Affective primes suppress attention bias to threat in socially anxious individuals

Anxious individuals show an attention bias towards threatening information. However, under conditions of sustained environmental threat this otherwise-present attention bias disappears. It remains unclear whether this suppression of attention bias can be caused by a transient activation of the fear system. In the present experiment, high socially anxious and low socially anxious individuals (HSA group, n=12; LSA group, n=12) performed a modified dot-probe task in which they were shown either a neutral or socially threatening prime word prior to each trial. EEG was collected and ERP components to the prime and faces displays were computed. HSA individuals showed an attention bias to threat after a neutral prime, but no attention bias after a threatening prime, demonstrating that suppression of attention bias can occur after a transient activation of the fear system. LSA individuals showed an opposite pattern: no evidence of a bias to threat with neutral primes but induction of an attention bias to threat following threatening primes. ERP results suggested differential processing of the prime and faces displays by HSA and LSA individuals. However, no group by prime interaction was found for any of ERP components.     

Sex differences in interpretation bias in adolescents

Interpretation biases, in which ambiguous information is interpreted negatively, have been hypothesized to place adolescent females at greater risk of developing anxiety and mood disorders than same‐aged males. We tested the hypothesis that adolescent girls interpret ambiguous scenarios more negatively, and/or less positively, than same‐aged males using the Adolescent Interpretation and Belief Questionnaire (N = 67, 11–15 years old). We also tested whether adolescent girls and boys differed in judging positive or negative interpretations to be more believable and whether the scenario content (social vs. non‐social) affected any sex difference in interpretation bias. The results showed that girls had higher average negative interpretation scores than boys, with no sex differences in positive interpretation scores. Girls and boys did not differ on which interpretation they found to be most believable. Both sexes reported that positive interpretations were less likely to come to mind, and were less believable, for social than for non‐social scenarios. These results provide preliminary evidence for sex differences in interpretation biases in adolescence and support the hypothesis that social scenarios are a specific source of anxiety to this age group. A greater understanding of the aetiology of interpretation biases will potentially enhance sex‐ and age‐specific interventions for anxiety and mood disorders.     

Peer behavior toward socially anxious adolescents: classroom observations

This study focused on the relation between adolescents' social anxiety and the way they are treated by classmates. The link between class behavior during oral presentations and the social anxiety of the speakers was investigated. Social anxiety was measured both as a trait variable and as manifest in two state anxiety characteristics. A group of 55 students from Grades 8 and 9 were selected to participate in the study. Class behavior during their presentations was rated by the students themselves, their teacher, and an independent observer. Results showed that negative class behavior was related to social anxiety, particularly when behavior was rated by the independent observer. The data suggested that this negative social outcome is related to longer lasting social interactions in the classroom and not to specific state anxiety characteristics.     

Money talks in attention bias modification: Reward in a dot-probe task affects attentional biases

Attention bias modification (ABM) aimed at correcting dysfunctional biases in anxiety patients has met with only mild success. Inspired by recent studies showing large effects of financial reward upon attention shifts, we contrasted effects of traditional dot-probe ABM and reward upon attention biases in a between-subject 2 × 2 design. Twenty-seven participants in group cognitive behavioural therapy (GCBT) for social anxiety disorder (SAD) were randomly assigned to undergo six sessions of a dot-probe task consisting of ABM or placebo ABM along with random or high reward following neutral stimuli. There was no influence of ABM on participants' attention bias over and above the influence of GCBT. Reward, however, had a strong influence on attention bias. Neither ABM nor reward reduced SAD symptoms over and above the effects of GCBT. The results add to the growing evidence that benefits of ABM through dot-probe training are unreliable but suggest on the other hand that rewarding attention may strongly influence dysfunctional attention biases.     

Biases in attention and interpretation in adolescents with varying levels of anxiety and depression

ABSTRACT

This is the first study to investigate multiple cognitive biases in adolescence simultaneously, to examine whether anxiety and depression are associated with biases in attention and interpretation, and whether these biases are able to predict unique variance in self-reported levels of anxiety and depression. A total of 681 adolescents performed a Dot Probe Task (DPT), an Emotional Visual Search Task (EVST), and an Interpretation Recognition Task. Attention and interpretation biases were significantly correlated with anxiety. Mixed results were reported with regard to depression: evidence was found for an interpretation bias, and for an attention bias as measured with the EVST but not with the DPT. Furthermore, interpretation and attention biases predicted unique variance in anxiety and depression scores. These results indicate that attention and interpretation biases are unique processes in anxiety and depression. They also suggest that anxiety and depression are partly based on similar underlying cognitive mechanisms.     

A case series of attention modification in clinically anxious youths

Research in the last fifteen years suggests that anxious individuals selectively attend towards threatening information. Attention modification interventions for internalizing adults have been developed to target cognition at this basic level; these programs have demonstrated initial efficacy in attention bias and anxiety symptom reduction. To date, there have been no published studies of attention modification in youths with clinical levels of anxiety. The current case series examined the initial efficacy of a four-week (12 sessions) attention modification program (AMP) designed to train attention away from threat in 16 children and adolescents (ages 10 to 17) diagnosed with DSM-IV anxiety disorders. Overall, youths experienced a significant decrease in anxiety and depression symptoms, and 12 of 16 youths no longer met criteria for any anxiety diagnosis at post-treatment. AMP was feasible with youths, and all youths and parents deemed the program acceptable. These findings provide support for further research on the use of cognitive bias modification interventions with clinically anxious youths.     

Social anxiety and adolescence: Interpretation bias in an Italian Sample

Interpretation bias, namely the tendency to systematically assign a negative meaning to ambiguous social situations, has been extensively studied in adult populations, while in adolescents it has received little attention. We aimed to address this gap by analyzing the three components of interpretation bias (negative interpretations, positive interpretations, belief in negative interpretations) in Italian adolescents aged between 14 and 17, comparing two groups: high (n = 32) and average (n = 33) social anxiety. The participants filled Social Phobia Inventory (SPIN), Positive and Negative Affect Schedule (PANAS), and Adolescents’ Interpretation and Belief Questionnaire (AIBQ). We found that the bias is specific to social anxiety (not due to the presence of negative mood) and present only in social situations. Instead, contrary to the hypothesis, Italian adolescents with high social anxiety have both negative bias and absence of the positive bias. Hence, preventive interventions should focus not only on the reduction of negative interpretations. They should also reinforce positive interpretations and target belief in negative interpretations. Based on these considerations, we gave some suggestions to improve the tasks of the Cognitive Bias Modification addressed to adolescents. Finally, belief in negative interpretations and the relationship between negative and positive interpretations in social anxiety deserve further study, both in adolescents and in adults.     

Negative self-evaluations and the relation to performance level in socially anxious children and adolescents

The current study investigated whether negatively biased self-evaluations of nervousness and social skills are related to how well an individual actually performs, that is performance level. Sixty-eight high socially anxious and 68 control participants (age range 9–17 years) gave a 5 min speech in front of a pre-recorded audience of same age peers and a teacher. Participants' evaluations immediately after the task were measured on a number of performance dimensions. Three independent observers also evaluated recordings of the speech performances. Participants were further divided into good and bad performers based on their actual performance level as judged by the observers. Self-evaluations of the high socially anxious participants were negatively biased for nervous appearance regardless of how well they actually performed. In contrast, a negative bias for social skills only occurred in the high anxious participants with a good performance. The social skill evaluations of the poor performers appear warranted. Taking actual performance level into account may help to clarify the exact nature of a negative bias in socially anxious youth and has clear implications for the choice of treatment approach.     

Differentiating between memory and interpretation biases in socially anxious and nonanxious individuals

Although individual cognitive biases toward threat in social anxiety are well established, few studies have examined the manner in which cognitive biases work in conjunction. In the present study, socially anxious ( n = 54 ) and nonanxious ( n = 58 ) individuals read 10 passages consisting of positive social or evaluative, negative social or evaluative, and neutral content and completed two cognitive tasks assessing memory of factual details and interpretation immediately and after 48 h. Socially anxious and nonanxious individuals did not differ in their memory for details presented in the passages. However, they made less positive and more negative interpretations of details included in the passages, particularly in positive passages that were self-relevant and particularly in positive passages after the delay. After including depression, state anxiety, and trait anxiety as covariates, biased interpretation of positive passages after the time delay remained significant, but biased interpretation of the self-relevant, positive passages did not. It is concluded that socially anxious individuals are characterized by accurate memory of threatening, factual material, but that they impose a biased interpretation upon that material, especially after some time has passed.     

Cultural evidence for interpretation bias as a feature of social anxiety in Chinese adolescents

Background and Objectives: Interpretation bias (IB), defined as the tendency to interpret ambiguous social situations in a threatening manner, has increasingly been studied in children and adolescents. Compared to Western samples, the relation between IB and social anxiety in Chinese youth has received little attention. The present study was to mainly examine the relationship between IB and social anxiety among Chinese adolescents.

Design: Cross-sectional design was utilized.

Methods: IB, measured by the Adolescents’ Interpretation Bias Questionnaire (AIBQ), and social anxiety were surveyed among a group of high socially anxious Chinese adolescents (n?=?25) and a control group (n?=?29). Participants were asked to rate the likelihood of interpretations coming to mind in social/non-social situations and to choose the most believable interpretation.

Results: The high social anxiety group had more negative interpretations and beliefs in social situations, and the interpretation bias was particular to social anxiety versus depression. Additionally, the cognitive content-specificity hypothesis was supported; the high anxious group showed interpretation bias in social situations, but didn’t have more negative interpretations of non-social situations, after controlling for depression.

Conclusions: The present study yielded comparable findings as found in Western samples regarding the relation between IB and social anxiety.     

Understanding associations between negatively biased attention and depression and social anxiety: positively biased attention is key

ABSTRACT

Background and objectives: Although research supports the premise that depressed and socially anxious individuals direct attention preferentially toward negative emotional cues, little is known about how attention to positive emotional cues might modulate this negative attention bias risk process. The purpose of this study was to determine if associations between attention biases to sad and angry faces and depression and social anxiety symptoms, respectively, would be strongest in individuals who also show biased attention away from happy faces.

Methods: Young adults (N?=?151; 79% female; M?=?19.63 years) completed self-report measures of depression and social anxiety symptoms and a dot probe task to assess attention biases to happy, sad, and angry facial expressions.

Results: Attention bias to happy faces moderated associations between attention to negatively valenced faces and psychopathology symptoms. However, attention bias toward sad faces was positively and significantly related to depression symptoms only for individuals who also selectively attended toward happy faces. Similarly, attention bias toward angry faces was positively and significantly associated with social anxiety symptoms only for individuals who also selectively attended toward happy faces.

Conclusions: These findings suggest that individuals with high levels of depression or social anxiety symptoms attend preferentially to emotional stimuli across valences.     

Change in gaze-based attention bias in adolescents with Social Anxiety Disorder

ABSTRACT

Although attention bias (AB) toward threat has been associated with Social Anxiety Disorder (SAD), concerns regarding the ability of current measures to detect change in AB following treatment exist. We sought to examine change in bias, as measured via eye-tracking, in adolescents with SAD receiving either attention-bias modification training (ABMT) or attention-control training (ACT). Gaze-based AB was associated (r?=??0.361) with symptoms of social anxiety prior to treatment, whereas there was no association between bias as measured via dot probe and social anxiety. Moreover, gaze-based bias to same-age face stimuli showed change following treatment. Large effects are seen for condition (ABMT or ACT) and for time, independent of treatment condition, in gaze-based AB to same-age stimuli. Findings suggest that further research on gaze-based bias, to assess stability over time outside of treatment and sensitivity to change following intervention, is warranted.     

Experimental modification of interpretation bias in socially anxious children: Changes in interpretation, anticipated interpersonal anxiety, and social anxiety symptoms

We report on an experimental manipulation of interpretation bias in socially anxious youths. A non-clinical sample of 10–11-year-olds selected for high social anxiety was trained over three sessions to endorse benign rather than negative interpretations of potentially threatening social scenarios. This group was subsequently less likely to endorse negative interpretations of new ambiguous social situations than children in a test–retest condition. Children who received interpretation training also showed reduced trait social anxiety and reported significantly less anxiety about an anticipated interpersonal encounter, compared with the control group.     

社交焦虑注意偏向的动态变化

注意偏向是社交焦虑障碍(Social Anxiety Disorder, SAD)个体症状维持的重要因素, 其中注意警觉、注意回避、注意脱离困难三种注意模式得到了研究者最广泛的研究与讨论。随着研究深入, 有研究者提出SAD个体的注意模式不是单一、静态模式, 更有可能在不同注意模式间切换, 表现为动态的过程。目前, 依据相关研究结果和理论假设, 证据均指向SAD个体的注意偏向具有随着焦虑水平提高和注意控制能力受损而动态变化的倾向, 从注意警觉过渡到注意回避与注意脱离困难均如此。此观点还需研究进一步证实, 并且基于研究结果提出更具有针对性的干预方式。     

Theory of mind ability in high socially anxious individuals

Background/Objectives: Research has demonstrated an association between social anxiety and impaired Theory of Mind (ToM). We assess whether ToM deficits occur even at a subclinical level of social anxiety and whether group differences in ToM performance are consistent with interpretation bias. We also explore potential reasons as to why socially anxious individuals may perform differently on ToM tasks.

Methods/Design: Undergraduate participants high (HSA; n?=?78) and low (LSA; n?=?35) in social anxiety completed a task of ToM decoding, the Reading the Mind in the Eyes (MIE), a task of ToM reasoning, the Movie for the Assessment of Social Cognition (MASC), and a post-task questionnaire about their experience completing the MASC.

Results: HSAs performed marginally worse than LSAs on the MIE on neutrally valenced trials, and their pattern of errors may be consistent with a negative interpretation bias. HSAs and LSAs did not differ overall in performance on the MASC, though HSAs reported experiencing more confusion and distress than LSAs during the task, and this distress was associated with more MASC errors for HSA participants only. These results provide insight into the nature of ToM ability in socially anxious individuals and highlight important avenues for future research.     

Spider fear and covariation bias in children and adolescents

Covariation bias can be defined as phobic people's tendency to overestimate the association between fear-relevant stimuli and negative outcomes. The current article presents two studies that examined this type of cognitive bias in children and adolescents aged 8-16 years. Study 1 was concerned with a thought experiment during which youths (N=150) were asked to imagine that they participated in an experiment during which they had to view a series of pictures showing spiders, guns, and flowers, that were occasionally followed by a negative outcome (i.e., a mild electric shock). Participants were asked to estimate the relation between each type of picture and the negative outcome. The results indicated that youths with higher levels of spider fear displayed a specific tendency to relate spider pictures to a negative outcome. In Study 2, youths (N=220) actually participated in a computer game during which they were confronted with pictures of spiders, guns, and flowers, each of which was equally often followed by a negative (i.e., losing candy), positive (i.e., winning candy), or neutral outcome. After the game, participants had to estimate the relation between each type of picture and various outcomes. It was found that youths with higher levels of spider fear estimated more negative and less positive outcomes in relation to spider pictures. Taken together, these findings provide support for a fear-related covariation bias in youths. Further developmental analyses indicated that this type of cognitive bias seems to be more consistently present among adolescents than among children.     

Cascading effects: the influence of attention bias to threat on the interpretation of ambiguous information

Both attention bias to threat and negative interpretive bias have been implicated in the emergence and maintenance of anxiety disorders. However, relations between attention and interpretive biases remain poorly understood. The current study experimentally manipulated attention bias to threat and examined the effects of attention training on the way ambiguous information was interpreted. Results suggest that the preferential allocation of attention towards threat affects the manner in which ambiguous information is interpreted. Individuals trained to attend to threat were more likely than individuals in a placebo training group to interpret ambiguous information in a threat-related manner. These data suggest that perturbations in the initial stages of information processing associated with anxiety may lead to a cascade of subsequent processing biases.     

Anxiety-linked attentional bias: backward glances and future glimpses

ABSTRACT

This brief reflection considers some of the important developments in anxiety-linked attentional bias research that have marked the three decades since the launch of Cognition and Emotion, and also identifies several challenges and opportunities that lie ahead. I suggest that the steady increase in our capacity to distinguish differing facets of attentional bias and alternative dimensions of anxiety vulnerability, together with the advent of attentional bias modification techniques that can illuminate causality, has enriched theoretical understanding and created the exciting potential for clinical translation. In order to fully capitalise on this potential, I propose that researchers should address the challenge of enhancing the psychometric properties of our assessment measures, and developing training procedures that not only modify attentional bias more effectively, but that motivate sustained patient engagement. I end with some personal advice to young investigators developing their research careers within this stimulating and rewarding field of scientific inquiry.     

Attenuation of attention bias in obsessive-compulsive disorder

Cognitive theories of obsessive-compulsive disorder (OCD) suggest that the disorder is characterized by an attention bias towards personally relevant threatening material. However, existing research on attention bias in OCD has yielded conflicting findings. One possibility that might account for the null findings is that attention bias may diminish over the course of the experiment. The present study tested this hypothesis using a visual dot-probe task with idiographic word selection. Results from our study confirmed that individuals with OC symptoms show an attention bias towards idiographically selected, threatening information in the first block of trials, and that the degree of this bias is correlated with the severity of OC symptoms. The temporal pattern of attention bias over the course of the experiment was consistent with our hypothesis. A comparison of early and late blocks of trials revealed an attenuation of attention bias in individuals with OC symptoms, potentially reflecting habituation to threatening information over the course of the experiment.     

Focus on the positive: Anxiety modulates the effects of emotional stimuli on hemispheric attention

People with high levels of trait anxiety are said to orient attention selectively to threatening stimuli ( and ), but this effect is sometimes difficult to replicate. We suggest a reason for this difficulty is that typical tests of the spatial attention bias in anxiety failed to consider together: (1) the differential effects of positive and threatening stimuli on attention in anxiety, (2) the separate contributions of each hemisphere to the attention bias, and (3) whether the attention bias in anxiety is restricted to orienting or can be observed more strongly in the conflict or alerting networks of attention. We compared the effects of schematic angry, happy, and neutral face cues using a lateralized version of Posner’s Attention Network Task (Lateralized Attention Network Test) which distinguishes spatial Orienting Cost (due to an invalid cue; disengagement) from spatial Orienting Benefit (due to a valid cue; hypervigilance), and which considers executive Conflict resolution and Alerting in addition to spatial Orienting in each hemisphere separately. We tested participants with high and low trait anxiety measured by the STAI-TA (Spielberger, Gorsuch, & Lushene, 1983). Surprisingly, happy face cues rather than angry face cues interacted with target visual field and participant level of anxiety. Happy face cues presented to participants with low anxiety elicited maximal Orienting Benefit and minimal Orienting Cost for targets presented to the left visual field. Anxious individuals failed to benefit from happy cues in the left visual field. We suggest that lateralized positive cues can provide a more sensitive index of attention changes in anxiety than is provided by centrally-presented threatening cues.