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.     

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.     

Biased attention in childhood Anxiety disorders: A preliminary study

This study provides preliminary tests of two hypotheses: (1) Anxiety-disordered children show an attentional bias toward emotionally threatening stimuli, and (2) normal controls show an attentional bias away from emotionally threatening stimuli. Twelve children, 9 to 14 years of age, with primary diagnoses of anxiety disorder were compared with 12 normal controls matched for age, gender, vocabulary level, and reading ability. Subjects completed a reaction time task that measured visual attention toward threatening versus neutral words. The anxious group showed the predicted attentional bias toward threat words. However, controls did not show the predicted bias away from threat words. These results are the first showing that biased attentional processing occurs among clinically anxious children. The potential role of such an attentional bias in childhood anxiety disorders and future direction for research are discussed.This research was supported by a Seed Grant and a Small Grant to the first author from The Ohio State University. Portions of this paper were presented at the 27th Annual Convention of the Association for the Advancement of Behavior Therapy, Atlanta, November 1993. Thanks are extended to the participants and all those who helped with the project.     

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.     

Selective attention to threat in the dot probe paradigm: differentiating vigilance and difficulty to disengage

The dot probe task [J Abnorm Psychol 95 (1986) 15] is an often-used paradigm to investigate selective attention to threat. A facilitated response to probes that appear at the same location of threat information in comparison with responses to probes at the opposite location of threat information is interpreted as vigilance for threat. We argue that the findings in the dot probe paradigm are ambiguous evidence for the vigilance to threat hypothesis. Results can also be interpreted as a difficulty to disengage from threat. In this study, 44 undergraduates performed a pictorial version of the probe detection task. Taking into account the reaction times on neutral trials, we found no evidence for a facilitated detection of threatening information. It was found that the dot probe effects are at least partially due to disengagement effects. The implications of these results for the understanding of attentional bias in normal and anxious individuals are discussed.     

Does anxiety lead to selective processing of threat-related information?

Four experiments investigating the detailed nature of the attentional bias in anxiety are reported. Previous research using the Stroop task has shown that, when compared with non-patient controls, anxious patients are relatively slower at colour naming threat-related words than non-threat words. Experiments One and Two investigated whether this apparent attentional bias is a function of anxiety per se and/or is related to patient/non-patient status. Experiment One compared colour-naming times for threat and non-threat words in low, medium and high trait anxiety normal subjects. High anxiety was not associated with slower colour-naming times for threat words. Experiment Two compared generalized anxiety disorder patients with equally anxious non-patients and found that the patients were significantly slower at colour-naming threat words. Read aloud and dwell tasks were also included in these experiments in order to identify the mechanism of Stroop interference. Experiments Three and Four investigated whether anxious patients' attentional bias is specific to threat-related material or also extends to certain positive, emotional material. In Experiment Three words used in previous Stroop studies were rated for emotionality. Threat words were more emotional, as well as more threatening, than control words, indicating that previous studies have confounded threat and emotionality. Experiment Four compared colour-naming times for threat words, equally emotional positive words, and neutral words. Consistent with the emotionality hypothesis, generalized anxiety disorder patients were slower than non-anxious controls at colour naming both threat words and positive words. The theoretical, methodological and clinical implications of these results are discussed.     

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.     

Threat-based cognitive biases in anxious children: comparison with non-anxious children before and after cognitive behavioural treatment

Attention and interpretation biases for threat stimuli were assessed in 19 anxious (ANX) children before and after cognitive behavioural therapy (CBT), and compared with responses from 19 non-anxious (NA) control children collected over the same period. Attentional bias was assessed using a picture version of the visual probe task with threat, neutral and pleasant pictures. Threat interpretation bias was assessed using both a homographs task in which children used homograph words in a sentence and their neutral or threatening meaning was assessed, and a stories task in which children rated their negative emotion, danger judgments, and influencing ability in ambiguous situations. ANX children showed attention biases towards threat on the visual probe task and threat interpretation biases on the stories task but not the homographs task at pre-treatment in comparison with NA children. Following treatment, ANX children's threat interpretation biases as assessed on the stories task reduced significantly to within levels comparable to NA children. However, ANX children continued to show larger attentional biases towards threat than pleasant pictures on the visual probe task at post-treatment, whereas NA children did not show attentional biases. Moreover, a residual threat interpretation style on the stories task at post-treatment was associated with higher anxiety symptoms in both ANX and NA children.     

Time-course of attention for threatening pictures in high and low trait anxiety

Cognitive studies about anxiety suggest that the interplay between automatic and strategic biases in attention to threat is related to the persistence of fear. In the present study, the time-course of attention to pictures with varying threat levels was investigated in high trait anxious (HTA, n=21) and low trait anxious (LTA, n=22) students. In a visual probe detection task, high and mild threat pictures were presented at three durations: 100, 500, and 1250 ms. Results indicated that all individuals attended to the high threat pictures for the 100 ms condition. Differential responding between HTA and LTA individuals was found for the 500 ms condition: only HTA individuals showed an attentional bias for mild threatening stimuli. For the 1250 ms condition, the HTA individuals attended away from high and mild threat pictures. The observed pattern of differential attention to threatening pictures may explain the persistence of fear in HTA individuals.     

Anxiety-related attentional biases and their regulation by attentional control

This study examined the role of self-reported attentional control in regulating attentional biases related to trait anxiety. Simple detection targets were preceded by cues labeling potential target locations as threatening (likely to result in negative feedback) or safe (likely to result in positive feedback). Trait anxious participants showed an early attentional bias favoring the threatening location 250 ms after the cue and a late bias favoring the safe location 500 ms after the cue. The anxiety-related threat bias was moderated by attentional control at the 500-ms delay: Anxious participants with poor attentional control still showed the threat bias, whereas those with good control were better able to shift from the threatening location. Thus, skilled control of voluntary attention may allow anxious persons to limit the impact of threatening information.     

Health anxiety,anxiety sensitivity,and attentional biases for pictorial and linguistic health‐threat cues

The study investigated attentional biases for pictorial and linguistic health‐threat stimuli in high and low health anxious individuals, who were selected from the upper and lower quartile ranges of a normal sample using a screening measure of health anxiety. Attentional bias was assessed using a visual probe task which presented health‐threat and neutral pictures and words at two exposure durations, 500 ms and 1250 ms. The prediction that the high health anxious group would show a greater attentional bias for health‐threat cues than the low health anxious group was not supported despite the groups being well‐differentiated on a general measure of health anxiety, the Illness Attitudes Scale (IAS). Instead, the results indicated that individuals with high levels of anxiety sensitivity showed a significantly greater initial attentional bias for threat pictures compared with those with low anxiety sensitivity, as assessed by the Anxiety Sensitivity Index (ASI).     

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.     

Attentional bias in anxiety: selective search or defective filtering?

Two experimental tasks were used to investigate the nature of a previously documented bias in attention associated with anxiety. Results from the first task failed to reveal any differences between anxious and nonanxious subjects, either in attention focusing or selective search for letters. The second task, with words as targets and distractors, suggested that selective search was less efficient in anxious subjects when distractors were present. Currently anxious subjects were slower than controls when required to search for the target among distractors of any type, whereas both currently anxious and recovered subjects were slower when the distractors were threatening words. It was therefore suggested that a bias favoring threat cues during perceptual search is an enduring feature of individuals vulnerable to anxiety, rather than a transient consequence of current mood state alone.     

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.     

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.     

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.     

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.     

Health anxiety, anxiety sensitivity, and attentional biases for pictorial and linguistic health-threat cues

The study investigated attentional biases for pictorial and linguistic health-threat stimuli in high and low health anxious individuals, who were selected from the upper and lower quartile ranges of a normal sample using a screening measure of health anxiety. Attentional bias was assessed using a visual probe task which presented health-threat and neutral pictures and words at two exposure durations, 500 ms and 1250 ms. The prediction that the high health anxious group would show a greater attentional bias for health-threat cues than the low health anxious group was not supported despite the groups being well-differentiated on a general measure of health anxiety, the Illness Attitudes Scale (IAS). Instead, the results indicated that individuals with high levels of anxiety sensitivity showed a significantly greater initial attentional bias for threat pictures compared with those with low anxiety sensitivity, as assessed by the Anxiety Sensitivity Index (ASI).     

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.