A cognitive-motivational analysis of anxiety

doi:10.1016/S0005-7967(98)00063-1

Behaviour Research and Therapy

Volume 36, Issue 9, 1 September 1998, Pages 809-848

https://doi.org/10.1016/S0005-7967(98)00063-1 Get rights and content

Abstract

Evidence of preattentive and attentional biases in anxiety is evaluated from a cognitive-motivational perspective. According to this analysis, vulnerability to anxiety stems mainly from a lower threshold for appraising threat, rather than a bias in the direction of attention deployment. Thus, relatively innocuous stimuli are evaluated as having higher subjective threat value by high than low trait anxious individuals, and it is further assumed that everyone orients to stimuli that are judged to be significantly threatening. This account is contrasted with other recent cognitive models of anxiety, and implications for the etiology, maintenance and treatment of anxiety disorders are discussed.

Introduction

An important consideration in the cognitive analysis of emotions is their evolutionary origins (e.g. Oatley and Johnson-Laird, 1987). For example, the main functions of the mechanisms underlying fear are to facilitate the detection of danger in the environment and to help the organism respond promptly and effectively to threatening situations. The attentional system provides the mechanism for detecting and monitoring environmental and interoceptive stimuli which are relevant to the motivational state of the organism. Guided by this perspective, the present paper will focus on biases in selective attention to threat-relevant information in anxiety. A notable feature of several recent cognitive theories is their emphasis on the role of attentional processes in the etiology and maintenance of anxiety states, and these theories will be summarised below. We will note some difficulties, and consider from a cognitive-motivational perspective the specific mechanisms that may be responsible for attentional biases in anxiety. Relevant experimental findings will then be considered, together with some methodological issues that are especially pertinent in this research area, in order to allow the various theoretical perspectives to be evaluated.

Section snippets

Cognitive formulations of anxiety

According to recent cognitive theories, biases in information processing play an important role in the etiology and maintenance of emotional disorders, such as generalised anxiety disorder (GAD) and major depressive disorder (e.g. Beck, 1976; Eysenck, 1992; Mathews and MacLeod, 1994). Beck's theoretical views have been particularly important in contributing to the development of cognitive behaviour therapy, which has proved an effective treatment for both depression and GAD (e.g. Simons et al.,

Biological formulations of anxiety

Gray (1985)proposed that vulnerability to anxiety is associated with individual differences in activity of the behavioural inhibition system (BIS) which is sited in septo-hippocampal and associated structures. A primary function of the BIS is to compare actual with expected stimuli. The BIS operates in two modes. If actual stimuli are compatible with expected stimuli, it remains in `checking' mode, and control over behaviour remains with other brain systems, such as those involved in pursuing

Cognitive-motivational view

A common feature of several influential psychobiological and personality theories is the proposal of at least two primary factors that determine normal and abnormal emotions. These factors have been variously labelled, such as the personality traits of Neuroticism and Extraversion (Eysenck and Eysenck, 1969) and Anxiety and Impulsivity (Gray, 1985, Gray, 1990); and the emotional states of Valence and Arousal (Lang et al., 1990; Lang et al., 1993) and Negative and Positive Affect (Watson and

Evidence of attentional biases in anxiety

In the following section, we will focus on studies of attentional responses to threat stimuli in high and low trait anxiety, and in GAD, which reflects the extreme end of the spectrum of trait differences in vulnerability to anxiety (Rapee, 1991). GAD is a relatively common anxiety disorder (e.g. 5% life-time prevalence; Kessler et al., 1994), has a chronic course and tends to be difficult to treat. Barlow (1988), p. 579) noted that sufferers from GAD have ``an exquisite sensitivity to

Does vigilance for threat involve processes outside awareness?

Several studies have examined whether clinical anxiety is associated with a bias in processing threat information outside awareness. Such biases are referred to as preconscious or preattentive, with these terms commonly being used interchangeably in the research literature. One paradigm used to investigate such biases is the dichotic listening task, which involves presenting two different channels of information simultaneously, one to each ear. In a study by Mathews and MacLeod (1986),

Is the preattentive bias for threat a vulnerability factor for emotional disorders?

To investigate whether the preattentive bias for threat is a predictor of subsequent emotional distress, MacLeod and Hagan (1992)conducted a modified Stroop colour-naming task, using both masked and unmasked presentation conditions, on a group of women who attended a clinic for routine cervical smear tests. Two months later, they followed up those with abnormal cell results. Women who had shown a processing bias for subthreshold threat stimuli subsequently reported more distress in response to

Influences of state and trait variables on preattentive and attentional biases

Evidence of the relative influences of state and trait variables on attentional biases was recently reviewed by Williams et al. (1997). Such evidence includes (a) correlational relationships between bias and self-report anxiety questionnaire measures, (b) the effect of short- and long-term stressors on attentional biases in high and low trait anxious individuals, and (c) the effect of reducing state anxiety by treatment in anxious patients. The correlational findings have been mixed (e.g.

Effects of stressors on preattentive and attentional biases

The interaction hypothesis, described earlier, comprises two separate effects. The first is that, in the absence of stress, there may be little apparent difference between high and low trait anxious individuals in their preattentive and attentional biases for aversive stimuli. However, when state anxiety or stress levels increase, high trait anxious individuals will become vigilant for threat. This implies that the vigilant attentional style is a latent, rather than manifest, vulnerability

Attentional biases for pictorial stimuli: emotional faces

During the last seven years we have carried out a number of studies to examine whether the anxiety-related deployment of attention to threat words generalises to threat pictures. In one series of studies, we used photographs of emotional facial expressions as stimuli, because the face is a special stimulus for humans, being one of the most interesting and meaningful stimuli encountered from birth. For example, there is experimental evidence that new-born babies show an attentional preference

Attentional biases for pictorial stimuli: high versus mild threat scenes

The `interaction' hypothesis and the cognitive-motivational view described above yield different predictions regarding the effect of stimulus threat value on attentional biases. According to the former (see Fig. 1), increases in stimulus threat value will produce greater activation of threat inputs. Thus, as stimulus threat value increases, high trait anxious individuals should show greater vigilance for threat, whereas low trait anxious individuals should show greater avoidance. As we noted

Time course of attentional biases

This paper has focussed so far mainly on biases in preattentive and attentional processes; in particular, those involved in initial orienting to threat. Another important question in this area of research is the extent to which anxiety exerts a consistent influence on all aspects of selective attention. There is growing evidence from research into selective attention suggesting that the attentional system is not unitary. For example, Posner and colleagues proposed that three separate subsystems

Preattentive and attentional biases in clinical anxiety versus depression

One controversial issue is whether depression is associated with an attentional bias for negative information, that corresponds to the bias found in anxiety. Research on this issue has been influential in the development of cognitive theories of emotional disorders (e.g. Williams et al., 1988). Several studies have failed to find evidence of preattentive biases for negative information in clinical depression on masked versions of the Stroop and dot probe tasks (e.g. Mathews et al., 1996;

Summary and concluding remarks

The cognitive-motivational perspective on anxiety, described here, has been developed with the following aims in mind:

(i) to be compatible with biological models of anxiety, and to integrate some of the main theoretical and experimental developments in the fields of personality, emotion and cognitive neuroscience, including theories of appraisal and selective attention;

(ii) to accommodate findings from both clinical and non-clinical studies of preattentive and attentional biases in anxiety;

Acknowledgements

Our research has been supported in part by the Wellcome Trust, Medical Research Council, Pinsent-Darwin trust of the University of Cambridge and Meres trust of St John's College. K. M. holds a Wellcome Senior Research Fellowship in Basic Biomedical Science. We thank Carla Groom for her help in preparing the manuscript. An abridged version describing some of the material in this article has been prepared as a chapter to appear in Dalgleish, T. and Power, M. (Eds.) A Handbook of Cognition and

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Invited EssayA cognitive-motivational analysis of anxiety

Abstract

Introduction

Section snippets

Cognitive formulations of anxiety

Biological formulations of anxiety

Cognitive-motivational view

Evidence of attentional biases in anxiety

Does vigilance for threat involve processes outside awareness?

Is the preattentive bias for threat a vulnerability factor for emotional disorders?

Influences of state and trait variables on preattentive and attentional biases

Effects of stressors on preattentive and attentional biases

Attentional biases for pictorial stimuli: emotional faces

Attentional biases for pictorial stimuli: high versus mild threat scenes

Time course of attentional biases

Preattentive and attentional biases in clinical anxiety versus depression

Summary and concluding remarks

Acknowledgements

Behaviour Research & Therapy

Behaviour Research and Therapy

Behaviour Research and Therapy

Behaviour Research and Therapy

Behaviour Research & Therapy

Behaviour Research & Therapy

Journal of Memory & Language

Advances in Behaviour Research & Therapy

Journal of Verbal Learning and Verbal Behaviour

Behaviour Research and Therapy

Behaviour Research & Therapy

Behaviour Research & Therapy

Behaviour Research & Therapy

Behaviour Research & Therapy

Behaviour Research & Therapy

Behaviour Research & Therapy

Behaviour Research & Therapy

Behaviour Research & Therapy

Behaviour Research & Therapy

Behaviour Research & Therapy

Behaviour Research & Therapy

Behaviour Research & Therapy

Behaviour Research & Therapy

Affect and memory: A review

Psychological Bulletin

Efficacy of applied relaxation and cognitive-behaviour therapy in the treatment of generalised anxiety disorder

Journal of Consulting and Clinical Psychology

Mood and memory

American Psychologist

Negative self-schemata in clinical depression

British Journal of Clinical Psychology

Selective processing of negative information: effects of clinical anxiety, concurrent depression, and awareness

Journal of Abnormal Psychology

Attentional biases for emotional faces

Cognition & Emotion

Anxiety and attentional bias: state and trait

Cognition & Emotion

Comparison of behaviour therapy and cognitive behaviour therapy in the treatment of generalised anxiety disorder

Journal of Consulting and Clinical Psychology

Trait anxiety, anxious mood and threat detection

Cognition & Emotion

The right hemisphere recognises the bad guys

Cognition & Emotion

On the control of automatic processes: a parallel distributed processing account of the Stroop effect

Psychological Review

Diurnal variation in clinical depression and accessibility of memories of positive and negative experiences

Journal of Abnormal Psychology

Invited Essay
A cognitive-motivational analysis of anxiety