Attentional bias and emotional reactivity as predictors and moderators of behavioral treatment for social phobia

Cognitive behavioral therapy (CBT) is a well-established treatment for anxiety disorders, and evidence is accruing for the effectiveness of acceptance and commitment therapy (ACT). Little is known about factors that relate to treatment outcome overall (predictors), or who will thrive in each treatment (moderators). The goal of the current project was to test attentional bias and negative emotional reactivity as moderators and predictors of treatment outcome in a randomized controlled trial comparing CBT and ACT for social phobia. Forty-six patients received 12 sessions of CBT or ACT and were assessed for self-reported and clinician-rated symptoms at baseline, post treatment, 6, and 12 months. Attentional bias significantly moderated the relationship between treatment group and outcome with patients slow to disengage from threatening stimuli showing greater clinician-rated symptom reduction in CBT than in ACT. Negative emotional reactivity, but not positive emotional reactivity, was a significant overall predictor with patients high in negative emotional reactivity showing the greatest self-reported symptom reduction.     

A Randomized Trial of Attention Training for Generalized Social Phobia: Does Attention Training Change Social Behavior?

The use of attention training protocols for the treatment of generalized social anxiety disorder (SAD) is undergoing increased examination. Initial investigations were positive but more recent investigations have been less supportive of the treatment paradigm. One significant limitation of current investigations is overreliance on self-report. In this investigation, we expanded on initial investigations by using a multimodal assessment of patient functioning (i.e., including behavioral assessment). Patients with a primary diagnosis of SAD (n = 31) were randomly assigned to eight sessions of attention training (n = 15) or placebo/control (n = 16). Participants were assessed at pre- and posttreatment via self- and clinician-report of social anxiety as well as anxious and behavioral response to two in vivo social interactions. Results revealed no differences between groups at posttreatment for all study outcome variables, suggesting a lack of effect for the attention training condition. The results are concordant with recent investigations finding a lack of support for the use of attention training as an efficacious treatment for patients with SAD.     

Measuring Change in Depression-Related Interpretation Bias: Development and Validation of a Parallel Ambiguous Scenarios Test

Depressed mood is associated with making negatively biased interpretations of ambiguous everyday events. Experimental modification towards a more optimistic interpretation has become a focus of recent research. However, to date, no measures exist that have been tested with respect to their psychometric properties that justify repeated administration to capture change. We aimed to develop and evaluate a pragmatic assessment instrument, consisting of a 30-item questionnaire (long version) and two 15-item parallel short versions (A and B). Items were generated as ambiguous sentences, reflecting three relevant content areas based on Beck's cognitive triad. The sentences were rated for pleasantness, and this emotional appraisal task indicates the emotional valence of the interpretation. Due to the intention to develop a parallel test version, item-twins were generated. All three versions of the instrument were found to be structurally stable, internally consistent and valid. In line with Beck's cognitive triad in depression, confirmatory factor analyses determined a three-factor solution (i.e. self, experiences and future). Significant correlations were found between all scales and depressive mood. The two short versions represent the same underlying constructs, share identical psychometric properties and possess high parallel-test reliability. This study is the first to evaluate and confirm the factorial validity as well as the parallel-test reliability of an interpretation bias measure. It is suitable to measure bias modification and has therefore great potential for research and clinical practice.     

Depth of processing and recall of threat material in fearful and nonfearful individuals

Abstract

Although many studies have examined the nature of memory distortions in anxious individuals, few have considered biases in specific memory processes, such as encoding or retrieval. To investigate whether the presentation of threat material facilitates encoding biases, spider fearful (n=63), blood fearful (n=73), and nonfearful (n=75) participants encoded spider related, blood related, and neutral words as a function of three levels of processing (i.e., structural, semantic, and self referent). Participants subsequently completed either a free recall or a recognition task. All participants demonstrated a partial depth of processing effect, such that they recalled more words encoded in the self referent condition than in the other two conditions, but groups did not differ in their recall of stimuli as a function of word type. Relative to participants in the other groups, spider fearful participants had fewer spider related intrusions in the recall condition, and they made fewer errors in responding to structural and semantic encoding questions when spider related words were presented. These results contribute to an increasingly large body of literature suggesting that anxious individuals are not characterized by a memory bias toward threat, and they raise the possibility that individuals with spider fears process threat-relevant information differently than individuals with blood fears.     

Understanding associations between negatively biased attention and depression and social anxiety: positively biased attention is key

ABSTRACT

Background and objectives: Although research supports the premise that depressed and socially anxious individuals direct attention preferentially toward negative emotional cues, little is known about how attention to positive emotional cues might modulate this negative attention bias risk process. The purpose of this study was to determine if associations between attention biases to sad and angry faces and depression and social anxiety symptoms, respectively, would be strongest in individuals who also show biased attention away from happy faces.

Methods: Young adults (N?=?151; 79% female; M?=?19.63 years) completed self-report measures of depression and social anxiety symptoms and a dot probe task to assess attention biases to happy, sad, and angry facial expressions.

Results: Attention bias to happy faces moderated associations between attention to negatively valenced faces and psychopathology symptoms. However, attention bias toward sad faces was positively and significantly related to depression symptoms only for individuals who also selectively attended toward happy faces. Similarly, attention bias toward angry faces was positively and significantly associated with social anxiety symptoms only for individuals who also selectively attended toward happy faces.

Conclusions: These findings suggest that individuals with high levels of depression or social anxiety symptoms attend preferentially to emotional stimuli across valences.     

Altered working memory capacity for social threat words in high versus low social anxiety

ABSTRACT

Background and objectives: Differences in working memory capacity (WMC) have been suggested in individuals with high levels of social anxiety (SA). Specifically, these individuals may preferentially maintain socially threatening material in working memory.

Design and methods: We adapted the digit span task to a series of word span tasks. We assessed WMC for lists of words that varied in terms of their threat-relatedness, in individuals either high or low in SA.

Results: Experiment 1 revealed reduced WMC for socially threatening words in those with high compared to low SA. Importantly, this relative reduction in WMC was driven by the low SA group showing expanded capacity for socially threatening words relative to neutral or generally threatening words. Furthermore, reductions in WMC for social threat were uniquely predicted by SA, and not by other theoretically related constructs such as state general anxiety, trait general anxiety, or depression. Experiment 2 showed that the semantic similarity of the words within each list was not responsible for the differences in WMC between list type or SA group.

Conclusions: Our findings suggest that individuals high in SA may fail to upregulate WMC for social information due to the activation of, or rumination upon, socially threatening concepts.     

Effects of anxiety on handgun shooting behavior of police officers: a pilot study

Abstract

The current pilot study aimed at providing an initial assessment of how anxiety influences police officers’ shooting behavior. Seven police officers participated and completed an identical shooting exercise under two experimental conditions: low anxiety, against a non-threatening opponent, and high anxiety (HA), against a threatening opponent who occasionally shot back using colored soap cartridges. Measurements included shooting accuracy, movement times, head/body orientation, and blink behavior. Results showed that under HA, shooting accuracy decreased. Underlying this degradation of performance, participants acted faster and made themselves smaller to reduce the chance of being hit. Furthermore, they blinked more often, leading to increases in the amount of time participants had their eyes closed. Findings provide support for attentional control theory, hereby also pointing to possible interventions to improve police officers’ shooting performance under pressure.     

Mechanisms for the Relationship between Traditional Masculine Ideologies and Rape Myth Acceptance Among College Men

We explored mechanisms for the relationship between traditional masculine ideologies and rape myth acceptance. We hypothesized that locus of control would serve as a mediator for victim precipitation rape myths, and negative attitudes toward women would serve as a mediator for victim masochism and victim fabrication rape myths. Using a sample of 100 male college students, the results indicated that negative attitudes toward women mediated the relationship between traditional masculine ideologies and all 3 types of rape myths, but locus of control did not serve as a mediator for any. Implications and directions for future research are discussed.     

Maternal Dysphoria,Maternal Attitudes Toward Parenting,and Childhood Externalizing Behavior as Predictors of Physical Aggression

The purpose of this study was to test for reciprocity and chaining in 4,897 children (2,568 boys, 2,329 girls) from the Fragile Families and Child Wellbeing Study (FFCWS). Cross-lagged correlations between maternal dysphoria and attitude at Waves 2 and 3 of the FFCWS revealed that maternal dysphoria and negative maternal attitudes toward parenting were reciprocally related. Regarding chaining, the direct effects of Wave 2 maternal dysphoria and attitudes on Wave 5 offspring physical aggression were nonsignificant, although both variables predicted Wave 5 physical aggression via their cross-lagged correlations with each other at Wave 3 and offspring externalizing behavior at Wave 4. These results indicate that dysphoria and negative maternal attitudes toward parenting are equally important in predicting offspring physical aggression.     

Reducing the own-race bias in face recognition by attentional shift using fixation crosses preceding the lower half of a face

Hills and Lewis (2006) reduced White participants’ own-race bias (ORB) in face recognition by training them to attend to features critical for Black faces (lower portion of the face). Here, the ORB was investigated following a brief fixation cross either in the upper portion of the face (critical for White faces) or the lower portion of the face. Results showed that when the cross preceded the lower portion of the face, Black faces were recognized more accurately than White faces and vice versa when it preceded the upper portion of the face. A second experiment demonstrated that this effect disappears if the participants are forced to delay their responses by 4 s. These results suggest that an immediate attentional mechanism can attenuate the ORB when immediate attention is paid to diagnostic features but this can be overridden with increased time spent viewing faces.