Threat-related Attention Bias Research Articles

Content specificity of threat-related attentional bias in health anxiety: evidence from computational modelling

Content specificity of threat-related attentional bias in health anxiety: evidence from computational modelling

Observational learning of threat-related attentional bias

ABSTRACT Attentional bias to threat has been almost exclusively examined after participants experienced repeated pairings between a conditioned stimulus (CS) and an aversive unconditioned stimulus (US). This study aimed to determine whether threat-related attentional capture can result from observational learning, when participants acquire knowledge of the aversive qualities of a stimulus without themselves experiencing aversive outcomes. Non-clinical young-adult participants (N = 38) first watched a video of an individual (the demonstrator) performing a Pavlovian conditioning task in which one colour was paired with shock (CS+) and another colour was neutral (CS−). They then carried out visual search for a shape-defined target. Oculomotor measures evidenced an attentional bias toward the CS+ colour, suggesting that threat-related attentional capture can ensue from observational learning. Exploratory analyses also revealed that this effect was positively correlated with empathy for the demonstrator. Our findings extend empirical and theoretical knowledge about threat-driven attention and provide valuable insights to better understand the formation of anxiety disorders.

The effect of working memory load on selective attention to emotional faces for social anxiety individuals.

Research has confirmed that individuals with social anxiety (SA) show an attentional bias towards threat-related stimuli. However, the extent to which this attentional bias depends on top-down cognitive control processes remains controversial. The present study investigated the effect of working memory (WM) load on selective attention to emotional faces in both high social anxiety (HSA) and low social anxiety (LSA) groups by manipulating WM load through the inclusion of forward counting in multiples of two (low load) or backward counting in multiples of seven (high load) within a modified flanker task. In the flanker task, emotional faces (angry, happy, or neutral faces) were used as targets and distractors. A total of 70 participants (34 HSA participants; 36 LSA participants) completed the flanker task in the laboratory. The results showed that the HSA individuals performed worse when responding to angry targets. Relative to LSA individuals, HSA individuals showed interference from angry distractors in the flanker task, resulting in significantly lower accuracy in identifying angry targets compared to happy targets. These results were unaffected by the manipulation of WM load. The findings imply HSA individuals have impaired attentional control, and that their threat-related attentional bias relies more on the bottom-up automatic attentional process.

Time course of attentional bias in social anxiety: Evidence from visuocortical dynamics

Threat-related attentional bias is thought to have a causal influence on the etiology of social anxiety. However, there is uncertainty on whether attention dwells on or diverts away from threats, and the measurements typically utilized to explore attentional bias cannot continuously quantify changes in attention. Here, we used steady-state visual evoked potentials (ssVEPs) as a continuous neurophysiological measure of visual attentional processing to examine the time course of attentional bias in social anxiety. Participants with high (n = 18) and low (n = 18) social anxiety passively viewed two faces flickering at 15 and 20 Hz frequency to evoke ssVEPs, and completed Attentional Control Scale. The results showed that angry faces, as compared to happy and neutral faces, elicited larger ssVEP amplitudes for the time window of 180–500 ms after facial stimuli onset only in the high socially anxious individuals, and the effect extended to the next two periods of 500–1000 ms and 1000–1500 ms. The ssVEP amplitudes differed most when individuals with high social anxiety viewed angry-neutral expression combinations. Additionally, attentional control was negatively correlated with social anxiety and threat-related attentional bias. The results suggested that individuals with social anxiety initially oriented attention toward the threat and subsequently exhibited difficulty in disengaging attention from it, possibly due to impaired attentional control.

Effects of attention bias modification for anxiety: Neurophysiological indices and moderation by symptom severity

ObjectiveAttention bias modification (ABM) aims to decrease anxiety symptom severity through the reduction of threat-related attention bias (AB). Individual differences in treatment response and poor measurement reliability of AB have called its clinical promise into question. The current study examined whether individual differences in anxiety severity at baseline moderated treatment response, and employed both behavioral and neurophysiological metrics of AB. MethodsParticipants (N = 99) were randomly assigned to four weeks of ABM or placebo control training (PT). Self-reported anxiety symptom severity, and AB metrics and ERPs generated during the dot probe task were collected at baseline (Time 1), one-week post-intervention (Time 5), and at a three-month follow-up (Time 6). ResultsABM, relative to PT, reduced ERPs indexing attention discrimination (N170) and increased ERPs indexing salience tracking (P3). Increases in P3 were associated with ABM-related reductions in anxiety. Anxiety severity was reduced following ABM, but only among those with higher baseline anxiety symptom severity. ConclusionsABM effectively reduced symptom severity among those with higher levels of anxiety, and modulated neurophysiological indices of AB. SignificanceResults provide evidence for attention-relevant ERPs as outcomes of ABM treatment responsivity and suggest that ABM may be most beneficial for those with more severe anxiety symptoms.

The relationship between emotional valence, anxiety, and attentional bias

Emotional expressions are an evolutionarily conserved means of social communication. It is well-established that emotional stimuli capture attention more easily than neutral stimuli, a phenomenon often referred to as “emotional attention”. However, contradictory findings of the “threat superiority effect” and the “happy face advantage” provoke questions about how emotional valence biases attentional capture. In addition, an enduring attentional bias toward threat is commonly observed in highly anxious individuals, but the exact type of anxiety—state or trait—that modulates the attentional bias for threat has not been agreed upon. To understand how the valence of emotional faces affects attentional capture and how the type of anxiety modulates emotional attention, we preregistered and conducted an online visual search experiment via Amazon’s Mechanical Turk. Participants (n=154) searched for a unique emotional face (happy or angry) among three or seven distractor faces that were closely cropped and balanced for low-level image statistics. Consistent with the “happy face advantage”, we found an attentional bias for positive over negative valence in visual search, robust at both set sizes, in accuracy, response time, and inverse efficiency score. We also found that the anxiety ratings from the State-Trait Anxiety Inventory (STAI)—both state and trait anxiety—correlated positively with search accuracy for angry targets, but negatively with search accuracy for happy targets. Given these opposing patterns of correlation, we further computed a valence index of emotional attention as a difference in search accuracy between angry and happy targets. This valence index correlated strongly with anxiety, suggesting that participants with higher anxiety showed more threat-related attentional bias and less attentional bias to stimuli with positive valence. Together, our findings reveal the role of emotional valence in attentional capture and unveil a distinct impact of anxiety on attention to positive and threatening stimuli.

Transcranial direct current stimulation does not improve clinical and neurophysiological outcomes in panic disorder: A randomized sham-controlled trial.

Emerging evidence suggests that transcranial direct current stimulation (tDCS) has anxiolytic effects and may enhance emotional processing of threat and reduce threat-related attentional bias. Panic disorder (PD) is considered to be a fear network disorder along with prefrontal activity alterations. We aim to assess the effect of tDCS on clinical and physiological parameters in PD for the first time. In this triple-blind randomized sham-controlled pilot study, 30 individuals with PD were allocated into active and sham groups to receive 10 sessions of tDCS targeting the dorsolateral prefrontal cortex bilaterally at 2 mA for 20-min duration over 2 weeks. The clinical severity, threat-related attentional bias, interoceptive accuracy, and emotional recognition were assessed before, immediately after, and 1 month after tDCS. Active tDCS, in comparison to sham, did not elicit more favorable clinical and neuropsychological/physiological outcomes in PD. The present study provides the first clinical and neurobehavioral results of prefrontal tDCS in PD and indicates that prefrontal tDCS was not superior to sham in PD.

Mindfulness-Based Cognitive Therapy: A Preliminary Examination of the (Event-Related) Potential for Modifying Threat-Related Attentional Bias in Anxiety.

ObjectivesMindfulness-based cognitive therapy (MBCT) can reduce anxiety and depression symptoms in adults with anxiety disorders, and changes in threat-related attentional bias may be a key mechanism driving the intervention’s effects on anxiety symptoms. Event-related potentials (ERPs) can illuminate the physiological mechanism through which MBCT targets threat bias and reduces symptoms of anxiety. This preliminary study examined whether P1 ERP threat–related attentional bias markers in anxious adults change from pre- to post-MBCT delivered in-person or virtually (via Zoom) and investigated the relationship between P1 threat–related attentional bias markers and treatment response.MethodsPre- and post-MBCT, participants with moderate to high levels of anxiety (N = 50) completed a dot-probe task with simultaneous EEG recording. Analyses focused on pre- and post-MBCT P1 amplitudes elicited by angry-neutral and happy-neutral face pair cues, probes, and reaction times in the dot-probe task and anxiety and depression symptoms.ResultsPre- to post-MBCT, there was a significant reduction in P1-Probe amplitudes (d = .23), anxiety (d = .41) and depression (d = .80) symptoms, and reaction times (d = .10). Larger P1-Angry Cue amplitudes, indexing hypervigilance to angry faces, were associated with higher levels of anxiety both pre- and post-MBCT (d = .20). Post-MBCT, anxiety symptoms were lower in the in-person versus virtual group (d = .80).ConclusionsMBCT may increase processing efficiency and decreases anxiety and depression symptoms in anxious adults. However, changes in threat bias specifically were generally not supported. Replication with a comparison group is needed to clarify whether changes were MBCT-specific.Clinical Trials RegistrationNCT03571386, June 18, 2018.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12671-022-01910-x.

Development and validation of the Attention Bias Questionnaire (ABQ).

ObjectivesVarious psychopathologies are associated with threat‐related attention biases, which are typically measured using mechanized behavioral tasks. While useful and objective, behavioral measures do not capture the subjective experience of biased attention in daily‐living. To complement extant behavioral measures, we developed and validated a self‐report measure of threat‐related attention bias – the Attention Bias Questionnaire (ABQ).MethodsThe ABQ consists of nine items reflecting the subjective experience of attention bias towards threats. To enable personalized relevance in threat‐content, the general term “threat” was used, and respondents were instructed to refer to specific things that threaten them personally. In a set of five studies, the ABQ was developed and validated. Internal consistency, discriminant validity, test‐retest reliability, and convergent validity were tested.ResultsThe ABQ emerged as a coherent and stable measure with two sub‐scales: Engagement with Threat and Difficulty to Disengage from Threat. ABQ scores were positively correlated with trait anxiety, social anxiety, PTSD, and depression, as well as behaviorally measured attention bias.ConclusionAssessing the subjective experience of threat‐related attention bias can enrich existing knowledge about the cognitive mechanisms underlying psychopathology and complement extant behavioral bias measures in research and clinical evaluation.

Linking Threat-Related Attentional Biases Toward Bicyclists to Driving Behavior

Linking Threat-Related Attentional Biases Toward Bicyclists to Driving Behavior

Attentional processing biases to threat in schizophrenia: Evidence from a free-viewing task with emotional scenes

Attentional biases to threatening stimuli have been suggested to play a key role in the onset and course of schizophrenia. However, current research has not completely demonstrated this assumption. The aim of this eye-tracking study was to shed light on the underlying psychological mechanisms of schizophrenia by examining the attentional processing of socio-emotional information. Forty-four individuals with schizophrenia and 47 healthy controls were assessed in a 3-s free-viewing task with a social scene (i.e., happy, threatening, or neutral) in competition with a non-social one to determine the effects of emotional information on the different stages of the attentional processing. The location and latency of initial fixations (i.e., initial orienting), the firs-pass fixations and gaze duration (i.e., attentional engagement), and the percentage of total duration and total fixations (i.e., attentional maintenance) were analyzed. It was found that the schizophrenia group showed longer first-pass gaze duration, as well as higher percentage of total fixations and total duration toward threatening scenes in relation to the non-social ones, compared to controls. Therefore, an attentional bias toward threatening scenes in schizophrenia was found in the attentional maintenance and engagement, but not in the initial orienting of attention. Of note, the threat-related attentional bias was not associated with positive symptoms of schizophrenia. These findings offer empirical support to affective-information processing models stating that threatening information may confer psychological vulnerability to develop schizophrenia. Moreover, the results can improve psychological treatments, such as attentional bias modification paradigms or cognitive-behavior interventions managing maladaptive schemas related to threat.

Increasing cognitive load attenuates the moderating effect of attentional inhibition on the relationship between posttraumatic stress symptoms and threat-related attention bias variability

Theory and empirical evidence suggest that those with higher posttraumatic stress (PTS) symptoms and better attentional control (i.e., the strategic control of higher-order executive attention in regulating bottom-up, stimulus driven responses to prepotent stimuli; Sarapas et al., 2017) can use that ability to disengage and shift attention away from threat stimuli and reduce threat-related attentional dysregulation (i.e., avoidance/overcontrollers). Those with relatively worse attentional control lack the requisite resources to do this, leading to prolonged attentional engagement with threat stimuli and threat-related attention dysregulation (i.e., maintenance/undercontrollers). Given that attentional control is a limited resource, strategic avoidance of threat information or reduced threat-related attention dysregulation may not be possible among those with relatively higher attentional control when cognitive load is relatively high. To test this hypothesis, the interaction between PTS symptoms, attentional control, and cognitive load was examined as a predictor of threat-related attentional bias and threat-related attention bias variability. Participants (N = 125 undergraduate students) were randomly assigned to high or low load conditions. Participants completed self-report measures of PTS symptoms, a behavioral measure of attentional control, and a novel task that assessed threat-related attentional bias via eye movements and threat-related attention bias variability via button press. The results of a series of hierarchical regressions showed that attentional control moderated the relationship between PTS symptoms and threat-related attention bias variability in the low, but not high, load condition. This moderation effect was not observed for threat-related attentional bias assessed via eye-tracking. Consistent with theory, under conditions of higher cognitive load, overcontrollers may not be able to use attentional control to consistently regulate threat-related attention. Study findings suggest that it may be important to consider contextual factors that increase cognitive load, as well as individual differences in attentional control, when developing attention bias modification interventions to reduce PTS symptomatology.

Attentional bias during emotional processing: Behavioral and electrophysiological evidence from an Emotional Flanker Task.

Threatening stimuli seem to capture attention more swiftly than neutral stimuli. This attention bias has been observed under different experimental conditions and with different types of stimuli. It remains unclear whether this adaptive behaviour reflects the function of automatic or controlled attention mechanisms. Additionally, the spatiotemporal dynamics of its neural correlates are largely unknown. The present study investigates these issues using an Emotional Flanker Task synchronized with EEG recordings. A group of 32 healthy participants saw response-relevant images (emotional scenes from IAPS or line drawings of objects) flanked by response-irrelevant distracters (i.e., emotional scenes flanked by line drawings or vice versa). We assessed behavioural and ERP responses drawn from four task conditions (Threat-Central, Neutral-Central, Threat-Peripheral, and Neutral-Peripheral) and subjected these responses to repeated-measures ANOVA models. When presented as response-relevant targets, threatening images attracted faster and more accurate responses. They did not affect response accuracy to targets when presented as response-irrelevant flankers. However, response times were significantly slower when threatening images flanked objects than when neutral images were shown as flankers. This result replicated the well-known Emotional Flanker Effect. Behavioural responses to response-relevant threatening targets were accompanied by significant modulations of ERP activity across all time-windows and regions of interest and displayed some meaningful correlations. The Emotional Flanker Effect was accompanied by a modulation over parietal and central-parietal regions within a time-window between 550-690ms. Such a modulation suggests that the attentional disruption to targets caused by response-irrelevant threatening flankers appears to reflect less neural resources available, which are seemingly drawn away by distracting threatening flankers. The observed spatiotemporal dynamics seem to concur with understanding of the important adaptive role attributed to threat-related attention bias.

A Preliminary Investigation of ERP Components of Attentional Bias in Anxious Adults using Temporospatial Principal Component Analysis.

Threat-related attention bias is thought to contribute to the development and maintenance of anxiety disorders. Dot-probe studies using event-related potentials (ERPs) have indicated that several early ERP components are modulated by threatening and emotional stimuli in anxious populations, suggesting enhanced allocation of attention to threat and emotion at earlier stages of processing. However, ERP components selected for examination and analysis in these studies vary widely and remain inconsistent. The present study used temporospatial principal component analysis (PCA) to systematically identify ERP components elicited to face pair cues and probes in a dot-probe task in anxious adults. Cue-locked components sensitive to emotion included an early occipital C1 component enhanced for happy versus angry face pair cues and an early parieto-occipital P1 component enhanced for happy versus angry face pair cues. Probe-locked components sensitive to congruency included a parieto-occipital P2 component enhanced for incongruent probes (probes replacing neutral faces) versus congruent probes (probes replacing emotional faces). Split-half correlations indicated that the mean value around the PCA-derived peaks were reliably measured in the ERP waveforms. These results highlight promising neurophysiological markers for attentional bias research that can be extended to designs comparing anxious and healthy comparison groups. Results from a secondary exploratory PCA analysis investigating the effects of emotional face position and analyses on behavioral reaction time data are also presented.

Disgust face captures more attention in individuals with high social anxiety when cognitive resources are abundant: Evidence from N2pc

There is a debate about the relative contributions of top-down and bottom-up attention to the threat-related attentional bias. In this study we investigated the attentional bias in individuals with social anxiety under conditions of no, low and high visual working memory (WM) load. Event-related potential (ERP) and response time (RT) data were recorded while participants performed the dot-probe task and a concurrent change-detection task. The ERP results revealed that the maximum N2pc effect emerged in no visual WM load condition in individuals with social anxiety. The difference of N2pc effect between high socially anxious (HSA) and low socially anxious (LSA) groups was observed in no visual WM load condition, whereas this difference was eliminated under low and high load conditions. However, no significant main effects or interactions were observed in the behavioral index (reflected by Trial Level-Bias Score variability). Overall, the findings indicate the critical role of top-down attention on social anxiety-related attentional bias, which have important implication for attentional bias modification.

Individual differences in attentional control explain the differential expression of threat-related attentional bias among those with posttraumatic stress symptomatology and predict symptom maintenance up to one year later

Individual differences in attentional control may explain null findings and inconsistent patterns of threat-related attentional bias (ABT) that are common in the posttraumatic stress disorder (PTSD) literature. At Time 1 (T1), trauma-exposed community participants (N = 89) completed a clinical interview, self-report measures, and an eye-tracking task developed to assess ABT. Participants completed follow-up assessments online 6 (T2) and 12 (T3) months later. Those with higher PTSD symptoms and deficits in attentional control exhibited a pattern of undercontrol, characterized by attention maintenance on threat and increased arousal. In contrast, those with higher PTSD symptoms and relatively better attentional control exhibited a pattern of overcontrol, characterized by threat avoidance and reduced arousal. These effects were specific to threat stimuli. Among PTSD symptom clusters, symptoms of hyperarousal were of central importance to the observed effects. Results from the longitudinal analysis indicate that both of these patterns of ABT are maladaptive, resulting in symptom maintenance at T2 and T3. These results have implications for (a) reconciling tensions between disparate models of ABT (i.e., vigilance-avoidance vs. attention maintenance), (b) precision medicine based approaches to targeting PTSD-related ABT, and (c) understanding the transdiagnostic role that attentional control may play in influencing ABT expression.

Anxiety and threat-related attentional biases in adolescents with fragile X syndrome.

Fragile X syndrome (FXS) is a single-gene disorder highly associated with anxiety; however, measuring anxiety symptoms in FXS and other neurogenetic syndromes is challenged by common limitations in language, self-awareness and cognitive skills required for many traditional assessment tasks. Prior studies have documented group-level differences in threat-related attentional biases, assessed via eye tracking, in FXS and non-FXS groups. The present study built on this work to test whether attentional biases correspond to clinical features of anxiety among adolescents and young adults with FXS. Participants included 21 male adolescents with FXS ages 15-20years who completed an adapted eye-tracking task that measured attentional bias towards fearful faces of varied emotional intensity. Among participants without anxiety disorders, attentional bias towards fear increased across age, similar to non-FXS paediatric anxiety samples. In contrast, participants with anxiety disorders exhibited greater stability in fear-related attentional biases across age. Across analyses, subtle fear stimuli were more sensitive to within-group anxiety variability than full-intensity stimuli. Our results provide novel evidence that although threat-related attentional biases may correspond with anxiety outcomes in FXS, these associations are complex and vary across developmental and task factors. Future studies are needed to characterise these associations in more robust longitudinal samples, informing whether and how eye-tracking tasks might be optimised to reliably predict and track anxiety in FXS.

The role of negative affect in the association between attention bias to threat and posttraumatic stress: An eye-tracking study

Biased processing of threatening stimuli, including attention toward and away from threat, has been implicated in the development and maintenance of PTSD symptoms. Research examining theoretically-derived mechanisms through which dysregulated processing of threat may be associated with PTSD is scarce. Negative affect, a transdiagnostic risk factor for many types of psychopathology, is one potential mechanism that has yet to be examined. Thus, the present study (n = 92) tested the indirect effect of attention bias on PTSD via negative affect using rigorous eye-tracking methodology in a sample of urban-dwelling, trauma-exposed African-American women. We found support for the hypothesis that attention bias toward threat was indirectly associated with PTSD symptoms through increased negative affect. These results suggest that negative affect may be an important etiological process through which attention bias patterns could impact PTSD symptom severity. Implications for psychological and pharmacological therapeutic interventions targeting threat-related attention biases and negative affect are discussed.

A computational account of threat-related attentional bias.

Visual selective attention acts as a filter on perceptual information, facilitating learning and inference about important events in an agent’s environment. A role for visual attention in reward-based decisions has previously been demonstrated, but it remains unclear how visual attention is recruited during aversive learning, particularly when learning about multiple stimuli concurrently. This question is of particular importance in psychopathology, where enhanced attention to threat is a putative feature of pathological anxiety. Using an aversive reversal learning task that required subjects to learn, and exploit, predictions about multiple stimuli, we show that the allocation of visual attention is influenced significantly by aversive value but not by uncertainty. Moreover, this relationship is bidirectional in that attention biases value updates for attended stimuli, resulting in heightened value estimates. Our findings have implications for understanding biased attention in psychopathology and support a role for learning in the expression of threat-related attentional biases in anxiety.

The influence of visual working memory representations on attention bias to threat in individuals with high trait anxiety

Experimental studies have yielded discrepant results regarding the relationship between anxiety and attention bias to threat. Cognitive factors modulating the presence of threat-related attention bias in anxiety have drawn growing attention. Previous research demonstrated that visual working memory (WM) representations can guide attention allocation in a top-down manner. Whether threat-related WM representations affected the presence of attention bias in anxiety awaits examination. Combining a memory task and a dot-probe task, this study investigated how WM representations of faces with neutral or negative expressions modulated the attention bias to threat among highly anxious individuals versus controls. Results showed that highly anxious individuals developed more pronounced attention bias to threat when maintaining WM representations of negative faces as compared to the control group. There were no significant between-group effects when the WM representations were neutral. These results suggested that highly anxious individuals were more susceptible to the influence of mental representations with negative valence on attention deployment.