How people make decisions about predictive genetic testing: An analogue study

Abstract

Persons scoring high on negative affectivity (NA) have more subjective health complaints. In this study, we tested the hypothesis that high NA persons are more likely to experience internal sensations as threatening signs of health problems. Low and high NA participants (N=44) were given four breathing trials: one room air trial followed by three trials containing 5.5% CO₂ which induced transient low intensity somatic sensations. Prior to each CO₂ trial, participants received either positive, negative or uncertain labelings of the sensations that might occur. Participants rated the (un)pleasantness of the experienced somatic sensations and the perceived intensity. Also respiratory responses were measured. During CO₂ trials, reliable main effects of information were found but no effects involving NA were observed, neither on pleasantness ratings nor on respiratory responses. However, during room air breathing, high NA participants reported more intense somatic sensations than low NA participants. Post-experimental data suggested that high NA participants had more negative meanings and worries about the consequences of the physical sensations. It is concluded that interpretational biases in high NA is situated at the level of attributional processes.     

Two Factors to be Considered in the Design of Experiments in Anxiety and Motor Behavior

The authors examined the influence that attentional focus on either a postural or a suprapostural task had on the performance of each task. Participants (N = 32) stood on an inflated rubber disk and held a pole horizontally. All participants performed under 4 attentional focus conditions: external (disk) or internal (feet) focus on the postural task, and external (pole) or internal (hands) focus on the suprapostural task. Compared with internal focuses, external focuses on either task resulted in similar and reduced postural sway. Response frequency on each task increased when participants focused on the respective task. Finally, an external focus on either task produced higher frequencies of responding on the suprapostural task. The authors conclude that suprapostural task goals have a stronger influence on postural control than vice versa, reflecting the propensity of the motor system to optimize control processes on the basis of the desired movement effect.     

Reciprocal influences of attentional focus on postural and suprapostural task performance

The authors examined the influence that attentional focus on either a postural or a suprapostural task had on the performance of each task. Participants (N = 32) stood on an inflated rubber disk and held a pole horizontally. All participants performed under 4 attentional focus conditions: external (disk) or internal (feet) focus on the postural task, and external (pole) or internal (hands) focus on the suprapostural task. Compared with internal focuses, external focuses on either task resulted in similar and reduced postural sway. Response frequency on each task increased when participants focused on the respective task. Finally, an external focus on either task produced higher frequencies of responding on the suprapostural task. The authors conclude that suprapostural task goals have a stronger influence on postural control than vice versa, reflecting the propensity of the motor system to optimize control processes on the basis of the desired movement effect.     

Accuracy of respiratory symptom perception in persons with high and low negative affectivity

Accuracy of respiratory symptom perception was investigated in different contexts in participants (N = 56) scoring high or low for negative affectivity (NA). Within subject-correlations were calculated between minute ventilation (frequency per minute × tidal volume) and the subjective symptom ‘faster and/or deeper breathing’ across 10 subsequent breathing trials of 2?min with varying air mixtures, containing fresh or foul smelling odours and/or 5.5% CO₂. Half the participants were given a positive information frame for the sensations (‘some air mixtures may induce a pleasantly arousing feeling, like when being in love’), whereas the other half was given a negative frame (‘some air mixtures may induce feelings of being anxious and distressed’). Interoceptive accuracy was overall fairly high (r = 0.56–0.74), but it dropped considerably (r = 0.27), when bodily sensations were induced in high NA persons in a negative information frame (interaction, p < 0.005). Interoceptive accuracy appears low when persons with high NA are in situations characterised by negative affective cues.     

Conflict adaptation in time: Foreperiods as contextual cues for attentional adjustment

Interference evoked by distractor stimulus information, such as flankers in the Eriksen task, is reduced when the proportion of conflicting stimuli is increased. This modulation is sensitive to contextual cues such as stimulus location or color, suggesting attentional adjustment to conflict contingencies on the basis of context information. In the present study, we explored whether conflict adjustment is modulated by temporal variation of conflict likelihood. To this end, we associated low and high proportions of conflict stimuli with foreperiods of different lengths. Flanker interference was higher with foreperiods associated with low conflict proportions, suggesting that participants use the foreperiod as a contextual cue for attentional adjustment. We conjecture that participants initially adopt the strategy useful for conflict contingencies associated with short foreperiods, and then readjust during the trial, in the absence of any additional exogenous cue, when the imperative stimulus has not occurred during a certain time interval.     

The effect of stimulus availability on task choice in voluntary task switching

The voluntary task switching paradigm allows subjects to choose which task to perform on each trial in a stimulus environment affording multiple tasks. The present study examined the effect of stimulus availability on task choice. Subjects viewed displays containing a digit and a letter and performed either an even/odd or a consonant/vowel judgment on each trial. The target stimuli appeared with a stimulus onset asynchrony (SOA) of 0, 50, 100, or 150 msec. The probability of performing the task associated with Stimulus 1 increased as SOA increased, indicating an effect of external or stimulus-driven factors on task choice. This effect of stimulus availability on task choice was greater when the response-stimulus interval was 400 msec than when it was 2,000 msec. This interaction of preparation interval and stimulus availability is explained within a model of task choice that includes both internal processes and external influences.     

Don’t let it distract you: how information about the availability of reward affects attentional selection

Previous research has shown that attentional selection is affected by reward contingencies: previously selected and rewarded stimuli continue to capture attention even if the reward contingencies are no longer in place. In the current study, we investigated whether attentional selection also is affected by stimuli that merely signal the magnitude of reward available on a given trial but, crucially, have never had instrumental value. In a series of experiments, we show that a stimulus signaling high reward availability captures attention even when that stimulus is and was never physically salient or part of the task set, and selecting it is harmful for obtaining reward. Our results suggest that irrelevant reward-signaling stimuli capture attention, because participants have learned about the relationship between the stimulus and reward. Importantly, we only observed learning after initial attentional prioritization of the reward signaling stimulus. We conclude that nonsalient, task-irrelevant but reward-signaling stimuli can affect attentional selection above and beyond top-down or bottom-up attentional control, however, only after such stimuli were initially prioritized for selection.     

Internal versus external attention in social anxiety: an investigation using a novel paradigm

Several cognitive models propose that social anxiety is associated with increased self-focused attention. Indirect evidence for this hypothesis has been provided by questionnaire studies, and by cognitive psychology paradigms that have demonstrated reduced processing of external information during feared social-evaluative situations. However, no studies have simultaneously measured on-line attention to internal and external events. A probe detection task that aimed to measure the balance of attention between internal and external stimuli was developed. High and low socially anxious individuals were instructed to detect two probes. The external probe was superimposed on pictures of faces (happy, neutral, angry) or household objects that were presented on a VDU. The 'internal' probe was a pulse to the finger which participants were led to believe represented significant changes in their physiology. Compared to low speech anxious individuals, high speech anxious individuals showed an internal attentional bias, that was specific to conditions of social-evaluative threat.     

Automatic influence of arousal information on evaluative processing: Valence–arousal interactions in an affective Simon task

Previous research showed that evaluation speed is faster for negative stimuli that are high in arousal and for positive stimuli that are low in arousal. The present study investigated whether arousal and valence analogously interact in automatic stimulus evaluations, i.e., if stimulus valence is irrelevant for the task. One sample of participants switched randomly between an evaluation task and an affective Simon task that assessed stimulus evaluations indirectly. Another sample completed a pure Simon task. In all conditions, the influence of affective stimuli on task performance was enhanced when valence and arousal were congruent (i.e., high-arousing negative and low-arousing positive stimuli) than when both stimulus dimensions were incongruent (i.e., low-arousing negative and high-arousing positive stimuli). These findings suggest that evaluative implications of stimulus arousal and valence are automatically inferred even when stimulus evaluation is irrelevant for the task at hand.     

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.     

Arrows don’t look at you: Qualitatively different attentional mechanisms triggered by gaze and arrows

Eye gaze conveys rich information concerning the states of mind of others, playing a critical role in social interactions, signaling internal states, and guiding others’ attention. On the basis of its social significance, some researchers have proposed that eye gaze may represent a unique attentional stimulus. However, contrary to this notion, the majority of the literature has shown indistinguishable attentional effects when eye gaze and arrows have been used as cues. Taking a different approach, in this study we aimed at finding qualitative attentional differences between gazes and arrows when they were used as targets instead of as cues. We used a spatial Stroop task, in which participants were required to identify the direction of eyes or arrows presented to the left or the right of a fixation point. The results showed that the two types of stimuli led to opposite spatial interference effects, with arrows producing faster reaction times when the stimulus direction was congruent with the stimulus position (a typical spatial Stroop effect), and eye gaze producing faster reaction times when it was incongruent (a “reversed” spatial Stroop effect). This reversed Stroop is interpreted as an eye-contact effect, therefore revealing the unique nature of eyes as special social-attention stimuli.     

Does ignoring lead to worse evaluations? A new explanation of the stimulus devaluation effect

Affective evaluation of stimuli just seen in visual search tasks has been shown to depend on task-relevant stimulus configuration (Raymond, Fenske, & Tavassoli, 2003): Whereas targets and novel stimuli were evaluated similarly, distractors were devaluated. These results were explained by an inhibition-based account of the influence of selective attention on emotion. In the present experiments, we demonstrated that stimulus devaluation might not be a consequence of attentional inhibition. By simply instructing participants to react to an accepted or rejected stimulus in the visual search task of Experiment 1, we found distractor devaluation in the first case and target devaluation in the second case. We conclude that devaluation of stimuli is mediated by the affective connotation implied by response labels and instructions. This was confirmed in Experiment 2: To-be-ignored stimuli were not devaluated when participants knew that those stimuli would become task-relevant during the experiment.     

Higher levels of depression are associated with reduced global bias in visual processing

Sleep-related attentional bias is a well-documented finding in patients with primary insomnia. To address the question of whether attentional preference for sleep-related stimuli is due to sleepiness (as measured by the Stanford Sleepiness Scale; SSS) or sleeplessness (as measured by the Pittsburgh Sleep Quality Index; PSQI) we investigated 105 non-clinical participants with two attentional bias tasks, an emotional Stroop task and a newly introduced mixed-modality task. The emotional Stroop task revealed significant positive linear relationships between sleep-related attentional bias and both poor sleep quality and sleepiness. Additionally, we found a significant negative interaction effect between these two variables on the cognitive bias. This means that attentional bias scores are reduced when poor sleep quality is associated with high sleepiness and high sleep quality is associated with low sleepiness. We did not find any significant result in the mixed-modality task. The results suggest that sleep-related attentional bias can be elicited by both sleepiness and sleeplessness.     

Is pain-related fear a predictor of somatosensory hypervigilance in chronic low back pain patients?

Pain-related fear has been found to be associated with increased disability and increased pain perception in patients with chronic low back pain. A possible mechanism by which pain-related fear could lead to increased pain perception is heightened attention to somatosensory sensations. In the present study, chronic pain patients reporting either a high or low level of pain related fear and control participants performed an auditory reaction time task, while occasionally non-painful electrical stimuli--accompanied by threatening instructions--were given to the arm or back. In the primary task condition, participants had to perform the auditory task while ignoring the electrical stimuli. Next, the task was presented under dual task conditions in which participants had to respond both to tones as well as to detection of electrical stimuli. It was hypothesized that for the primary task, high fearful patients would show greater disruption of performance on the auditory task than low fearful patients and controls when stimuli were presented to the back. For the dual task, slower reaction times for the auditory task, in combination with faster detection of electrical stimuli was expected. The hypotheses were not confirmed but patients scoring high on pain-related fear did show an overall increase in reaction time for all conditions of the primary task, with or without simultaneous stimulation. Regression analyses demonstrated that high pain-related fear was associated with increased reaction time to tones both in patients and healthy controls, and that within patients pain-related fear was a better predictor of reaction time to tones than present pain intensity. The findings may be interpreted as showing that patients with elevated levels of pain-related fear habitually attend to somatic sensations, giving less priority to other attention-demanding tasks.     

Factors impacting emergence of behavioral control by underselected stimuli in humans after reduction of control by overselected stimuli

Stimulus overselectivity occurs when only one of potentially many aspects of the environment controls behavior. Adult participants were trained and tested on a trial-and-error discrimination learning task while engaging in a concurrent load task, and overselectivity emerged. When responding to the overselected stimulus was reduced by reinforcing a novel stimulus in the presence of the previously overselected stimulus in a second trial-and-error discrimination task, behavioral control by the underselected stimulus became stronger. However, this result was only found under certain circumstances: when there was substantial overselectivity in the first training phase; when control by the underselected stimulus in the first phase was particularly low; and when there was effective reduction in the behavioral control exerted by the previously overselected stimuli. The emergence of behavioral control by the underselected stimulus suggests that overselectivity is not simply due to an attention deficit, because for the emergence to occur, the stimuli must have been attended to and learned about in the training phase; but that a range of additional learning factors may play a role.     

ERP correlates of attentional processing in spider fear: evidence of threat-specific hypervigilance

Attentional bias towards threat can be demonstrated by enhanced processing of threat-related targets and/or greater interference when threat-related distractors are present. These effects are argued to reflect processing within the orienting and executive control networks of the brain respectively. This study investigated behavioural (RT) and electrophysiological correlates of early selective attention and top-down attentional control among females with high (n?=?16) or low (n?=?16) spider fear (Mean age?=?22 years). Participants completed a novel flanker go/nogo task in which a central schematic flower or spider stimulus was flanked by either congruent or incongruent distractors. Participants responded to green stimuli (go trials) and withheld response to yellow stimuli (nogo trials). High fear participants demonstrated significantly shorter reaction times and greater P1 amplitude to spider targets, suggesting specific hypervigilance towards threat-relevant stimuli. In contrast to predictions, there was little evidence for behavioural interference effects or differences in N2 amplitude when distractor stimuli were threat-relevant.     

Altering attentional control settings causes persistent biases of visual attention

Attentional control settings have an important role in guiding visual behaviour. Previous work within cognitive psychology has found that the deployment of general attentional control settings can be modulated by training. However, research has not yet established whether long-term modifications of one particular type of attentional control setting can be induced. To address this, we investigated persistent alterations to feature search mode, also known as an attentional bias, towards an arbitrary stimulus in healthy participants. Subjects were biased towards the colour green by an information sheet. Attentional bias was assessed using a change detection task. After an interval of either 1 or 2 weeks, participants were then retested on the same change detection task, tested on a different change detection task where colour was irrelevant, or were biased towards an alternative colour. One experiment included trials in which the distractor stimuli (but never the target stimuli) were green. The key finding was that green stimuli in the second task attracted attention, despite this impairing task performance. Furthermore, inducing a second attentional bias did not override the initial bias toward green objects. The attentional bias also persisted for at least two weeks. It is argued that this persistent attentional bias is mediated by a chronic change to participants’ attentional control settings, which is aided by long-term representations involving contextual cueing. We speculate that similar changes to attentional control settings and continuous cueing may relate to attentional biases observed in psychopathologies. Targeting these biases may be a productive approach to treatment.     

Cuing interacts with perceptual load in visual search

We tested the strong form of the perceptual-load hypothesis, which posits that the amount of perceptual load is the only factor determining whether attention can be effectively focused. Participants performed a visual search task under conditions of low and high load and with either a 100% valid spatial cue or no spatial cue. With no cue, participants showed evidence of processing to-be-ignored stimuli when perceptual load was low but not when it was high, consistent with the perceptual-load hypothesis. However, with a 100% valid spatial cue, participants showed little evidence of processing to-be-ignored stimuli, even when perceptual load was low. These results suggest that although perceptual load may be an important factor in attentional selectivity, load alone is not sufficient to explain how and when selective attention is effective.     

Contingency awareness in a symptom learning paradigm: necessary but not sufficient?

In previous studies, we found that bodily symptoms can be learned in a differential conditioning paradigm, using odors as conditioned stimuli (CSs) and CO2-enriched air as unconditioned stimulus (US). However, this only occurred when the odor CS had a negative valence (a selective conditioning effect), and tended to be more pronounced in persons scoring high for Negative Affectivity (NA). This paper considers the necessity and/or sufficiency of awareness of the CS-US contingency in three studies using this paradigm. The relation between contingency awareness and the selective conditioning effect, and between contingency awareness and NA was also considered. Both self reported symptoms and respiratory physiology served as dependent variables. A learning effect on symptoms was found only for participants aware of the CS-US contingency, but not all participants reporting contingency awareness showed a learning effect. No conditioning effects appeared on the physiological measures. Also contingency awareness did not account for the selective conditioning effect, and did not interact with NA. Overall, the necessity but insufficiency hypotheses can only be withhold for group data and not for individual data.     

Negative Affectivity, Effortful Control, and Attention to Threat-Relevant Stimuli

There is increasing recognition of temperamental influences on risk for psychopathology. Whereas the link between the broad temperament construct of negative affectivity (NA) and problems associated with anxiety and depression is now well-established, the mechanisms through which this link operate are not well understood. One possibility involves interactions between reactive and effortful components of temperament, as well as cognitive factors, like attentional biases to threat stimuli. This study tested a predicted relation between high levels of NA, low levels of effortful control (EC), and an attentional bias toward threat in children. A sample of 104 4th through 12th graders, selected from a larger screening sample because they reported high or low levels of trait NA and EC, completed a dot probe detection task. Results indicated that EC moderated the relation between NA and attentional bias; only children with low levels of EC and high levels of NA showed an attentional bias to threat stimuli. This pattern was not moderated by grade level or age.