Attentional Bias Research Articles

Abstract Background Stroke is a leading cause of disability, often accompanied by unilateral spatial neglect (USN), which severely impairs recovery. Traditional assessments like paper-pencil tests provide limited insights into behaviors and eye–hand coordination during real-world tasks. Advances in hand pose estimation and eye tracking in combination with augmented reality (AR) offer potential for data-driven assessments of naturalistic interactions. Objective This proof-of-concept study presents and evaluates a multimodal behavioral tracking system that captures gaze, body, and hand movements during interactions within an AR environment. Our primary goals are to (1) validate that this system can achieve robust and accurate interaction data capture in clinical settings, (2) show that the system can reliably detect known USN behavioral patterns, and (3) explore how comprehensive data can provide new understanding of eye–hand coordination deficits in USN. Methods We developed an AR-based assessment system using Microsoft HoloLens 2 and an external body-tracking camera to capture real-time gaze, hand, and body movements in an interactive environment. Multimodal data streams were temporally synchronized, fused, and filtered to enhance spatial accuracy and availability. Tracking performance was benchmarked against a traditional optical motion-capture system to validate reliability. In a study, 7 patients with right-brain lesions with mild to moderate USN and 8 healthy controls participated. Each performed a designed reaching task, stamping virtual sheets of paper that appeared randomly on a table. We analyzed participants’ search behavior patterns to assess attentional biases and examined gaze anchoring timing during targeted reaching motions to explore potential eye–hand coordination deficits. Results The fusion of hand-tracking data from the HoloLens 2 and external system reduced tracking loss from 25.7% to 2.4%, with an absolute trajectory error of 3.27 cm. The system demonstrated high usability and was well accepted by patients. Data from the control group confirmed the absence of intrinsic lateral biases in the system and task design. The USN group displayed typical search behavior through ipsilesional biases in gaze direction during visual exploration (median deviation 7.46 [1.61-9.48] deg, P <.05) and longer times to find contralesional targets (median difference 1.08 [0.20-1.80] s, P =.02). Additionally, the eye–hand coordination analysis revealed lateral differences in gaze anchoring during targeted reaching motions in the USN group, with earlier fixation on contralesional targets (median difference 112 [71-146] ms, P =.02). Conclusions The proposed AR framework provides a novel, comprehensive data-driven method for capturing interaction behavior in a controlled, yet naturalistic environment. Our results demonstrated the system’s effectiveness in measuring hallmark USN symptoms, such as gaze and head orientation biases, and highlighted its potential to complement traditional assessments by offering deep insights into torso rotation and eye–hand coordination with a high resolution and accuracy. This data-driven approach shows promise for enhancing current USN assessment practices and gaining new insights into patients’ behaviors.

In this manuscript, I provide a reflection on Bartlett et al.'s (2022) study, No Meaningful Difference in Attentional Bias Between Daily and Non-Daily Smokers. I begin with an overview of attentional bias and its measurement in addiction research, followed by a summary of the study by Bartlett et al. (2022). I then discuss the broader implications of this research, with particular emphasis on methodological implications for the field. Finally, I outline directions for future research that address limitations of previous studies and seek to integrate attentional bias mechanisms into contemporary value-based decision-making frameworks.

Eyes tell all: Dissecting attentional bias in social anxiety through emotional faces.

Linking attention bias to youth social anxiety and depression: Insights from computational modeling of the affective Posner task.

The association between social anxiety and deficits in reward processing is well established. However, it remains unclear how individuals with social anxiety process reward with different controllability as well as the underlying mechanisms. Hence, the current study aimed to investigate social reward processing in individuals with social anxiety, focusing on reward controllability to identify potential deficiencies in processing. 24 individuals with low social anxiety (LSAs) and 24 individuals with high social anxiety (HSAs) completed a Social Incentive Delay Cued-Flanker task. HSAs showed no difference in cue-P3 amplitude increase between controllable and uncontrollable reward cues, whereas LSAs did, indicating an early-stage attentional bias in HSAs. However, HSAs exhibited larger contingent negative variation (CNV) for controllable reward cues, indicating greater motor preparation at a later stage of cue processing. Additionally, under uncontrollable conditions, HSAs showed a blunted ΔRewP compared to LSAs in response to "worse-than-expectation" rewards, and the largest ΔRewP for "better-than-expectation" rewards. This suggests a pessimistic expectancy bias in HSAs towards obtaining social rewards under uncontrollable conditions. These results highlight the bias of HSAs in processing rewards with different controllability, which could be crucial mechanisms in the development and maintenance of social anxiety.

Modulation of attentional bias by hypnosis: Disentangling the effect of induction and suggestion.

Background Green spaces have been identified as beneficial for children’s mental health, as well as cognitive performance, however, less is known about the role of biodiversity within these environments. Here, we study the impact of greening schoolyards, especially with regard to biodiversity enrichment, on children’s behavior, emotion recognition, cognitive performance and mental effort, and attentional bias, compared to observations in control schools. Methods This study employs an interventional design, including two intervention and two control schools located in Belgium and the Netherlands. Data was collected from 169 children aged 7–12 years, assessing cognitive performance using a battery of cognitive tasks combined with eye tracking, as well as socio-emotional wellbeing via eye tracking and validated questionnaires. Baseline measurements were followed up every 6 months for 2 years. Findings Selective attention in the Stroop test and mental effort, as indicated by enlarged pupil diameters during cognitive tasks, increased more over time in the intervention group compared to the control group as schoolyard greening progressed. The intervention was associated with improved scores on prosocial behavior over time. These associations were independent of sex, age, country, education level of the household, the capacity to manage household incomes, and season. Attentional bias towards the emotion of happiness using eye-tracking did not show a significant difference in changes over time between intervention and control groups. Interpretation These findings suggest that a green, more biodiverse school environment could improve children’s cognitive and emotional functioning, highlighting the importance of designing schoolyard green spaces that enhance both nature contact and biodiversity as a valuable public health initiative.

BackgroundDeficits in the adaptive allocation of attention are considered a feature associated with autism spectrum disorder (ASD). It remains unclear whether the attention of children with ASD can be modulated involuntarily by stimulus-driven processes. Visual processing is believed to initiate with topological perception; thus, we investigate the modulation of attention shifts in children with ASD by altering topological properties. This approach aims to elucidate the mechanism underlying atypical attentional capture in ASD.MethodsOur study recruited 32 ASD children and 30 age-matched typically developing (TD) children. Employing an attentional capture paradigm, we systematically documented the eye movement of both ASD and TD participants in response to stimuli that included non-topological change (nTC), topological change (TC) and abrupt onset.ResultsThe results suggest that the attention of children with ASD fails to be captured by TC and onset stimuli, and the degree of attentional bias towards TC is significantly correlated with their scores on clinical diagnostic scales.ConclusionOur results suggest that atypical attentional capture in ASD children is likely a result of impaired processing of topological perception. This finding not only enhances our understanding of their attentional atypicality but also provides insights for intervention practices to improve global processing.

Background Attentional control abilities can affect a substance user’s attentional bias toward substance-related cues; however, research on this mechanism remains limited. Objectives This study used a dot-probe task to investigate the attentional processing mechanisms of smokers with different attentional control abilities for cigarette-related cues. Methods In total, 136 male smokers completed a flanker task to assess their attentional control ability. The attentional control scores of the participants were sorted from low to high, with the top 27% (36 participants) belonging to the high-attentional control group and the bottom 27% (36 participants) belonging to the low-attentional control group. Both groups then completed a dot-probe task to assess their attentional bias toward cigarette-related cues. Results The low attentional control group exhibited a significantly longer reaction time to inconsistent than to consistent trials (p < 0.001); meanwhile, the attentional bias and disengaging indices of smokers with low attentional control abilities were significantly greater than 0. No significant differences were found in the high attentional control group. Conclusion In smokers, attentional control abilities regulate attentional disengagement difficulties toward cigarette-related cues. Smokers with low attentional control ability may have an attentional bias toward cigarette-related cues due to difficulties in disengaging from cigarette-related cues, which may be an important factor in maintaining cigarette use. These results may guide approaches for the prevention of smoking and auxiliary treatment for smoking cessation.

Faces are special for humans. This importance is reflected in increased relative attention to faces, referred to as face attention bias (FAB). This preregistered study investigated FAB transdiagnostically in two neurodevelopmental disorders associated with social symptoms, autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). We assessed exogenous selective attention to faces using a dot-probe paradigm in adults with ASD, adults with ADHD, adults with both and non-clinical comparison adults. While comparison adults showed FAB as expected, adults with ASD did not. Yet, the between-group difference in FAB was not credible, contrary to our hypothesis. Critically, adults with ADHD but no ASD showed increased FAB, suggesting heightened exogenous selective attention towards faces. This increase was not reflected in oculomotor behaviour, indicating covert attentional mechanisms. Adults with comorbid ASD and ADHD did not show increased FAB. Saccades were produced faster towards face-cued targets across all groups, but no significant interaction with group emerged regarding oculomotor behaviour. These findings unveil an attentional signature in ADHD: a heightened bias for faces possibly connected to social symptoms. Furthermore, they highlight the nuanced and distinct attentional profiles in different neurodevelopmental disorders, underscoring the critical need to understand shared and distinct mechanisms of ASD and ADHD.

Readers utilize both foveal and parafoveal information to recognize letters and words effectively. In the fovea, the ability to identify letters is maximized, resulting in greater accuracy for letters that are directly fixated upon. Conversely, the accuracy of letter identification diminishes in the parafovea. Notably, letters at the beginning and end of words are often recognized more accurately than those in the middle, which yields a W-shaped function in identification accuracy and an M-shaped function in response times. Building upon these observations, word identification rates are higher for strings presented in the foveal area. Due to an attentional bias toward reading direction, there exists a greater ability to identify words in the right parafovea compared to the left. Given that deaf readers display a distinct distribution of visual attention, the present study aims to investigate, using a Rapid Parallel Visual Presentation paradigm, whether deaf readers differ in their ability to identify letters and words. Participants were presented with three-letter nonword and word sequences at foveal and parafoveal positions and instructed to identify post-cued letter and word targets. While both groups demonstrated the W-shaped accuracy function for letter identification, response times for deaf readers were characterized by a distinct M-shaped pattern, particularly for letters in the right visual field (RVF). Hearing participants exhibited a RVF advantage in word identification; however, deaf participants displayed a reduced RVF advantage, suggesting a more bilateral distribution of visual attention during reading. These results indicate that deafness leads to subtle yet significant differences in letter and word identification processes.

Military service members are frequently exposed to high-stress situations that profoundly impact both their psychological and physiological health. Understanding the interplay between stress and its multifaceted impacts is crucial for designing targeted interventions to optimize the health and performance of this population. This study investigated the relationships among psychological stress, psychological resilience, attention biases (attention to positive information, API; attention to negative information, ANI), emotional regulation strategies (cognitive reappraisal, CR; expression inhibition, EI), and key physiological markers, including hemoglobin (HGB) levels and red cell distribution width (RDW), in a sample of 673 male Chinese military personnel. The results revealed significant associations between psychological stress and attention biases and emotional regulation strategies, with direct effects for physiological markers such as HGB and RDW. Notably, EI emerged as a complex mediator, significantly reducing RDW despite increased psychological stress. These findings highlight the imperative to incorporate comprehensive stress management into military training programs, thereby enhancing health and operational readiness of service members in high-stress contexts.

Adolescence is a sensitive period for identity formation and peer evaluation. Teenagers are exposed to idealised and digitally altered content that perpetuates limited standards of attractiveness due to the growth of image-centric platforms like Instagram, TikTok, and Snapchat.Body Dysmorphic Disorder (BDD), affecting about 2.2% of adolescents, involves a persistent preoccupation with perceived flaws and is linked to depression, anxiety, and social withdrawal. This study examines the available data and makes the case that appearance-focused behaviours, such as obsessive feedback monitoring, filter dependence, and selfie editing, are more responsible for the link between social media and BDD than overall screen time. It highlight a filter paradox: beautification tools can provide short-term relief while increasing long-term vulnerability by widening the gap between the digital self and the mirror self. By combining cognitive-behavioral models, social comparison, and objectification, we suggest a mechanism through which exposure to in dealized imagery promotes self-objectification, upward comparison, and biases attention towards perceived flaws, all of which reinforce safety behaviours and sustain symptoms. By highlighting variations in samples, measurements, and overlooked modifiers, we resolve contradictory results. Platform-level disclosures, algorithmic diversity, and therapeutic approaches aimed at promoting digital safety behaviours are among the ramifications. We list the top goals for studies that focus on mechanisms and test BDD specifically.

Binge eating disorder (BED) is maintained by increased food-related incentive salience, which is reflected by an attentional bias for food. Oxytocin acutely attenuates this bias in patients with anorexia nervosa and reduces food intake in males with normal or increased body weight. However, results in individuals with BED have been inconclusive. We assessed the acute effect of oxytocin on food stimulus processing and reward-driven eating behavior in females with or without BED in a double-blind, placebo-controlled cross-over study. Females with BED (n = 48) and female control participants with overweight (n = 46) or normal weight (n = 40) received intranasal oxytocin (24 IU) and, respectively, placebo, after an overnight fast and a standardized breakfast. In participants with a natural menstrual cycle, sessions were scheduled during consecutive luteal phases. Participants completed a food-related dot-probe task with concurrent eye tracking and a bogus taste test measuring snack intake. Oxytocin compared to placebo increased dwell time bias on food stimuli in the BED relative to the overweight control group, in which this effect was reversed. Contrary to our hypothesis, oxytocin increased calorie intake across groups. Exploratory analyses indicated that the latter effect focused on females taking hormonal contraception. These results indicate disorder- and, respectively, sex-specific effects of oxytocin on food-related incentive salience and food intake and point to a role of oxytocin in binge eating pathology. They moreover suggest that sex hormones determine the acute effect of oxytocin on eating behavior in females.

Cognitive electroencephalographic potentials evoked by words as markers of the severity of the pathology and resistance to treatment in obsessive-compulsive disorder.

Background/Objectives: Attentional bias toward drug-related cues is a characteristic of drug dependence and plays a detrimental role during drug withdrawal. The present study examined attentional bias in female individuals with drug dependence. We focused on its temporal and spatial characteristics using drug-related and negative emotion dot-probe tasks. Methods: Fifty-one female participants with drug dependence (mean age = 24.71 ± 7.58 years) took part in the study. These participants were primarily dependent on methamphetamine and novel psychoactive substances. They completed tasks with two cue exposure durations (500 ms and 2000 ms) under three spatial conditions: match, mismatch, and neutral. Results: Results indicated that a global attentional bias toward drug-related cues, rather than a location-specific bias, was evident during the short cue exposure (500 ms), regardless of spatial alignment (ps < 0.05), whereas no bias was observed during the sustained attention stage (2000 ms). No attentional bias was observed for negative emotional stimuli, highlighting the stimulus-specific nature of this effect. Conclusions: These findings further support the incentive sensitization model of addiction, showing that interference from drug-related items, regardless of the specific orientation of attention, primarily drives short cue exposure attentional bias in females.

Previous studies have demonstrated that numerical magnitudes can induce attentional biases mainly in a horizontal space. The present study aimed to clarify spatial-numerical association in horizontal, vertical, and two-dimensional square stimuli composed of visually aligned strings of relatively smaller Arabic numerals (i.e., 1 or 2) or larger numerals (i.e., 8 or 9). Neurologically and psychiatrically healthy participants, all of whom were Japanese speakers, were instructed to identify the veridical center of the stimuli. The results indicated that, with horizontal stimuli, participants placed their subjective midpoint farther left when smaller numbers were presented compared to larger numbers, consistent with the predicted left-to-right mental number line. With vertical stimuli, however, smaller numbers induced biases upwards, inconsistent with the predicted bottom-to-top representation. For the square, the stimuli with number strings elicited biases with a stronger vertical component, whereas the stimuli without number strings elicited biases with a stronger horizontal component. The upward biases for the square stimuli with number strings may reflect the activation of object-based processing rather than the cognitive function of numerical processing. These findings suggest that distinct mechanisms may predominate over spatial-numerical associations with regard to the biases in the two-dimensional plane.

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

Hyperphagia-characterized by an overwhelming drive to consume food-is a core feature of Prader-Willi syndrome (PWS) that profoundly impacts individuals and families. Objective measures of hyperphagia are urgently needed to support therapeutic development and improve clinical outcomes for individuals with PWS. Eye tracking may offer a scalable, noninvasive method for capturing attentional responses to food cues. By capturing visual attentional responses to food before and after eating, eye tracking may offer an indirect, objective method for assessing impairments in satiety that are associated with hyperphagia. We adapted a previously developed eye-tracking task-designed to detect attentional bias to food stimuli in hungry versus satiated states-for use with the PWS community. A codesign approach was used, involving focus groups with caregivers and professionals. Stakeholders identified key barriers to participation, including food-related anxiety, sensory sensitivities and the need for predictable routines. Protocol adaptations included flexible scheduling, individualized meal options and 'food certainty' to reduce stress and enhance adherence. The adapted protocol was feasible and acceptable, with a 92.6% completion rate and full adherence to fasting and standardized meal requirements among participants with PWS. Stakeholders reported high engagement and comfort with the revised approach. This study demonstrates the value of codesign in tailoring neurocognitive protocols for individuals with complex needs. By integrating stakeholder insights, we enhanced feasibility, accessibility and data quality. The adapted eye-tracking protocol shows promise as a scalable, objective method to assess hyperphagia-related cognitive responses and may inform future clinical trials in PWS and related conditions.

BACKGROUNDAlthough extensive research has investigated attentional biases based on the looming vulnerability model of anxiety, the characteristics of attentional biases in individuals with looming cognitive styles (LCS) remain incompletely elucidated. No prior eye-tracking studies have examined the spatiotemporal dynamics of their threat-related attentional preferences.AIMTo investigate the nature and temporal pattern of attentional biases toward threat stimuli in individuals exhibiting different levels of LCS using eye-tracking technology.METHODSA total of 212 participants were stratified according to their Looming Maladaptive Style Questionnaire scores. From the high and low scoring subgroups, 35 participants were randomly selected for an eye-tracking experiment using a classic dot-probe paradigm featuring threat and neutral images. Four eye-tracking metrics, including first fixation latency, first fixation duration, total fixation duration, and fixation count, were analyzed to assess detection speed, attentional orienting, initial maintenance/avoidance, and overall engagement.RESULTSDistinct attentional bias patterns were observed between high and low LCS groups. High LCS individuals exhibited a vigilance-avoidance pattern characterized by initial vigilance toward threat stimuli (evidenced by faster detection and preferential orienting), followed by attentional avoidance, alongside sustained attention maintenance to threat.CONCLUSIONThese findings reveal a temporal dissociation between early vigilance and later avoidance during threat processing in high LCS individuals, providing novel empirical evidence to refine models of cognitive vulnerability and attentional dynamics in threat perception.