Attention training toward and away from threat in social phobia: Effects on subjective, behavioral, and physiological measures of anxiety

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Abstract

Social phobics exhibit an attentional bias for threat in probe detection and probe discrimination paradigms. Attention training programs, in which probes always replace nonthreatening cues, reduce attentional bias for threat and self-reported social anxiety. However, researchers have seldom included behavioral measures of anxiety reduction, and have never taken physiological measures of anxiety reduction. In the present study, we trained individuals with generalized social phobia (n = 57) to attend to threat cues (attend to threat), to attend to positive cues (attend to positive), or to alternately attend to both (control condition). We assessed not only self-reported social anxiety, but also behavioral and physiological measures of social anxiety. Participants trained to attend to nonthreatening cues demonstrated significantly greater reductions in self-reported, behavioral, and physiological measures of anxiety than did participants from the attend to threat and control conditions.

Highlights

► We investigated the effects of attentional training on measures of social anxiety. ► We assessed not only self-reported social anxiety, but also behavioral and physiological measures. ► Training to attend to nonthreat reduces self-report, behavioral, and physiological anxiety.

Section snippets

Overview and general procedure

Participants came to the laboratory for six visits. At the baseline visit, participants completed two self-report measures of social anxiety, a probe discrimination task that assessed attentional bias for threat, and a stressful speech task during which we recorded behavioral and physiological responses. We then randomly assigned participants to receive one of the three attentional training conditions: Attend to threat stimuli, attend to positive stimuli, or control. Neither the participant nor

Results

We lost three participants, one from the AT condition and two from the control condition. The AT participant and one control participant dropped out without explanation, whereas the other control participant got sick during training. All statistical analyses were conducted on the 57 remaining participants (nAP = 20, nAT = 19, nControl = 18). Three participants (one from the AT condition and two from the AP condition) missed one training session. They were included in the analyses, but the

Discussion

The primary purpose of this study was to answer two major questions. First, does attention training reduce physiological, self-report, and behavioral measures of anxiety in people with social phobia? Indeed, no previous attention training study involving participants with social phobia had included all three types of measure. Second, we sought to further examine whether attention training in any direction, regardless of valence, would result in reduced anxiety relative to a control condition,

Acknowledgments

This work was supported by a grant from the Belgian National Fund for Scientific Research, awarded to Alexandre Heeren (1.1.315.09.F), and by a Joined Research Grant (ARC 06/11-337) from the Belgian French Community, awarded to Pierre Philippot. We thank Nathalie Vrielynck and François Maurage for their help in the inter-rater agreement.

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