Time course of pupillary response to threat words before and after attention bias modification for transdiagnostic anxiety disorders: A randomized controlled trial

Adolescent girls' physiological reactivity to real-world peer feedback: A pilot study to validate a Peer Expressed Emotion task

Peer feedback becomes highly salient during adolescence, especially for girls. The way in which adolescents react to social feedback is associated with psychosocial adjustment and mental health. Consequently, researchers are increasingly interested in understanding the physiological and neural underpinnings of adolescent response to feedback by simulating the experience of rejection and acceptance using computer-based paradigms. However, these paradigms typically use nonfamiliar peers and the facade of internet chatrooms or games to present artificial peer feedback. The current study piloted the use of a novel and potentially more ecologically valid peer expressed emotion paradigm in which participants listen to prerecorded clips of ostensible personalized feedback made by their close friend. Physiological data measuring autonomic nervous system response were collected as an index of emotional reactivity/arousal and cognitive-affective processing. Results show promising preliminary evidence validating the task for future use. Participants (N = 18 girls, aged 11-17 years) reported feeling more positive following praise, relative to critical and neutral feedback, and reported feeling more upset following criticism, relative to praise and neutral feedback. Girls exhibited greater pupillary dilation, skin conductance levels (N = 17), and/or heart rate (N = 17) while listening to affectively charged, peer feedback compared with neutral yet personally relevant statements. Girls also exhibited variable physiological response when listening to praising versus critical feedback. Findings from this pilot study validate the use of this novel Peer Expressed Emotion task for the investigation of adolescents' emotional and physiological reactivity in response to real-world peer evaluation. However, it is important to recognize that this study provides only preliminary findings and that future research is needed to replicate the results in larger samples.

Time course of pupillary response to threat words before and after attention bias modification for transdiagnostic anxiety disorders: A randomized controlled trial

INTRODUCTION

Altered attention to threatening stimuli at initial and sustained stages of processing may be dissociable dimensions that influence the development and maintenance of transdiagnostic symptoms of anxiety, such as vigilance, and possibly require distinct intervention. Attention bias modification (ABM) interventions were created to implicitly train attention away from threatening stimuli and have shown efficacy in treating anxiety. ABM alters neurocognitive functioning during initial stages of threat processing, but less is known regarding effects of ABM on neural indices of threat processing at sustained (i.e., intermediate and late) stages, or if ABM-related neural changes relate to symptom response. The current study utilized pupillary response as a temporally sensitive and cost-effective peripheral marker of neurocognitive response to ABM.

MATERIALS AND METHODS

In a randomized controlled trial, 79 patients with transdiagnostic anxiety provided baseline data, 70 were randomized to receive eight sessions of twice-weekly ABM (n = 49) or sham training (n = 21), and 65 completed their assigned treatment condition and returned for post-training assessment.

RESULTS

Among ABM, but not sham, patients, pupillary response to threat words during initial and intermediate stages decreased from pre- to post-training. Pre- to post-training reductions in intermediate and late pupillary response to threat were positively correlated with reductions in patient-reported vigilance among ABM, but not sham, patients.

CONCLUSIONS

All measured stages of threat processing had relevance in understanding the neural mechanisms of ABM, with overlapping yet dissociable roles exhibited within a single neurophysiological marker across an initial-intermediate-late time continuum. Pupillometry may be well suited to measure both target engagement and treatment outcome following ABM.