Samantha Denefrio’s research while affiliated with The Graduate Center, CUNY and other places

Generalized anxiety disorder (GAD) has been inconsistently associated with exaggerated threat monitoring measured via the error-related negativity (ERN). This suggests the need to consider whether the link between GAD and ERN is influenced by additional processes, such as cognitive inhibition of non-threat. The current study explored this possibility by employing a novel, trait-like measure of cognitive processing inhibition, neural quenching (NQ). Electroencephalography was recorded while 16 adults diagnosed with GAD and 14 age-matched healthy controls viewed angry and neutral faces prior to individual trials of a flanker task. NQ was generated to aversive (angry) and non-aversive (neutral) facial primes, and the ERN was generated to incorrect and correct responses on the flanker task. We tested the hypothesis that higher GAD symptom severity would be associated with larger-magnitude ERN when NQ to non-aversive was enhanced (higher levels of non-aversive processing inhibition), but with blunted ERN when NQ to non-aversive was also blunted (lower levels of non-aversive processing inhibition). Overall, greater NQ to non-aversive faces was associated with larger-magnitude ERNs. As predicted, higher GAD symptom severity was associated with blunted ERN when accompanied by blunted NQ to non-aversive. Findings suggest that exaggerated threat processing is not uniform in GAD and may depend on individual differences in the ability to inhibit processing of non-aversive and other types of information.

Implementations of attention bias modification training (ABMT) attempt to retrain attention away from rather than towards threat, thereby disrupting the anxiety-related attentional bias (AB). Yet, results of ABMT studies have been mixed due to limitations in knowledge of mechanisms underlying ABMT efficacy. Dual-process models of anxiety posit that ABMT works primarily through strengthening of the top-down cognitive control of attention to threat. If this is the case, introducing a working memory load (WML) during ABMT should reduce training efficacy. However, prior studies employing this method show mixed results (Booth et al., 2014; Clarke et al., 2017) and fail to directly compare low and high WML with no WML or to account for individual differences in anxiety and working memory capacity (WMC). The present study (N = 306) assessed trait anxiety and WMC in neurotypical adults who were then randomly assigned to ABMT that trained attention toward or away from threat, with either no, low, or high WML, for a total of six training groups. Attentional bias was assessed before and after training. Results showed ABMT successfully trained attention under low WML, but not under high or no WML, suggesting that ABMT is facilitated by engaging but not overtaxing WML.

Despite the pervasive use of computer-mediated communication, relatively little is known about its implications for emotional adjustment. Recent studies suggest that a preference for computer-mediated communication over other types of communication is associated with emotional vulnerabilities, and its active forms (e.g., direct communication) confer psychosocial benefits compared its passive forms (e.g., browsing Facebook). In this study, we simultaneously examined quality, quantity, and preferences for computer-mediated communication in relation to emotional competencies (emotion detection and regulation) and emotional well-being (self-report of mood and anxiety symptoms). In Study 1, participants (N = 123) completed a facial morphing task, a computerized assessment of the speed and accuracy of emotion detection, and the Social Media and Communication Questionnaire assessing quantity and preferences to communicate via computer-mediated communication versus face-to-face. More use of computer-mediated communication along with preferring it for casual communication, was associated with faster and more accurate emotion detection. More use of computer-mediated communication, along with preferring it for positive communication and expressing distress, was associated with more difficulties with emotion regulation. Study 2 (N = 32) added a task-based assessment of active and passive Facebook use in relation to measures of emotional functioning in Study 1. More active Facebook use was associated with greater emotional well-being, whereas more passive Facebook use was associated with less emotional well-being. Active and passive Facebook use was not significantly associated with self-report of broader computer-mediated communication preferences. Together, results suggest that greater use and preference for computer-mediated versus face-to-face communication may be related to heightened emotional sensitivity and more problems with emotion regulation, yet active versus passive use may serve to bolster emotional well-being.

Anxiety-related attention bias (AB) has been studied for several decades as a clinically relevant output of the dynamic and complex threat-detection and -response system. Despite research enthusiasm for the construct of AB, current theories and measurement approaches cannot adequately account for the growing body of mixed, contradictory, and null findings. Drawing on clinical, neuroscience, and animal models, we argue that the apparent complexity and contradictions in the empirical literature can be attributed to the field’s failure to clearly conceptualize AB heterogeneity and the dearth of studies on AB that consider additional cognitive mechanisms in anxiety, particularly disruptions in threat-safety discrimination and cognitive control. We review existing research and propose a working model of AB heterogeneity, positing that AB may be best conceptualized as multiple subtypes of dysregulated processing of, and attention to, threat anchored in individual differences in threat-safety discrimination and cognitive control. We review evidence for this working model and discuss how it can be used to advance knowledge of AB mechanisms and inform personalized prevention and intervention approaches.

Generalized anxiety disorder (GAD) is characterized by a range of cognitive and affective disruptions, such as pathological worry. There is debate, however, about whether such disruptions are specifically linked to heightened responses to aversive stimuli, or due to overgeneralized threat monitoring leading to deficits in the ability to discriminate between aversive and non-aversive affective information. The present study capitalized on the temporal and functional specificity of scalp-recorded event-related potentials (ERPs) to examine this question by exploring two targeted neurocognitive responses in a group of adults diagnosed with GAD: (1) visual processing of angry (aversive) versus neutral (non-aversive) faces; and (2) response monitoring of incorrect (aversive) versus correct (non-aversive) responses. Electroencephalography was recorded while 15 adults with GAD and 15 age-matched controls viewed angry and neutral faces prior to individual trials of a flanker task. ERPs to faces were the P1, reflecting attention allocation, the early posterior negativity (EPN), reflecting early affective discrimination, and the N170, reflecting face-sensitive visual discrimination. The error-related negativity (ERN) and positivity (Pe) were generated to incorrect and correct responses. Results showed reduced discrimination between aversive and non-aversive faces and responses in the GAD relative to the control group during visual discrimination (N170) and later-emerging error monitoring (Pe). These effects were driven by exaggerated processing of non-aversive faces and responses, suggesting over-generalized threat monitoring. Implications for cognitive-affective models of GAD are discussed.

The beneficial effect of valid compared to invalid cues on attention performance is a basic attentional mechanism, but the impact of emotional content on cue validity is poorly understood. We tested whether the effect of cue validity on attention performance differed when cues were angry, happy, or neutral faces. Moreover, we used scalp-recorded event-related potentials (ERPs) reflecting the capture of early visual attention (P1, N170) to test whether effects were strengthened when neurocognitive responses to angry or happy cues were enhanced (larger P1 and N170 amplitudes). Twenty-five participants completed a modified flanker task using emotional face cues to measure the effects of emotion on conflict interference. Attention performance was enhanced following valid versus invalid cues, but effects did not differ by emotion cue type. However, for participants showing relatively larger N170 amplitudes to angry face cues, attention performance was specifically disrupted on those trials. Conversely, participants with relatively larger N170 amplitudes to happy face cues showed facilitated performance across all valid trials. These findings suggest that individual neurocognitive sensitivities to emotion predict the impact of emotional content on the basic attentional phenomenon of cue validity.

Stress and anxiety during pregnancy are associated with a range of adverse health outcomes, thus there is an unmet need for low-barrier treatments that target stress and anxiety. One such treatment approach, attention bias modification training (ABMT), reduces the anxiety-related attentional threat bias, which is also associated with disrupted neural processing of threat. It remains unclear, however, whether reducing treatment barriers via mobile delivery of ABMT is effective and whether ABMT efficacy varies depending on individual differences in neural processing of threat. The present study tested whether mobile, gamified ABMT reduced prenatal threat bias, anxiety and stress, and whether ABMT efficacy varied with individual differences in neural responses to threat. Participants were 29 women in their 19th–29th week of pregnancy, randomized to four weeks of ABMT versus placebo training (PT) versions of the mobile app using a double-blind design. Self-report of anxiety, depression, and stress were obtained, and salivary cortisol was collected at home and in lab in response to stressors to index biological stress reactivity. Threat bias was measured using a computerized attention assay during which EEG was recorded to generate event-related potentials (ERPs) to threat cues. Results showed lower levels of threat bias (1-tailed) and lab cortisol following ABMT versus PT. Although the main effect of ABMT on subjective anxiety was not significant, the magnitude of cortisol reduction was correlated with lower levels of subjective anxiety and threat bias. Those receiving ABMT also reported less anxiety when showing smaller ERPs to threat (P1, P2) prior to training, but, conversely reported more anxiety when showing larger ERPs to threat. Use of gamified, mobile ABMT reduced biobehavioral indices of prenatal stress and anxiety, but effects on anxiety varied with individual differences in cortisol response and neurocognitive indices of early attention to threat.

The efficacy of attention bias modification training (ABMT) for anxiety is debated, in part because individual differences in task engagement and pre-training threat bias impact training efficacy. In the present study, an engaging, gamified ABMT mobile application, or "app," was utilized in 42 (21 females) trait-anxious adults. EEG was recorded during pre- and post-training threat bias assessment to generate scalp-recorded event-related potentials (ERPs) reflecting neurocognitive responses to threat. Following app play (ABMT versus placebo), subjective anxiety and stress responses (observed and self-reported) were measured. ABMT, versus placebo, resulted in improved behavioral performance during the stress task for females, and in potentiation of the N2 ERP to threat for males, suggesting increased attention control. Training groups did not differ in self-reported anxiety. ABMT also resulted in improved performance during the stress task among those evidencing specific pre-training ERP responses: decreased P1, suggesting less attention allocation, but potentiated N170, suggesting enhanced attention selection and discrimination. Differences in behavioral threat bias did not moderate training effects. Results suggest that efficient allocation of attention to threat combined with enhanced discrimination between threat and non-threat may facilitate stress-reduction effects of ABMT. Targeting neurocognitive responses to threat to personalize ABMT and develop more effective methods of treatment delivery, such as gamification, are discussed.