Attentional bias to threat as a biomarker for populations exposed to armed conflicts.

The aim of this study was to elucidate individual difference factors that modulate the attentional processing of game stimuli to explain the heterogeneity of extant findings. The current study examined whether individual differences in components of attentional control (AC-shifting and AC-focusing) moderated the link between internet gaming addiction symptom and attentional engagement to and disengagement biases from game-relevant cues. A total of 75 male undergraduate students who have played League of Legend (LOL) for more than 2 years completed well-established self-report questionnaires of internet gaming disorder symptoms and attentional control. The attentional bias toward game stimuli was measured for attentional engagement and disengagement using the attentional response to the distal vs. proximal emotional information (ARDPEI) task. The results revealed that attentional control was a significant moderator of the relationship between internet game addiction symptoms and attentional disengagement bias. Further analyses revealed a positive relationship between internet game addiction symptoms and attentional disengagement bias only among those with low levels of AC-shifting ability. Contrary to our expectations, AC-shifting also moderated the relationship between internet gaming disorder and attentional engagement bias. The positive relationship between internet game addiction symptoms and attentional engagement bias only appeared among those with low levels of AC-shifting ability. Individual differences in AC-focusing did not moderate the relationship between internet gaming disorder and any attentional bias. This study confirmed that the greater the symptoms of game addiction, the stronger the attentional bias, especially in individuals with low AC-shifting ability. Therefore, it is necessary to examine sub-factors of AC in understanding the nature of attentional bias mechanisms in the development of internet game addiction and consider it as a psychological intervention to improve attentional bias.

Theories posit that the combination of external (e.g. cue exposure) and internal (e.g. attention biases) factors contributes to the development of game craving. Nevertheless, whether different components of attentional biases (namely, engagement bias and disengagement bias) play separate roles on game craving has not been fully elucidated. We aimed to examine the associations between two facets of attentional biases and game craving dynamics under a daily life setting. Participants (110 regular internet game players) accomplished the modified attentional assessment task in the laboratory, after which they entered a 10-day ecological momentary assessment (EMA) to collect data on their momentary game craving and occurrence of game-related events at five different time points per day. We found that occurrence of game-related events was significantly associated with increased game craving. Moreover, attentional disengagement bias, instead of engagement bias, bore on the occasional level variations of game craving as moderating variables. Specifically, attentional disengagement bias, not engagement bias, was associated with a greater increase in game craving immediately after encountering a game-related event; however, neither attentional engagement bias nor disengagement bias was associated with the craving maintenance after a relatively long period. The present study highlights the specific attentional processes involved ingame craving dynamics, which could be crucial for designing interventions for attentional bias modification (ABM) in Internet Gaming Disorder (IGD) populations.

BackgroundAutomatic processes, such as attentional biases or interpretative biases, have been purported to be responsible for several psychiatric disorders. Recent reviews have highlighted that cognitive biases may be modifiable. Advances in eHealth and mHealth have been harnessed for the delivery of cognitive bias modification. While several studies have evaluated mHealth-based bias modification intervention, no review, to our knowledge, has synthesized the evidence for it. In addition, no review has looked at commercial apps and their functionalities and methods of bias modification. A review is essential in determining whether scientifically validated apps are available commercially and the proportion of commercial apps that have been evaluated scientifically.ObjectiveThe objective of this review was primarily to determine the proportion of attention or cognitive bias modification apps that have been evaluated scientifically and secondarily to determine whether the scientifically evaluated apps were commercially available. We also sought to identify commercially available bias modification apps and determine the functionalities of these apps, the methods used for attention or cognitive bias modification, and whether these apps had been evaluated scientifically.MethodsTo identify apps in the published literature, we searched PubMed, MEDLINE, PsycINFO, and Scopus for studies published from 2000 to April 17, 2018. The search terms used were “attention bias” OR “cognitive bias” AND “smartphone” OR “smartphone application” OR “smartphone app” OR “mobile phones” OR “mobile application” OR mobile app” OR “personal digital assistant.” To identify commercial apps, we conducted a manual cross-sectional search between September 15 and 25, 2017 in the Apple iTunes and Google Play app stores. The search terms used to identify the apps were “attention bias” and “cognitive bias.” We also conducted a manual search on the apps with published evaluations.ResultsThe effectiveness of bias modification was reported in 7 of 8 trials that we identified in the published literature. Only 1 of the 8 previously evaluated apps was commercially available. The 17 commercial apps we identified tended to use either an attention visual search or gamified task. Only 1 commercial app had been evaluated in the published literature.ConclusionsThis is perhaps the first review to synthesize the evidence for published mHealth attention bias apps. Our review demonstrated that evidence for mHealth attention bias apps is inconclusive, and quite a few commercial apps have not been validated scientifically.

Binging and purging are transdiagnostic features of eating disorders (EDs). Attentional biases (ABs) toward food and body shape cues and negative affect (NA) are associated with ED psychopathology. These ABs might also be present in people with subthreshold ED not meeting full diagnostic criteria. We investigated ABs to food and body shape cues and the interaction between ABs and NA in young people with binge/purge behavior (B/P group) and healthy controls (HC group). Our B/P sample consisted of individuals with threshold and subthreshold ED, including participants with BN, AN-R, and AN-B/P. We conducted two studies. Study 1 recruited n=54 HC and n=53 B/P participants aged 16-25, and Study 2 recruited n=73 HC and n=72 B/P participants. In Study 1, ABs toward food and body shape cues were compared between B/P versus HC participants using a pictorial dot-probe task. In Study 2, ABs were compared between B/P versus HC participants after NA induction using the Cyberball social exclusion task. Indexes of attentional engagement and disengagement were computed. There was a main effect of cue type on attentional engagement at 0.2s (p=0.006, =0.075) and 2s (p=0.040, =0.043), and attentional disengagement at 2s (p=0.006, =0.077) in Study 1. Findings were not replicated following NA induction in Study 2. No main effect of group or group × cue type interaction was found. Our results disagree with previous research supporting the importance of ABs toward food and body shape cues in young people with threshold and subthreshold EDs and suggest these might not constitute a relevant target in the treatment of ED behavior. However, due to a heterogeneous approach to measuring ABs and multiple types of AB being described in EDs, further research is needed to clarify whether ABs map onto transdiagnostic models of behavioral dysregulation.

Attentional and Interpretational Biases Toward Pain-Related Stimuli in Children and Adolescents: ASystematic Review of the Evidence

Women are diagnosed with posttraumatic stress disorder (PTSD) at twice the rate of men. This gender difference may be related to differences in PTSD experiences (e.g., more hypervigilance in women) or types of trauma experienced (e.g., interpersonal trauma). We examined whether attentional threat biases were associated with gender, PTSD diagnosis, and/or trauma type. Participants were 70 civilians and veterans (38 women, 32 men; 41 with PTSD, 29 without PTSD) assessed with the Clinician Administered PTSD Scale for DSM-IV who completed a facial dot-probe attention bias task and self-report measures of psychiatric symptoms and trauma history. Factorial ANOVA and regression models examined associations between gender, PTSD diagnosis, index trauma type, lifetime traumatic experiences, and attentional threat biases. Results revealed that compared to women without PTSD and men both with and without PTSD, women with PTSD demonstrated attentional biases toward threatening facial expressions, d = 1.19, particularly fearful expressions, d = 0.74. Psychiatric symptoms or early/lifetime trauma did not account for these attentional biases. Biases were related to interpersonal assault index traumas, ηp 2 = .13, especially sexual assault, d = 1.19. Trauma type may be an important factor in the development of attentional threat biases, which theoretically interfere with trauma recovery. Women may be more likely to demonstrate attentional threat biases due to higher likelihood of interpersonal trauma victimization rather than due to gender-specific psychobiological pathways. Future research is necessary to clarify if sexual assault alone or in combination with gender puts individuals at higher risk of developing PTSD.

La modification du biais attentionnel dans les troubles anxieux et la dépression : une revue synthétique de la littérature

Table ronde : anxiété-dépression

The Effect of Perceived Injustice on Appraisals of Physical Activity: An Examination of the Mediating Role of Attention Bias to Pain in a Chronic Low Back Pain Sample.

Research reveals that selective attentional bias to socially negative information is a reliable characteristic of individuals with high-trait anxiety (HTA). However, for selective attentional bias across sensory channels (visual and auditory), the interaction between attentional bias type and negative face type remains unclear. In this study, we recruited 30 individuals with high- and low-trait anxiety (LTA) (15 in each group), and measured their engagement and disengagement bias indices using the cross-modal attentional-probe paradigm, and measured the occipital P1 component using a 64-channel electroencephalography system. The results showed that under the engagement condition in the HTA group, the occipital P1 amplitude of an angry face was smaller than that of a neutral face, and there also exhibited smaller attentional bias indices of angry faces in the HTA group than that of the LTA group. For the presence of disgusted faces, the attentional bias indices of the HTA group were smaller than that of the LTA group under the disengagement condition. These findings demonstrate that the selective attentional bias occurs both in the engagement and the disengagement facets within the cross modal. There is a feature of facilitated attentional engagement bias for an angry face, and a feature of promoted attentional disengagement bias for a disgusted face in HTA individuals.

Theoretical accounts of attentional and interpretation biases in pain suggest that these biases are interrelated and are both influenced by perceived threat. A laboratory-based study was conducted to test whether these biases are influenced by threat and their interrelationship and whether attention or interpretation biases predict pain outcomes. Healthy participants (n=87) received either threatening or reassuring pain information and then completed questionnaires, interpretation and attentional bias tasks (with eye-tracking) and a pain task (the cold pressor). There was an interaction effect for threat group and stimuli type on mean dwell time for face stimuli, such that there was an attentional bias towards happy faces in the low- but not high-threat group. Further, high threat was also associated with shorter pain tolerance, increased pain and distress. In correlational analyses, avoidance of affective pain words was associated with increased pain. However, no relationship was found between attention and interpretation biases, and interpretation biases were not influenced by threat or associated with pain. These findings provide partial support for the threat interpretation model and the importance of threat and affective pain biases, yet no relationship between cognitive processing biases was found, which may only occur in clinical pain samples. WHAT DOES THIS STUDY ADD?: In healthy participants, no relationship between attention and interpretation biases was found. Eye tracking revealed an association between later attentional processes and pain. Threat influenced attentional biases and pain outcomes, partially supporting theoretical accounts.

Eye-tracking measurement of attention bias to social threat among youth: A replication and extension study

Background and objectivesIt is well established that attention bias and interpretation bias each have a key role in the development and continuation of anxiety. How the biases may interact with one another in anxiety is, however, poorly understood. Using cognitive bias modification techniques, the present study examined whether training a more positive interpretation bias or attention bias resulted in transfer of effects to the untrained cognitive domain. Differences in anxiety reactivity to a real-world stressor were also assessed. MethodsNinety-seven first year undergraduates who had self-reported anxiety were allocated to one of four groups: attention bias training (n = 24), interpretation bias training (n = 26), control task training (n = 25) and no training (n = 22). Training was computer-based and comprised eight sessions over four weeks. Baseline and follow-up measures of attention and interpretation bias, anxiety and depression were taken. ResultsA significant reduction in threat-related attention bias and an increase in positive interpretation bias occurred in the attention bias training group. The interpretation bias training group did not exhibit a significant change in attention bias, only interpretation bias. The effect of attention bias training on interpretation bias was significant as compared with the two control groups. There were no effects on self-report measures. LimitationsThe extent to which interpretive training can modify attentional processing remains unclear. ConclusionsFindings support the idea that attentional training might have broad cognitive consequences, impacting downstream on interpretive bias. However, they do not fully support a common mechanism hypothesis, as interpretive training did not impact on attentional bias.

According to cognitive-behavioural theories, attentional biases, especially increased symptom-focused attention, are crucial for the maintenance of health anxiety. Therefore, the attention training technique (ATT) seems to be a promising approach in reducing body-focused attention and hypochondriacal fears in people with high health anxiety. However, previous research has never implemented ATT on its own but always in combination with psychoeducation. The present study experimentally investigates the isolated impact of ATT on self-reported body-focused attention, health anxiety, and attentional bias towards health threatening stimuli. Fifty-four students with elevated health anxiety were randomised into the following conditions: attention training group (ATG), which received ATT; ATGbody, which received a variation of ATT that focused on training attention towards the body; and a control group without intervention. The ATG and ATGbody spent 1 week actively practicing the trainings. Before and after the training phase, we assessed the self-report measures, and attentional bias by using the Emotional Stroop Task. The ATG displayed no effects on self-report measures of body-focused attention or health anxiety. Against our expectations, the ATGbody experienced a significant decrease in the attentional bias (p = .001, Cohen’s d = 0.93). Attention training towards the body in people with elevated health anxiety might, therefore, be beneficial in reducing illness-related attentional bias.

Life is … great! Emotional attention during instructed and uninstructed ambiguity resolution in relation to depressive symptoms