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.     

Autobiographical memory bias in social anxiety

In social anxiety the psychological self is closely related to the feared stimulus. Socially anxious individuals are, by definition, concerned about how the self is perceived and evaluated by others. As autobiographical memory is strongly related to views of the self it follows that biases in autobiographical memory play an important role in social anxiety. In the present study high (n = 19) and low (n = 29) socially anxious individuals were compared on autobiographical memory bias, current goals, and self-discrepancy. Individuals high in social anxiety showed a bias towards recalling more negative and more social anxiety-related autobiographical memories, reported more current goals related to overcoming social anxiety, and showed larger self-discrepancies. The pattern of results is largely in line with earlier research in individuals with PTSD and complicated grief. This suggests that the relation between autobiographical memory bias and the self is a potentially valuable trans-diagnostic factor.     

Recall bias for stimulus and response anxiety words in spider phobics

Abstract

Experiments on memory bias in patients with anxiety disorders have produced inconsistent results. It is suggested that results may depend on whether the words studied relate to anxiety-inducing stimulus features or to the anxiety response. It was predicted, following previous results, that phobic subjects would show diminished recall of stimulus words, but that recall of response words might be enhanced. In fact, for both stimulus and response words, phobics showed better recall of phobia-related words than of control words. The results are consistent with the hypothesis that phobic anxiety is associated with a bias towards recall of phobia-related words. However, it seems likely that phobic anxiety has several potentially conflicting effects on recall, and that this accounts for the inconsistent results in literature.     

Trait anxiety, defensiveness and selective processing of threat: an investigation using two measures of attentional bias

Attentional biases for threat were examined in a non-clinical sample (N=60), with each participant tested on both the modified Stroop colour-naming and dot probe tasks. Three groups were selected on the basis of trait anxiety and social desirability scale (SDS) scores: “low anxiety” (LA: low trait, low SDS), “repressor” (REP: low trait, high SDS) and “high anxiety” (HA: high trait, low SDS). Results from the colour-naming task suggested that high levels of defensiveness (in combination with low trait anxiety) were associated with greater avoidance of threat. The REP group showed less interference in colour-naming threat than neutral words; whereas the HA group showed increased interference due to threat words. On the dot probe task, there was a general tendency for this non-clinical sample as a whole to show avoidance of social threat relative to neutral words, but there was no bias for physical threat words. Avoidance of social threat was significant only within the REP group. No relationships were found between the measures of cognitive bias from the two tasks, suggesting different underlying mechanisms. Results are discussed in relation to previous findings and theoretical views of the effects of anxiety and defensiveness on the processing of threat.     

Anxiety sensitivity and attentional bias to threat interact to prospectively predict anxiety

The purpose of the present study was to examine anxiety sensitivity, attentional bias to threat (ABT), and the aggregate influence of these constructs as prospective predictors of anxiety. Participants (N = 176) completed a baseline assessment session which included the completion of self-report measures of anxiety and anxiety sensitivity, as well as an eye-tracking task in which eye movements were recorded during the viewing of neutral and threat images. Measures of anxiety and anxiety sensitivity were completed again as part of an online questionnaire battery at a 1-year follow-up session. As predicted, baseline anxiety sensitivity and ABT predicted anxiety at 1-year follow-up even after accounting for baseline anxiety. However, these main effects were qualified by a significant interaction effect such that those high in anxiety sensitivity at baseline reported relatively higher anxiety at the 1-year follow-up, but only if they also exhibited higher levels of ABT at baseline. Results suggest that individuals with this combination of vulnerability factors (high levels of both anxiety sensitivity and ABT) may be at particularly high risk for developing anxiety and may benefit from preemptive efforts to reduce ABT.     

Attentional bias toward fear-related stimuli: an investigation with nonselected children and adults and children with anxiety disorders

Research investigating anxiety-related attentional bias for emotional information in anxious and nonanxious children has been equivocal with regard to whether a bias for fear-related stimuli is unique to anxious children or is common to children in general. Moreover, recent cognitive theories have proposed that an attentional bias for objectively threatening stimuli may be common to all individuals, with this effect enhanced in anxious individuals. The current study investigated whether an attentional bias toward fear-related pictures could be found in nonselected children (n=105) and adults (n=47) and whether a sample of clinically anxious children (n=23) displayed an attentional bias for fear-related pictures over and above that expected for nonselected children. Participants completed a dot-probe task that employed fear-related, neutral, and pleasant pictures. As expected, both adults and children showed a stronger attentional bias toward fear-related pictures than toward pleasant pictures. Consistent with some findings in the childhood domain, the extent of the attentional bias toward fear-related pictures did not differ significantly between anxious children and nonselected children. However, compared with nonselected children, anxious children showed a stronger attentional bias overall toward affective picture stimuli.     

Attention bias modification for reducing speech anxiety

The mechanisms mediating the anxiolytic effects of attention bias modification (ABM) remain unclear. Accordingly, we randomly assigned speech-anxious subjects to receive four sessions of one of three training conditions: ABM, inverse ABM, and control. In the ABM condition, subjects viewed pairs of photographs of models displaying facial expressions of disgust and joy on a computer screen. Probes always replaced the positive face, and subjects pushed a button to indicate the identity of the probe (E or F) as rapidly as possible. In the inverse condition, the probes always replaced the negative face, and in the control condition, the probes replaced each face type equally often. After four training sessions, all groups exhibited statistically indistinguishable, but significant, reductions on self-report, behavioral, and physiological measures of speech anxiety. Self-report and behavioral measures of attentional control improved likewise. Contrary to early studies, ABM was not superior to control procedures in producing reductions on measures of social anxiety.     

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.     

The causal role of interpretive bias in anxiety reactivity

Elevated anxiety vulnerability is associated with a tendency to interpret ambiguous stimuli as threatening, but the causal basis of this relationship has not been established. Recently, procedures have been developed to systematically manipulate interpretive bias, but the impact of such manipulation on anxiety reactivity to a subsequent stressor has not yet been examined. In the present study, training procedures were used to induce interpretive biases favoring the threatening or nonthreatening meanings of ambiguous information in a sample of 48 undergraduate students. Following this interpretive training, participants' emotional reactions to a stressful video were assessed. The finding that the manipulation of interpretive bias modified emotional reactivity supports the hypothesis that interpretive bias can indeed play a causal role in anxiety vulnerability.     

Ego-threat interpretive bias in test anxiety: On-line inferences

Abstract

The hypothesis that test anxiety is associated with an on-line bias towards threatening interpretations of ambiguous information was explored by means of a lexical decision task. Ambiguous sentences (concerned with ego-threat, physical-threat, or non-threat events) were presented to high- and low- test-anxiety subjects. Sentences were followed by a disambiguating word or a very wordlike corresponding nonword, which either confirmed or disconfirmed the threat implied by the sentence. A control condition involved the presentation of words and nonwords alone, without being primed by the sentences. Results indicated that there were no differences in lexical decision times as a function of test anxiety when words and nonwords were presented alone. In contrast, when they were primed, high-anxiety subjects took longer to respond correctly to the ego-threat confirming nonword, and to the ego-threat disconfirming word, compared with low-anxiety subjects; likewise, high-anxiety subjects responded faster to the ego-threat confirming word than to the ego-threat disconfirming word, compared with low-anxiety subjects. These results suggest that test anxious individuals are likely to draw inferences with an ego-threat meaning, but not with a physical-threat meaning, when reading ambiguous sentences.     

Threat is in the eye of the beholder: social anxiety and the interpretation of ambiguous facial expressions

The current study investigated the tendency of individuals with high levels of social anxiety to interpret ambiguous facial expressions in a threatening manner. Results obtained from self-report measures were consistent with previous studies in which highly socially anxious individuals endorsed threatening interpretations for ambiguous social information. More importantly, highly socially anxious participants showed relative facilitation of processing of threatening faces following neutral faces when a priming technique was used to eliminate artifact due to response selection bias. These findings support the hypothesized social anxiety-linked interpretive bias.     

The association between ruminative thinking and negative interpretation bias in social anxiety

Cognitive models propose that both, negative interpretations of ambiguous social situations and ruminative thoughts about social events contribute to the maintenance of social anxiety disorder. It has further been postulated that ruminative thoughts fuel biased negative interpretations, however, evidence is rare. The present study used a multi-method approach to assess ruminative processing following a social interaction (post-event processing by self-report questionnaire and social rumination by experience sampling method) and negative interpretation bias (via two separate tasks) in a student sample (n?=?51) screened for high (HSA) and low social anxiety (LSA). Results support the hypothesis that group differences in negative interpretations of ambiguous social situations in HSAs vs. LSAs are mediated by higher levels of post-event processing assessed in the questionnaire. Exploratory analyses highlight the potential role of comorbid depressive symptoms. The current findings help to advance the understanding of the association between two cognitive processes involved in social anxiety and stress the importance of ruminative post-event processing.     

Attention bias to threat in mothers with emotional disorders predicts increased offspring anxiety symptoms: a joint cross-sectional and longitudinal analysis

There is convincing evidence of the transmission of anxiety and depression from parents to children; however, mechanisms by which this vulnerability is passed on are unclear. Cognitive models and a small body of cross-sectional research suggest that parental attention biases (ABs) may be one mechanism involved in transmission. Longitudinal associations of maternal and offspring ABs with offspring symptoms have been scarcely studied. Forty-three mothers–child dyads were included. All children (7–12 years old) were diagnosis-free while 24 mothers had a lifetime emotional disorder (anxiety or depression) (high risk, HR) and 19 mothers had no psychiatric diagnoses (low risk, LR). This study examined cross-sectional and longitudinal associations of maternal and child AB and child anxiety symptomology at initial and 12-month assessments. ABs were assessed using a visual-probe task with emotional faces. There was a significant cross-sectional but not longitudinal association of increased child anxiety symptoms with increased maternal threat AB for HR but not LR dyads. At the cross-sectional level, increases in HR but not LR offspring anxiety symptomology were associated with maternal threat AB. Larger longitudinal studies are required that examine the interplay between parent–child variables and include multiple time-points of assessment and measures of AB.     

Affective forecasting and self-rated symptoms of depression,anxiety, and hypomania: Evidence for a dysphoric forecasting bias

Emerging research has examined individual differences in affective forecasting; however, we are aware of no published study to date linking psychopathology symptoms to affective forecasting problems. Pitting cognitive theory against depressive realism theory, we examined whether dysphoria was associated with negatively biased affective forecasts or greater accuracy. Participants (n=325) supplied predicted and actual emotional reactions for three days surrounding an emotionally evocative relational event, Valentine's Day. Predictions were made a month prior to the holiday. Consistent with cognitive theory, we found evidence for a dysphoric forecasting bias—the tendency of individuals in dysphoric states to overpredict negative emotional reactions to future events. The dysphoric forecasting bias was robust across ratings of positive and negative affect, forecasts for pleasant and unpleasant scenarios, continuous and categorical operationalisations of dysphoria, and three time points of observation. Similar biases were not observed in analyses examining the independent effects of anxiety and hypomania. Findings provide empirical evidence for the long-assumed influence of depressive symptoms on future expectations. The present investigation has implications for affective forecasting studies examining information-processing constructs, decision making, and broader domains of psychopathology.     

Comorbid interpretation and expectancy bias in social anxiety and alcohol use

Background: In two studies, the present research examined whether being high in both social anxiety and alcohol use disorder symptoms is associated with a comorbid interpretation and expectancy bias that reflects their bidirectional relationship.

Design: Cross-sectional, quantitative surveys.

Methods: Measures of social anxiety and alcohol use disorder symptoms, as well as an interpretation and expectancy bias task assessing biases for social anxiety, drinking, and comorbid social anxiety and drinking.

Results: In Study 1 (N?=?447), individuals high (vs. low) in social anxiety had stronger social threat bias and individuals high (vs. low) in alcohol use disorder symptoms had stronger drinking bias. Those high in both social anxiety and alcohol use disorder symptoms endorsed interpretations and expectancies linking social interaction with alcohol use. Comorbid bias predicted membership into the high social anxiety/drinking group, even after taking into account single-disorder biases. In Study 2 (N?=?325), alcohol use disorder symptoms predicted drinking bias and social anxiety symptoms predicted social anxiety bias. Alcohol use disorder symptoms, social anxiety symptoms, and their interaction predicted comorbid interpretation and expectancy bias.

Conclusion: Results indicate unique cognitive vulnerability markers for persons with comorbid social anxiety and alcohol use disorder symptoms, which may improve detection and treatment of this serious comorbidity.     

Jumping to interpretations: social anxiety disorder and the identification of emotional facial expressions

A small body of research suggests that socially anxious individuals show biases in interpreting the facial expressions of others. The current study included a clinically anxious sample in a speeded emotional card-sorting task in two conditions (baseline and threat) to investigate several hypothesized biases in interpretation. Following the threat manipulation, participants with generalized social anxiety disorders (GSADs) sorted angry cards with greater accuracy, but also evidenced a greater rate of neutral cards misclassified as angry, as compared to nonanxious controls. The controls showed the opposite pattern, sorting neutral cards with greater accuracy but also misclassifying a greater proportion of angry cards as neutral, as compared to GSADs. These effects were accounted for primarily by low-intensity angry cards. Results are consistent with previous studies showing a negative interpretive bias, and can be applied to the improvement of clinical interventions.     

Fear-relevant selective associations and social anxiety: absence of a positive bias

An illusory correlation paradigm was used to compare high and low socially anxious individuals' initial, on-line and a posteriori covariation estimates between emotional faces and aversive, pleasant and neutral outcomes. Overall, participants demonstrated an initial expectancy bias for aversive outcomes following angry faces, and pleasant outcomes following happy faces. On-line expectancy biases indicated that initial biases were extinguished during the task, with the exception of low socially anxious individuals who continued to over-associate positive social cues with pleasant outcomes. In addition to lacking this protective positive on-line bias, the high social anxiety group reported retrospectively more negative social cues than the low socially anxious group. Findings are discussed in relation to similar evidence from recent interpretive and memory paradigms.     

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.     

Attentional bias for words and faces in social anxiety

Conflicting findings concerning the nature and presence of attentional bias in social anxiety and social phobia have been reported in the literature. This paper reports the findings of two studies comparing people with high and low social anxiety on dot probe tasks using words, faces photographed in front view, and faces photographed in profile as stimuli. In Study 1 those with high social anxiety displayed an attentional bias towards negative faces. The low social anxiety group showed an attentional bias towards positive faces. No significant effects were observed on the dot probe using words as stimuli. Study 2 used pairs of faces presented in profile as though looking at each other. One of the faces displayed either a positive, negative or neutral expression. The second face always had a neutral expression, and in half of the trials it was the subject's own face. The findings of this more ecologically valid procedure replicated those of Study 1. Facilitated attention to dots following emotional faces was specific to threatening facial stimuli. From these studies it appears that the facial dot probe task is a more sensitive index of attentional bias than the word task in a non-clinical sample with social anxiety.     

Attentional bias to respiratory- and anxiety-related threat in children with asthma

This study investigated attentional biases in children with asthma. The study aimed at testing whether children with asthma are vigilant to asthma and/or anxiety cues. Thirty-six children (18 with asthma and 18 healthy controls) aged 9–12 completed a computerised dot probe task designed to measure attentional bias to three different categories of words: asthma, anxiety symptom and general negative emotion. Main caregiver anxiety was also assessed, as was frequency of inhaler use for those with asthma. Children with asthma showed an attentional bias towards asthma words but not anxiety or general negative emotion words. Children without asthma showed no significant attentional biases to any word categories. Caregiver anxiety was correlated with asthma word attentional bias in the asthma group. The findings indicate that attentional bias is present in children with asthma. Further research is required to ascertain if this exacerbates or maintains health-related problems.