Memory biases in problematic social media use: The impact of attachment insecurity.

To align with emerging policies for adolescents, feasible, accurate, and equitable trauma-focused assessment protocols need to be developed. To date, most research on this topic has focused on whether traditional adverse childhood experiences (i.e., maltreatment, impaired caregiving) can adequately index mental health risk. Yet, there are noted clinical and statistical drawbacks to this approach. Instead, examining threat and reward biases, two subtypes of cognitive biases stemming from interpersonal trauma exposure, may provide a reasonable alternative to adversity screening. Thus, the aim of this study was to examine the accuracy and fairness of self-reported, trauma-informed cognitive vulnerabilities for classifying concurrent and prospective adolescent mental health risk relative to more commonly assessed childhood adversities. In a diverse adolescent sample (N = 584; MAge = 14.43; 48.9% female; 35% African American; 38.5% White; 40% Hispanic) youth completed measures for adversity exposure (family, dating, and community violence), threat biases (posttraumatic cognitions, hostility), and reward biases (anticipatory, consummatory) during an initial assessment, as well as symptoms of posttraumatic stress (PTS), depression, and violent behavior at baseline and 1 year later. Indices of statistical discrimination, calibration, and statistical fairness were examined using an evidence-based medicine analytic approach, which was subsequently compared to a machine learning approach. Overall, posttraumatic cognitions emerged as an accurate and statistically fair predictor of prospective PTS (area under the curve [AUC]95% CI = [0.63, 0.78]; diagnostic likelihood ratio [DLR]95% CI = [1.32, 3.52]), and to a lesser extent depression (AUC95% CI = [0.56, 0.70]; DLR95% CI = [1.25, 2.98]), and both models were well calibrated (i.e., p-value >05 for Spiegelhalter's Z test). Meanwhile, community violence (CV) exposure best classified the risk for prospective violent behavior (AUC95% CI = [0.62, 0.73]; DLR95% CI = [2.68, 5.49]), especially in males, and was well calibrated. The machine learning algorithms added limited incremental validity to our predictions. Our study suggests that focusing on posttraumatic cognitions and less invasive adversity items (i.e., CV exposure) may lead to trauma screening and assessment protocols that are accurate, equitable, and feasible to implement within applied settings serving diverse youth.

Rapidly acting therapeutics like 3,4-methylenedioxymethamphetamine (MDMA) are promising treatments for disorders such as posttraumatic stress disorder (PTSD). However, understanding who benefits most and the underlying neural mechanisms remains a critical gap. Stratifying individuals by neural circuit profiles could help differentiate neural, behavioral, and affective responses to MDMA, enabling personalized treatment strategies. To investigate whether baseline stratification of individuals based on negative affect circuit profiles, particularly in response to nonconscious threat stimuli, can differentiate acute responses to MDMA. This randomized clinical trial, implementing a double-blinded, within-participant, placebo- and baseline-controlled design, was conducted at Stanford University School of Medicine between November 2, 2021, and November 9, 2022, for wave 1 data collection. Participants had used MDMA on at least 2 prior occasions, but not in the past 6 months, and had subthreshold PTSD symptoms and early life trauma but no current psychiatric disorders. Data were analyzed from March 1, 2023, to January 1, 2024. Participants completed 4 visits: 1 baseline session followed by 1 placebo session and 2 MDMA sessions in a randomized order, totaling 64 visits. Baseline functional magnetic resonance imaging (fMRI) assessed the negative affect circuit using a nonconscious threat processing task (NTN). Primary outcomes included activity and connectivity of amygdala and subgenual anterior cingulate cortex (sgACC) defining the negative affect circuit. Secondary outcomes were behavioral measures of implicit threat bias, likability of threat expressions, and affective assessments. Sixteen participants (10 [63%] female; mean [SD] age, 40.8 [7.6] years) were stratified into subgroups with high and low levels of NTN activity in the amygdala (NTNA+ [n = 8] and NTNA- [n = 8], respectively), based on a median split of baseline nonconscious threat-evoked fMRI responses. Following administration of the 120 mg of MDMA vs placebo, the NTNA+ subgroup showed significant reductions in amygdala (contrast estimate [CE], -1.43; 95% CI, -2.60 to -0.27; Cohen d, -1.22; P = .02) and sgACC activity (CE, -1.48; 95% CI, -2.42 to -0.54; Cohen d, -1.56; P = .004), increased sgACC-amygdala connectivity (CE, 0.65; 95% CI, 0.02-1.28; Cohen d, 1.02; P = .04), and increased likability of threat expressions (CE, 14.38; 95% CI, 1.46-27.29; Cohen d, 0.86; P = .03) compared with the NTNA- subgroup. In this randomized clinical trial of MDMA's acute profiles, 120 mg of MDMA acutely normalized negative affect circuit reactivity in participants stratified by heightened amygdala reactivity at baseline, demonstrating the potential of neuroimaging to identify prospective biomarkers and guide personalized MDMA-based therapies. ClinicalTrials.gov Identifier: NCT04060108.

Research has shown that some individuals do not benefit from exposure therapy and for those who do, fear can return. Occasional reinforcement, which involves intermittently reinforcing the feared outcome during exposure, and affect labeling, in which individuals describe their current affective state during exposure, are two inhibitory retrieval strategies that have shown promise for augmenting exposure interventions. Yet, it remains unclear whether these strategies differ in their efficacy for attenuating return of fear across multiple levels of analysis. Accordingly, the present treatment-analogue experiment examined the effects of a multi-session imagery-based exposure manipulation that included reminders of the feared outcome or prompts to label one’s affective experience in a phobic sample on threat expectancy, behavioral avoidance, and attentional bias for threat. Community adults ( N = 136) who met diagnostic criteria for snake phobia were randomized to a single-cue video exposure alone condition (S), a multiple-cue video exposure condition that occasionally reinforced the feared outcome (i.e., snake bite; FO), or a multiple-cue video exposure condition that instructed participants to label their affective response (AL). Results revealed significant reductions in threat expectancy and behavioral avoidance, but not attentional bias for threat, for all three groups. Although there were no significant group differences in threat expectancy and attentional bias for threat at a 1-week follow up, those in the FO condition completed significantly more BAT steps than the AL group and this group difference was partially mediated by distress variability and within-session fear reduction. The implications of these findings for the inhibitory retrieval theory are discussed.

Attachment styles can influence how individuals perceive and cope with chronic pain. This study examined the relationships between attachment security, pain coping and functioning in young adults with chronic pain, focusing on the mediating role of cognitive appraisals. This cross-sectional study included 206 young adults attending university aged 17-29 with chronic pain (Mage = 19.24, SD = 2.03) and 346 without pain (Mage = 19.11, SD = 1.79). Participants completed measures assessing pain characteristics, attachment security, pain coping strategies, physical and social functioning and cognitive appraisals relating to bodily and social threat bias and pain catastrophising. SPSS PROCESS macro was used to test mediational hypotheses. Young adults with chronic pain had greater insecure attachment than controls (Mann-Whitney U = 41639.50, p < 0.001). Insecure attachment was significantly associated with poorer solution-focused coping and social functioning (r = -0.330 and - 0.355 respectively), and increased emotion-focused avoidance (r = 0.317). Social threat bias partially mediated the effects of attachment security on emotion-focused avoidance and social functioning. Pain catastrophising partially mediated the effects of attachment security on solution-focused coping and social functioning, and fully mediated its effects on emotion-focused avoidance. An indirect effect of attachment security on reframing and distraction was found via social threat and pain catastrophising. Insecure attachment is heightened in young adults with chronic pain and may contribute to poorer pain coping and social functioning through cognitive appraisals, specifically social threat and pain catastrophising. These may be useful targets for intervention.

Low working memory underpins the association between aberrant functional properties of pain modulation circuitry and chronic back pain severity.

ABSTRACT Exposure therapy is an efficacious treatment for anxiety-related disorders. Yet, fear often returns after treatment. Occasional reinforcement, in which the feared stimulus is intermittently presented during extinction, increases safety learning and slows fear renewal in conditioning paradigms and analogue samples, but no studies to date have examined this strategy in clinical samples. The present study examined the effects of vicarious occasional reinforcement on fear renewal in a snake-phobic sample across multiple levels of analysis. Fear was intermittently reinforced by providing reminders of the feared outcome (a snake bite) throughout a two-session analogue video exposure manipulation. Snake-phobic adults were randomized to one of three conditions: a single-cue [S], multiple-cue [M], or multiple-cue+fear-outcome [M+FO] exposure group. Results showed the three groups did not significantly differ in threat expectancy or attentional bias for threat at follow-up. Despite sustained anxiety, however, the M+FO condition completed significantly more steps on a visual avoidance task at follow-up than the M and S conditions and heightened mean distress during exposure mediated this effect. The M and S groups did not significantly differ in visual avoidance at follow-up. These findings suggest incorporating reminders of the feared outcome into exposure may be an effective strategy for increasing inhibitory retrieval.

Emotional stimuli are preferentially processed in the visual system, in particular, fearful faces. Evidence comes from unimodal studies with emotional faces, although real-life emotional encounters typically involve input from multiple sensory channels, such as a face paired with a voice. Therefore, in this study, we investigated how emotional voices influence preferential processing of co-occurring emotional faces. To investigate early visual processing, we used the breaking continuous flash suppression paradigm (b-CFS): We presented fearful, happy, or neutral faces to one eye, which were initially inaccessible to conscious awareness due to the predominant perception of a dynamic mask presented to the other eye. Faces were presented either unimodally or paired with non-linguistic vocalizations (fearful, happy, neutral). Thirty-six healthy participants were asked to respond as soon as the faces reached conscious awareness. We replicated earlier findings that fearful faces broke suppression faster overall, supporting a threat bias. Moreover, all faces broke suppression faster when paired with voices. Interestingly, faces paired with neutral and happy voices broke suppression the fastest, followed by faces with fearful voices. Thus, in addition to supporting a threat bias in unimodally presented fearful faces, we found evidence for crossmodal facilitation.

Cognitive vulnerability to anxiety can partly be explained by an interplay of attentional biases and control processes. This suggests that when aiming to reduce anxiety, simultaneously reducing an attentional bias for threat and strengthening control processes would be the optimal approach. We investigated whether a combined web-based Attentional Bias Modification (ABM) with affective Working Memory Training (WMT) was effective in reducing trait anxiety relative to control conditions and whether state anxiety moderated ABM effects. In this pre-registered randomized controlled trial, adults with heightened trait anxiety (n = 433) received either an active or control visual search ABM combined with an active or control emotional chessboard WMT training (2 × 2 design). Trait anxiety (primary outcome) was assessed at pre- (T1), mid- (T2), and post-training (T3), and at 1, 2, and 3-months follow-up. Attentional Bias (AB) and Working Memory (WM) capacity were assessed at T1, T2, T3, and FU3. State anxiety was measured prior to each training session. Irrespective of the training conditions, participants showed a decrease in trait anxiety over time. The ABM training was associated with stronger reductions in AB. The WMT training was not associated with more improvements in WM capacity relative to the control condition. No moderating effects of state anxiety, baseline AB or WM capacity were observed. The findings suggested that the current type of ABM combined with WMT in a web-based format, without therapist support, was not effective in reducing trait anxiety beyond control conditions.The study was registered in the Netherlands Trial Register (NTR-NL4525, https://www.onderzoekmetmensen.nl/en/trial/23135). The online version contains supplementary material available at 10.1007/s10608-024-10565-y.

Visual and behavioral responses to social and non-social threats: A multi-site replication

Interpersonal trauma Dissociates borderline from other personality disorders in social orienting

A multilevel examination of an inhibitory retrieval approach to exposure: Differentiating the unique and combined effects of multiple-context and multiple-stimulus cues

The possibility of experiencing physical harm caused by an object, animal, or person is an omnipresent risk in almost any situation. People show variability in their in the propensity to perceive the possibility of harm from any ostensibly innocuous object or situation-a so-called threat bias. Despite the important psychological and societal consequences resulting from individual differences in physical threat bias, there does not currently exist an easily administered means to capture this disposition. We therefore endeavored to create a brief reliable self-report index of threat sensitivity for use by the many fields interested in the role of threat processing. We present here a physical threat sensitivity scale (TSS) that captures the dispositional tendency to perceive the possibility of physical harm in ostensibly innocuous situations or objects. We detail the development and validation of the TSS as a reliable index of individual threat bias (Studies 1a and 1b) and provide strong convergent evidence of the relationship between TS and both relevant individual differences (Study 2) and behavioral and perceptual indicates of threat bias (Study 3 and Study 4).

People are evolutionarily predisposed to associate threat relevant stimuli with fear or aversiveness and show an attentional bias toward threat. Attentional bias modification (ABM) has been shown to reduce threat biases, while quantitative reviews assessing the effectiveness of bias modification yielded inconsistent results. The current study examined the relationship between the training effect of attentional bias to threat and the type of threatening stimuli. Twenty-two participants performed a modified dot-probe task while undergoing functional near-infrared spectroscopy (fNIRS) imaging. Results indicated that there was a strong pattern of attentional avoidance among individuals in an animal but not human threat condition. Furthermore, findings from fNIRS confirmed that the influence from type of threatening stimulus would be modulated by cortical activation patterns, especially in the ventrolateral prefrontal cortices (vlPFC) and angular gyrus. Overall, these results suggest that stimulus-specific may play a major role in personalization of specific psychological interventions.

Top-down processes such as expectations have a strong influence on pain perception. Predicted threat of impending pain can affect perceived pain even more than the actual intensity of a noxious event. This type of threat bias in pain perception is associated with fear of pain and low pain tolerance, and hence the extent of bias varies between individuals. Large-scale patterns of functional brain connectivity are important for integrating expectations with sensory data. Greater integration is necessary for sensory integration; therefore, here we investigate the association between system segregation and top-down threat bias in healthy individuals. We show that top-down threat bias is predicted by less functional connectivity between resting-state networks. This effect was significant at a wide range of network thresholds and specifically in predefined parcellations of resting-state networks. Greater system segregation in brain networks also predicted higher anxiety and pain catastrophizing. These findings highlight the role of integration in brain networks in mediating threat bias in pain perception.

IntroductionLoss-of-control (LOC) eating, a key feature of binge-eating disorder, may relate attentional bias (AB) to highly salient interpersonal stimuli. The current pilot study used magnetoencephalography (MEG) to explore neural features of AB to socially threatening cues in adolescent girls with and without LOC-eating.MethodsGirls (12–17 years old) with overweight or obesity (BMI &amp;gt;85th percentile) completed an AB measure on an affective dot-probe AB task during MEG and evoked neural responses to angry or happy (vs. neutral) face cues were captured. A laboratory test meal paradigm measured energy intake and macronutrient consumption patterns.ResultsGirls (N = 34; Mage = 15.5 ± 1.5 years; BMI-z = 1.7 ± 0.4) showed a blunted evoked response to the presentation of angry face compared with neutral face cues in the left dorsolateral prefrontal cortex, a neural region implicated in executive control and regulation processes, during attention deployment (p &amp;lt; 0.01). Compared with those without LOC-eating (N = 21), girls with LOC-eating (N = 13) demonstrated a stronger evoked response to angry faces in the visual cortex during attention deployment (p &amp;lt; 0.001). Visual and cognitive control ROIs had trends suggesting interaction with test meal intake patterns among girls with LOC-eating (ps = 0.01).DiscussionThese findings suggest that girls with overweight or obesity may fail to adaptively engage neural regions implicated in higher-order executive processes. This difficulty may relate to disinhibited eating patterns that could lead to excess weight gain.

BackgroundIrritability is common in multiple psychiatric disorders and is hallmark of disruptive mood dysregulation disorder. Child irritability is associated with higher risk of suicide and adulthood mental health problems. However, the psychological mechanisms of irritability are understudied. This study examined the relationship between anxiety sensitivity and irritability among youth, and further explored three possible mediated factors: selective attention for threat, delayed reward discounting, and insomnia.MethodsParticipants were 1417 students (51.7% male; mean age 13.83 years, SD = 1.48) recruited from one high school in Hunan province, China. Self-report questionnaires were used to measure irritability (The Affective Reactivity Index and The Brief Irritability Test), anxiety sensitivity (The Childhood Anxiety Sensitivity Index), selective attention for threat (The Davos Assessment of Cognitive Biases Scale-attention for threat bias subscale), insomnia (The Youth Self-Rating Insomnia Scale), and delayed reward discounting (The 27-item Monetary Choice Questionnaire). Structural equation modal (SEM) was performed to examine mediated relations.ResultsAnxiety sensitivity was modestly related to irritability and insomnia (r from 0.25 to 0.54) and slightly correlated with selective attention for threat (r from 0.12 to 0.28). However, there is no significant relationship of delayed rewards discounting with anxiety sensitivity and irritability. The results of SEM showed that selective attention for threat (indirect effect estimate = 0.04) and insomnia (indirect effect estimate = 0.20) partially mediate the relationship between anxiety sensitivity and irritability, which explained 34% variation.ConclusionsAnxiety sensitivity is an important susceptibility factor for irritability. Selective attention for threat and insomnia are two mediated mechanisms to understand the relationship between anxiety sensitivity and irritability.

Putting things right: An experimental investigation of memory biases related to symmetry, ordering and arranging behaviour

ABSTRACT Past studies argued that the attentional capture by threats is hard to inhibit. When using threats as task-irrelevant stimuli, this effect can deteriorate performance on the primary task. Whether attentional capture is driven by affective information (threat) or visual features (shape) is still debated. Here we aimed to investigate the role of threat value and shape in modulating attentional resources by conducting two experiments (total N = 87). Participants engaged in a semantic vigilance task responding to masked words appearing at the centre of the screen while ignoring threat-relevant (threatening or visually similar but nonthreatening) and neutral control distractor images placed at different distances from the target word. We found no performance difference between participants exposed to threat-related stimuli via affective or shape features. Moreover, while performance decreased when a neutral distractor appeared close (compared to further away) to the target word, stimulus eccentricity had no effect when the distractor (irrespective of the conveying feature) was threat relevant. Our findings are in line with previous studies showing an initial capture of attention by threat-relevant information but that this negative effect is compensated by an increase in arousal. We conclude that even the visual features of a stimulus can modulate attention toward threats.

IntroductionCultural differences in self-reported social anxiety between people of East Asian heritage and European heritage may be related to differences in independent and interdependent self-construals, which potentially influence the processing of social threat.MethodsWe examined the roles of two different aspects of threat bias: threat appraisal (Study 1) and attentional bias (Study 2) to explain cultural group differences in social anxiety between Japanese and European American college students.ResultsStudy 1 demonstrated that sequential mediations of lower independent self-construal and higher appraisal of threat among Japanese could explain their higher social anxiety compared to European Americans. However, Study 2 failed to find the relation between cultural group differences in self-construals and attentional bias. In addition, the cultural group differences in attentional bias were unexpectedly due to stronger selective attention toward neutral stimuli among European Americans, rather than bias toward social threat among Japanese. After selective attention was experimentally manipulated, there were significant cultural group differences in self-reported social anxiety and anxious behavior in a speech task.DiscussionThese conflicting findings suggested that an alternative theoretical framework other than the self-construal theory might be needed to fully account for cultural differences in attentional bias in explaining cultural group differences in social anxiety.