Attentional threat biases and their role in anxiety: A neurophysiological perspective

Matthias J Wieser,Andreas Keil

doi:10.1016/j.ijpsycho.2020.05.004

Abstract

One of the most important function of selective attention is the efficient and accurate detection and identification of cues associated with threat. However, in pathological anxiety, this attentional mechanism seems to be dysfunctional, which leads to an exaggeration of threat processing and significant functional impairment. This attentional threat bias (ATB) has been proposed as a key mechanism in the etiology and maintenance of anxiety disorders. Recently, evidence has accumulated that the behavioral assessment of ATB by means of reaction times is compromised by conceptual and methodological problems. In this review paper we argue that a brain-based assessment of ATB, which includes different mechanistic aspects of biased attention, may provide neuromechanistic knowledge regarding the etiology and maintenance of anxiety, and potentially start identifying different targets for effective treatment. We summarize examples for such an approach, highlighting the strengths of electrophysiological measurements, which include the sensitivity to time dynamics, specificity to specific neurocomputational mechanisms, and the continuous/dimensional nature of the resulting variables. These desirable properties are a prerequisite for developing trans-diagnostic biomarkers of attentional bias, and hence may inform individually tailored treatment approaches.

Highlights

One of the most important function of selective attention is the efficient and accurate detection and identification of cues associated with threat
Based on the aforementioned findings, MacLeod et al (2019), Dennis-Tiwary et al (2019) and Rosen et al (2019) concluded that based on RT-based indices, the evidence for the existence of an attentional threat bias (ATB) in anxious adults or children is none, or very weak at best. Considering these challenges, they suggest that current forms of attentional bias assessment may reveal characteristics of groups rather than individuals, which seems especially problematic if attentional bias indices are used in the context of individual attentional bias modification (ABM) treatment procedures
As an example for this approach, we summarize recent studies employing steady-state visual evoked potentials technology to investigate aforementioned neurophysiological processes

Summary

Threat biases in attention and perception: a mechanistic approach

The human nervous system is the product of millions of years of natural selection, driven by ever-changing environmental pressures. This hypothesis is based on cognitive theories that highlight the prioritized processing of threat cues as a central mechanism in the etiology and maintenance of anxiety (for a recent review see Van Bockstaele et al, 2014) One prediction of this mode is that individuals with high levels of self-reported trait anxiety, and patients with disorders in the fear and anxiety spectrum should show evidence of this so-called attentional bias, i.e., they are expected to display preferential allocation of attention to threatening cues, compared to other stimuli. This work in turn has strongly relied on experimental designs developed for the behavioral assessment of biased information processing, discussed

Cognitive task performance indices of ATB and their psychometric properties

Cognitive neuroscience studies of ATB in anxiety

Studies of neural gain at the level of visuocortical population activity

Studies of changing representations as a function of experience

Studies of lateral inhibition between visuocortical representations

Conclusions and future directions