis resulted in a 22-item version of the measure, consisting of subscales with good psychometric properties corresponding to the 3 theoretical constructs. Persistence was associated with lower levels of psychopathology, whereas perseveration was associated with higher levels of psychopathology. Perfectionism was weakly associated with psychopathology. Further work is needed to develop these constructs with clinical groups, but the findings support the hypothesis that persistence is an adaptive construct whereas perseveration is maladaptive.     

Serotonin transporter genetic variation and biased attention for emotional word stimuli among psychiatric inpatients

The short allele in a variable repeat sequence of the promoter region of the serotonin transporter gene (5-HTTLPR) has been associated with stronger activation in brain regions critical for processing emotional stimuli. The authors examined whether variants of the 5-HTTLPR promoter polymorphism were also associated with individual differences in attentional biases for emotional stimuli. Words related to anxious and dysphoric emotional states were presented to psychiatric inpatients in a standard dot-probe reaction time task. Compared with participants with two long alleles, carriers of the short 5-HTTLPR allele exhibited a stronger attentional bias for anxious word stimuli. No genetic group difference was observed for dysphoric word stimuli. Findings from this preliminary study highlight the potential for integrating genetic and cognitive models of psychopathology.     

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.     

A review of existing measures of attentional biases in body image and eating disorders research

Cognitive theories emphasise the important role of attentional biases in the development and maintenance of body image issues and eating pathology. A wealth of research has been conducted to examine attentional biases toward body‐related information among individuals with eating pathology. However, there is considerable variability in the methods that have been used to measure attention and, importantly, these methods tap into different attentional processes. Given the multifaceted nature of attention, it is important for researchers to select the right tools to test their hypotheses. This review critically evaluates the attentional measures that have been used in previous research, primarily the modified Stroop task, dot probe task, visual search task, and eyetracking. The strengths and limitations of each measure will be discussed in order to provide a guide for researchers to further investigate the attentional mechanisms underlying body image issues and eating disorders. Overall, we recommend that researchers use a combination of eyetracking technology and specific reaction‐time measures that target the specific attentional mechanism of interest.     

Further validation of a measure of irrational belief

Malouff and Schutte (1986) developed a measure of irrational belief intended to be shorter and more content valid than other such measures and reported preliminary evidence of reliability and validity for the measure. The present two studies examined further the validity of the new measure. Study 1 produced evidence of construct validity in that a significant correlation was found between scores on the Malouff & Schutte measure and scores on a measure of hostility, which is a theoretically related construct. Study 2 produced evidence of construct validity in that scores on the Malouff & Schutte measure were found to be correlated with scores on two measures of theoretically related constructs: anxiety and irrational tendencies/beliefs. Study 2 also produced evidence of discriminant validity in that scores on the Malouff & Schutte measure were found to be significantly more highly correlated with scores on the more theoretically similar irrational tendencies/beliefs scale than with scores on the anxiety measure.     

The multidimensionality of psychopathology in a community sample

Some researchers have advocated the use of rating scales that measure global constructs such as mental health or psychological distress. Others have advocated the use of discrete diagnostic categories. Using multidimensional scaling, we examine whether there is a single dimension of psychopathology among community respondents or whether there are distinct types. We find that psychopathology is multidimensional: distinct clusters of symptoms including physiological malaise, antisocial attitudes, demoralization, mistrust, and alcoholism appear. We conclude with a synthesis of the two approaches to measuring psychopathology.     

Improving Treatment Response for Paediatric Anxiety Disorders: An Information-Processing Perspective

Cognitive behavioural therapy (CBT) is considered the treatment of choice for paediatric anxiety disorders, yet there remains substantial room for improvement in treatment outcomes. This paper examines whether theory and research into the role of information-processing in the underlying psychopathology of paediatric anxiety disorders indicate possibilities for improving treatment response. Using a critical review of recent theoretical, empirical and academic literature, the paper examines the role of information-processing biases in paediatric anxiety disorders, the extent to which CBT targets information-processing biases, and possibilities for improving treatment response. The literature reviewed indicates a role for attentional and interpretational biases in anxious psychopathology. While there is theoretical grounding and limited empirical evidence to indicate that CBT ameliorates interpretational biases, evidence regarding the effects of CBT on attentional biases is mixed. Novel treatment methods including attention bias modification training, attention feedback awareness and control training, and mindfulness-based therapy may hold potential in targeting attentional biases, and thereby in improving treatment response. The integration of novel interventions into an existing evidence-based protocol is a complex issue and faces important challenges with regard to determining the optimal treatment package. Novel interventions targeting information-processing biases may hold potential in improving response to CBT for paediatric anxiety disorders. Many important questions remain to be answered.     

On inhibition/disinhibition in developmental psychopathology: views from cognitive and personality psychology and a working inhibition taxonomy

Disinhibition is a common focus in psychopathology research. However, use of inhibition models often is piecemeal, lacking an overarching taxonomy of inhibitory processes. The author organizes key concepts and models pertaining to different kinds of inhibitory control from the cognitive and temperament/personality literatures. Within the rubrics of executive inhibitory processes, motivational inhibitory processes, and automatic attentional inhibition processes, 8 kinds of inhibition are distinguished. Three basic temperament traits may address key executive and motivational inhibitory processes. Future developmental psychopathology research should be based on a systematic conceptual taxonomy of the kinds of inhibitory function relevant to a given disorder. Such an approach can clarify which inhibition distinctions are correct and which inhibition deficits go with which disorders.     

Previous reward decreases errors of commission on later ‘No‐Go’ trials in children 4 to 12 years of age: evidence for a context monitoring account

Inhibitory control is widely hypothesized to be the cornerstone of executive function in childhood and the central deficit in a number of developmental disorders, including attention‐deficit/hyperactivity disorder (ADHD). However, recent evidence from adults indicates that performance on response inhibition tasks may primarily reflect non‐inhibitory attentional control (context monitoring) processes. Yet it may be that inhibition plays a more central role in childhood – a time when the architecture of cognitive processes might be more transparent due to wide variability in skill level. Here we directly test inhibitory and context monitoring explanations of task performance on a Go/No‐Go task in a large group of children 4–12 years of age. We conclude that traditional inhibitory conceptualizations of task performance on the Go/No‐Go task cannot account for our findings, calling into question evidence supporting a central role for inhibitory control in cognitive development or developmental psychopathology.     

Attentional mechanisms in learned predictiveness

Cues that reliably predict an outcome in an initial phase of training (Phase 1) are learned faster in a second phase of training (Phase 2) than cues that were unreliable in Phase 1. This result is observed despite objectively equal relationships between the cues and the outcomes in Phase 2, and consequently constitutes a nonnormative bias in learning. The present experiments sought to confirm that this learned predictiveness effect is the product of attentional processes (Experiment 1), and to test further whether these processes are under voluntary control or are automatic in nature (Experiment 2). In addition to the usual outcome prediction measure, eye-gaze behavior was also monitored. The results indicated an important role for top-down strategic attentional processes in the learned predictiveness task. In contrast, no evidence for an automatic attentional bias was found.     

The influence of emotional stimuli on the oculomotor system: A review of the literature

In the past decade, more and more research has been investigating oculomotor behavior in relation to attentional selection of emotional stimuli. Whereas previous research on covert emotional attention demonstrates contradictory results, research on overt attention clearly shows the influence of emotional stimuli on attentional selection. The current review highlights studies that have used eye-movement behavior as the primary outcome measure in healthy populations and focusses on the evidence that emotional stimuli—in particular, threatening stimuli—affect temporal and spatial dynamics of oculomotor programming. The most prominent results from these studies indicate that attentional selection of threatening stimuli is under bottom-up control. Moreover, threatening stimuli seem to have the greatest impact on oculomotor behavior through biased processing via the magnocellular pathway. This is consistent with an evolutionary account of threat processing, which claims a pivotal role for a subcortical network including pulvinar, superior colliculus, and amygdala. Additionally, I suggest a neurobiological model that considers possible mechanisms by which emotional stimuli could affect oculomotor behavior. The present review confirms the relevance of eye-movement measurements in relation to researching emotion in order to elucidate processes involved in emotional modulation of visual and attentional selection.     

Difficulties in Interpersonal Emotion Regulation: Initial Development and Validation of a Self-Report Measure

Recent attention has focused on the role of interpersonal emotion regulation (IER) in the development and maintenance of a range of forms of psychopathology, including anxiety, depression, and borderline personality disorder (BPD). Despite the relevance of IER in psychopathology, few measures exist to characterize patterns of maladaptive IER. Our aim was to (1) develop a measure of maladaptive IER, (2) begin to explore the factor structure of this new measure, the difficulties in interpersonal regulation of emotions (DIRE), and (3) examine its association with symptoms of psychopathology. In Study 1, 853 Mechanical Turk workers completed the DIRE and measures of psychopathology symptoms. We identified two factors each in the IER and intrapersonal emotion regulation scales. In Study 2, 142 undergraduate students completed the DIRE and daily measures of emotion regulation and coping for 14 days. Preliminary findings suggest that the DIRE has adequate internal consistency and construct and predictive validity. This measure has the potential to supplement future efforts in assessing IER in psychopathology.     

Patient experiences with treatment in private practice compared with public mental health services

The study compared patient experiences with psychiatric treatment provided by private practitioners and public outpatient clinics. Questionnaires were completed by 642 outpatients in private practice and 6,677 outpatients in public clinics. The questionnaire included a measure of patient experiences comprising six items: treatment outcome, enough time for contact and dialogue with clinician, clinicians' understanding of patient's situation, suitability of therapy and treatment, clinician follow-up of planned actions, and influence on treatment. Patients in private practice had generally better experiences than patients in public outpatient treatment. The difference between private and public patients was largest for patients with poor self-evaluated mental health or those who had just one consultation in the previous three months. Private practitioners appear to have an important role in mental health services delivery, and patients have relatively good experiences with services. Further studies that assess the patient - clinician interaction in different mental health services may give further insights into potential service improvements.     

The Need to Present a Perfect Body Image: Development of a New Measure of Perfectionistic Self-Presentation

Perfectionistic self-presentation is linked to different clinical conditions and specially to eating disorders. In fact, the role that the drive to reach “perfection” and display it to others plays on eating and body image-related symptoms has long been the target of theoretical and empirical interest. However, an instrument that specifically assessed the need to present a perfect body image to others did not exist. The current study presents the development and validation of the Perfectionistic Self-Presentation Scale – Body Image (PSPS-BI), a measure designed to assess the need to present a perfect body image to others by displaying a flawless physical appearance and by occulting perceived imperfections in a public context. Three studies that included a total of 364 males and 541 females with ages between 18 to 38 years, were used to examine the structure and psychometric properties of the scale. Results showed that PSPS-BI presents two factors that measure the concealment of body imperfections and the display of body perfection. PSPS-BI revealed good internal reliability and temporal stability. Also, the PSPS-BI revealed good concurrent validity, tested with measures of perfectionism, body image flexibility, and general and eating psychopathology. Furthermore, a mediational analysis indicated that the need to present a perfect body image to others fully mediates the relationship between a general measure of perfectionistic self-presentation and drive for thinness, in both men and women. PSPS-BI showed good preliminary evidence as a reliable and accurate measure that seems to offer new possibilities to the research field of body image and eating-related difficulties.     

Anger and psychopathology in prison inmates

The relationship between anger and psychopathology was examined in a sample of 137 inmates. The State-Trait Anger Scale and the Anger Expression Inventory were used to measure anger and the Basic Personality Inventory was used to measure psychopathology. State and trait anger correlated positively with 8 and 9, respectively, out of 12 scales of psychopathology. The factor scales for the State-Trait Anger Scale, anger/hostility, arousal and situational anger correlated positively with 8, 9 and 4, respectively, out of 12 measures of psychopathology. Anger-control had an inverse relationship with 8 out of 12 measures of psychopathology, anger-out was positively related to measures of interpersonal problems, alienation, impulse expression and deviation, and anger-in had positive correlations with 11 out of 12 indices of psychopathology. Alternative treatment approaches which are sensitive to individual differences in anger style were discussed.     

Intrinsic enjoyment and boredom coping scales: Validation with personality,evoked potential and attention measures

This paper reports the validation of brief, self-report measures of intrinsic enjoyment and boredom coping. Intrinsic enjoyment is characterized by intense involvement, interest and absorbed concentration; boredom coping is designed to reflect the disposition to restructure one's perceptions and participation in potentially boring activities so as to decrease boredom. Both traits are hypothesized to reflect the capacity for good attentional control across a variety of situations. Reliability was established by test-retest correlation and by an inter-item consistency measurement. Construct validity was established by comparison with previously-validated personality tests, real-life measures (such as Random Activities Experiential Sampling, which involves repeated self-report measures in daily life), as well as with laboratory measures of attention (including the averaged visual evoked potential (EP) and the Continuous Performance Test). Intrinsic enjoyment is significantly correlated with an independent measure of intrinsic involvement (low wish to be elsewhere in one's daily life), the affective experience of potency, self-reports of concentrating well with ease, high ego development, an internal locus of control, lack of boredom susceptibility and certain EP indices of attentional change and ‘cortical’ augmenting. Boredom coping is associated with a higher percent of time actually spent alone, high continuous performance task measures of attentional capacity, and low MMPI and Research Diagnostic Criteria indices of psychopathology.