Interpretation bias and social anxiety: does interpretation bias mediate the relationship between trait social anxiety and state anxiety responses?

Two studies aimed to examine whether high socially anxious individuals are more likely to negatively interpret ambiguous social scenarios and facial expressions compared to low socially anxious individuals. We also examined whether interpretation bias serves as a mediator of the relationship between trait social anxiety and state anxiety responses, in particular current state anxiety, bodily sensations, and perceived probability and cost of negative evaluation pertaining to a speech task. Study 1 used ambiguous social scenarios and Study 2 used ambiguous facial expressions as stimuli to objectively assess interpretation bias. Undergraduate students with high and low social anxiety completed measures of state anxiety responses at three time points: baseline, after the interpretation bias task, and after the preparation for an impromptu speech. Results showed that high socially anxious individuals were more likely to endorse threat interpretations for ambiguous social scenarios and to interpret ambiguous faces as negative than low socially anxious individuals. Furthermore, negative interpretations mediated the relationship between trait social anxiety and perceived probability of negative evaluation pertaining to the speech task in Study 1 but not Study 2. The present studies provide new insight into the role of interpretation bias in social anxiety.     

Attentional bias to threat: Roles of trait anxiety, stressful events, and awareness

Attentional biases for threat stimuli were assessed in high and low trait anxious subjects (n = 66) using a probe detection task. To examine the effects of trait anxiety and situational stressors, each subject was tested three times: Under no stress, laboratory-induced stress, and examination-induced stress. To evaluate the role of awareness, half the word stimuli were presented very briefly (14 msec) and masked, and the other half were presented for 500 msec without a mask. Results showed that high trait anxious subjects under exam stress showed an attentional bias towards unmasked threat stimuli compared with low trait subjects. This effect was not found under lab-induced stress, suggesting that the attentional bias for unmasked threat in high trait subjects may be a function of a prolonged stressor, rather than a transient increase in state anxiety. The results from the masked exposure condition were not predicted; high trait anxious subjects shifted attention towards the spatial location of threat words despite lack of awareness of their lexical content, but this bias was only apparent in the no-stress condition. The results are discussed in relation to recent cognitive theories of 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.     

Vigilance for threat: effects of anxiety and defensiveness

Eysenck’s (1997) theory that attentional biases for threat vary as an interactive function of trait anxiety and defensiveness was tested using a visual probe task. Two stimulus exposure conditions were used to explore a secondary issue concerning attentional allocation over time. Results indicated that, among high trait anxious participants, only those with low levels of defensiveness showed vigilance for threatening faces presented for 500 ms. They also showed an attentional preference for neutral faces, relative to happy faces, irrespective of exposure condition. This pattern was reversed in high trait anxious participants with high levels of defensiveness, who showed an attentional bias towards happy faces (relative to neutral faces) under both exposure conditions. The findings are discussed in relation to their implications for (a) the significance of measures of defensiveness for the conceptualization of high trait anxious individuals, and (b) the status of anxiety-related biases at different stages of information processing.     

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.     

Selective attention for masked and unmasked emotionally toned stimuli: Effects of trait anxiety,state anxiety,and test order

We investigated selective attention for masked and unmasked, threat, and positively valenced words, in high trait anxious (HTA) and low trait anxious (LTA) individuals using the emotional Stroop colour‐naming task. State anxiety was varied within participants through the threat of electric shock. To investigate whether the sequencing of the state anxiety manipulation affected colour‐naming latencies, the ordering of the shock threat and shock safe conditions was counterbalanced across participants. The results indicated that the ordering of the state anxiety manipulation moderated masked and unmasked threat bias effects. Specifically, relative to LTA individuals, HTA individuals showed a threat interference effect, but this effect was limited to those who performed under the threat of shock in the later stages of the experiment. Irrespective of exposure mode and state anxiety status, all individuals showed interference for threat in the early stages of the experiment, relative to a threat facilitation effect in the later stages of the experiment. For the unmasked trials alone, the data also revealed a significant threat interference effect for the HTA group relative to the LTA group in the shock threat condition, and this effect was evident irrespective of shock threat order. The results are discussed with respect to the automatic nature of emotional processing in anxiety.     

The time-course of visual threat processing: High trait anxious individuals eventually avert their gaze from angry faces

Several experiments have shown that anxious individuals have an attentional bias towards threat cues. It is also known, however, that exposure to a subjectively threatening but relatively harmless stimulus tends to lead to a reduction in fear. Accordingly, some authors have hypothesised that high trait anxious individuals have a vigilant-avoidant pattern of visual attention to threatening stimuli. In the present study, 52 high trait anxious and 48 low trait anxious subjects were shown pairs of emotional faces, while their direction of gaze was continuously monitored. For 0-1000 ms, both groups were found to view angry faces more than happy faces. For 2000-3000 ms, however, only high trait anxious subjects averted their gaze from angry faces more than they did from happy faces.     

Social Anxiety and Attention away from Emotional Faces

A substantial literature indicates that anxiety is often associated with selective attention to threat cues. Socially anxious individuals are excessively concerned about negative evaluation by others. One might therefore predict that high social anxiety would be associated with selective attention to negative facial expressions. On the other hand, some recent models have suggested that social anxiety may be associated with reduced processing of external social cues. A modified dot-probe task was used to investigate face attention. High and low socially anxious individuals were presented with pairs of pictures, consisting of a face (positive, neutral, or negative) and a household object, under conditions of social-evaluative threat or no threat. The results indicated that, compared to low socially anxious individuals, high socially anxious individuals show an attentional bias away from emotional (positive and negative) faces but this effect is only observed under conditions of social-evaluative threat. Theoretical and clinical implications of the 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.     

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.     

Emotional context influences access of visual stimuli to anxious individuals' awareness

Anxiety has been associated with enhanced unconscious processing of threat and attentional biases towards threat. Here, we focused on the phenomenology of perception in anxiety and examined whether threat-related material more readily enters anxious than non-anxious individuals' awareness. In six experiments, we compared the stimulus exposures required for each anxiety group to become objectively or subjectively aware of masked facial stimuli varying in emotional expression. Crucially, target emotion was task irrelevant. We found that high trait-anxiety individuals required less sensory evidence (shorter stimulus exposure times) to become aware of the face targets. This anxiety-based difference was observed for fearful faces in all experiments, but with non-threat faces, it emerged only when these were presented among threatening faces. Our findings suggest a prominent role for affective context in high-anxiety individuals' conscious perception of visual stimuli. Possible mechanisms underlying the influence of context in lowering awareness thresholds in anxious individuals are discussed.     

Attentional biases for angry faces: Relationships to trait anger and anxiety

In two experiments selective attention to angry faces was investigated in relation to trait anger and anxiety. A pictorial emotional Stroop task comparing colour-naming latencies for neutral and angry faces was employed. In Experiment 1 using an unmasked task, individuals scoring high on trait anger showed an attentional bias for angry faces. In Experiment 2, unmasked and masked versions of the task were used. Individuals were selected on low and high trait anxiety, but there was no indication of a relation between attentional bias scores and anxiety. When individuals were subsequently reallocated to groups on the basis of trait anger scores, the high anger group showed an attentional bias for angry faces in the unmasked and the masked task. Results are discussed in relation to recent neurobiological findings from our laboratory, as reflecting an evolutionary-evolved, content-specific response to the facial expression of anger.     

Impact of fearful expression on danger processing: The influence of the level of trait anxiety

Threat estimation is crucial for the adaptation of behavior to a dangerous situation. In anxiety, a bias to threat has been described as a core feature. Therefore, the sensitivity for threatening information in anxious individuals may have consequences for danger estimation. In this study, we used the affective priming paradigm to test the assumption that fearful expressions would facilitate danger detection in natural scenes in anxious individuals. Twenty-three high trait anxious individuals and 22 low trait anxious individuals participated in the study. They had to detect the potential threat of a target scene (neutral or threatening) following neutral or fearful face primes. High trait anxious participants detected threat more rapidly than low trait anxious participants, consistent with previous reports of emotional hypervigilance in anxiety. Furthermore, this effect was enhanced when the target scene followed a fearful expression: Only in anxious participants were reaction times shorter to detect danger following a fearful prime than a neutral prime. Our results tend to show that in anxiety, the hypervigilance to threat may be of an important value such as increasing the detection of a subsequent potential danger. Implication of attentional processes and attentional control is discussed.     

Selective attention for masked and unmasked threatening words in anxiety: Effects of trait anxiety, state anxiety and awareness

We investigated the effects of awareness on selective attention for masked and unmasked verbal threat material using a computerised version of the emotional Stroop. Participants were assigned to the high trait anxious (HTA) and low trait anxious (LTA) groups on the basis of questionnaire scores, and state anxiety was manipulated within participants through the threat of electric shock. To investigate the effects of awareness on responses to threat, the mode of exposure was blocked such that half the participants received masked trials before the unmasked trials, whereas the other half received the reverse order. The results revealed that there was no difference between the HTA and LTA groups in responses to threat for those who received the masked trials before the unmasked trials. However, when unmasked trials were presented before the masked trials HTA individuals were significantly slower to respond to both masked and unmasked threat words compared to the LTA group, and these effects were not further modified by participants' state anxiety status. The results are discussed in terms of the automatic nature of threat processing in anxiety.     

Intergenerational transmission of attentional bias and anxiety

Earlier evidence has revealed a bi‐directional causal relationship between anxiety and attention biases in adults and children. This study investigated the prospective and concurrent relations between anxiety and attentional bias in a sample of 89 families (mothers, fathers, and first‐born children). Parents’ and children's attentional bias was measured when children were 7.5 years old, using both a visual probe task and visual search task with angry versus happy facial expressions. Generalized and social anxiety symptoms in parents and children were measured when children were 4.5 and 7.5 years old. Anxiety in parents and children was prospectively (but not concurrently) related to their respective attentional biases to threat: All participants showed a larger attentional bias to threat in the visual search (but not in the visual probe) task if they were more anxious at the 4.5 (but not at the 7.5) year measurement. Moreover, parents’ anxiety levels were prospectively predictive of the visual search attentional bias of their children after controlling for child anxiety. More anxiety in mothers at 4.5 years was related to a faster detection of angry among happy faces, while more anxiety in fathers predicted a faster detection of happy among angry faces in children at 7.5 years. We found no direct association between parental and child attentional biases. Our study contributes to the recently emerging literature on attentional biases as a potential mechanism in the intergenerational transmission of anxiety by showing that parents’ anxiety rather than parents’ attentional bias contributes to the intergenerational transmission of risk for child anxiety.     

Memory and attention for social threat: anxious hypercoding-avoidance and submissive gaze aversion

Rivalry for dominance is a recurrent challenge in human social interaction. During these social dominance interactions, some people rapidly break eye contact, whereas others merely try to avoid such eye-to-eye confrontations. The first is an example of submissive gaze aversion, whereas the second reflects anxious gaze avoidance. We tested these distinct forms of gaze behavior within a social-memory setting and show that anxious individuals vigilantly attend to, superiorly remember, and subsequently avoid social threats (i.e., angry faces). Furthermore, submissive individuals, as indexed by high trait anxiety and low trait anger, exhibit rapid gaze aversion from facial anger. Mechanisms of hypervigilance-avoidance thus seem to underlie natural gaze behavior and enhanced memory for threat in anxiety. Accordingly, we propose the term hypercoding-avoidance, which describes how anxious individuals habitually scan their immediate social environment for threat, remember its location, and subsequently avoid it. Moreover, this is the first experimental evidence showing that submissive gaze aversion is distinct from anxious gaze avoidance.     

Social anxiety and cognitive expectancy of aversive outcome in avoidance conditioning

Fear conditioning studies have shown that social anxiety is associated with enhanced expectancy of aversive outcome. However, the relation between cognitive expectancy and social anxiety has never been tested in avoidance conditioning paradigms. We compared 48 low (LSA) and high socially anxious individuals (HSA) on subjective expectancy of aversive outcome during an avoidance conditioning task. Displays of neutral faces were coupled with an aversive outcome (US): a shout and a shock. Participants could avoid the US by pressing a correct button from a button box. First, HSA showed higher US expectancy than LSA during the initial phase of avoidance conditioning, supporting the view that socially anxious individuals have an expectancy bias when social situations are ambiguous. Second, when the avoidance response became unavailable, LSA showed lower US expectancy than HSA, suggesting that low socially anxious individuals are prone to a positive bias when perceived threat is high. A lack of such positive bias in socially anxious individuals may lead to higher susceptibility to safety behavior interpretations. Together, these findings support the role of cognitive processes in avoidance conditioning and underscore the relevance to encounter avoidance learning when studying social anxiety.     

Terror mismanagement: evidence that mortality salience exacerbates attentional bias in social anxiety

Death anxiety is a basic fear underlying a range of psychological conditions, and has been found to increase avoidance in social anxiety. Given that attentional bias is a core feature of social anxiety, the aim of the present study was to examine the impact of mortality salience (MS) on attentional bias in social anxiety. Participants were 36 socially anxious and 37 non-socially anxious individuals, randomly allocated to a MS or control condition. An eye-tracking procedure assessed initial bias towards, and late-stage avoidance of, socially threatening facial expressions. As predicted, socially anxious participants in the MS condition demonstrated significantly more initial bias to social threat than non-socially anxious participants in the MS condition and socially anxious participants in the control condition. However, this effect was not found for late-stage avoidance of social threat. These findings suggest that reminders of death may heighten initial vigilance towards social threat.     

Intolerance for approach of ambiguity in social anxiety disorder

Previous research has utilised the approach–avoidance task (AAT) to measure approach and avoidance action tendencies in socially anxious individuals. “Neutral” social stimuli may be perceived as ambiguous and hence threatening to socially anxious individuals, however it is unclear whether this results in difficulty approaching ambiguous (“neutral”) versus unambiguous threat (e.g. disgust) faces (i.e. intolerance of ambiguity). Thirty participants with social anxiety disorder (SADs) and 29 non-anxious controls completed an implicit AAT in which they were instructed to approach or avoid neutral and disgust faces (i.e. pull or push a joystick) based on colour of the picture border. Results indicated that SADs demonstrated greater difficulty approaching neutral relative to disgust faces. Moreover, intolerance for approach of ambiguity predicted social anxiety severity while controlling for the effects of trait anxiety and depression. Our results provide further support for the role of intolerance of ambiguity in SAD.