Effects of Naturalistic Benzodiazepine Use on Selective Attention to Threat Cues Among Anxiety Disorder Patients

Abstract

The present study examined the effects of naturalistic benzodiazepine (BZ) use on selective attention to threat cues in 50 patients diagnosed with anxiety disorders, according to DSM-IV (APA, 1994) criteria. Patients provided information on their BZ use histories, demographics, and severity of anxiety symptomatology, and completed a computerized Stroop task involving color naming of social threat, physical threat, and matched no-threat control words. Patients were selected to fill two age-, gender-, and diagnosis-matched groups based on self-reported BZ use histories: 25 current BZ users versus 25 medication nonusing controls. Planned comparisons were conducted to determine whether BZ use groups differed in degree of selective attention to either the physical and/or social threat stimuli, or overall. Even with BZ use group differences in anxiety severity covaried out, the BZ users demonstrated significantly greater selective attention to threat than the medication nonusers, particularly in the case of physical threat stimuli. These findings are consistent with Westra and Stewart's (1998) suggestion that BZ use may increase preferential attention to physical threat cues, since BZs are often taken on an “as needed” (prn) basis. This “prn enhancement” interpretation was further supported through the finding of a significant positive correlation between frequency of prn use of BZs and degree of physical threat-related interference on the Stroop among the BZ users group. Theoretical explanations and clinical implications of these findings are discussed.