创伤后应激障碍个体对威胁刺激的注意偏向：眼动研究的证据

对威胁刺激的注意偏向是创伤后应激障碍(PTSD)个体的一种表现。近年来, 研究者利用眼动技术探讨了注意偏向的加工特点及其内在机制。尽管针对是否存在注意定向加速、注意解除困难或注意回避的研究结果并不一致, 但都试图为验证如警戒-回避模型、注意保持模型等提供眼动证据。未来研究在记录PTSD个体注视模式时, 不仅需要从多个维度构建、整合PTSD个体的眼动模型, 也要结合多种技术从多模态角度共同考察PTSD个体的威胁信息注意偏向机制。     

Saccadic eye movement programming: sensory and attentional factors

The relationship between attention and eye movements is explored by consideration of the variety of ways attention may affect saccade programming. Four forms of attention are distinguished: one exogenous and three endogenous through either locations or objects or features. Each of these can control or influence the saccadic generation process. Visual onsets generate a rapid transient signal with low resolution that travels from the visual system to the oculomotor system. Generation of an eye movement is associated with an attentional signal, probably also with low resolution, travelling from the oculomotor system to the visual system. A high-resolution attentional signal, which appears to require voluntary effort, can also select saccadic targets.     

The effects of self-focus on attentional biases in social anxiety:An ERP study

Cognitive theories of social anxiety disorder suggest that biased attention plays a key role in maintaining symptoms. These biases include self-focus and attention to socially threatening stimuli in the environment. The goal of this study was to utilize ERPs that are elicited by a change detection task to examine biases in selective attention (i.e., N2pc) and working memory maintenance (i.e., contralateral delay activity; CDA). Additionally, the effect of self-focus was examined using false heart rate feedback. In support of the manipulation, self-focus cues resulted in greater self-reported self-consciousness and task interference, enhanced anterior P2 amplitude and reduced SPN amplitude. Moreover, P2 amplitude for self-focus cues was correlated with reduced task performance for socially anxious subjects only. The difference in P2 amplitude between self-focus and standard cues was correlated with social anxiety independent of depression. As hypothesized, socially anxious participants (n = 20) showed early selection and maintenance of disgust faces relative to neutral faces as indicated by the N2pc and CDA components. Nonanxious controls (n = 22) did not show these biases. During self-focus cues, controls showed marginal evidence of biased selection for disgust faces, whereas socially anxious subjects showed no bias in this condition. Controls showed an ipsilateral delay activity after being cued to attend to one hemifield. Overall, this study supports early and persistent attentional bias for social threat in socially anxious individuals. Furthermore, self-focus may disrupt these biases. These findings and supplementary data are discussed in light of cognitive models of social anxiety disorder, recent empirical findings, and treatment.     

Continual training of attentional bias in social anxiety

Using the dot-probe paradigm, it has been shown that high social anxiety is associated with an attentional bias toward negative information. In the present study, individuals with high social anxiety were divided into two groups randomly. One group was the attentional bias training group (Group T), and the other was the control group (Group C). For Group T, 7 days' continuous training of attentional bias was conducted using the dot-probe paradigm to make socially anxious individuals focus more on positive face pictures. The results showed that the training was effective in changing attentional bias in Group T. Scores of the Social Interaction Anxiety Scale (SIAS) in Group T were reduced compared to Group C, while the scores of Social Phobia Scale (SPS) and scores of Negative Evaluation Scale (FNE) showed no difference between the two groups, which suggested a limited reduction of social anxiety.     

Citalopram for social anxiety disorder: an open-label pilot study in refractory and nonrefractory patients

There is limited systematic data assessing alternate pharmacotherapy of social anxiety disorder in patients failing to tolerate or fully respond to initial treatment; no data specifically address the efficacy of citalopram in this scenario. We present a prospective open-label trial of citalopram in 10 patients with generalized social anxiety disorder, 6 of 10 of whom had not responded to or not tolerated a prior treatment intervention for the disorder. Citalopram, at a mean dose of 55 mg (SD+/-12.7 mg) was well tolerated, and patients improved significantly on all outcome measures. Results of this study suggest that citalopram may be a safe and effective treatment for generalized social anxiety disorder, including patients who have failed to tolerate or respond to a prior treatment trial.     

Negative post-event processing and decreased self-appraisals of performance following social stress in childhood social anxiety: an experimental study

Cognitive models of social phobia (SP) assume that following social evaluative stress, individuals with SP engage into dysfunctional post-event processing (PEP), a detailed negative review of the past event. While previous research has already shown, that children with high levels of social fears suffer from more frequent negative PEP, it remains unclear how stable PEP is across time in this age group and whether it leads to degraded self-appraisals of performance. Therefore in the present study we exposed a group of high (HSA) and low socially anxious children (LSA; both n = 20), aged 10–12 years, to a social evaluative situation and assessed negative and positive PEP as well as self-rated performance at 2.5 h and one week after the task. Our results revealed that HSA children reported more negative PEP than LSA children, independent of levels of depression. Moreover, negative PEP was related to measures of social anxiety and performance ratings within the tasks. Only the performance ratings in HSA children worsened over the course of the following week and were related to more negative PEP. Thus, these results speak for the high clinical relevance dysfunctional PEP may have for the maintenance of social fears already in childhood.     

Theories and measurement of visual attentional processing in anxiety

Most theoretical models of anxiety disorders implicate maladaptive visuo-spatial attentional processing of threat-relevant information in the onset and maintenance of symptoms. We discuss the central mechanistic hypotheses in clinical science regarding problematic attentional processing of threat in anxiety, reconcile what appear to be contradictory predictions, and integrate those hypotheses to describe comprehensively the overt and covert mechanisms of attentional processing within discrete perceptual episodes. In so doing, we examine critically the prevailing theoretical assumptions and measurement models underlying the current investigations of attention and anxiety, and we advocate for increased precision in the translation of models from vision science to the examination of the mechanisms of attentional processing in anxiety. Finally, we discuss the implications of this approach for future translational research that examines the role of attention in anxiety and its treatment.     

The effect of attentional focus on social anxiety

The aim of the present study was to examine the effect of attentional focus on social anxiety in a group of high and low blushing-anxious subjects. One hundred and fourteen psychology undergraduate students were screened using the Fear of Blushing subscale of the Blushing Questionnaire [B?gels, S. M., & Reith, W. (1999). Validity of two questionnaires to assess social fears: The Dutch social phobia and anxiety questionnaire and the blushing, trembling and sweating questionnaire. Journal of Psychopathology and Behavioral Assessment, 21, 51-66]. Those with the most extreme scores in the top and bottom 20% of the distribution were selected to form a high (n=22) and a low (n=22) blushing-anxious group. Subjects were randomly allocated to either a self-focused attention (SFA) condition or a task-focused attention (TFA) condition. They were asked to engage in a 5 min conversation with the first author, and were instructed to either self-focus (SFA condition) or task-focus (TFA condition). Levels of social anxiety and self-awareness were measured using visual analogue scales. Results suggest that the there was a significant condition by group interaction, with high blushing individuals showing considerably higher levels of social anxiety in the SFA condition compared to the TFA condition while low blushing individuals showed no significant difference across the two conditions.     

Post-event processing in social anxiety

A psychometric study was conducted in order to collect basic information about post-event processing in social anxiety. It was found that such processing occurs commonly after an anxiety-evoking or embarrassing social event and post-event processing scores were significantly correlated (r = 0.40) with social anxiety. The recollections of the social event tended to be recurrent and intrusive, interfering with concentration. Post-event processing was associated with the avoidance of similar social situations. The results are discussed in terms of the Clark and Wells model of social phobia.     

Post-event processing in social anxiety

Clark and Wells’ [1995. A cognitive model of social phobia. In: R. Heimberg, M. Liebowitz, D.A. Hope, & F.R. Schneier (Eds.) Social phobia: Diagnosis, assessment and treatment (pp. 69-93). New York: Guildford Press.] cognitive model of social phobia proposes that following a social event, individuals with social phobia will engage in post-event processing, during which they conduct a detailed review of the event. This study investigated the relationship between self-appraisals of performance and post-event processing in individuals high and low in social anxiety. Participants appraised their performance immediately after a conversation with an unknown individual and prior to an anticipated second conversation task 1 week later. The frequency and valence of post-event processing during the week following the conversation was also assessed. The study also explored differences in the metacognitive processes of high and low socially anxious participants. The high socially anxious group experienced more anxiety, predicted worse performance, underestimated their actual performance, and engaged in more post-event processing than low socially anxious participants. The degree of negative post-event processing was linked to the extent of social anxiety and negative appraisals of performance, both immediately after the conversation task and 1 week later. Differences were also observed in some metacognitive processes. The results are discussed in relation to current theory and previous research.     

Predicting post-event processing in social anxiety disorder following two prototypical social situations: State variables and dispositional determinants

This study investigated self-reported state (anxiety, physical symptoms, cognitions, internally focused attention, safety behaviors, social performance) and trait (social anxiety, depressive symptoms, dysfunctional self-consciousness) predictors of post-event processing (PEP) subsequent to two social situations (interaction, speech) in participants with a primary diagnosis of social anxiety disorder (SAD) and healthy controls (HC). The speech triggered significantly more intense PEP, especially in SAD. Regardless of the type of social situation, PEP was best predicted by situational anxiety and dysfunctional cognitions among the state variables. If only trait variables were considered, PEP following both situations was accounted for by trait social anxiety. In addition, dysfunctional self-consciousness contributed to PEP-speech. If state and trait variables were jointly considered, for both situations, situational anxiety and dysfunctional cognitions were confirmed as the most powerful PEP predictors above and beyond trait social anxiety (interaction) and dysfunctional self-consciousness (speech). Hence, PEP as assessed on the day after a social situation seems to be mainly determined by state variables. Trait social anxiety and dysfunctional self-consciousness also significantly contribute to PEP depending on the type of social situation. The present findings support dysfunctional cognitions as a core cognitive mechanism for the maintenance of SAD. Implications for treatment are discussed.     

Biased processing of emotional information in sub-clinical anxiety: Evidence from Simon effects

We tested the idea that in high trait-anxiety, behavioural responses are influenced by spatial correspondence to emotional information. It is suggested that if an emotional stimulus is preferentially processed, it may act as if presented alone and yield a Simon effect: faster responses when stimulus and response spatially correspond than when not. High-trait-anxious undergraduates indeed showed a content-specific Simon effect for social-threat (not physical-threat) words that were presented together with a neutral word for 14 ms; they showed the reverse response pattern for positive words. Low-anxious undergraduates had no bias. When presentation time was lengthened to 500 ms, the response pattern for social-threat and positive words shown by high-anxious undergraduates reversed as compared to the pattern with 14 ms, but there were no significant group differences. These results can be taken to suggest that in high trait-anxiety, the processing of social-threat is specifically prioritized; social-threat and positive information may elicit an immediate response, counteracted by mood-regulation strategies. We argue that the present approach opens up interesting avenues for investigating biased information processing and response tendencies.     

Working memory load moderates late attentional bias in social anxiety

The vigilance–avoidance hypothesis suggests that socially anxious individuals attempt to detect signs that they are being evaluated (vigilance) and subsequently direct attention away from such stimuli (avoidance). Although extensive evidence supports vigilance, data concerning subsequent avoidance is equivocal. Drawing from models of attention, the current study hypothesised that working memory load moderates late attentional bias in social anxiety such that avoidance occurs if working memory load is low, and difficulty disengaging attention occurs if working memory load is high. Forty-one undergraduates (19 socially anxious; 22 non-anxious controls) completed a dot-probe task with emotional (happy and disgust) and neutral facial expressions and a concurrent n-back task. Results supported the hypothesis such that socially anxious subjects demonstrated avoidance of disgust faces when working memory load was absent, but had difficulty disengaging attention during high working memory load. Theoretical implications and directions for future research are discussed.     

Eye movement assessment of emotional processing in anxiety

Eye fixations of participants high or low in trait anxiety were monitored during reading of context sentences predicting threatening or nonthreat events, followed by sentences in which a target word represented the predictable event or an inconsistent event. No effects were found on the target word but on the regions following it. When this word represented a threatening event suggested by the context, high anxiety facilitated reading of the posttarget region. When the target word was inconsistent with a threatening event, high anxiety was associated with interference in the final region. No such effects occurred with nonthreat sentences. This reveals selective prediction of threat in high anxiety. However, rather than being automatic, this bias involves elaboration that takes time to develop.     

Linguistic correlates of social anxiety disorder

The goal of this study was to examine the linguistic correlates of social anxiety disorder (SAD). Twenty-four individuals with SAD (8 of them with a generalised subtype) and 21 non-anxious controls were asked to give speeches in front of an audience. The transcribed speeches were examined for the frequency of negations, I-statements, we-statements, negative emotion words, and positive emotion words. During their speech, individuals with either SAD subtype used positive emotion words more often than controls. No significant differences were observed in the other linguistic categories. These results are discussed in the context of evolutionary and cognitive perspectives of SAD.     

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.     

Probing the attentional control theory in social anxiety: An emotional saccade task

Volitional attentional control has been found to rely on prefrontal neuronal circuits. According to the attentional control theory of anxiety, impairment in the volitional control of attention is a prominent feature in anxiety disorders. The present study investigated this assumption in socially anxious individuals using an emotional saccade task with facial expressions (happy, angry, fearful, sad, neutral). The gaze behavior of participants was recorded during the emotional saccade task, in which participants performed either pro- or antisaccades in response to peripherally presented facial expressions. The results show that socially anxious persons have difficulties in inhibiting themselves to reflexively attend to facial expressions: They made more erratic prosaccades to all facial expressions when an antisaccade was required. Thus, these findings indicate impaired attentional control in social anxiety. Overall, the present study shows a deficit of socially anxious individuals in attentional control—for example, in inhibiting the reflexive orienting to neutral as well as to emotional facial expressions. This result may be due to a dysfunction in the prefrontal areas being involved in attentional control.     

Biases in visual orienting to negative and positive scenes in dysphoria: An eye movement study

The study investigated biases for negative information in component processes of visual attention (initial shift vs. maintenance of gaze) in dysphoric and nondysphoric individuals. Eye movements were recorded while participants viewed a series of picture pairs depicting negative, positive, and neutral scenes (each pair presented for 3 s). Biases in initial orienting were assessed from the direction and latency of the initial shift in gaze, whereas biases in the maintenance of attention were assessed from the duration of gaze on the picture that was initially fixated. Results indicated that the dysphoric group showed a significantly greater bias to maintain gaze longer on negative pictures, relative to control pictures, compared with the nondysphoric group. There was no evidence of a dysphoria-related bias in initial shift of orienting to negative cues. Results are consistent with a depression-related bias that operates in the maintenance of attention on negative material.     

Self and identity in social anxiety disorder

Models of social anxiety (SA) place the self as an organizing and causal center involved in the maintenance of this condition. An integrative conceptual framework for the understanding of the self is used to review the literature on the self in SA. Two main distinctions are emphasized: the self-as-a-subject (I-self) versus self-as-an-object (Me-self), and the evolutionary-based distinction of social rank versus affiliation. We argue that (a) although much progress has been made in understanding the association between SA and Me-self, the association between SA and I-self remains largely unexplored (with the important exception of anxiety-related processes in social situations); and (b) experiences and representations of the self in SA center on social rank. We suggest that in SA, social rank themes constitute the linchpins of identity, defined as the content and structure of the Me-self. We speculate that processes related to low social rank contribute to the focus on representational (Me), rather than experiential (I), self-aspects. Finally, we delineate the ways in which such an understanding may direct and refine the construction of novel, individually tailored, therapeutic approaches.