Threat Bias Research Articles

The Moderating Effect of Ego Depletion in the Relationship between Pain Threat and Attentional bias: Eye-tracking study

The Moderating Effect of Ego Depletion in the Relationship between Pain Threat and Attentional bias: Eye-tracking study

A Randomized Double-Blind Trial of D-Cycloserine Augmented Single-Session Exposure Therapy for Anxiety: Neurocognitive Mechanisms

Background - Drugs targeting the N-Methyl-D-aspartic acid (NMDA) system and learning rates have been proposed as potential adjunct treatments to boost the success of exposure therapy for anxiety disorders. However, the effects of the NMDA partial agonist d-cycloserine on psychological treatment have been mixed. We therefore investigated potential neurocognitive mechanisms underlying the clinical effects of d-cycloserine-augmented exposure therapy using a single-session testbed, to inform the optimal combination of this and similar agents with psychological treatment. Methods - This randomized double-blind study was run at a single location (university environment). Unmedicated patients with panic disorder received single-dose d-cycloserine (250mg; N=17) or matching placebo (N=16) 2hrs before one session of exposure therapy. Clinical symptom severity was measured using self-report and clinician-rated scales the day before and after treatment, and at 1- and 6-months follow-up. Neurocognitive markers were assessed one day after treatment, including two primary outcome measures threat bias for fearful faces (FDOT) and implicit panic associations (IAT) and a secondary outcome measure amygdala response to threat. Analysis was by intention-to-treat. Outcome - Threat bias (FDOT) reduced to a larger extent following d-cycloserine (CYC) versus placebo (PLAC) but failed to reach the corrected level of significance (p < 0·025) (mean difference -19·0, 95% CI -38·04 to -0·14; p=0·042, d=0·77). There were no significant drug effects on the IAT (mean difference -0·01, 95% CI -0·32 to 0·29; p=0·93, d=0·11). On the day after treatment, amygdala threat response was lower in the drug compared to the placebo group (mean difference -0·32, 95% CI -0·61 to -0·03; p=0·023, d=1·08), with lower magnitude predicting greater clinical improvement during follow-up across groups. D-cycloserine led to greater clinical recovery at 1-month follow-up (CYC 71% versus PLAC 25%, RR 2·55, CI 1·16-5·61, p=0·015). No serious side effects were reported. Interpretation - D-cycloserine-augmented single-session exposure therapy reduces amygdala response to threat, and this effect predicts later clinical response. These findings highlight a neurocognitive mechanism by which d-cycloserine may exert its augmentative effects on psychological treatment and bring forward a marker that may help understand and facilitate future development of adjunct treatments with CBT for anxiety disorders. Trial Registration Number: clinicaltrials.gov, NCT01680107 Funding - Medical Research Council, Oxford University John-Fell-Fund (D-cycloserine Augmented CBT for Panic Disorder; clinicaltrials.gov; NCT01680107). Declaration of Interest: AR and AN report no conflicts of interest. MB has received travel expenses from Lundbeck for attending conferences and has acted as a consultant for J&J. CH has received consultancy fees from Lundbeck, P1vital, J&J, Pfizer and Servier. Ethical Approval: Ethical approval was obtained from the South Central - Hampshire research ethics committee. All participants gave written informed consent.

Comorbid interpretation and expectancy bias in social anxiety and alcohol use

ABSTRACTBackground: In two studies, the present research examined whether being high in both social anxiety and alcohol use disorder symptoms is associated with a comorbid interpretation and expectancy bias that reflects their bidirectional relationship.Design: Cross-sectional, quantitative surveys.Methods: Measures of social anxiety and alcohol use disorder symptoms, as well as an interpretation and expectancy bias task assessing biases for social anxiety, drinking, and comorbid social anxiety and drinking.Results: In Study 1 (N = 447), individuals high (vs. low) in social anxiety had stronger social threat bias and individuals high (vs. low) in alcohol use disorder symptoms had stronger drinking bias. Those high in both social anxiety and alcohol use disorder symptoms endorsed interpretations and expectancies linking social interaction with alcohol use. Comorbid bias predicted membership into the high social anxiety/drinking group, even after taking into account single-disorder biases. In Study 2 (N = 325), alcohol use disorder symptoms predicted drinking bias and social anxiety symptoms predicted social anxiety bias. Alcohol use disorder symptoms, social anxiety symptoms, and their interaction predicted comorbid interpretation and expectancy bias.Conclusion: Results indicate unique cognitive vulnerability markers for persons with comorbid social anxiety and alcohol use disorder symptoms, which may improve detection and treatment of this serious comorbidity.

Maternal pre- and postnatal anxiety symptoms and infant attention disengagement from emotional faces

BackgroundBiases in socio-emotional attention may be early markers of risk for self-regulation difficulties and mental illness. We examined the associations between maternal pre- and postnatal anxiety symptoms and infant attention patterns to faces, with particular focus on attentional biases to threat, across male and female infants. MethodsA general population, Caucasian sample of eight-month old infants (N = 362) were tested using eye-tracking and an attention disengagement (overlap) paradigm, with happy, fearful, neutral, and phase-scrambled faces and distractors. Maternal self-reported anxiety symptoms were assessed with the Symptom Checklist-90/anxiety subscale at five time points between gestational week 14 and 6 months postpartum. ResultsProbability of disengagement was lowest for fearful faces in the whole sample. Maternal pre- but not postnatal anxiety symptoms associated with higher threat bias in infants, and the relation between maternal anxiety symptoms in early pregnancy and higher threat bias in infants remained significant after controlling for maternal postnatal symptoms. Maternal postnatal anxiety symptoms, in turn, associated with higher overall probability of disengagement from faces to distractors, but the effects varied by child sex. LimitationsThe small number of mothers suffering from very severe symptoms. No control for the comorbidity of depressive symptoms. ConclusionsMaternal prenatal anxiety symptoms associate with infant's heightened attention bias for threat. Maternal postnatal anxiety symptoms, in turn, associate with infant's overall disengagement probability differently for boys and girls. Boys may show enhanced vigilance for distractors, except when viewing fearful faces, and girls enhanced vigilance for all socio-emotional stimuli. Long-term implications of these findings remain to be explored.

Anxiety and Attentional Bias in Children with Specific Learning Disorders.

Children with specific learning disorders (SLDs) face a unique set of socio-emotional challenges as a result of their academic difficulties. Although a higher prevalence of anxiety in children with SLD is often reported, there is currently no research on cognitive mechanisms underlying this anxiety. One way to elucidate these mechanisms is to investigate attentional bias to threatening stimuli using a dot-probe paradigm. Our study compared children ages 9-16 with SLD (n = 48) to typically-developing (TD) controls (n = 33) on their attentional biases to stimuli related to general threats, reading, and stereotypes of SLD. We found a significant threat bias away from reading-related stimuli in the SLD, but not TD group. This attentional bias was not observed with the general threat and stereotype stimuli. Further, children with SLD reported greater anxiety compared to TD children. These results suggest that children with SLD experience greater anxiety, which may partially stem from reading specifically. The finding of avoidance rather than vigilance to reading stimuli indicates the use of more top-down attentional control. This work has important implications for therapeutic approaches to anxiety in children with SLD and highlights the need for attention to socio-emotional difficulties in this population. Future research is needed to further investigate the cognitive aspects of socio-emotional difficulties in children with SLD, as well as how this may impact academic outcomes.

Attention bias for social threat in youth with tic disorders: Links with tic severity and social anxiety

ABSTRACTMany individuals with Tourette syndrome and chronic tic disorders (TS/CTDs) report poor social functioning and comorbid social anxiety. Yet limited research has investigated the role of cognitive factors that highlight social threats in youth with TS/CTD, and whether these biases underlie tic severity and co-occurring social anxiety. This study examined whether selective attention to social threat is enhanced young people with TS/CTDs compared to healthy controls, and whether attention biases are associated with tic severity and social anxiety. Twenty seven young people with TS/CTDs and 25 matched control participants completed an experimental measure of attention bias toward/away from threat stimuli. A clinician-rated interview measuring tic severity/impairment (YGTSS Total Score) and questionnaire measures of social anxiety were completed by participants and their parents. Young people with TS/CTD showed an attention bias to social threat words (relative to benign words) compared to controls but no such bias for social threat faces. Attention bias for social threat words was associated with increasing YGTSS Total Score and parent-reported social anxiety in the TS/CTDs group. Mediation analysis revealed a significant indirect path between YGTSS Total Score and social anxiety, via attention to social threat. Tentatively, these associations appeared to be driven by impairment rather than tic severity scores. Preliminary data suggests that youth with TS/CTD have enhanced attention to threat, compared to controls, and this is associated with impairment and social anxiety. Attention to threat could offer a cognitive mechanism connecting impairment and social anxiety, and so be a valuable trans-diagnostic treatment target.

Impact of Vortex Initialization with Satellite Data Assimilation for Predicting Track and Intensity of Tropical Cyclone Chapala

The present study evaluates the impact of vortex initialization (VI) with assimilation of satellite observations in the National Centre for Medium Range Weather Forecasting-UK Met Office Unified (NCUM) global Model for prediction of extremely severe cyclonic storm (ESCS) Chapala formed over the Arabian Sea (AS) during 28 October–03 November 2015. For this purpose, two numerical experiments viz. Vort-Gts (assimilation of only Global Telecommunication System (GTS) observations with VI) and Vort-Rad (assimilation of GTS plus satellite observations with VI) are conducted. The model is run with a total of five different initial conditions (ICs) through 24 h cycles. The standard metrics of cyclone track errors such as Direct Position Errors (DPEs), Cross-Track Errors (CTEs), and Along-Track Errors (ATEs) are computed and found to have improved by 47, 40, and 57%, respectively in Vort-Rad over Vort-Gts. The intensity and land fall (LF) errors are significantly reduced in Vort-Rad in comparison with the Vort-Gts. The statistical skill scores such as equitable threat score (ETS) and bias are better represented in the Vort-Rad.

Attention Bias Modification Treatment for Adolescents With Social Anxiety Disorder

Social anxiety disorder (SAD) tends to emerge during the early teenage years and is particularly refractory to change even when standard evidence-based CBT treatments are delivered. Efforts have been made to develop novel, mechanistic-driven interventions for this disorder. In the present study, we examined Attention Bias Modification Treatment (ABMT) for youth with SAD. Participants were 58 adolescents (mean age = 14.29 years) who met diagnostic criteria for SAD and who were randomized to ABMT or a placebo control condition, Attention Control Training (ACT). We predicted that ABMT would result in greater changes in both threat biases and social anxiety symptoms. We also explored potential moderators of change including the severity of social anxiety symptoms, the level of threat bias at pretreatment, and the degree of temperament-defined attention control. Contrary to our hypotheses, changes in attention bias were not observed in either condition, changes in social anxiety symptoms and diagnosis were small, and significant differences were not observed between the ABMT and ACT conditions. Little support for the proposed moderators was obtained. Reasons for our failure to find support for ABMT and its potential moderators are explored and recommendations for changes in the ABMT paradigm are suggested.

S52. WORKING MECHANISMS OF VIRTUAL REALITY BASED CBT FOR PARANOIA: A RANDOMIZED CONTROLLED TRIAL EXAMINING COGNITIVE BIASES, SCHEMATIC BELIEFS AND SAFETY BEHAVIOR

BackgroundRecently, the efficacy of a novel virtual reality based cognitive behavior therapy (VR-CBT) for paranoia was demonstrated. Cognitive biases, cognitive limitations, negative schematic beliefs and safety behavior have been associated with paranoid ideations and delusions. It is unknown whether VR-CBT affects these associated factors, and how changes in these factors relate to changes in paranoid ideation.MethodsIn this multi-center randomized controlled trial patients with a psychotic disorder and paranoia were randomized to VR-CBT (n = 58) or treatment as usual (TAU; n = 58). VR-CBT consisted of maximally sixteen 60-minute individual therapy sessions. Paranoia, safety behavior, schematic beliefs, cognitive biases and limitations were assessed at baseline, post-treatment (at three months) and follow-up (at six months). Mixed model analyses were conducted to study treatment effects. Mediation analyses were performed to explore putative working mechanisms by which VR-CBT reduced paranoia.ResultsVR-CBT, but not TAU, led to reductions in jumping to conclusions, attention for threat bias and social cognition problems. Schematic beliefs remained unaffected. The effect of VR-CBT on paranoia was mediated by reductions in safety behavior and social cognition problems.DiscussionVR-CBT affects multiple mechanisms that are associated with paranoid ideation. Although maintaining factors of paranoia are likely to influence each other, targeting safety behavior and social cognitive problems seems effective in breaking the vicious circle of paranoia.

Threat Bias and Emotion Recognition in Victims of IPV.

Although there is growing evidence of the association between threat bias and psychopathology in many trauma-exposed populations, there are few studies with intimate partner violence (IPV) victims. The present study assessed threat bias in IPV victims. It also examined potential differences in facial recognition ability between victims and nonvictims. Participants were 153 female college students currently in a dating relationship. Participants completed demographic and abuse severity measures. They then completed a dot-probe task to assess threat bias, and a facial expression recognition task to assess speed and accuracy of recognition. Approximately 32% of the students sampled were currently in a physically abusive relationship. Results indicated that IPV victims had a bias toward fearful faces, and showed worse recognition of happy faces than nonvictims. These data suggest that the psychological impact of threat bias might vary temporally. Vigilance during threat may serve as a protective mechanism, whereas postthreat vigilance might be associated with psychopathology. Researchers should carefully consider the presence of threat bias in victim samples and include other victim groups in future assessments of threat bias. It will be important to test these relationships in other IPV victim samples, such as help-seeking victims and other community living victims.

Dynamic Measures of Anxiety-Related Threat Bias: Links to Stress Reactivity.

Exaggerated attention to threatening information, or the threat bias, has been implicated in the development and maintenance of anxiety disorders. Recent research has highlighted methodological limitations in threat bias measures, such as temporal insensitivity, leading to the development of novel metrics that capture change and variability in threat bias over time. These metrics, however, have rarely been examined in non-clinical samples. The present study aimed to explore the utility of these trial-level metrics in predicting anxiety-related stress reactivity (stress-induced negative mood state) in trait anxious adults (N = 52). Following a stressor, participants completed the dot probe task to generate threat bias scores. Stress reactivity was measured via stress-induced changes in subjective mood state. More variability in trial-level bias scores and greater bias away from threat (both mean and peak negative trial-level bias scores) predicted increased stress reactivity. The temporal characteristics of threat bias and implications for clinically-relevant measurement are discussed.

Stimulating the left dorsolateral prefrontal cortex reduces attentional bias for intergroup threat

Attentional bias (AB) towards threat is a common phenomenon in the context of intergroup threat, which plays an important role of protection for individuals. However, sustaining attentional bias towards the information of intergroup threat has a lot of negative effects on people’s life and social interaction. For example, it not only occupies cognitive resources, but also brings anxiety and interferences with individual’s judgment, even causes conflicts and contradictions among groups. So, it is significant to reduce excessive attention bias toward intergroup threat appropriately for the effective communication and cooperation among individuals and groups. According to Neurocognitive models of selective attention to threat, the allocation of attention in the presence of threat is regulated by two primary neural systems: a bottom-up amygdala-based system and a top-down system relying on the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortices (ACC). The first system would be related to the rapid response to the perceived salience of threatening stimuli in the environment, while the second system would be related to attentional control, responsible for regulating the attention to threatening stimuli. In this perspective, the attentional bias towards threat would be related to an increase of amygdala activation and a reduced activity of the DLPFC. What’s more, reducing AB via attention bias modification (ABM) procedures is associated with increased activation of the left dorsolateral prefrontal cortex (DLPFC). These suggested that DLPFC, in particular in the left hemisphere, is involved in the attentional control in presence of threatening stimuli. Therefore, in the present study, the causal role of the left DLPFC on AB towards intergroup threat was investigated by using the transcranial direct current stimulation (tDCS) technique during the completion of a dot-probe measure task. The transcranial direct current stimulation (tDCS), another non-invasive method of brain stimulation, which is able to reach the modulation of the cortical activities t through electrodes positioned over one’s scalp. Anodal stimulation facilitates cortical activity, whereas cathodal stimulation has opposite effects. In the present study, to stimulate the left dorsolateral prefrontal cortex, the anode electrode was positioned centered over the F3 according to the 10–20 international system and the reference electrode was placed at the ipsilateral arm. The results are as follows: compared to the sham stimulation; anodal tDCS exhibited a significant reduction in attentional bias towards intergroup threat. Further, the reaction time of target after threatening group significantly shorter than that after non-threatening group in sham group; we didn’t find attentional Bias for Intergroup threat in anodal group. Finds suggested that Anodal tDCS over the left DLPFC can reduce attentional bias to intergroup threat.

Association between attention bias to threat and anxiety symptoms in children and adolescents.

Considerable research links threat-related attention biases to anxiety symptoms in adults, whereas extant findings on threat biases in youth are limited and mixed. Inconsistent findings may arise due to substantial methodological variability and limited sample sizes, emphasizing the need for systematic research on large samples. The aim of this report is to examine the association between threat bias and pediatric anxiety symptoms using standardized measures in a large, international, multi-site youth sample. A total of 1,291 children and adolescents from seven research sites worldwide completed standardized attention bias assessment task (dot-probe task) and child anxiety symptoms measure (Screen for Child Anxiety Related Emotional Disorders). Using a dimensional approach to symptomatology, we conducted regression analyses predicting overall, and disorder-specific, anxiety symptoms severity, based on threat bias scores. Threat bias correlated positively with overall anxiety symptoms severity (ß=0.078, P=.004). Furthermore, threat bias was positively associated specifically with social anxiety (ß=0.072, P=.008) and school phobia (ß=0.076, P=.006) symptoms severity, but not with panic, generalized anxiety, or separation anxiety symptoms. These associations were not moderated by age or gender. These findings indicate associations between threat bias and pediatric anxiety symptoms, and suggest that vigilance to external threats manifests more prominently in symptoms of social anxiety and school phobia, regardless of age and gender. These findings point to the role of attention bias to threat in anxiety, with implications for translational clinical research. The significance of applying standardized methods in multi-site collaborations for overcoming challenges inherent to clinical research is discussed.

Self-reported Cognitive Biases Moderate the Associations Between Social Stress and Paranoid Ideation in a Virtual Reality Experimental Study.

Cognitive biases are associated with psychosis liability and paranoid ideation. This study investigated the moderating relationship between pre-existing self-reported cognitive biases and the occurrence of paranoid ideation in response to different levels of social stress in a virtual reality environment. This study included 170 participants with different levels of psychosis liability (55 recent onset psychosis, 20 ultrahigh risk for psychosis, 42 siblings of psychotic patients, and 53 controls). All participants were exposed to virtual environments with different levels of social stress. The level of experienced paranoia in the virtual environments was measured with the State Social Paranoia Scale. Cognitive biases were assessed with a self-report continuous measure. Also, cumulative number of cognitive biases was calculated using dichotomous measures of the separate biases, based on general population norm scores. Higher belief inflexibility bias (Z = 2.83, P < .001), attention to threat bias (Z = 3.40, P < .001), external attribution bias (Z = 2.60, P < .001), and data-gathering bias (Z = 2.07, P < .05) were all positively associated with reported paranoid ideation in the social virtual environments. Level of paranoid response increased with number of cognitive biases present (B = 1.73, P < .001). The effect of environmental stressors on paranoid ideation was moderated by attention to threat bias (Z = 2.78, P < .01) and external attribution bias (Z = 2.75, P < .01), whereas data-gathering bias and belief inflexibility did not moderate the relationship. There is an additive effect of separate cognitive biases on paranoid response to social stress. The effect of social environmental stressors on paranoid ideation is further enhanced by attention to threat bias and external attribution bias.

The interplay between trait anxiety, cognitive biases and attentional control in healthy individuals with psychotic-like experiences

Although both anxiety and cognitive biases contribute to psychosis, it is still unclear whether these factors interact in their influence on psychotic symptoms. The aim of the study was to examine the interactions between trait anxiety, cognitive biases and delusion-like experiences (PLEs) in a non-clinical sample; the moderational role of attentional control on this relationship was also considered in the study. Two subgroups of participants, 92 individuals (M=24.76; SD=6.33) with heightened (HA) trait anxiety and 78 individuals (M=23.09; SD=5.66) with lowered (LA) trait anxiety took part in the study. Anxiety, cognitive biases and attentional control were measured using self-report questionnaires. Regression analyses and moderation analyses were performed. External attribution bias predicted psychotic-like experiences in both groups, whereas attention to threat bias and belief inflexibility predicted PLEs within LA group. Further moderation analyses revealed that in LA group attention to threat bias increases PLEs only among individuals with a high and moderate ability to focus attention. The results indicated that trait anxiety is an important factor influencing the relationship between cognitive biases and PLEs, and that the ability to voluntarily focus attention is a significant moderator of the linkage between attention to threat bias and delusion-like experiences among low-anxious healthy individuals.

Attention bias modification reduces neural correlates of response monitoring

The error-related negativity (ERN) is an electrophysiological response to errors. Individual differences in the ERN have been posited to reflect sensitivity to threat and linked with risk for anxiety disorders. Attention bias modification is a promising computerized intervention that has been shown to decrease threat biases and anxiety symptoms. In the present study, we examined the impact of a single session of attention bias modification, relative to a control task, on the neural correlates of response monitoring, including the ERN, correct response negativity (CRN), and their difference (i.e., the ERN – CRN or ΔERN). The final sample included 60 participants who first completed a flanker task to elicit the ERN and CRN, and were then randomly assigned to attention bias modification (n=30) or a control task (n=30). After completing the attention bias modification or control task, participants completed the same flanker task to again elicit the ERN and CRN. Among participants who completed attention bias modification training, the ERN, CRN, and ΔERN decreased from the pre- to post-training assessment. In contrast, in participants who completed the control task, the CRN, ERN, and ΔERN did not differ between the pre- and post-training assessment. The presents study suggests that a single session of attention bias modification reduces neural correlates of response monitoring, including error-related brain activity. These results also support attention bias modification as a potential mechanistic-based intervention for the prevention and treatment of anxiety pathology.

Distress Intolerance Moderation of Attention to Emotion: An Eye-Tracking Study

Distress intolerance (DI) is an important individual difference reflective of the inability to endure aversive affective states and is relevant to multiple clinical populations, but underlying emotional processing mechanisms remain unclear. The current study used eye-tracking to examine biased attention towards emotional stimuli at baseline and in the context of acute stress in a non-clinical sample (N = 165). We hypothesized that DI would incrementally predict greater stressor-elicited increases in sustained/delayed disengagement, but not initial orientation/facilitated engagement negative (i.e., threat, dysphoric) attention biases, and that DI’s association with maladaptive stress regulation would depend on these increases. Partially consistent with predictions, DI was only independently associated with stressor-elicited increases in sustained negative bias and, unexpectedly, decreases in sustained positive bias. Further, DI and change in sustained threat bias marginally interacted to predict cardiovascular but not subjective anxious mood recovery. Theoretical implications are discussed.

Exogenous testosterone affects early threat processing in socially anxious and healthy women

Testosterone plays an important role in social threat processing. Recent evidence suggests that testosterone administration has socially anxiolytic effects, but it remains unknown whether this involves early vigilance or later, more sustained, processing-stages. We investigated the acute effects of testosterone administration on social threat processing in 19 female patients with Social Anxiety Disorder (SAD) and 19 healthy controls. Event-related potentials (ERPs) were recorded during an emotional Stroop task with subliminally presented faces. Testosterone induced qualitative changes in early ERPs (<200ms after stimulus onset) in both groups. An initial testosterone-induced spatial shift reflected a change in the basic processing (N170/VPP) of neutral faces, which was followed by a shift for angry faces suggesting a decrease in early threat bias. These findings suggest that testosterone specifically affects early automatic social information processing. The decreased attentional bias for angry faces explains how testosterone can decrease threat avoidance, which is particularly relevant for SAD.

Attentional biases for threat after fear-related autobiographical recall

ABSTRACTBackground: Previous studies suggested that affective state could enhance stimulus salience and modulate attention allocation for mood-congruent information, but contrasting data have been reported on the effects of mood induction on attentional biases for threat (ABTs) in non-clinical individuals.Objective: We aimed to assess whether laboratory-induced negative mood can increase individuals’ tendency to allocate attention on threatening stimuli, thus determining a difficulty in attentional disengagement from threat. We also aimed at assessing whether level of trait anxiety could modulate the effect of mood induction on attentional biases.Methods: We used an autobiographical episode recall procedure for mood induction (fear, happiness and neutral episode recall), and an exogenous cueing task with threatening and non-threatening images to assess attentional biases in 120 undergraduate students.Results: Participants showed a significant difficulty in disengaging attention from threat after recalling fear-related episodes, independently from their trait anxiety level.Conclusions: These findings clarify that the ABTs are not exclusive to anxiety disorders or high trait anxiety individuals, and could also arise in non-clinical individuals in a fearful context.

The effect of bicephalic stimulation of the dorsolateral prefrontal cortex on the attentional bias for threat: A transcranial direct current stimulation study.

Previous stimulation studies demonstrated that the dorsolateral prefrontal cortex (DLPFC) is involved in threat processing. According to a model of emotional processing, an unbalance between the two DLPFCs, with a hyperactivation of right frontal areas, is involved in the processing of negative emotions and genesis of anxiety. In the present study, we investigated the role of the right and left DLPFC in threat processing in healthy women who also completed the State-Trait Anxiety Inventory (STAI). We simultaneously modulated the activity of the right and left dorsolateral prefrontal cortex by applying bicephalic transcranial direct current stimulation (tDCS) before participants completed a modified version of the classic Posner task using threatening and nonthreatening stimuli as spatial cues. Anodal stimulation on the right DLPFC with a simultaneous cathodal stimulation over the left side induced a disengagement bias in individuals with low STAI scores and a facilitation bias in individuals with high STAI scores. Anodal stimulation on the left DLPFC with the simultaneous cathodal stimulation over the right side did not affect threat processing. The findings of the present study provided specific support to the hypothesis that unbalanced activation between left and right hemispheres with enhanced activation of the right DLPFC is critical in early top-down threat processing in healthy individuals.