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Cognitive Bias in Panic Disorder: A Process Dissociation Approach to Automaticity

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Abstract

We applied a variant of Jacoby's (1991) process dissociation procedure to parse the relative contributions of automatic and controlled processes to word-stem completion performance involving threatening, positive, and neutral material in patients with panic disorder and healthy control participants. Contrary to prediction, processing of threatening (relative to nonthreatening) information in panic disorder was not disproportionately influenced by automatic processing. We found limited evidence, however, that panic patients exhibit a baseline bias for completing stems relevant to threat relative to nonthreat stems, perhaps indicating a proneness to engage in self-generated priming of threat material.

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... Both studies found no support for the hypothesis that social anxious individuals favor a negative interpretation of ambiguous stimuli in these online tasks. Similarly, McNally, Otto, Hornig, and Deckersbach (2001) found no evidence that the influence of strategic and automatic processing is stronger for completing threat stems than nonthreat stems in panic patients compared to healthy control participants when using a stem completion task involving threatening, positive, and neutral material. ...
... In adult research, studies using online tasks also found less support for the hypothesis that socially anxious individuals favor a negative interpretation of ambiguous stimuli compared to offline studies (Hirsch & Mathews, 1997, 2000. Similarly, McNally et al. (2001) did not find evidence for their hypotheses that the influence of strategic and automatic processing is stronger for completing threat stems than nonthreat stems in panic patients compared to healthy control participants. Furthermore, cognitive biases may be represented in beliefs, rather than in the selective processing of threat stimuli. ...
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... In classic dual task experiments, participants perform a primary task along with a concurrent secondary task such as performing a calculation while being shown various visual stimuli (Brunken et al., 2002). In its origin, dual task tests were designed for cognitive process dissociation (Jacoby, 1991) in order to determine how different cognitive structures attended to different stimuli ( Richardson-Klavehn et al., 2002), such as to learn how much cognitive effort is applied to visual versus auditory tasks while a participant attends to a writing task (McNally et al., 2001). Subsequent research using dual task tests has investigated the effects of tasks competing for use of the same cognitive structures (known as consonant modality pairing); that is to say, to pair stimuli that compete for the same cognitive structures to induce cognitive load (Engonopoulos et al., 2013;Hazeltine et al., 2006). ...
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... As pointed out by McNally (1995), however, it is difficult, if not impossible, to develop a process-pure measure of attention, as extant paradigms (e.g., e-Stroop, dot-probe, visual cueing, visual search) readily require a mix of both automatic and strategic processes (see also Sherman et al., 2008). As such, experiments purporting to assess automatic and strategic information processing in anxiety have either relied on the assumption that time-course of responding (e.g., responses to stimuli presented at different durations) reflects concrete differences in automatic and strategic processing (e.g., Amir, Coles, & Foa, 2002), or utilized mathematical modeling procedures to estimate the relative contributions of automatic and strategic processes (e.g., McNally, Otto, Hornig, & Deckersbach, 2001). ...
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... The PDP has been used as an efficient research tool to investigate cognitive functioning in various psychopathological states (e.g. panic disorder-McNally, Otto, Horning, & Deckersbach, 2001; chronic pain- Grisart & Van der Linden, 2001; Alzheimer disease- Knight, 1998;Smith & Knight, 2002;Koivisto, Portin, & Rinne, 1998). Memory performance in mood disorders have also been studied using this procedure. ...
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Experimental psychopathologists have increasingly relied upon the concepts and methods of cognitive psychology in their attempts to elucidate information-processing biases associated with anxiety disorders. Many of these biases presumably constitute instances of automatic, not strategic, processing. But research has shown that attributes of automaticity (i.e. capacity-free, unconsious, involuntary) do not all apply to selective processing of threat associated with anxiety. Experimental and clinical findings suggest that biases are automatic in the sense of being involuntary (and sometimes unconscious), but not in the sense of being capacity-free. Implications of involuntary automatic processing of threat for behavior therapy are discussed.
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Dysphoric and nondysphoric students (48 women and 24 men) participated in an experiment that was designed to separate automatic and controlled uses of memory in a modified recognition paradigm. First, they judged the relation of target words to paired words. Later they made recognition decisions on target items alone or in the context of the original paired item. The use of L.L. Jacoby's (1991) process dissociation procedure revealed depressive deficits in estimates of recollection but not in estimates of familiarity. The paired test improved recollection for all subjects and showed a trend in the direction of increased familiarity. These outcomes support approaches to depressive cognition that emphasize impaired cognitive control.
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Thirty patients with a diagnosis of panic disorder with agoraphobia and 30 normal controls were compared on explicit memory (cued recall) and implicit memory (word stem completion) for positive, neutral, social threat, and physical threat words. The panic patients showed an explicit memory bias, but no implicit memory bias, for physical threat words. The index of explicit memory bias for physical threat words was found to correlate with anxiety sensitivity and degree of agoraphobic fear and avoidance. The index of baseline bias for threat words on the word completion task, on the other hand, correlated with trait anxiety. Although there were no correlations between explicit and implicit memory bias for physical threat words, explicit memory bias for physical threat words correlated with explicit memory bias indexes for positive words and social threat words. The results are discussed in terms of the functional role of an explicit memory bias for physically threatening events in panic disorder. The negative results on implicit memory bias are discussed in relation to earlier studies, the use of different implicit memory tasks, and the role of baseline bias on implicit memory tasks. Finally, the hypothesis is suggested that explicit and implicit memory bias for emotional information may represent two different styles of information processing, which serve as vulnerability factors for different emotional disorders.
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