Thesis

Social Anxiety: Understanding the Attentional Bias to Threat

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Abstract

Biased attention toward threatening facial expressions is an important maintaining and possibly aetiological factor for social anxiety. However, little is known about the underlying mechanisms. To develop our understanding of this threat bias, the relative contributions of top-down attention, bottom-up attention, and selection history were differentiated across four studies. In Study One, the roles of top-down attention, bottom-up attention, and selection history were tested in an unselected sample using a modification of the dot-probe task, in which participants were cued to attend to a happy or angry face on each trial. Results showed that attentional orienting toward facial expressions was not exclusively driven by bottom-up attentional capture as some previous theories suggest; but instead, participants could shift attention toward emotional faces in a top-down manner. This effect was eliminated when the faces were inverted, demonstrating that top-down attention relies on holistic face processing. Study One found no evidence of selection history (i.e., no improvement on repeated trials or blocks of trials in which the task was to orient to the same expression). Study Two tested whether this ability to use top-down attention to orient to emotional faces is impaired for individuals with social anxiety. Using the same task as Study One, Study Two found that participants with higher levels of social anxiety were selectively impaired in attentional shifting toward a cued happy face when it was paired with an angry face, but not when paired with a neutral face. These results indicate that high social anxiety is associated with deficits in top-down control of attention, which are selectively revealed in the presence of non-task-relevant threat. The results of Study Two could be explained by bottom-up attention to threat or a top-down set for threat that could not be overcome by the instruction to attend to a happy face. To test this, Study Three utilised a modified dot-probe task in which participants were presented with an upright face paired with an inverted face (displaying a disgust or neutral expression) and engagement with and disengagement of attention from threatening faces were measured separately. The task was performed under no, low, and high working-memory load conditions. Since working-memory load draws on the same resources as top-down attention, interference from increasing working-memory load on attentional orienting would point to a role for top-down attention. Social anxiety was not associated with delayed disengagement from threat. However, surprisingly, high social anxiety was associated with an engagement bias away from threat, while low social anxiety was associated with a bias toward threat. These results were unaffected by the working-memory load manipulation. However, some methodological issues were identified with the study. Study Four overcame these methodological issues by using a paired angry and neutral face under no, low and high working-memory load conditions. Higher levels of social anxiety were associated with increased engagement with threat under no-load, but not under low- and high-load conditions. Thus, this body of research provides evidence that social anxiety is associated with an engagement bias to threat, which is driven by top-down attention.

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The sample size necessary to obtain a desired level of statistical power depends in part on the population value of the effect size, which is, by definition, unknown. A common approach to sample-size planning uses the sample effect size from a prior study as an estimate of the population value of the effect to be detected in the future study. Although this strategy is intuitively appealing, effect-size estimates, taken at face value, are typically not accurate estimates of the population effect size because of publication bias and uncertainty. We show that the use of this approach often results in underpowered studies, sometimes to an alarming degree. We present an alternative approach that adjusts sample effect sizes for bias and uncertainty, and we demonstrate its effectiveness for several experimental designs. Furthermore, we discuss an open-source R package, BUCSS, and user-friendly Web applications that we have made available to researchers so that they can easily implement our suggested methods.
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Alcohol use is associated with attentional biases for alcohol-related stimuli, as it has been measured via effects on mean performance measures in dot-probe tasks. However, the variability of attentional biases may contain essential information related to behavior and symptoms. Bias variability refers to short-time scale fluctuation in bias to and from salient stimuli, measurable within the duration of a task. The first aim of the current study was to relate attentional bias variability for alcohol cues to risky drinking behavior. The second aim was to explore a conditioned-cue version of the dot probe in which arbitrary cues signaled the location of subsequent alcoholic or nonalcoholic pictorial cues, which was designed to avoid sources of interference that could play a role in the normal dot probe. Results showed strong associations between measures of attentional bias variability and drinking behavior. Effects in the conditioned cues version of the task were weaker and appeared to require a longer training period. Nevertheless, heavier drinkers tended to respond too late to probes appearing at locations of cues predicting the appearance of nonalcohol stimuli. This suggests that predictive cues can capture an aspect of attentional processes related to alcohol use. The results indicate that attentional bias variability is worth studying further. It may be fruitful for theory and future research to focus on fluctuations in attention rather than consistent tendencies toward or away from alcohol. The potential use of predictive cues remains uncertain. Such designs may require relatively long training periods but could prove methodologically and theoretically useful.
Article
Background: Attentional bias (AB) to threat is thought to play a key role in the development and maintenance of posttraumatic stress symptomatology (PTS). Empirical evidence though is inconsistent. Some studies report associations between AB towards, threat and PTS; other studies report associations between AB away from threat and PTS; yet other studies fail to find any association. We propose that prospective-longitudinal study of AB as a dynamic process, expressed from moment to moment in time, may help to understand these mixed findings and the role of AB in PTS. Methods: We tested cross-sectional and prospective-longitudinal associations between AB and PTS among German soldiers from pre- to post-deployment in Afghanistan (n = 144). AB to threat and positive emotion stimuli (angry/happy faces) was measured using the dot-probe task. PTS was assessed by the PTSD Checklist. The number of traumatic experiences was assessed using CIDI-traumatic experience lists for military. Results: We found that AB dynamics (i.e., towards, away, temporal variability) at pre- and post-deployment, with respect to angry and happy faces, predicted higher levels of PTS after deployment as a function of number of intermediate traumatic experiences. Traditional aggregated mean bias scores did not similarly prospectively predict PTS post deployment. Conclusions: Findings indicate that AB to emotionally arousing stimuli may play an important function in the development and maintenance of PTS. We argue that mixed and null findings appear to be due to failure to model the within-subject temporal variability in AB expression. Theoretical, empirical, and clinical implications of these findings are discussed.
Article
Previous studies investigating the hypothesis that elevated social anxiety vulnerability is characterized by an attentional bias to negative social information have yielded inconsistent findings. One possible explanation for this inconsistency is that most such studies have failed to distinguish bias in attentional engagement with, and in attentional disengagement from, negative social information. It has been proposed that only one of these two possible forms of attentional bias may be associated with elevated social anxiety vulnerability, potentially giving rise to observed inconsistencies when assessment approaches have failed to dissociate them. The few studies that have sought to investigate this issue have been hampered by methodological limitations, which have compromised their capacity to differentially assess these two facets of attentional selectivity. In the present study, we employed a recently developed variant of the attentional-probe task that has proven capable of dissociating attentional engagement bias and disengagement bias, to contrast the patterns of attentional selectivity shown by participants high and low in social anxiety. Our findings reveal that elevated social anxiety vulnerability is characterized only by facilitated attentional engagement with socially negative information and not by impaired attentional disengagement from socially negative information.
Article
Background: Identification of reliable targets for therapeutic interventions is essential for developing evidence-based therapies. Threat-related attention bias has been implicated in the etiology and maintenance of social anxiety disorder. Extant response-time-based threat bias measures have demonstrated limited reliability and internal consistency. Here, we examined gaze patterns of socially anxious and nonanxious participants in relation to social threatening and neutral stimuli using an eye-tracking task, comprised of multiple threat and neutral stimuli, presented for an extended time-period. We tested the psychometric properties of this task with the hope to provide a solid stepping-stone for future treatment development. Methods: Eye gaze was tracked while participants freely viewed 60 different matrices comprised of eight disgusted and eight neutral facial expressions, presented for 6000ms each. Gaze patterns on threat and neutral areas of interest (AOIs) of participants with SAD, high socially anxious students and nonanxious students were compared. Internal consistency and test-retest reliability were evaluated. Results: Participants did not differ on first-fixation variables. However, overall, socially anxious students and participants with SAD dwelled significantly longer on threat faces compared with nonanxious participants, with no difference between the anxious groups. Groups did not differ in overall dwell time on neutral faces. Internal consistency of total dwell time on threat and neutral AOIs was high and one-week test-retest reliability was acceptable. Limitations: Only disgusted facial expressions were used. Relative small sample size. Conclusion: Social anxiety is associated with increased dwell time on socially threatening stimuli, presenting a potential target for therapeutic intervention.
Article
Attention serves to represent selectively relevant information at the expense of competing and irrelevant information, but the mechanisms and effects of attention are not unitary. The great variety of methods and techniques used to study automaticity and attention for facial expressions suggests that the time should now be ready for a better breaking down of the concepts of automaticity and attention into elementary constituents that are more tractable to investigations in cognitive neuroscience. This article reviews both the behavioral and neuroimaging literature on the automatic perception of facial expressions of emotion in healthy volunteers and patients with brain damage. It focuses on aspects of automaticity in face perception that relate to task goals, attentional control, and conscious awareness. Behavioral and neuroimaging findings converge to support some degree of automaticity in processing facial expressions and is likely to reflect distinct components that should be better disentangled at both the behavioral and neural level.
Article
The ability to regulate emotions is essential for adaptive behavior. This ability is suggested to be mediated by the connectivity between prefrontal brain regions and the amygdala. Yet, it is still unknown whether the ability to regulate emotions can be trained by using a non-emotional procedure, such as the recruitment of executive control (EC). Participants who were trained using a high-frequent executive control (EC) task (80% incongruent trials) showed reduced amygdala reactivity and behavioral interference of aversive pictures. These effects were observed only following multiple-session training and not following one training session. In addition, they were not observed for participants exposed to low-frequent EC training (20% incongruent trials). Resting-state functional connectivity analysis revealed a marginally significant interaction between training groups and change in the connectivity between the amygdala and the right inferior frontal gyrus (IFG). Amygdala-IFG connectivity was significantly increased following the training only in the high-frequent EC training group. These findings are the first to show that non-emotional training can induce changes in amygdala reactivity to aversive information and alter amygdala-prefrontal connectivity.
Article
Trait anxiety is associated with impairments in attentional control and processing efficiency (see Berggren & Derakshan, 2013for a review). Working memory training using the adaptive dual n-back task has shown to improve attentional control in subclinical depression with transfer effects at the behavioral and neural level on a working memory task (Owens, Koster, & Derakshan, 2013). Here, we examined the beneficial effects of working memory training on attentional control in pre-selected high trait anxious individuals who underwent a three week daily training intervention using the adaptive dual n-back task. Pre and post outcome measures of attentional control were assessed using a Flanker task that included a stress induction and an emotional Antisaccade task (with angry and neutral faces as target). Resting state EEG (Theta/Beta ratio) was recorded to as a neural marker of trait attentional control. Our results showed that adaptive working memory training improved attentional control with transfer effects on the Flanker task and resting state EEG, but effects of training on the Antisaccade task were less conclusive. Finally, training related gains were associated with lower levels of trait anxiety at post (vs pre) intervention. Our results demonstrate that adaptive working memory training in anxiety can have beneficial effects on attentional control and cognitive performance that may protect against emotional vulnerability in individuals at risk of developing clinical anxiety.
Article
Background and objectives: Difficulties with attentional control have long been thought to play a key role in anxiety and depressive disorders. However, the nature and extent of attentional control difficulties in social anxiety disorder (SAD) are not yet well understood. The current study was designed to assess whether attentional control for non-emotional information is impaired in SAD when taking comorbid depression into account.. Methods: Individuals with SAD and healthy controls (HCs) were administered an attentional blink (AB) task in which they identified number targets in a rapid serial visual presentation stream of letters. Results: Individuals with SAD and current comorbid depression exhibited reduced accuracy to identify a target that fell within the AB window after the presentation of a first target compared to individuals with SAD without current comorbid depression, as well as to HCs. The latter two groups did not differ from each other, and the three groups did not differ in accuracy for the second target when it was presented after the AB window. Limitations: Although we included two clinical groups and the sample size for the non-comorbid SAD group was large, the comorbid SAD group was relatively small. Conclusions: These results suggest that impaired attentional control among individuals with SAD may be limited to those suffering from current comorbid depression..
Article
Among studies of visual search for a singleton, some studies show evidence of top-down attentional guidance driven by goals, while others do not, leading to uncertainty as to how goal-driven guidance should be included in attentional theories. Six experiments tested this guidance when a target shape is found by locating a singleton feature (color or shape) and an orientation within the target is then reported. Experiments 1 and 2 use the dimensional priming paradigm underlying the most effective arguments against goal-driven guidance, and show evidence for guidance in many circumstances. Experiment 3 extends the results to feature priming, and demonstrates a complex interaction between attentional goals and memory for previous targets. In Experiment 4, symbolic (word) cues were just as effective as image cues, further strengthening the case for goal-driven guidance. In Experiments 5 and 6, as in the previous experiments, valid cues again produced faster responses than invalid cues, showing the advantage of goal-driven guidance. Surprisingly, however, responses were even faster when the cues were uninformative. Furthermore, participants who began the experiment with neutral cues seemed to ignore informative cues later in the experiment. The results show that attention can be guided by goals even in easy searches, but that searchers have much flexibility in the use of this guidance, and may choose not to use it. Furthermore, their decisions about using this guidance are not always well informed, because they are not aware of the relative costs and benefits. Copyright © 2015. Published by Elsevier Ltd.
Chapter
This chapter provides a perspective on conceptual, definitional, and diagnostic nosology issues for the field. It is proposed that social anxieties and fears, like other phobic disorders, exist along a continuum across the general population. The range of social anxieties/fears along this continuum is from no anxiety/fear to "normal" levels to psychopathological extremes. The debate on "overpathologizing" socially anxious people then may be addressed by a conceptualization that acknowledges both "normal" social anxieties that are mildly to moderately intense, or transient, and also their potential connectedness to social anxiety disorder (SAD), depending on potentially contributing environmental and individual factors. The chapter also reviews the evolution of constructs important to the area. Finally, it reemphasizes the need for a multidisciplinary approach to studying and understanding distress and dysfunction related to social situations. It uses the term "social anxiety" in an attempt to broadly encompass the various constructs emanating from the various disciplines and subdisciplines.
Article
When people search for targets within rapid streams of images, irrelevant emotional distractors - relative to neutral distractors - spontaneously demand attention and impair subsequent target detection, an effect that can be likened to an emotion-induced "attentional blink". But what happens when emotional distractors appear after a target has already come and gone? Here, we describe new findings of retroactive emotion-induced effects on target awareness. First, emotion-induced impairments of target awareness extended even to targets that appeared immediately before emotional distractors (Experiment 1). Second, when targets preceded distractors by two items - rather than by one item - negative distractors led to enhanced target processing relative to when distractors were neutral (Experiment 2). In contrast, when a target appeared after an emotional distractor, target awareness was impaired regardless of whether it was the first or second subsequent item. These results potentially implicate separable impacts of emotion on target processing, which can be distinguished by their facilitatory versus disruptive effects and by their temporal dynamics.
Article
Synesthesia is the phenomenon in which individuals experience unusual involuntary cross-modal pairings. The evidence to date suggests that synesthetes have access to advantageous item-specific memory cues linked to their synesthetic experience, but whether this emphasis on item-specific memory cues comes at the expense of semantic-level processing has not been unambiguously demonstrated. Here we found that synesthetes produce substantially greater semantic priming magnitudes, unrelated to their specific synesthetic experience. This effect, however, was moderated by whether the synesthetes were projectors (their synesthetic experience occurs in their representation of external space), or associators (their synesthetic experience occurs in their 'mind's eye'). That is, the greater a synesthetes's tendency to project their experience, the weaker their semantic priming when the task did not require them to semantically categorize the stimuli, whereas this trade-off was absent when the task did have that requirement. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.
Article
A growing theoretical and research literature suggests that trait and state social anxiety can predict attentional patterns in the presence of emotional stimuli. The current study adds to this literature by examining the effects of state anxiety on visual attention and testing the vigilance-avoidance hypothesis, using a method of continuous visual attentional assessment. Participants were 91 undergraduate college students with high or low trait fear of negative evaluation (FNE), a core aspect of social anxiety, who were randomly assigned to either a high or low state anxiety condition. Participants engaged in a free view task in which pairs of emotional facial stimuli were presented and eye movements were continuously monitored. Overall, participants with high FNE avoided angry stimuli and participants with high state anxiety attended to positive stimuli. Participants with high state anxiety and high FNE were avoidant of angry faces, whereas participants with low state and low FNE exhibited a bias toward angry faces. The study provided partial support for the vigilance-avoidance hypothesis. The findings add to the mixed results in the literature that suggest that both positive and negative emotional stimuli may be important in understanding the complex attention patterns associated with social anxiety. Clinical implications and suggestions for future research are discussed.
Article
A wealth of research demonstrates attentional biases toward threat in the anxiety disorders. Several models have been advanced to explain these biases in anxiety, yet the mechanisms comprising and mediating the biases remain unclear. In the present article, we review evidence regarding the mechanisms of attentional biases through careful examination of the components of attentional bias, the mechanisms underlying these components, and the stage of information processing during which the biases occur. Facilitated attention, difficulty in disengagement, and attentional avoidance comprise the components of attentional bias. A threat detection mechanism likely underlies facilitated attention, a process that may be neurally centered around the amygdala. Attentional control ability likely underlies difficulty in disengagement, emotion regulation goals likely underlie attentional avoidance, and both of these processes may be neurally centered around prefrontal cortex functioning. The threat detection mechanism may be a mostly automatic process, attentional avoidance may be a mostly strategic process, and difficulty in disengagement may be a mixture of automatic and strategic processing. Recommendations for future research are discussed.