Mechanisms of attentional biases towards threat in anxiety disorders: An integrative review

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Abstract

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.

Section snippets

Brief overview of major findings

Attentional bias towards threat among anxious populations is a relatively robust phenomenon (Bar-Haim et al., 2007, Cisler et al., 2009, Mogg and Bradley, 1998, Williams et al., 1996), with a recent meta-analysis demonstrating an aggregate effect size of d = .45 (Bar-Haim et al., 2007). The following sections review 2 major findings. First, attentional biases are observed across several different experimental tasks. Second, attentional biases are observed across anxiety disorders.

Previous theoretical models of attentional biases towards threat in anxiety

In the past 20 years several models have been put forward to account for the mechanisms underlying attentional bias in anxiety. The review of these models will focus on the mechanisms of attentional bias postulated by the models. It is important to note that these models have mainly focused on individual differences in trait anxiety. Spielberger, Gorsuch, Lushene, Vagg, and Jacobs (1983) described trait anxiety as a personality trait that predisposes an individual to respond with anxiety to

Review of evidence for the mechanisms of attentional bias

Given the theoretical discord, we now review the evidence in regards to the components of attentional bias, mediating mechanisms, and stages of processing.

How do the biases relate to other aspects of anxious responding?

There is a surprising lack of research investigating how the different components of attentional bias correlate with other aspects of anxious responding. The research is limited to demonstrating correlations between emotional Stroop biases and self-reported distress during actual or imagined stressors (MacLeod and Hagan, 1992, Nay et al., 2004, van den Hout et al., 1995). It remains unclear whether facilitated attention, difficulty in disengagement, and attentional avoidance similarly predict

Conclusions

The present paper conceptualized attentional biases in terms of three complimentary aspects: the attentional components, mediating mechanisms, and stages of information processing. Research has identified elements within each domain and suggested specific interrelations between the domains. Though future research is still needed to clarify inconsistencies and ambiguities, there has been clear progress in identifying the mechanisms of attentional biases. Future research in this area will

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