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ABSTRACT: Although several studies have documented an attentional bias toward threat in posttraumatic stress disorder (PTSD), the nature of this bias has not been clearly delineated. The present study utilized eye tracking technology to delineate the time course and components of attentional bias for threat cues in combat-related PTSD.
Veterans with PTSD (n = 21), combat-exposed veterans without PTSD (n = 16), and nonveteran controls (n = 21) viewed emotional expressions (fearful, disgusted, happy) paired with neutral expressions for 3 s presentations.
Veterans with PTSD maintained attention longer on the fearful and disgusted expressions relative to the happy expression. This negativity bias was sustained over the course of the 3 s trials, and robustly distinguished veterans with PTSD from both veterans without PTSD and nonveteran controls.
Dwelling on potential threat cues may reflect current PTSD symptoms, or it could reflect a cognitive vulnerability factor for PTSD.
Depression and Anxiety 05/2013; 30(5):497-502. · 4.18 Impact Factor
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ABSTRACT: Blood-injection-injury (BII) phobia is an anxiety disorder that can cause serious health consequences by interfering with medical treatment. Although attentional bias for threat appears to be a core feature of many anxiety disorders and a potential target of treatment, very little is known about attentional bias in BII phobia. In the present study, eye movements were recorded in individuals high and low in injection fear (HIF, LIF) during 18-s exposures to stimulus arrays containing injection, attack, appetitive, and neutral images. Evidence for attentional vigilance was mixed, as HIF individuals oriented to injection images more often than LIF individuals, but did not orient to injection images more often than other emotional images. In contrast, evidence of attentional avoidance was highly robust. HIF individuals rapidly disengaged from injection images on initial viewing and viewed these images less overall compared to other image types, a pattern not observed in the LIF group. Furthermore, attentional avoidance of injection threat was found to uniquely predict behavioral avoidance on an injection behavioral avoidance task (BAT), and group differences on the BAT were mediated by group differences in attentional avoidance. The implications of these findings for further delineating the nature and function of attentional biases in BII phobia are discussed.
Behaviour research and therapy 03/2013; 51(6):266-273. · 3.00 Impact Factor
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ABSTRACT: Although an attentional bias for threat-relevant cues has been theorized in posttraumatic stress disorder (PTSD), to date empirical demonstration of this phenomenon has been at best inconsistent. Furthermore, the nature of this bias in PTSD has not been clearly delineated. In the present study, veterans with PTSD (n = 20), trauma-exposed veterans without PTSD (n = 16), and healthy nonveteran controls (n = 22) completed an emotional attentional blink task that measures the extent to which emotional stimuli capture and hold attention. Participants searched for a target embedded within a series of rapidly presented images. Critically, a combat-related, disgust, positive, or neutral distracter image appeared 200 ms, 400 ms, 600 ms, or 800 ms before the target. Impaired target detection was observed among veterans with PTSD relative to both veterans without PTSD and healthy nonveteran controls after only combat-related threat distracters when presented 200 ms, 400 ms, or 600 ms before the target, indicating increased attentional capture by cues of war and difficulty disengaging from such cues for an extended period. Veterans without PTSD and healthy nonveteran controls did not significantly differ from each other in target detection accuracy after combat-related threat distracters. These data support the presence of an attentional bias toward combat related stimuli in PTSD that should be a focus of treatment efforts. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Journal of Abnormal Psychology 11/2012; · 4.86 Impact Factor
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ABSTRACT: A large body of research has demonstrated that affective disorders are characterized by attentional biases for emotional stimuli. However, this research relies heavily on manual reaction time (RT) measures that cannot fully delineate the time course and components of attentional bias. Eye tracking technology, which allows relatively direct and continuous measurement of overt visual attention, may provide an important supplement to RT measures. This article reviews eye tracking research on anxiety and depression, evaluating the experimental paradigms and eye movement indicators used to study attentional biases. Also included is a meta-analysis of extant eye tracking research (33 experiments; N=1579) on both anxiety and depression. Relative to controls, anxious individuals showed increased vigilance for threat during free viewing and visual search, and showed difficulty disengaging from threat in visual search tasks, but not during free viewing. In contrast, depressed individuals were not characterized by vigilance for threat during free viewing, but were characterized by reduced orienting to positive stimuli, as well as reduced maintenance of gaze on positive stimuli and increased maintenance of gaze on dysphoric stimuli. Implications of these findings for theoretical accounts of attentional bias in anxiety and depression are discussed, and avenues for future research using eye-tracking technology are outlined.
Clinical psychology review 09/2012; 32(8):704-23. · 4.90 Impact Factor
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ABSTRACT: Although current cognitive-behavioral models have highlighted a central role of dysfunctional “obsessive beliefs” about threat,
responsibility, uncertainty, perfectionism, importance and control of thoughts in the development of obsessive-compulsive
disorder (OCD), empirical evidence in support of this notion has been inconsistent. The present investigation further examines
the association between obsessive beliefs and OCD symptoms among nonclinical (Study 1) and clinical samples (Study 2). Findings
from Study 1 (n=368) demonstrated that OCD symptom dimensions are associated with some form of obsessive belief (generality). Although
findings from Study 1 revealed that different obsessive beliefs related to different OCD symptom dimensions in a meaningful
way (congruence), findings from Study 2 failed to support the hypothesis that OCD patients (n=30) would endorse obsessive beliefs more strongly than patients (n=30) with generalized anxiety disorder (specificity). However, both patient groups endorsed obsessive beliefs more strongly
than non-clinical controls (n=30). Implications of these findings for conceptualizing the relationship between obsessive beliefs and specific dimensions
of OCD are discussed.
KeywordsObsessive-compulsive disorder–Obsessive beliefs–Symptom dimensions–Vulnerability–Specificity
Cognitive Therapy and Research 04/2012; 35(2):108-117. · 1.33 Impact Factor
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ABSTRACT: Obsessive-compulsive disorder (OCD) and generalized anxiety disorder (GAD) are both defined by excessive negatively-valenced cognitions. Although obsessional thoughts are considered essential to OCD and perseverative worry is considered essential to GAD, these excessive cognitions have been found to co-occur in both disorders. Accordingly, a common diathesis may influence the emergence of excessive thoughts in both disorders. The present study examined deficits in attentional control as a cognitive vulnerability that may contribute to both obsessional thought and perseverative worry. Patients with OCD (n=30), GAD (n=29), and non-clinical controls (NCC; n=29) completed measures of obsessional thoughts, perseverative worry, and attentional control. Deficits in self-reported attentional control were found in both OCD and GAD relative to the NCC. However, attentional control was only related to excessive cognition in the GAD patient group, where deficits were associated with increased perseverative worry. Mediational modeling suggested that trait anxiety mediated the relationship between attentional control and perseverative worry in GAD. Implications of these findings for conceptualizing the role of attentional control in the genesis of excessive cognitions in OCD and GAD are discussed.
Behaviour research and therapy 08/2011; 49(11):756-62. · 3.00 Impact Factor
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ABSTRACT: Recent research suggests that an attentional bias toward threat may play a causal role in obsessive-compulsive disorder (OCD) with contamination concerns. However, the attentional components involved in this bias, as well as its behavioral correlates, remain unclear. In the present study, eye movements were recorded in individuals high and low in contamination fear (HCF, LCF, respectively) during 30-s exposures to stimulus arrays containing contamination threat, general threat, pleasant, and neutral images. HCF individuals oriented gaze toward contamination threat more often than LCF individuals in initial fixations, and this bias mediated group differences in responding to a behavioral challenge in a public restroom. No group differences were found in the maintenance of gaze on contamination threat, both in terms of initial gaze encounters, as well as gaze duration over time. However, the HCF group made shorter fixations on contamination threat relative to other image types. The implications of these findings for further delineating the nature and function of attentional biases in contamination-based OCD are discussed.
Journal of Abnormal Psychology 06/2011; 121(1):232-7. · 4.86 Impact Factor
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ABSTRACT: Although contamination sensitivity has been implicated in several disorders, there is a paucity of research examining the influence of this trait on various outcomes. Accordingly, the present study examined the extent to which individual differences in contamination sensitivity moderated state affect in response to a mood induction and subsequent information processing biases, as assessed by a lexical decision task (LDT). It was hypothesised that the moderating effects of contamination sensitivity would be specific to disgust responding to a negative but not positive mood induction, and to reaction times to disgust and fear compared to happy words on the LDT. The findings were largely consistent with this hypothesis, as contamination sensitivity predicted increased disgust and arousal to the negative mood induction. Contamination sensitivity was also a better predictor of reaction times to disgust and fear words than happy words. However, the moderating effect of contamination sensitivity on reaction times on the LDT was not mediated by its effects on response to the negative mood induction. Implications of these findings for conceptualising the role of contamination sensitivity and its association with disgust in specific disorders are discussed.
Cognition and Emotion 04/2011; 26(1):136-43. · 2.52 Impact Factor
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ABSTRACT: Although facial expressions are thought to vary in their functional impact on perceivers, experimental demonstration of the differential effects of facial expressions on behavior are lacking. In the present study, we examined the effects of exposure to facial expressions on visual search efficiency. Participants (n = 31) searched for a target in a 12 location circle array after exposure to an angry, disgusted, fearful, happy, or neutral facial expression for 100 ms or 500 ms. Consistent with predictions, exposure to a fearful expression prior to visual search resulted in faster target identification compared to exposure to other facial expressions. The effects of other facial expressions on visual search did not differ from each other. The fear facilitating effect on visual search efficiency was observed at 500-ms but not at 100-ms presentations, suggesting a specific temporal course of the facilitation. Subsequent analysis also revealed that individual differences in fear of negative evaluation, trait anxiety, and obsessive-compulsive symptoms possess a differential pattern of association with visual search efficiency. The experimental and clinical implications of these findings are discussed.
Emotion 04/2011; 11(5):1073-9. · 3.88 Impact Factor
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ABSTRACT: Although an attentional bias for threat has been implicated in generalized anxiety disorder (GAD), evidence supporting such a bias has been inconsistent. This study examines whether exposure to different emotional content modulates attention disengagement and impairs the perception of subsequently presented nonemotional targets in GAD.
Patients with GAD (n = 30) and controls (n = 30) searched for a target embedded within a series of rapidly presented images. Critically, an erotic, fear, disgust, or neutral distracter image appeared 200 msec or 800 msec before the target.
Impaired target detection was observed among GAD patients relative to controls following only fear and neutral distractors. However, this effect did not significantly vary as a function of distractor stimulus duration before the target. Furthermore, group differences in target detection after fear distractors were no longer significant when controlling target detection after neutral distractors. Subsequent analysis also revealed that the impaired target detection among those with GAD relative to controls following neutral (but not fear) distractors was mediated by deficits in attentional control.
The implications of these findings for further delineating the function of attentional biases in GAD are discussed.
Depression and Anxiety 03/2011; 28(5):427-34. · 4.18 Impact Factor
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ABSTRACT: The present investigation examined the factor structure and psychometric properties of the Injection Phobia Scale-Anxiety (IPS-Anx). Principal components analysis of IPS-Anx items in Study 1 (n = 498) revealed a 2-factor structure consisting of Distal Fear and Contact Fear. However, CFA results in Study 2 (n = 567) suggest that a 1-factor structure may be more parsimonious. IPS-Anx scores demonstrated excellent reliability including test-retest over a 12-week period in Study 3 (n = 195). Supportive evidence for convergent and divergent validity of IPS-Anx scores was also found in Study 4 (n = 319), with strong associations with disgust propensity and sensitivity and weak associations with positive affect. Further evidence of validity was found in Study 5 (n = 1,674) because IPS-Anx scores discriminated those who have experienced fainting symptoms or avoided medical procedures from those without a history of such symptoms. In Study 6, data from Studies 2 through 5 were pooled, and the findings of Study 2 were replicated. The 1-factor model also fit the data well for men and women in Study 6. Lastly, IPS-Anx scores differentiated those with blood-injection-injury phobia (n = 39) from those without this phobia (n = 43) in Study 7. These findings suggest that the IPS-Anx has excellent psychometric properties, making it suitable for use in programmatic research on injection phobia. However, future research examining the validity of a short form of the scale with only the Contact Fear items may further improve the efficiency and utility of the IPS-Anx.
Psychological Assessment 03/2010; 22(1):167-79. · 2.99 Impact Factor
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ABSTRACT: Experimental research has shown that emotional stimuli can either enhance or impair attentional performance. However, the relative effects of specific emotional stimuli and the specific time course of these differential effects are unclear.
In the present study, participants (n = 50) searched for a single target within a rapid serial visual presentation of images. Irrelevant fear, disgust, erotic or neutral images preceded the target by two, four, six, or eight items. At lag 2, erotic images induced the greatest deficits in subsequent target processing compared to other images, consistent with a large emotional attentional blink. Fear and disgust images also produced a larger attentional blinks at lag 2 than neutral images. Erotic, fear, and disgust images continued to induce greater deficits than neutral images at lag 4 and 6. However, target processing deficits induced by erotic, fear, and disgust images at intermediate lags (lag 4 and 6) did not consistently differ from each other. In contrast to performance at lag 2, 4, and 6, enhancement in target processing for emotional stimuli was observed in comparison to neutral stimuli at lag 8.
These findings suggest that task-irrelevant emotion information, particularly erotica, impairs intentional allocation of attention at early temporal stages, but at later temporal stages, emotional stimuli can have an enhancing effect on directed attention. These data suggest that the effects of emotional stimuli on attention can be both positive and negative depending upon temporal factors.
PLoS ONE 01/2010; 5(11):e13860. · 4.09 Impact Factor
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ABSTRACT: The present study examines the extent to which attentional biases in contamination fear commonly observed in obsessive-compulsive disorder (OCD) are specific to disgust or fear cues, as well as the components of attention involved. Eye tracking was used to provide greater sensitivity and specificity than afforded by traditional reaction time measures of attention. Participants high (HCF; n = 23) and low (LCF; n = 25) in contamination fear were presented with disgusted, fearful, or happy faces paired with neutral faces for 3 s trials. Evidence of both vigilance and maintenance-based biases for threat was found. The high group oriented attention to fearful faces but not disgusted faces compared to the low group. However, the high group maintained attention on both disgusted and fearful expressions compared to the low group, a pattern consistent across the 3 s trials. The implications of these findings for conceptualizing emotional factors that moderate attentional biases in contamination-based OCD are discussed.
Behaviour research and therapy 01/2010; 48(5):402-8. · 3.00 Impact Factor
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ABSTRACT: The present study examined the effect of a disgust mood induction on self-reported distress during exposure to 5 stimuli with increasing potential for contagion in a public restroom among contamination fearful individuals. Participants were 36 adults identified as high in contamination fear (HCF) and 47 adults identified as low in contamination fear (LCF) who were randomly assigned to either a disgust or neutral emotion induction condition. Consistent with predictions, HCF participants exhibited significantly more distress than LCF participants during exposure to the sources of contagion in the restroom. However, this main effect was moderated by type of mood induction and task difficulty. Specifically, significant differences in distress between HCF and LCF participants emerged only for stimuli with low potential for contagion (i.e., touching the inside of the bathroom sink) in the disgust condition, whereas such group differences in distress emerged only for stimuli with a relatively high potential for contagion (i.e., touching the inside of the bathroom toilet) in the neutral condition. The implications of these findings for better understanding the functional role of disgust in contamination fear are discussed.
Emotion 09/2009; 9(4):592-7. · 3.88 Impact Factor
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ABSTRACT: The present study examines the association between disgust sensitivity (DS) and obsessive-compulsive disorder (OCD) symptoms in two non-clinical samples. Findings from Study 1 (n=270) revealed a significant association between DS and OCD symptoms even after controlling for negative affect and anxiety sensitivity. Subsequent analysis also revealed a specific association between DS and the washing subtype of OCD symptoms when controlling for other OCD symptom dimensions. DS did not significantly predict residual change in total symptoms of OCD over a 12-week period (n=300) when controlling for risk factors for anxiety disorder symptoms in general (e.g., negative affect, anxiety sensitivity) and OCD specifically (e.g., obsessive beliefs) in Study 2. However, exploratory analyses suggest that DS may be predictive of residual change in some OCD symptom subtypes but not others. Implications of these findings for future research on the role of disgust in OCD are discussed.
Journal of behavior therapy and experimental psychiatry 08/2009; 40(4):533-43. · 2.48 Impact Factor
