Trait anxiety and the alignment of attentional bias with controllability of danger

The effects of emotional distress on attentional bias toward cigarette warnings according to smokers' anxiety levels

Anxiety is related with the substance use, including cigarette smoking. Avoidance is one of the strategies smokers with anxiety adopt to manage negative affect, which can be contradictory to a strategy of cigarette warnings that is used to induce negative affect to change smoking behaviors. Therefore, this study examined whether smokers' anxiety levels decrease their attentional biases toward cigarette warnings, especially in response to emotional distress. High-anxiety (n = 60) and low-anxiety (n = 60) smokers were randomly assigned to either a stress condition that utilized the PASAT-C task (Paced Auditory Serial Addition Task-Computer version) or a controlled condition. With the eye-tracking task that involved viewing 8 visual stimuli of cigarette packs composed of warnings and brandings, time to first fixation and fixation duration to warnings compared to brandings were measured both pre and post conditions. The results revealed that high-anxiety smokers detected warnings faster after stress conditions while low-anxiety smokers showed the consistent time to first fixation on warnings. In terms of fixation durations, high-anxiety smokers showed hypervigilance toward warnings that are considered to be a threat, but low-anxiety smokers showed avoidance under stress conditions, particularly toward social-focused warnings. These results indicate that high-anxiety smokers are more vulnerable to emotional distress and have an attentional bias toward fear appeals. Despite hypervigilance, they had greater psychological reactance toward warnings that the conflict between avoidance and hypervigilance might have contributed to, so the effectiveness of fear appeals may be limited regardless of the increased fixation duration.

Attentional Processes in Pain: The Importance of Context and Attentional Alignment

The attentional bias literature has consistently failed to take context into account. We developed a novel paradigm in immersive virtual reality (VR) with pain stimuli where it would be adaptive or nonadaptive to attend to the stimuli. Participants had to indicate the location of the stimuli. Seventy participants were recruited. The VR-attention task assessed overall attentional bias (the tendency to prioritize pain compared with nonpain stimuli) and attentional alignment (the tendency to attend to pain more in adaptive than nonadaptive situations). Pain tolerance and threshold were measured using electrocutaneous stimulation and thermal pain. We conducted 2 (context: adaptive vs nonadaptive) × 2 (congruence: congruent vs incongruent) Analysis of Covariance, controlling for threat. Participants responded to pain probes more quickly in adaptive than nonadaptive contexts. There was an overall bias away from pain-related stimuli (avoidance) in reaction time to the target. There was also an interaction where avoidance was greater in nonadaptive contexts, indicative of attentional alignment. For gaze behavior, both attentional alignment and attentional bias were observed for latency to first fixation on the target, such that participants showed vigilance for pain particularly in the adaptive context. Attentional alignment was correlated with threshold and tolerance from electrocutaneous stimulation but not thermal pain. In conclusion, we found overall attentional biases indicating vigilance (latency to first fixation) and avoidance (response to target). We also found that participants evidenced a pattern of attention favoring adaptive over nonadaptive contexts (attentional alignment). It was attentional alignment, but not overall attentional bias, that predicted pain tolerance and threshold. PERSPECTIVE: The study explored attentional processes in pain through a novel paradigm designed in VR. The results found that positive attentional alignment, or the tendency to attend to pain more in adaptive contexts rather than nonadaptive contexts, predicted pain outcomes.

The change of state-trait anxiety among patients undergoing orthognathic surgery: A longitudinal study

INTRODUCTION

This study aimed to assess state-trait anxiety level changes in Chinese patients with dentofacial discrepancies before and after orthognathic surgery and to explore the feasibility of developing a reference index for the preoperative screening of postoperative patients with high anxiety.

METHODS

A total of 96 Chinese patients with dentofacial discrepancies who underwent orthognathic surgery were included in this study. Data were collected before orthognathic surgery and at 2 weeks (T2), 3 months, and 6 months (T4) after surgery using the State-Trait Anxiety Inventory. Receiver operating characteristic and linear regression analyses were performed to screen for preoperative indicators of postoperative high-state anxiety.

RESULTS

State-trait anxiety levels in patients with dentofacial discrepancies decreased after surgery (F = 18.95, P <0.01; F = 6.90, P <0.01). Trait Anxiety Inventory can be used to screen patients with high-state anxiety from T2 to T4 (area under cover 95% confidence interval: T2, 0.74 [0.62-0.86]; 3 months, 0.79 [0.69-0.90]; T4, 0.77 [0.66-0.87], P <0.01), corresponding to cutoff values of 48.5, 46.5, and 45.5, respectively.

CONCLUSIONS

All participants' state-trait anxiety levels improved after surgery compared with their preoperative levels. Preoperative trait anxiety levels can be used as a reference indicator to screen patients who may have high-state anxiety levels after orthognathic surgery. The creation of a screening scale will assist health care professionals to more pertinently help patients with high anxiety.

Attentional biases to signals of negative information: Reliable measurement across three anxiety domains

Cognitive models propose that individuals with elevated vulnerability to experiencing negative emotion are characterised by biased attentional responding to negative information. Typically, methods of examining these biases have measured attention to pictures of emotional scenes, emotional faces, or rewarding or feared objects. Though these approaches have repeatedly yielded evidence of anxiety-linked biases, their measurement reliability is suggested to be poor. Recent research has shown that attentional responding to cues signalling negative information can be measured with greater reliability. However, whether such biases are associated with emotion vulnerability remains to be demonstrated. The present study conducted three experiments that recruited participants who varied in trait and state anxiety (N = 134), social anxiety (N = 122), or spider fear (N = 131) to complete an assessment of selective attention to cues signalling emotionally congruent negative information. Analyses demonstrated that anxiety and fear were associated with biased attentional responding to cues signalling negative information, and that such biases could be measured with acceptable reliability (rsplit-half = .69-.81). Implications for research on the relation between emotion and attention are discussed.

Ecological anxiety and pro-environmental behaviour: The role of attention

Climate change is a serious threat to human health and the awareness of this threat can elicit ecological anxiety (eco-anxiety), which could be considered a rational and potentially adaptive response. However, the experience of eco-anxiety does not always lead to adaptive behaviour. The present study investigated whether differential patterns of selective attention towards climate-related information, and variability in this attention, might explain this inconsistent relationship. Participants completed a dot-probe assessment of attentional bias to images of both climate change mitigation strategies and of climate change causes and consequences, and measures of eco-anxiety, climate change belief, environmental self-efficacy, and general psychological symptoms. Engagement in pro-environmental behaviours was measured using a daily behavioural diary. Eco-anxiety and attentional bias independently predicted behaviour, but did not interact. However, attentional bias variability moderated the relationship between eco-anxiety and behaviour, such that higher eco-anxiety predicted greater behavioural engagement, but only when attentional bias variability was low. This was the first known study to examine the potential moderating effect of attentional bias on the relationship between eco-anxiety and pro-environmental behaviours. This growing field of research can help in identifying how the rational response of eco-anxiety can be better harnessed to motivate an adaptive response to the climate crisis.

Attentional bias malleability as a predictor of daily pain interference

ABSTRACT

Despite a preponderance of pain-related attentional bias research, little is known about how these biases arise and change over time. We tested whether the degree of attentional bias malleability , that is, ability to acquire and relinquish patterns of selective attention towards pain information, predicts daily pain interference. Individuals with chronic pain (N = 66) completed a novel attentional bias malleability procedure based on a modified dot-probe paradigm. Participants received a contingency that encouraged an attentional preference toward and away from pain words across 2 counterbalanced blocks, and attentional bias was assessed before and after each contingency block. Participants then completed a daily diary for 7 days, including the Patient-Reported Outcomes Measurement Information System-29 pain severity and interference. Multilevel modelling was conducted to predict daily pain interference from attentional bias malleability constructs, controlling for pain severity and demographic factors. Greater attentional bias (F 1,391 = 3.97, P = 0.047), greater readiness to acquire an attentional bias (F 1,389 = 4.92, P = 0.027), and less readiness to lose an acquired attentional bias toward pain (F 1,354 = 5.18, P = 0.024) all predicted less pain interference. There was also an interaction between pain severity and overall attentional bias malleability (F 1,62 = 5.48, P = 0.023), such that as pain severity increased, those who showed greater attentional bias malleability showed less corresponding increase in their pain interference than those who showed less attentional bias malleability. This study adds new thinking to the dynamic nature of attentional bias and how such biases might arise and influence pain outcomes.

The Effect of Auriculotherapy on Situational Anxiety Trigged by Examinations: A Randomized Pilot Trial

Background: Auriculotherapy may activate the parasympathetic nerve system and reduce anxiety levels. Short-term auriculotherapy’s effects and safety on university students’ anxiety levels was assessed prior to exams. Methods: A randomized, controlled pilot trial was conducted. The day before the exam, university students were randomly allocated to the auriculotherapy group (AA, n = 13) or the waiting-list group (WG, n = 13). Baseline measures were taken 4 weeks before the exam at Time point (TP 0); at 7.30 a.m. on the day before the exam (TP I); at 11 a.m. before auriculotherapy (TP II); 30 min after AA (TP III); and at 7.30 a.m. before the exam (TP IV). The outcomes were the State-Trait-Anxiety Inventory (STAI); quality of night-sleep, Visual Analogue scale (VAS) for anxiety, and salivary cortisol. Adverse events were also recorded. Results: A total of 26 students participated in this study and became more anxious as assessed by STAI in TPII (p = 0.002) and TPIV (p = 0.000) than TP0. AA reduced the STAI in TPIII (p = 0.045) and PIV (p = 0.001) and the VAS (p = 0.012) in TPIV. Cortisol was reduced in TPIII (p = 0.004), and the AA slept better (p = 0.014) at TPIV. Discomfort at the auricular site was reported in only one AA participant. Conclusions: Auriculotherapy appeared safe and effective in reducing anxiety levels before university exams.

Attentional Biases toward Face-Related Stimuli among Athletes after State Thwarting Need for Relatedness

The present study aimed to examine attentional biases' components and processes toward the interpersonal evaluation information among athletes after state thwarting need for relatedness. 51 athletes completed a visual dot-probe task while their eye-movements were tracking. Results indicated athletes showed different attentional bias pattern. Acceptance information is early orientation (directional bias); early acceleration detection; sustained to late attention maintenance (difficulty in disengaging). Rejection information is early orientation (directional bias); early accelerated detection; continuous attention to maintenance (attention avoidance); late attention to maintenance (difficulty in disengaging). That is to say, they had motivation to seek acceptance toward the accepted interpersonal evaluation information and to avoid rejection information toward the rejected one. Therefore, it is suggested that the coaches provide more interpersonal communicating opportunities, so as to help them to restore their demands toward interpersonal communication, and provide the customized attentional bias trainings to improve their coping response after state thwarted need for relatedness.

The relationship between worry and attentional bias to threat cues signalling controllable and uncontrollable dangers

People vary in the frequency with which they worry and there is large variation in the degree to which this worry disrupts their everyday functioning. Heightened tendency to experience disruptive worry is characterised by an attentional bias towards threat. While this attentional bias is often considered maladaptive, it can be adaptive when it concerns threat cues signalling dangers that can be mitigated through personal action. In this case, the resulting worry may increase the likelihood of this action being taken, with beneficial rather than disruptive consequences for everyday functioning. Thus, depending on its focus, attentional bias to threat could potentially drive worry that is high or low in disruptiveness. The current study addressed this possibility, by testing the novel hypothesis that the degree to which worry is disruptive is a function of the degree to which this attentional bias concerns all threat cues, rather than being restricted to threat cues signalling controllable dangers. Participants completed a novel probe task assessing their attention to threat cues signalling a future danger that could be controlled on some blocks, but not on others. Thus, the task revealed the degree to which their selective attention to threat cues was ‘aligned’ with danger controllability, by being more evident on blocks that permitted participant control of the danger signalled by the threat cues. The results indicate, contradicting the hypothesis under test, participants who reported high levels of disruptive worry demonstrated alignment of attentional bias to variations in danger controllability, whereas this was not the case for participants who reported high levels of non-disruptive worry. While caution is needed in the interpretation of the results due to methodological limitations, this study provides a new conceptual and methodological framework for future research on the attentional basis of individual differences in the tendency to experience disruptive vs non-disruptive worry.

Dispositional negativity, cognition, and anxiety disorders: An integrative translational neuroscience framework

When extreme, anxiety can become debilitating. Anxiety disorders, which often first emerge early in development, are common and challenging to treat, yet the underlying mechanisms have only recently begun to come into focus. Here, we review new insights into the nature and biological bases of dispositional negativity, a fundamental dimension of childhood temperament and adult personality and a prominent risk factor for the development of pediatric and adult anxiety disorders. Converging lines of epidemiological, neurobiological, and mechanistic evidence suggest that dispositional negativity increases the likelihood of psychopathology via specific neurocognitive mechanisms, including attentional biases to threat and deficits in executive control. Collectively, these observations provide an integrative translational framework for understanding the development and maintenance of anxiety disorders in adults and youth and set the stage for developing improved intervention strategies.