Examination of emotional Stroop interference in obsessive-compulsive disorder

Previous research has produced conflicting findings on whether or not patients with subclinical or manifest obsessive-compulsive disorder (OCD) share an attentional bias for anxiety-related material. In the present study, 35 OCD patients were compared with 20 healthy controls on their performance in an emotional Stroop paradigm. Nine different stimulus conditions were compiled, including sets for depression-related and anxiety-related words as well as stimuli from two constructs with a potential relevance for the pathogenesis and maintenance of OCD symptomatology: responsibility and conscientiousness. Patients did not show enhanced interference for any of the conditions. Syndrome subtype and severity, avoidance and speed of information processing did not moderate results. The present study concurs with most prior research that OCD patients display no interference effect for general threat words. It deserves further consideration, that emotional interference effects in OCD as seen in other anxiety disorders occur when using idiosyncratic word material with a direct relation to the individual's primary concerns.     

“Why Am I so Anxious?” A Study of Attention Bias in Obsessive Compulsive Disorder

Previous research investigating attentional bias has produced intriguingly equivocal results. The present large-scale study explored attentional bias in subjects diagnosed with obsessive-compulsive disorder (OCD) and in a control group (n = 80) using the Emotional Stroop Test. Results clearly indicated poorer performances across the board amongst patients diagnosed with OCD compared to the control group, particularly in the case of anxiety-related stimuli. This paper discusses, in the light of current models of attentional bias towards threat in anxiety disorders, the processes whereby attentional bias towards anxiety stimuli might play a vital role in the causation and maintenance of OCD.     

Attentional bias and anxiety in individuals with coronary heart disease

This study examined whether in an emotional Stroop task, individuals with coronary heart disease (CHD) would show greater attention towards the threatening words related to their disease than healthy persons, and if such an attentional bias is associated with anxiety. An emotional Stroop task with threatening words related to CHD as well as positive, negative and neutral words was administered to 35 individuals with CHD and 35 healthy controls. Additionally, the original Stroop task, the Beck anxiety inventory and the state-trait anxiety inventory were administered. The results indicated an attentional bias towards threatening words related to CHD in the individuals with CHD. They experienced higher interference than healthy participants from threatening words related to CHD but not from positive or negative words. Moreover, the level of interference was associated with their level of anxiety, and a vicious circle may exist in this association. In addition, results indicated a possible deficit of executive functioning among individuals with CHD. Attentional bias, as well as its association with anxiety, and an indication of deficit in executive functioning among individuals with CHD might be the risk factors for these individuals’ quality of life and for further development of their disease.     

The Pictorial Fire Stroop: A Measure of Processing Bias for Fire-Related Stimuli

Fire interest is a risk factor for firesetting. This study tested whether a fire-specific emotional Stroop task can effectively measure an information-processing bias for fire-related stimuli. Clinic-referred and nonreferred adolescents (aged 13–16 years) completed a pictorial “Fire Stroop,” as well as a self-report fire interest questionnaire and several control tasks. Results showed (a) comparatively greater fire-specific attentional bias among referred adolescent firesetters, (b) a negative relationship between Fire Stroop attentional bias and self-reported fire interest, and (c) positive correspondence between Fire Stroop attentional bias and self-reported firesetting frequency. These findings suggest that instruments that measure an automatic bias for fire-specific stimuli may usefully supplement self-report measures in the assessment and understanding of firesetting behavior.     

Attention bias towards personally relevant stimuli: the individual emotional Stroop task

The emotional Stroop task is a widely used method for investigating attentional bias towards stimuli due to mood or affect. In general, standardized stimuli are used, which might not be appropriate when investigating individual contextual frameworks. It was investigated whether words chosen to be related to individuals' personal life events would produce more pronounced Stroop interference (as an indicator of attentional bias) than stimuli without any personal relevance. Twenty-six nonclinical subjects, 20 female and 6 male, participated in the study. Mean age was 36.1 yr. (SD = 18.1). All were recruited by means of local advertising. Stimulus material consisted of four word types: personal words related to negative life events with and without current personal relevance, and negative and neutral words without any personal relevance. Words were presented in three blocks. Analysis of variance showed main effects for word type and blocks, with slower reactions in the personally relevant conditions than in the negative, or neutral conditions, and in response to the first blocks as opposed to the last. These findings indicate that regardless of the word valence, personally relevant stimuli evoke more pronounced Stroop interference than do stimuli without personal relevance.     

Selective Processing of Threat Cues in Subjects with Panic Attacks

Abstract

Previous research has demonstrated that patients with generalised anxiety disorder, phobias, and obsessive-compulsive disorder show an attentional bias towards threat cues related to their respective disorders. Two studies are presented that used a modified Stroop colour naming task to assess attentional bias in subjects with panic attacks. In Study 1, 24 panic disorder patients and 24 normal controls were presented three cards containing threat words related to physical harm, separation, or social embarrassment. Colour naming times were compared between these cards and control cards containing matched non-threat words. Reaction time differences in the two groups were in opposite directions, patients tending to be slower in colour naming threat words, and controls, faster. In Study 2, 18 non-clinical panickers and 18 controls were presented cards containing physical threat words, neutral control words, or colour words, respectively. Panickers showed greater interference than controls in colour naming threat words but not in colour naming colour words. The results are consistent with an attentional bias for threat-related material in subjects with panic attacks. Implications for psychophysiological models of 'spontaneous' panic attacks are discussed.     

Pointing and the interference effect in obsessive‐compulsive disorder (OCD)

The interference effect in obsessive‐compulsive disorder (OCD) was investigated in order to analyze cognitive aspects of motor stereotypy in OCD‐related compulsions. So far, the domain of cognitive control in compulsive behavior has been under‐investigated. Twelve participants (OCD patients and healthy controls) completed a newly created computer‐based pointing task as well as standard clinical and psychological background measures. Findings showed that the patients displayed a larger visual interference effect compared to the controls and pointing paths were longer in time as well as distance when a distractor stimulus was present. It is concluded that, for compensation, patients would need to generate excessive amounts of attentional resources not available to overcome motor rigidity on the one side and visual distraction on the other side.     

Mood-congruent free recall bias in anxious individuals is not a consequence of response bias

The status of mood-congruent free recall bias in anxious individuals was evaluated following incidental encoding of target words. Individuals with high and low levels of trait anxiety completed a modified Stroop task, which revealed an attentional bias for threat-related stimuli in anxious individuals. This group was significantly slower in naming the colour in which threat-related words were displayed compared to neutral words. In a subsequent free recall test for the words used in the modified Stroop task, anxious individuals recalled more threat-related words compared to low-anxious people. This difference was significant even when controlling for the false recall of items that had not been presented during study. These results support the view put forward by Russo, Fox, Bellinger, and Nguyen-Van-Tam (2001) that mood-congruent free recall bias in anxious individuals can be observed if the target material is encoded at a relatively shallow level. Moreover, contrary to Dowens and Calvo (2003), the current results show that the memory advantage for threat-related information in anxious individuals is not a consequence of response bias.     

Mood-congruent free recall bias in anxious individuals is not a consequence of response bias

The status of mood-congruent free recall bias in anxious individuals was evaluated following incidental encoding of target words. Individuals with high and low levels of trait anxiety completed a modified Stroop task, which revealed an attentional bias for threat-related stimuli in anxious individuals. This group was significantly slower in naming the colour in which threat-related words were displayed compared to neutral words. In a subsequent free recall test for the words used in the modified Stroop task, anxious individuals recalled more threat-related words compared to low-anxious people. This difference was significant even when controlling for the false recall of items that had not been presented during study. These results support the view put forward by Russo, Fox, Bellinger, and Nguyen-Van-Tam (2001) that mood-congruent free recall bias in anxious individuals can be observed if the target material is encoded at a relatively shallow level. Moreover, contrary to Dowens and Calvo (2003), the current results show that the memory advantage for threat-related information in anxious individuals is not a consequence of response bias.     

Selective processing of threat cues in panic disorder

A computerized Stroop color-naming paradigm was used to investigate attentional biases for selectively processing threat information in panic-disordered patients. Subjects named the colors of neutral words (e.g. TYPICAL), fear words (e.g. PANIC), bodily sensation words (e.g. HEARTBEAT), and catastrophe words (e.g. HEART ATTACK). To control for familiarity with threat concepts, we used clinicians who treat panic disorder as normal control subjects. In contrast to normal controls, panic patients exhibited greater Stroop interference for all threat words, especially those associated with catastrophe. Stroop interference waned during the course of the experiment, thereby indicating habituation to the semantic content of the cues. These findings suggest that panic disorder, like other anxiety disorders, is associated with an attentional bias for processing threatening information.     

Spontaneous attention to word content versus emotional tone: differences among three cultures

A Stroop interference task was used to test the hypothesis that people in different cultures are differentially attuned to verbal content vis-à-vis vocal tone in comprehending emotional words. In Study 1, Americans showed greater difficulty ignoring verbal content than ignoring vocal tone (which reveals an attentional bias for verbal content); but Japanese showed greater difficulty ignoring vocal tone than ignoring verbal content (which reveals a bias for vocal tone). In Study 2, Tagalog-English bilinguals in the Philippines showed an attentional bias for vocal tone regardless of the language used, suggesting that the effect is largely cultural rather than linguistic. Implications for culture-and-cognition research are discussed.     

Attentional bias and evoked heart-rate response in specific phobia

The relationship between the evoked heart-rate (HR) reaction to phobic pictures and the attentional bias was investigated in specific phobics. Forty-five specific phobic and 39 control participants were shown phobia-related pictures while HR was being recorded; they were administered the modified dot-probe task, the modified Stroop task, and gave subjective ratings of pictures. Unlike control participants, specific phobics showed HR acceleration to phobia-related pictures, which was significantly correlated with their fear ratings, and a significant Stroop interference effect. There were no group differences with regard to an attentional bias in the dot-probe task but early deceleration of the HR reaction to phobic pictures was related to more pronounced selective attention toward these stimuli in phobics. The results provide partial support for Cook and Turpin's (1997) conjecture of a relationship between the early decelerative orienting component of the HR reaction and the selective attentional bias in phobia.     

Attentional Processing of Threat in Bipolar Disorder: Going Beyond Mood-Congruency

Emotional processing in bipolar disorder (BD) entails a complex attentional pattern not merely restricted to happy or sad biases, but also directed towards threatening information. This study examined threat-related bias on attentional orienting when participants were not instructed about the presentation of emotional stimuli (i.e., implicit instructions). An emotional dot-probe task in which an emotional face (i.e., threat, sad, happy) is simultaneously displayed with a neutral face was applied to BD individuals in their different episodes: mania (n?=?26), depression (n?=?24), and euthymia (n?=?28) as well as to a group of healthy controls (n?=?28). Symptomatic BD patients (i.e., in a manic or depressive episode) showed an attentional orienting bias toward threatening faces but not for happy or sad faces, while euthymic BD patients did not exhibit any attentional bias for emotional stimuli. A bias toward happy faces was found in the control group. Threat-related bias was not related to the severity of affective and anxiety symptoms in BD. When attention is not explicitly directed to emotional information, threat-related bias may characterize attentional orienting during mania and depression, but may be attenuated during euthymia.

     

Does anxiety lead to selective processing of threat-related information?

Four experiments investigating the detailed nature of the attentional bias in anxiety are reported. Previous research using the Stroop task has shown that, when compared with non-patient controls, anxious patients are relatively slower at colour naming threat-related words than non-threat words. Experiments One and Two investigated whether this apparent attentional bias is a function of anxiety per se and/or is related to patient/non-patient status. Experiment One compared colour-naming times for threat and non-threat words in low, medium and high trait anxiety normal subjects. High anxiety was not associated with slower colour-naming times for threat words. Experiment Two compared generalized anxiety disorder patients with equally anxious non-patients and found that the patients were significantly slower at colour-naming threat words. Read aloud and dwell tasks were also included in these experiments in order to identify the mechanism of Stroop interference. Experiments Three and Four investigated whether anxious patients' attentional bias is specific to threat-related material or also extends to certain positive, emotional material. In Experiment Three words used in previous Stroop studies were rated for emotionality. Threat words were more emotional, as well as more threatening, than control words, indicating that previous studies have confounded threat and emotionality. Experiment Four compared colour-naming times for threat words, equally emotional positive words, and neutral words. Consistent with the emotionality hypothesis, generalized anxiety disorder patients were slower than non-anxious controls at colour naming both threat words and positive words. The theoretical, methodological and clinical implications of these results are discussed.     

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.     

强迫症患者反应抑制缺陷及注意的调节作用

使用内外源线索结合不同冲突水平的侧抑制任务,考察强迫症患者对分心刺激的抑制有无缺陷、注意定向对分心刺激的干扰效应有无调节作用及在何水平上发挥作用。结果表明:强迫症患者不同冲突水平的侧抑制任务均无明显反应抑制缺陷,可能与其注意威胁性信息等有关;集中注意在知觉冲突水平上对强迫症患者和正常人的反应冲突进行调节且无显著性差异,可能与强迫症患者关注内容非空间定向有关。     

Violent Video Games Induce an Affect Processing Bias

This study investigated the effects of violent video game play and trait hostility on attentional bias toward negatively valenced words. Following video game play, participants completed an emotional Stroop task. Results indicated greater Stroop interference for participants high in trait hostility and for participants playing violent video games. Implications of these findings are discussed with respect to current models of aggressive behavior.     

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.     

Cognitive processing of emotional information in panic disorder.

Panic-disordered (PD) patients, obsessive-compulsive (OCD) patients, and normal control subjects were exposed to either a high (i.e. exercise) or low arousal manipulation prior to performing a computerized version of the modified Stroop color-naming paradigm. Subjects named the colors of neutral nonlexical stimuli, positive words, and threat words associated with fear, bodily sensations, and catastrophes. After the Stroop task, subjects rated the personal emotional significance of the words. Inconsistent with the emotionality hypothesis of Stroop interference, PD patients rated positive words as more emotional than catastrophe words, but took longer to color-name the latter than the former. Yet consistent with the emotionality hypothesis, PD patients took as long to color-name positive words as to color-name fear and bodily sensation words. Contrary to expectation, OCD patients resembled PD patients in terms of interference, and arousal did not enhance interference for threat words in PD patients.     

Social presence effects on the stroop task: Boundary conditions and an alternative account

Two studies investigated boundary conditions of an effect of social presence on the Stroop task and its interpretation in terms of an attentional view (P. Huguet, M. P. Galvaing, J. M. Monteil, & F. Dumas, 1999). In this view, social presence leads to attentional focusing, enhancing participants’ ability to screen out the distracting features of Stroop stimuli. As predicted, Stroop interference was found to be reduced by social presence, but an alternative account in which social presence exerts an effect on task selection received more support.