Attentional bias to threat in social phobia: facilitated processing of threat or difficulty disengaging attention from threat?

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Abstract

There is a growing body of research pointing to the possibility that anxious individuals may have difficulty disengaging their attention from threat-relevant information when this information is task irrelevant (e.g., Amir and Elias, 2002, Yiend and Mathews, 2001). In the current paper, we report a direct test of this hypothesis in individuals with social phobia. Participants performed a variation of the Posner paradigm (Quart. J. Exp. Psycho. 32 (1980) 3). Social threat, neutral, or positive words cued one of two locations on the computer screen. After the cue disappeared, participants had to detect a probe (“”) that appeared in one of the two locations. On some trials the cue was valid (i.e., the probe appeared in the same location as the cue). On other trials the cue was invalid (the probe appeared in a different location than the cue). Yet, on other trials, no cue was presented. All participants were slower in detecting probes following invalid cues than probes following valid cues. Furthermore, individuals with social phobia showed significantly longer response latencies when detecting invalidly cued targets than did controls, but only when the probe followed a social threat word. These results suggest that individuals with social phobia may have difficulty disengaging their attention from socially threatening material.

Introduction

Individuals with social phobia tend to show preferential attention to threat-relevant information (e.g., Asmundson and Stein, 1994, Hope, Rapee, Heimberg and Dombeck, 1990). However, the mechanisms underlying this bias are not well delineated. Recently, a number of researchers have implicated the role of difficulties in disengaging attention from threat-related information in anxious individuals (e.g., Amir and Elias, 2002, Fox, Russo, Bowels and Dutton, 2001, Fox, Russo and Dutton, 2002, Yiend and Mathews, 2001). These researchers have used the methods of basic human attention research (e.g., Posner, 1988) to address this question. Attention researchers have identified at least two processes that may contribute to selective attention (e.g., Posner, 1988, Posner, Inhoff, Friedrich and Cohen, 1987, Posner and Petersen, 1990). For example, Posner suggested that visual spatial attention involves facilitation and inhibition of various spatial locations. The presentation of a cue increases alertness and directs attention to that spatial location. This mechanism enhances the processing of targets in this location. As attention is directed to that specific location, a second mechanism is initiated resulting in less efficient (i.e., inhibited) processing of all other locations. Posner (1988) referred to this second mechanism as the “cost” of attending. More specifically, Posner (1988) decomposed spatial attention into a series of basic processes: 1) interruption of ongoing activity, 2) disengaging attention from the present stimuli, 3) moving attention to the new location, and 4) reengaging attention to the new stimulus.

Posner and colleagues (e.g., Posner, Cohen, & Rafal, 1982) used a cued target paradigm to study covert shifts of spatial attention. The paradigm involves a trial-by-trial cuing procedure. The specific sequence of events is the following: 1) participants are instructed to focus on a fixation point between two rectangles, 2) a cue is presented, (e.g., brightening of one of the rectangles), 3) an asterisk appears in one of the two rectangles, and 4) participants are instructed to press one of two buttons indicating the position of the asterisk (i.e., in the right or left rectangle). On two thirds (2/3) of the trials the cue draws participants’ attention to the rectangle in which the asterisk will appear (valid trials). On one sixth (1/6) of the trials the cue draws participants’ attention away from the rectangle in which the asterisk will appear (invalid trials). Finally, on the remaining 1/6 of the trials no cue is presented, i.e., neither rectangle is brightened and participants receive no information as to where the asterisk will appear (uncued trials). Participants are faster at responding to asterisks following a valid cue than asterisks following an invalid cue (Posner, 1980, Posner, Walker, Friedrich and Rafal, 1984). This speeding of response latency on valid trials compared to invalid trials is thought to reflect cue dependency.

Researchers have used variations of the Posner paradigm to examine disengagement difficulties in anxious and non-anxious individuals. For example, Stormark, Nordby and Hugdahl (1995) investigated the role of emotional cues in moderating attentional processes using a modification of the Posner task. They presented participants with emotionally valenced and neutral stimuli as cues during valid and invalid trials. Uncued trials were included to keep participants from becoming sensitive to the fixed cue-target interval but were not analyzed further. These authors found that participants were faster in detecting validly cued targets than invalidly cued targets, but only when emotion words served as cues. Thus, the authors concluded that emotional stimuli serve to attract attention and also to impair the ability to shift attention. The authors also collected brain activity data associated with various components of attention using event-related potentials (ERPs). They concluded that the reaction time data were consistent with both facilitated attention to emotional stimuli as well as difficulty disengaging from it, and that the ERP data supported mainly facilitation. However, because neutral words did not produce the expected cue dependency effect (valid trials faster than invalid trials), the generalizability of this study is limited.

Compton (2000) used the Posner task to evaluate general disengagement difficulties for non-emotional information. Participants completed the Posner task and the Profile of Mood States questionnaire (POMS; McNair, Lorr, & Droppleman, 1971) before viewing a 10-minute film documenting the personal account of a Holocaust survivor. Participants were then administered the POMS a second time after viewing the film. Compton (2000) examined their reaction time data in relation to changes in negative affect by calculating indices of attentional “benefits” and “cost” (i.e., facilitation and disengagement) for each participant. The attentional benefits index was defined as mean reaction time on uncued trials minus mean reaction time on valid trials, and the attentional cost index was defined as mean reaction time on invalid trials minus mean reaction time on uncued trials. Thus, scores on each index could be positive or negative, where positive scores indicate greater attentional benefit or cost. Compton found that scores on the cost index (i.e., disengagement) were positively correlated with increase in negative affect from pre- to post-viewing, while scores on the benefit index (i.e., facilitation) were not correlated with changes in negative affect. However, because the participants in the Compton (2000) study were unselected undergraduate students and the orienting of attention involved non-threat material, this study may have limited relevance to anxious individuals’ processing of threat-relevant material.

Yiend and Mathews (2001) used threatening and non-threatening pictures from the International Affective Pictures Systems (IAPS; Lang, Bradley, & Cuthbert, 1995) to examine anxiety and attention. In the second experiment in that paper, these authors examined components of visual attention, engagement and disengagement, using the Posner paradigm (Posner, 1988). To this end, these authors presented their participants with validly cued, invalidly cued, and uncued trials. Participants saw a target arrow, pointing either up or down, that replaced one of the two picture cues. They were asked to determine whether the arrow was facing up or down. The results indicated that the high anxious group was slower in detecting the orientation of an invalidly cued target than a validly cued target, but only when the cue picture was threatening. The authors concluded that: “There is no evidence to suggest that greater engagement with threatening pictures led to speeding. The significant slowing seen following invalid threatening cues (486 ms) thus indicates that the main effect of threatening pictures was to delay attentional disengagement” (Yiend & Mathews, 2001, p. 674-675). These findings indicate that anxious individuals have difficulties disengaging attention from threat-related information.

In summary, a number of studies have implicated the role of disengagement difficulties in anxious populations. However, it is not clear whether any observed differences on attention are due to emotional valence of the material (positive or negative; Martin, Williams, & Clark, 1991) or are specific to negative emotional information. In the current study, we modified the Posner paradigm to measure disengagement difficulties in individuals with social phobia. To examine the specificity of the effect to social threat we also included neutral and positive words.

Section snippets

Participants

Participants were 18 clients (81% males) diagnosed with social phobia and 20 (50% males) non-anxious controls. The socially phobic group was comprised of individuals seeking treatment for their disorder at the Center for the Understanding and Treatment of Anxiety at the University of Georgia. All socially phobic individuals were diagnosed according to DSM-IV criteria (American Psychiatric Association, 1994) and met these criteria as their primary diagnosis. They participated in the study before

Results

We first eliminated response latencies for inaccurate trials. Inaccurate trials consisted of trials where the probe was presented on the left side and the participant pressed the button corresponding to the right side or visa versa. This resulted in the elimination of 1% of the trials. Furthermore, response latencies less than 50 ms and greater than 1200 ms were considered outliers and eliminated from the analysis. These ranges were determined based on the inspection of the data using box plots

Discussion

The results of this study show that individuals with social phobia have difficulty disengaging their attention from social threat words. As revealed in the analysis of validity cue, the dependence on threat-related cues may explain the enhanced interference from negative information in socially phobic individuals. This paradigm allowed us to examine the mechanisms of attentional bias in social phobia (i.e., facilitation vs cost; Posner, 1980). We conclude that the cost of attending to

Acknowledgements

The preparation of this manuscript was supported by faculty development grants from the University of Georgia Institute for Behavioral Research (IBR) and University of Georgia Research Foundations Inc. awarded to the first author.

References (31)

  • M. Martin et al.

    Does anxiety lead to selective processing of threat-relevant information?

    Behaviour Research and Therapy

    (1991)
  • M.A. Morgan et al.

    Extinction of emotional learning: Contribution of medial prefrontal cortex

    Neuroscience Letters

    (1993)
  • S. Reiss et al.

    Anxiety sensitivity, anxiety frequency and the predictions of fearfulness

    Behaviour Research and Therapy

    (1986)
  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, (4th ed., rev.)....
  • Amir, N., & Elias, J. (2002). Allocation of attention to threat in social phobia: difficulty in disengaging from task...
  • C.M. Arrington et al.

    Neural mechanisms of visual attention: object-based selection of a region in space

    Journal of Cognitive Neuroscience

    (2000)
  • J.G. Asmundson et al.

    Selective processing of social threat in patients with generalized social phobia: Evaluation using a dot-probe paradigm

    Journal of Anxiety Disorders

    (1994)
  • A.T. Beck et al.

    Beck depression inventory manual

    (1987)
  • N.W. Bond et al.

    The prepared account of social phobia: some data and alternative explanations

  • R.J. Compton

    Ability to disengage attention predicts negative affect

    Cognition and Emotion

    (2000)
  • R.J. Davidson et al.

    Emotion, plasticity, context, and regulation: Perspectives from affective neuroscience

    Psychological Bulletin

    (2000)
  • M.B. First et al.

    Structured clinical interview for DSM-IV axis 1 disorders

    (1995)
  • E. Fox et al.

    Do threatening stimuli draw or hold visual attention in subclinical anxiety?

    Journal of Experimental Psychology: General

    (2001)
  • E. Fox et al.

    Attentional bias for threat: Evidence for delayed disengagement from emotional faces

    Cognition and Emotion

    (2002)
  • W.N. Francis et al.

    Frequency analysis of English usage

    (1982)
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