Affective primes suppress attention bias to threat in socially anxious individuals

Scene effects on disgusted facial expression detection in individuals with social anxiety: The role of emotional intensity

Individuals exhibiting high social anxiety (HSA) typically encounter challenges in identifying threatening stimuli with varying levels of intensity in different social scenes, ultimately affecting their social interactions. However, it is not well understood how social scenes, emotional intensity, and interaction influence the recognition of threat stimuli among HSA individuals (HSAs). To address this issue, a face recognition task was administered to 20 HSA participants and 22 individuals exhibiting low social anxiety (LSA) in this study. Results indicated that during the social scene presentation stage, HSAs produced larger P2 amplitude than LSA individuals (LSAs) no matter the valence of the scenes. During the face recognition stage, HSAs had smaller N170 amplitude than LSAs and exhibited lower recognition time for 2 % disgusted faces compared to LSAs. Furthermore, the consistency between scenes and faces led to faster recognition of disgusted faces in HSAs, but not in LSAs. Consequently, our findings suggested that HSAs exhibited unique cognitive processing patterns in social scenes, manifested by increased attention to scenes and decreased attention to faces. In addition, the emotional congruence between the scene and the faces could facilitate the recognition of faces by HSAs.

Differences in attentional bias between self-related information and external cues from others in individuals with social anxiety: An event-related potential study

Individuals with high social anxiety show a more considerable attentional bias toward self-relevant information and outwardly threatening stimuli than do those with low social anxiety. Some studies have investigated the attentional bias between self-relevant information and external social cues in people with high social anxiety but have not reached consistent conclusions. This study used a modified dot-probe task and collected temporal and electroencephalogram responses to three self-other face pairs among 15 people with high social anxiety and 20 people with low social anxiety. Both groups responded quicker to self-relevant information than external social cues. Others' emotional potencies moderated the attentional bias. Individuals with high social anxiety exhibited larger P1 amplitudes and smaller N170 amplitudes (mainly in the right hemisphere) for all face pairs and larger P2 amplitudes for the self-neutral and other-angry face pairs than those with low social anxiety. These findings suggest that people with social anxiety prioritize allocating attentional resources to self-relevant information, with others' angry faces having the greatest influence on the allocation. Individuals with high social anxiety initially exhibit more attentional vigilance and less structural coding for face pairs, followed by heightened engagement with threatening cues compared to those with low social anxiety.

Attention Bias and Anxiety: The Moderating Effect of Sociocultural Variables in Rural Latinx Youth

Attention bias confers risk for anxiety development, however, the influence of sociodemographic variables on the relationship between attention bias and anxiety remains unclear. We examined the association between attention bias and anxiety among rural Latinx youth and investigated potential moderators of this relationship. Clinical symptoms, demographic characteristics, and a performance-based measure of attention bias were collected from 66 rural Latinx youth with clinical levels of anxiety (33.3% female; Mage = 11.74; 92.4% Latinx, 7.6% Mixed Latinx). No moderating effects for age or gender were found. Youth below the poverty line displayed an attention bias away from threat in comparison to youth above the poverty line, who displayed an attention bias towards threat. Among youth below the poverty line, this bias away from threat was associated with increased anxiety. Findings highlight the importance of economic adversity in understanding the relationship between attention bias and anxiety.

Neural evidence of face processing in social anxiety disorder: A systematic review with meta-analysis

Numerous previous studies have used event-related potentials (ERPs) to examine facial processing deficits in individuals with social anxiety disorder (SAD). However, researchers still need to determine whether the deficits are general or specific and what the dominant factors are behind different cognitive stages. Meta-analysis was performed to quantitatively identify face processing deficits in individuals with SAD. Ninety-seven results in 27 publications involving 1032 subjects were calculated using Hedges' g. The results suggest that the face itself elicits enlarged P1 amplitudes, threat-related facial expressions induce larger P2 amplitudes, and negative facial expressions lead to enhanced P3/LPP amplitudes in SAD individuals compared with controls. That is, there is face perception attentional bias in the early phase (P1), threat attentional bias in the mid-term phase (P2), and negative emotion attentional bias in the late phase (P3/LPP), which can be summarized into a three-phase SAD face processing deficit model. These findings provide an essential theoretical basis for cognitive behavioral therapy and have significant application value for the initial screening, intervention, and treatment of social anxiety.

Characteristics of attentional bias in meditators: An ERP study

Attentional bias is closely related to individual mental health. To explore the effect of mindfulness meditation on attentional bias, we use the dot-probe task to measure and compare the attentional bias of 16 Shaolin monks with meditation experience (meditator group) and 18 ordinary people without meditation experience (control group). The results were as follows: (1) The control group showed attentional bias to anger stimuli, while the meditator group did not show attentional bias; (2) The P1 amplitude induced by emotion stimuli was significantly less in the meditator group than in the control group; (3) When the control group observed angry-neutral faces, the P2 amplitude was greater than when they saw neutral-neutral faces. In comparison, there was no significant difference in P2 amplitude when the meditator group viewed faces with different emotions. This leads us to contend that people highly practiced in meditation can reduce their attentional bias to negative information, and show the cognitive characteristics of "impartial" treatment to external information.

Neurophysiological Correlates for Dynamic Variability Between Vigilance and Avoidance in Test Anxiety

Attention bias (ABs) to threat is essential in the etiology and maintenance of test anxiety. However, little is known about the attention pattern of ABs in test anxiety. The stimulus duration affects the attention pattern in anxiety. Thus, the present research combined the dot-probe paradigm and event-related potentials (ERPs) and varied the stimulus duration (100ms or 500ms) to test the ABs in test anxiety. Consequently, both groups showed a threat N2pc in 100ms and 500ms duration, suggesting that both groups allocated attention to the test-related threat. However, in the 100ms duration, the high test-anxious (HTA) group had smaller target-elicited P1 and greater target-elicited N2 in the threat-congruent condition than in the neutral condition. In the 500ms duration, an earlier threat N2pc and a threat PD followed a greater target P1, and smaller target N2 were pronounced in the HTA group. The current results provided electrophysiological evidence that the HTA group kept a dynamic attention pattern that fluctuated shift between vigilance and avoidance in the 100ms and 500ms duration. The HTA group was more vigilant than the LTA group in the 500ms duration when strategic attention was concerned, proposing that the vigilance in test anxiety was not an automatic process.

A Preliminary Investigation of ERP Components of Attentional Bias in Anxious Adults using Temporospatial Principal Component Analysis

Threat-related attention bias is thought to contribute to the development and maintenance of anxiety disorders. Dot-probe studies using event-related potentials (ERPs) have indicated that several early ERP components are modulated by threatening and emotional stimuli in anxious populations, suggesting enhanced allocation of attention to threat and emotion at earlier stages of processing. However, ERP components selected for examination and analysis in these studies vary widely and remain inconsistent. The present study used temporospatial principal component analysis (PCA) to systematically identify ERP components elicited to face pair cues and probes in a dot-probe task in anxious adults. Cue-locked components sensitive to emotion included an early occipital C1 component enhanced for happy versus angry face pair cues and an early parieto-occipital P1 component enhanced for happy versus angry face pair cues. Probe-locked components sensitive to congruency included a parieto-occipital P2 component enhanced for incongruent probes (probes replacing neutral faces) versus congruent probes (probes replacing emotional faces). Split-half correlations indicated that the mean value around the PCA-derived peaks were reliably measured in the ERP waveforms. These results highlight promising neurophysiological markers for attentional bias research that can be extended to designs comparing anxious and healthy comparison groups. Results from a secondary exploratory PCA analysis investigating the effects of emotional face position and analyses on behavioral reaction time data are also presented.

Influence of acute stress on attentional bias toward threat: How a previous trauma exposure disrupts threat apprehension

While previous trauma exposure is known to be a risk factor for the development and maintenance of many psychological disorders, it remains unclear how it increases individual risk for prospective psychopathology in the aftermath of a new trauma exposure. The aim of this study was to investigate how a prior exposure to trauma affects attentional processing of threat before and after an acute stress task. Specifically, we assessed attentional biases to threat before and after a cold pressor task in 17 individuals who have been exposed to trauma (TE) compared to 18 individuals without trauma exposure (NTE). Behavioral results showed difficulties to disengage from threat in TE but not in the control group prior to stress induction, as well as a switch to an attentional bias toward threat after the cold pressor task in the TE group. For the ERPs, we highlighted (1) decreased N1 negativity in response to threatening stimuli after an acute stress in both groups, and (2) a parallel increase in P1 for such stimuli only in the TE group. Those results suggest a vulnerability presented by previously traumatized individuals when dealing with threats as well as an acute responsitity toward stress. Those results are interpreted in regards with the theorical models of stress and anxiety.

Gender differences in subliminal affective face priming: A high-density ERP study

INTRODUCTION

Subliminal affective priming effects (SAPEs) refer to the phenomenon by which the presentation of an affective prime stimulus influences the subsequent affective evaluation of a target stimulus. Previous studies have reported that unconsciously processed stimuli affect behavioral performance more than consciously processed stimuli. However, the impact of SAPEs on the face-specific N170 component is unclear. We studied how SAPEs for fearful faces affected the N170 for subsequent supraliminal target faces using event-related potentials (ERPs).

METHODS

Japanese adults (n = 44, 20 females) participated in this study. Subliminal prime faces (neutral or fearful) were presented for 17 ms, followed by a backward mask for 283 ms and 800 ms target faces (neutral, emotionally ambiguous, or fearful). 128-channel ERPs were recorded while participants judged the expression of target faces as neutral or fearful. Response rates and response times were also measured for assessing behavioral alterations.

RESULTS

Although the behavioral results revealed no evidence of SAPEs, we found gender-related SAPEs in right N170 amplitude. Specifically, female participants exhibited enhanced right N170 amplitude for emotionally neutral faces primed by fearful faces, while male participants exhibited decreased N170 amplitude in fearful prime trials with fearful target faces. Male participants exhibited significant correlations between N170 amplitude and behavioral response time in the fearful prime-neutral target condition.

CONCLUSIONS

Our ERP results suggest the existence of a gender difference in target-face processing preceded by subliminally presented face stimuli in the right occipito-temporal region.

Your face scares me: Effects of Perceptual load and Social Anxiety on processing of threatening and neutral faces

Social Anxiety Disorder is among the most widely studied psychiatric conditions. However, the role of attentional and emotional processes in the maintenance of the condition is still not well-established. This study addressed the impact of individual differences in Social Anxiety, by examining the effects of perceptual load and stimulus valence when processing faces vs objects, here used as distractors, within a letter-search task. In addition to RT and accuracy on the letter search task, heart rate, and skin conductance during the task and participants’ self-report emotional evaluation were assessed to help interpret performance effects. Results suggest that distractor stimuli that are either threatening or faces impair performance of high SA participants. Results demonstrate a hypervigilance for threatening faces in SA but indicate that this happens primarily when cognitive resources are available, that is, under low perceptual load.

Neural basis underlying the trait of attachment anxiety and avoidance revealed by the amplitude of low-frequency fluctuations and resting-state functional connectivity

Background

Attachment theory demonstrates that early attachment experience shapes internal working models with mental representations of self and close relationships, which affects personality traits and interpersonal relationships in adulthood. Although research has focused on brain structural and functional underpinnings to disentangle attachment styles in healthy individuals, little is known about the spontaneous brain activity associated with self-reported attachment anxiety and avoidance during the resting state.

Methods

One hundred and nineteen individuals participated in the study, completing the Experience in Close Relationship scale immediately after an 8-min fMRI scanning. We used the resting-state functional magnetic resonance imaging (rs-fMRI) signal of the amplitude of low-frequency fluctuation and resting-state functional connectivity to identify attachment-related regions and networks.

Results

Consequently, attachment anxiety is closely associated with the amplitude of low-frequency fluctuations in the right posterior cingulate cortex, over-estimating emotional intensity and exaggerating outcomes. Moreover, the functional connectivity between the posterior cingulate cortex and fusiform gyrus increases detection ability for potential threat or separation information, facilitating behavior motivation. The attachment avoidance is positively correlated with the amplitude of low-frequency fluctuation in the bilateral lingual gyrus and right postcentral and negatively correlated with the bilateral orbital frontal cortex and inferior temporal gyrus. Functional connection with attachment avoidance contains critical nodes in the medial temporal lobe memory system, frontal-parietal network, social cognition, and default mode network necessary to deactivate the attachment system and inhibit attachment-related behavior.

Conclusion and implications

These findings clarify the amplitude of low-frequency fluctuation and resting-state functional connectivity neural signature of attachment style, associated with attachment strategies in attachment anxiety and attachment avoidance individuals. These findings may improve our understanding of the pathophysiology of the attachment-related disorder.

Attentional Bias Among Adolescents Who Stutter: Evidence for a Vigilance-Avoidance Effect

Purpose The purpose of this study was to examine group and individual differences in attentional bias toward and away from socially threatening facial stimuli among adolescents who stutter and age- and sex-matched typically fluent controls. Method Participants included 86 adolescents (43 stuttering, 43 controls) ranging in age from 13 to 19 years. They completed a computerized dot-probe task, which was modified to allow for separate measurement of attentional engagement with and attentional disengagement from facial stimuli (angry, fearful, neutral expressions). Their response time on this task was the dependent variable. Participants also completed the Social Anxiety Scale for Adolescents (SAS-A) and provided a speech sample for analysis of stuttering-like behaviors. Results The adolescents who stutter were more likely to engage quickly with threatening faces than to maintain attention on neutral faces, and they were also more likely to disengage quickly from threatening faces than to maintain attention on those faces. The typically fluent controls did not show any attentional preference for the threatening faces over the neutral faces in either the engagement or disengagement conditions. The two groups demonstrated equivalent levels of social anxiety that were both, on average, very close to the clinical cutoff score for high social anxiety, although degree of social anxiety did not influence performance in either condition. Stuttering severity did not influence performance among the adolescents who stutter. Conclusion This study provides preliminary evidence for a vigilance-avoidance pattern of attentional allocation to threatening social stimuli among adolescents who stutter.

Are avoidance biases in social anxiety due to biases in stimulus coding or in post-coding behavioral tendencies?

On the Approach-Avoidance Task (AAT) high socially anxious (HSA) individuals exhibit increased behavioral avoidance of faces displaying emotional expressions. Two accounts could explain these findings: 1) HSA individuals have a heightened readiness to code faces in terms of emotionality, and all individuals behaviorally avoid faces coded as emotional (pre-behavior coding bias hypothesis), or 2) everyone is equally ready to code faces in terms of emotionality, but when faces are coded as emotional HSA have a heightened tendency to behaviorally avoid such stimuli (post coding behavioral bias hypothesis). To test these hypotheses, we created the Stimulus-Coding AAT. Participants categorized emotional and non-emotional faces in terms of either gender or emotional expression, before making a standard AAT response. Time to make each type of categorization, and to execute AAT responses following categorization, was assessed in 32 HSA and 32 LSA participants. Groups did not differ in their relative speed to categorize face stimuli on the two dimensions. When participants coded faces in terms of their emotionality, HSA relative to LSA participants demonstrated increased behavioral avoidance of emotional faces. We conclude that these findings are inconsistent with the pre-behavior coding bias hypothesis and support the post-coding behavioral bias hypothesis.

Neural Correlates of Attentional Processing of Threat in Youth with and without Anxiety Disorders

Late-stage attentional processing of threatening stimuli, quantified through event-related potentials (ERPs), differentiates youth with and without anxiety disorders. It is unknown whether early-stage attentional processing of threatening stimuli differentiates these groups. Examining both early and late stage attentional processes in youth may advance knowledge and enhance efforts to identify biomarkers for translational prevention and treatment research. Twenty-one youth with primary DSM-IV-TR anxiety disorders (10 males, ages 8-15 years) and 21 typically developing Controls (15 males, ages 8-16 years) completed a dot probe task while electroencephalography (EEG) was recorded, and ERPs were examined. Youth with anxiety disorders showed significantly larger (more positive) P1 amplitudes for threatening stimuli than for neutral stimuli, and Controls showed the opposite pattern. Youth with anxiety showed larger (more negative) N170 amplitudes compared with Controls. Controls showed significantly larger (more positive) P2 and P3 amplitudes, regardless of stimuli valence, compared with youth with anxiety disorders. ERPs observed during the dot probe task indicate youth with anxiety disorders display distinct neural processing during early stage attentional orienting and processing of faces; this was not the case for Controls. Such results suggest these ERP components may have potential as biomarkers of anxiety disorders in youth.

The neural chronometry of threat-related attentional bias: Event-related potential (ERP) evidence for early and late stages of selective attentional processing

Rapid and accurate detection of threat is adaptive. Yet, threat-related attentional biases, including hypervigilance, avoidance, and attentional disengagement delays, may contribute to the etiology and maintenance of anxiety disorders. Behavioral measures of attentional bias generally indicate that threat demands more attentional resources; however, indices exploring differential allocation of attention using reaction time fail to clarify the time course by which attention is deployed under threatening circumstances in healthy and anxious populations. In this review, we conduct an interpretive synthesis of 28 attentional bias studies focusing on event-related potentials (ERPs) as a primary outcome to inform an ERP model of the neural chronometry of attentional bias in healthy and anxious populations. The model posits that both healthy and anxious populations display modulations of early ERP components, including the P1, N170, P2, and N2pc, in response to threatening and emotional stimuli, suggesting that both typical and abnormal patterns of attentional bias are characterized by enhanced allocation of attention to threat and emotion at earlier stages of processing. Compared to anxious populations, healthy populations more clearly demonstrate modulations of later components, such as the P3, indexing conscious and evaluative processing of threat and emotion and disengagement difficulties at later stages of processing. Findings from the interpretive synthesis, existing bias models, and extant neural literature on attentional systems are then integrated to inform a conceptual model of the processes and substrates underlying threat appraisal and resource allocation in healthy and anxious populations. To conclude, we discuss therapeutic interventions for attentional bias and future directions.

Impaired early visual categorization of fear in social anxiety

Social anxiety is associated with biased social perception, especially of ambiguous cues. While aberrations in high-level processes (e.g., cognitive appraisal and interpretation) have been implicated in such biases, contributions of early, low-level stimulus processing remain unclear. Categorical perception represents an efficient process to resolve signal ambiguity, and categorical emotion perception can swiftly classify sensory input, "tagging" biologically important stimuli at early stages of processing to facilitate ecological response. However, early threat categorization could be disrupted by exaggerated (or disinhibited) threat processing in anxiety, resulting in biased perception of ambiguous signals. We tested this hypothesis among individuals with low and high trait social anxiety (LSA/HSA; defined relative to the current sample), who performed a two-alternative forced-choice (fear or neutral) task on facial expressions parametrically varied along a neutral-fear continuum. The groups diverged in the reaction time (RT) profile along the neutral-fear continuum, which was characteristic of categorical perception in the LSA (vs. HSA) group with drastically increased RT from neutral to intermediate (boundary) fear intensities, contrasting monotonic, nonsignificant RT changes in the HSA group. Neurometric analysis along the continuum identified an early neutral-fear categorization operation (arising in the P1, an early visual ERP at 100 ms), which was nonetheless impaired in the HSA group (due to disinhibited response at the neutral-fear boundary). Absent group differences in higher-level cognitive operations (identified by later ERPs), current findings highlight a dispositional cognitive vulnerability in early visual categorization of social threat, which could precipitate further cognitive aberrations and, eventually, the onset of social anxiety disorder.

Social anxiety as a precursor for depression: Influence of interpersonal rejection and attention to emotional stimuli

Social anxiety disorder (SAD) and major depressive disorder (MDD) are comorbid conditions, and SAD confers risk for MDD. Biased attention and interpersonal rejection are important for the development of SAD and MDD, but little research has examined how these processes may lead to MDD. We hypothesized that interpersonal rejection would result in SAD symptoms being associated with more "depression-like" attention biases. Participants (n = 164) completed a measure of SAD symptoms and an eye tracking task before and after a task in which they were randomized to be socially included or rejected. SAD symptoms, inclusion or rejection condition, and the interaction term were entered into separate hierarchical linear regressions predicting change in attention for five emotional faces. Rejection condition significantly moderated the effects of SAD on change in attention to sad, happy, and neutral faces. SAD predicted increased attention to sad faces and decreased attention to happy faces in the rejection condition, but not in the inclusion condition. SAD predicted increased attention to neutral faces in the inclusion condition, but not in the rejection condition. There were no significant effects for angry or disgust. Results suggest that SAD symptoms are associated with more depression-like attention biases in the context of interpersonal rejection.

Awareness of Emotional Expressions in Cannabis Users: An Event-Related Potential Study

Cannabis use has been associated with anxiogenic effects when used in low frequency for a short duration, but cannabis can also have anxiogenic effects when used heavily for a long duration. Animal studies have indicated the neurobiological mechanisms related to cannabis and anxiety; however, research has been limited on the related neurocognitive mechanisms. Previous research has indicated that cannabis use is associated with alterations in event-related potentials (ERPs). The purpose of the current study was to examine anxiety related attentional processing of emotional expressions using ERP methods. We used a backward masking paradigm to restrict awareness of facial expressions (i.e., fearful, happy, and neutral). The results indicated that cannabis use was associated with differences in emotional processing. Specifically, the results suggested cannabis users had increased P1 amplitudes toward happy facial expressions compared to fearful and neutral. Additionally, cannabis users seemed to have reduced N170 hemisphere lateralization.

Effect of attention bias modification on event-related potentials in patients with irritable bowel syndrome: A preliminary brain function and psycho-behavioral study

BACKGROUND

Attention bias modification normalizes electroencephalographic abnormalities in alpha and beta power percentages related to attention in patients with irritable bowel syndrome (IBS). Yet, it is unknown whether ABM contributes to the normalization of event-related potentials (ERP) in these patients. We hypothesized that ERP related to attention deficit would be normalized after ABM implementation in individuals with IBS.

METHODS

Thirteen patients with IBS and 10 control subjects completed a 2-month intervention that included five ABM sessions. Each session included 128 trials, resulting in a total of 640 trials during the study period. Event-related potentials were measured at the first and fifth sessions. As per the international 10-20 system for electroencephalographic electrode placement, right parietal P4 was evaluated to measure the attention component of facial expression processing.

KEY RESULTS

A group comparison of P100 latency at P4 revealed that latencies were significantly different between groups in session 1 (IBS vs control, 108 ± 8 vs 97 ± 14; t = -2.51, P = .0203). This difference was absent in session 5 (94 ± 11 vs 93 ± 11, respectively; t = -0.397, P = .6954, r = .09), indicating an effect of ABM in the IBS group.

CONCLUSIONS AND INFERENCES

Attention bias modification may have clinical utility for normalizing brain function and specifically attentional abnormalities in patients with IBS.

The dot-probe task to measure emotional attention: A suitable measure in comparative studies?

For social animals, attending to and recognizing the emotional expressions of other individuals is of crucial importance for their survival and likely has a deep evolutionary origin. Gaining insight into how emotional expressions evolved as adaptations over the course of evolution can be achieved by making direct cross-species comparisons. To that extent, experimental paradigms that are suitable for investigating emotional processing across species need to be developed and evaluated. The emotional dot-probe task, which measures attention allocation toward emotional stimuli, has this potential. The task is implicit, and subjects need minimal training to perform the task successfully. Findings in nonhuman primates, although scarce, show that they, like humans, have an attentional bias toward emotional stimuli. However, the wide literature on human studies has shown that different factors can have important moderating effects on the results. Due to the large heterogeneity of this literature, these moderating effects often remain unnoticed. We here review this literature and show that subject characteristics and differences in experimental designs affect the results of the dot-probe task. We conclude with specific recommendations regarding these issues that are particularly relevant to take into consideration when applying this paradigm to study animals.

Subliminal Priming-State of the Art and Future Perspectives

The influence of subliminal priming (behavior outside of awareness) in humans is an interesting phenomenon and its understanding is crucial as it can impact behavior, choices, and actions. Given this, research about the impact of priming continues to be an area of investigative interest, and this paper provides a technical overview of research design strengths and issues in subliminal priming research. Efficient experiments and protocols, as well as associated electroencephalographic and eye movement data analyses, are discussed in detail. We highlight the strengths and weaknesses of different priming experiments that have measured affective (emotional) and cognitive responses. Finally, very recent approaches and findings are described to summarize and emphasize state-of-the-art methods and potential future directions in research marketing and other commercial applications.

Socio-cognitive load and social anxiety in an emotional anti-saccade task

The anti-saccade task has been used to measure attentional control related to general anxiety but less so with social anxiety specifically. Previous research has not been conclusive in suggesting that social anxiety may lead to difficulties in inhibiting faces. It is possible that static face paradigms do not convey a sufficient social threat to elicit an inhibitory response in socially anxious individuals. The aim of the current study was twofold. We investigated the effect of social anxiety on performance in an anti-saccade task with neutral or emotional faces preceded either by a social stressor (Experiment 1), or valenced sentence primes designed to increase the social salience of the task (Experiment 2). Our results indicated that latencies were significantly longer for happy than angry faces. Additionally, and surprisingly, high anxious participants made more erroneous anti-saccades to neutral than angry and happy faces, whilst the low anxious groups exhibited a trend in the opposite direction. Results are consistent with a general approach-avoidance response for positive and threatening social information. However increased socio-cognitive load may alter attentional control with high anxious individuals avoiding emotional faces, but finding it more difficult to inhibit ambiguous faces. The effects of social sentence primes on attention appear to be subtle but suggest that the anti-saccade task will only elicit socially relevant responses where the paradigm is more ecologically valid.

Event-related potentials of attentional bias toward faces in the dot-probe task: A systematic review

The dot-probe task is a common task to assess attentional bias toward different stimuli and how groups differ (e.g., attentional bias in anxiety disorders). However, measuring reaction time has been suggested to be unreliable. Neuroimaging methods such as fMRI were shown to be more reliable in assessing attentional bias, but fMRI has poor temporal resolution and therefore cannot assess timing of attention. ERPs have been used to examine the time course of attentional bias. Although ERP research may be more reliable than reaction time, there have been inconsistencies in the literature. This review systematically searched for articles that used the dot-probe task with facial expressions and measured neural correlates with ERP. We found that some of the inconsistencies might be the cause of methodological differences (e.g., timing of stimuli), differences in emotional expression, and/or sample differences (e.g., sex, age, etc.). Suggestions on how future research could address the issues presented in this review were discussed.

Acute Psychological Stress Disrupts Attentional Bias to Threat-Related Stimuli

The present study investigated the effect of acute stress on attentional bias to threat using behavioral and ERP methods. Sixty-two male participants were randomly assigned to a stress condition (Trier Social Stress Test) or a control condition. To examine the impact of stress-induced cortisol on attentional bias to threat, participants in the stress group were split into Low- and High cortisol responders. All participants were then administered a modified dot probe task in which the cues were neutral and angry faces. Behavioral results showed a pattern of attentional bias toward threat in the Control group but not in the stress group. For the ERPs, the P100 peaked earlier for the angry-cued targets than the neutral-cued targets in the Control group, which suggests a rapid, adaptive response toward threat. However, this effect was not observed in the stress group, suggesting a suppressed attentional bias under stress. In addition, the stress group (including both Low and High cortisol responders) showed reduced P300 amplitude to target onset than the Control group. These results suggest that acute stress disrupts attentional bias to threat including a reduction in early bias to threat in addition to a subsequent change of attention allocation.

Age As Moderator of Emotional Stroop Task Performance in Posttraumatic Stress Disorder (PTSD)

Emotional Stroop task (EST) has been extensively used to investigate attentional processes in posttraumatic stress disorder (PTSD). Even though aging significantly changes the dynamics of emotion-cognition interactions, very little is known about its role in shaping EST performance in PTSD patients. In the present study we tested a uniquely large sample of motor vehicle accident victims. Data of 194 participants (75.3% female; mean age = 36.64 years, SD = 12.3) were included in the analysis, out of which 136 (70.1%) were diagnosed with PTSD. Prior to the psychiatric assessment, participants completed the pictorial version of EST (neutral, positive, negative, and accidents photos were presented). Comparison of the PTSD and control groups revealed a specific increase in reaction times (RTs) related to the exposure of trauma-related material. At the same time, previously unreported, moderating effects of age were also discovered. Older participants, in contrast to the younger group, showed no increase in RTs and interference scores in trials where accident photos were presented. Our study points to the key role of age as a previously understudied factor modifying EST performance in PTSD patients.

Threat Monitoring and Attention-Bias Modification in Anxiety and Stress-Related Disorders

Extensive research has demonstrated the effects of threat-related attentional bias on anxiety and stress-related disorders. This review summarizes recent findings from clinical affective neuroscience. It takes a multilevel analysis approach by presenting behavioral and neural findings from studies conducted in laboratories, clinical settings, and real-life situations. Building on recent findings, we propose a new working model linking individual tendencies to attend or avoid threats with the level of danger in a given context. Namely, adaptive or pathological response is determined by threat-monitoring flexibility and plasticity in an ever-changing environment. The review culminates by describing the potential therapeutic value of attention-bias modification in the treatment of anxiety and stress-related disorders.

Sex differences in socioemotional functioning, attentional bias, and gray matter volume in maltreated children: A multilevel investigation

While maltreatment is known to impact social and emotional functioning, threat processing, and neural structure, the potentially dimorphic influence of sex on these outcomes remains relatively understudied. We investigated sex differences across these domains in a large community sample of children aged 10 to 14 years (n = 122) comprising 62 children with verified maltreatment experience and 60 well-matched nonmaltreated peers. The maltreated group relative to the nonmaltreated comparison group exhibited poorer social and emotional functioning (more peer problems and heightened emotional reactivity). Cognitively, they displayed a pattern of attentional avoidance of threat in a visual dot-probe task. Similar patterns were observed in males and females in these domains. Reduced gray matter volume was found to characterize the maltreated group in the medial orbitofrontal cortex, bilateral middle temporal lobes, and bilateral supramarginal gyrus; sex differences were observed only in the supramarginal gyrus. In addition, a disordinal interaction between maltreatment exposure and sex was found in the postcentral gyrus. Finally, attentional avoidance to threat mediated the relationship between maltreatment and emotional reactivity, and medial orbitofrontal cortex gray matter volume mediated the relationship between maltreatment and peer functioning. Similar mediation patterns were observed across sexes. This study highlights the utility of combining multiple levels of analysis when studying the "latent vulnerability" engendered by childhood maltreatment and yields tentative findings regarding a neural basis of sex differences in long-term outcomes for maltreated children.

Attentional biases in high social anxiety using a flanker task

BACKGROUND AND OBJECTIVES

The existence of threat-related attentional bias has been well supported in social anxiety research. However, most previous studies investigated separately attentional bias toward targets or distractors. This study examined the selective attention of socially anxious individuals in the presence of both emotional targets and distractors.

METHODS

Participants with high vs. low social anxiety (HSA vs. LSA) took part in a modified flanker task. Participants initially focused on the center of the screen, and then were required to identify the emotion of the central face (target) regardless of the flanking faces (distractors).

RESULTS

The response times (RTs) of the HSA and LSA groups did not differ significantly when responding to different central faces (targets), but the HSA group responded more slowly to central faces when the flankers (distractors) were negative faces as opposed to positive or neutral.

LIMITATIONS

The depression levels of participants in this non-clinical sample were not controlled.

CONCLUSION

The results support attention control theory and suggest impaired inhibition control in HSA..

Attention Biases Towards and Away from Threat Mark the Relation between Early Dysregulated Fear and the Later Emergence of Social Withdrawal

Fearful temperament, mostly studied as behavioral inhibition (BI), has been extensively associated with social withdrawal in childhood and the later emergence of anxiety disorders, especially social anxiety disorder (SAD). Recent studies have characterized a distinct type of fearful temperament marked by high levels of fear in low threat situations - labeled dysregulated fear. Dysregulated fear has been related to SAD over and above risks associated with BI. However, the mechanism by which dysregulated fear is related to SAD has not been studied. Cognitive mechanisms, such as attentional bias towards threat, may be a possible conduit. We examined differences in attentional bias towards threat in six-year-olds who displayed a pattern of dysregulated fear at age two (N = 23) compared with children who did not display dysregulated fear (N = 33). Moreover, we examined the concurrent relation between attentional bias and social withdrawal. Results indicated that children characterized by dysregulated fear showed a significant bias away from threat, and that this bias was significantly different from the children without dysregulated fear, who showed no significant bias. Moreover, attentional bias towards threat was positively related to social withdrawal only for the dysregulated fear group. These results are discussed in consideration of the existing knowledge of attentional bias to threat in the developmental and pediatric anxiety literatures, as well as recent studies that find important heterogeneity in attentional bias.

Neural correlates of attention biases, behavioral inhibition, and social anxiety in children: An ERP study

Behavioral inhibition (BI) is a biologically-based temperament characterized by vigilance toward threat. Over time, many children with BI increasingly fear social circumstances and display maladaptive social behavior. BI is also one of the strongest individual risk factors for developing social anxiety disorder. Although research has established a link between BI and anxiety, its causal mechanism remains unclear. Attention biases may underlie this relation. The current study examined neural markers of the BI-attention-anxiety link in children ages 9-12 years (N=99, Mean=9.97, SD=0.97). ERP measures were collected as children completed an attention-bias (dot-probe) task with neutral and angry faces. P2 and N2 amplitudes were associated with social anxiety and attention bias, respectively. Specifically, augmented P2 was related to decreased symptoms of social anxiety and moderated the relation between BI and social anxiety, suggesting that increasing attention mobilization may serve as a compensatory mechanism that attenuates social anxiety in individuals with high BI. The BI by N2 interaction found that larger N2 related to threat avoidance with increasing levels of BI, consistent with over-controlled socio-emotional functioning. Lastly, children without BI (BN) showed an augmented P1 to probes replacing angry faces, suggesting maintenance of attentional resources in threat-related contexts.

What does the facial dot-probe task tell us about attentional processes in social anxiety? A systematic review

BACKGROUND/OBJECTIVES

Current models of SAD assume that attentional processes play a pivotal role in the etiology and maintenance of social anxiety disorder. Social anxiety is supposedly associated with an attentional bias towards disorder related stimuli such as threatening faces. Using the facial dot probe task in socially anxious individuals has, however, revealed inconsistent findings.

METHODS

The current systematic review aims at disentangling the heterogeneous findings using effect sizes across results by systematically taking into account potential moderating variables (stimulus type, stimulus duration, situational anxiety, disorder severity).

RESULTS

Results provide some evidence that socially anxious individuals preferentially allocate their attention towards threat faces compared to non-anxious controls. This bias seems to depend on the type of reference stimulus, stimulus duration and clinical level of social anxiety. Avoidance of threat was neither found at early, nor at later stages of attentional processing.

LIMITATIONS

Importantly, the results have to be considered in the light of the only few studies available. Given the heterogeneity of results and some methodological restrictions of the studies included, the picture of attentional bias seems to be much less clear than suggested in the recent social anxiety literature.

CONCLUSIONS

Methodologically, combined measures of dot-probe and eye movement measures might be beneficial to detect overt attentional biases. Importantly, our results show that preferential processing of threat cues might guide early attentional processes in social anxiety, depending however on several contextual and situational factors. Clinically, patients with greater severity of SAD may be more prone to such an attentional bias, thus therapists should take this into account when planning behavioral experiments and exposure therapy.

The Effect of Affective Context on Visuocortical Processing of Neutral Faces in Social Anxiety

It has been demonstrated that verbal context information alters the neural processing of ambiguous faces such as faces with no apparent facial expression. In social anxiety, neutral faces may be implicitly threatening for socially anxious individuals due to their ambiguous nature, but even more so if these neutral faces are put in self-referential negative contexts. Therefore, we measured event-related brain potentials (ERPs) in response to neutral faces which were preceded by affective verbal information (negative, neutral, positive). Participants with low social anxiety (LSA; n = 23) and high social anxiety (HSA; n = 21) were asked to watch and rate valence and arousal of the respective faces while continuous EEG was recorded. ERP analysis revealed that HSA showed elevated P100 amplitudes in response to faces, but reduced structural encoding of faces as indexed by reduced N170 amplitudes. In general, affective context led to an enhanced early posterior negativity (EPN) for negative compared to neutral facial expressions. Moreover, HSA compared to LSA showed enhanced late positive potentials (LPP) to negatively contextualized faces, whereas in LSA this effect was found for faces in positive contexts. Also, HSA rated faces in negative contexts as more negative compared to LSA. These results point at enhanced vigilance for neutral faces regardless of context in HSA, while structural encoding seems to be diminished (avoidance). Interestingly, later components of sustained processing (LPP) indicate that LSA show enhanced visuocortical processing for faces in positive contexts (happy bias), whereas this seems to be the case for negatively contextualized faces in HSA (threat bias). Finally, our results add further new evidence that top-down information in interaction with individual anxiety levels can influence early-stage aspects of visual perception.

Hypervigilance to Rejecting Stimuli in Rejection Sensitive Individuals: Behavioral and Neurocognitive Evidence

Individuals who are high in rejection sensitivity are vigilant toward social cues that signal rejection, and they exhibit attention biases towards information that confirms expectations of rejection. Little is known, however, about the neural correlates of rejection sensitivity. The present study examined whether rejection sensitivity is associated with individuals' neural responses to rejection-relevant information. Female participants, classified as high or average in rejection sensitivity, completed a modified dot-probe task in which a neutral face was paired with either another neutral face or a gaze-averted ("rejecting") face while EEG was collected and ERP components were computed. Behavioral results indicated that average rejection sensitive participants showed an attention bias away from rejecting faces, while high rejection sensitive participants were equally vigilant to neutral and rejecting faces. High rejection sensitivity was associated with ERP components signaling elevated attention and arousal to faces. These findings suggest that rejection sensitivity shapes behavioral and neurocognitive responses to faces.

Longitudinal relations among exuberance, externalizing behaviors, and attentional bias to reward: the mediating role of effortful control

The present study examined the associations between temperamental exuberance during toddlerhood (20 months), attention bias towards reward at the end of kindergarten (76 months), and externalizing behaviors across the kindergarten year. Moreover, we examined the role of effortful control at 48 months on the relation between early exuberance and attention bias. Attention bias towards reward was positively predicted by exuberance, negatively predicted by effortful control, and positively related to externalizing problems. Finally, the longitudinal path between exuberance and attention bias to reward was mediated by effortful control - such that higher toddler exuberance led to increased attention bias towards reward by way of lower effortful control. These results extend the attention bias and socioemotional functioning literature and have implications for the identification of children at risk for behavioral problems.

A Critical Review of Attentional Threat Bias and Its Role in the Treatment of Pediatric Anxiety Disorders

Threat bias, or exaggerated selective attention to threat, is considered a key neurocognitive factor in the etiology and maintenance of pediatric anxiety disorders. However, upon closer examination of the literature, there is greater heterogeneity in threat-related attentional biases than typically acknowledged. This is likely impacting progress that can be made in terms of interventions focused on modifying this bias and reducing anxiety, namely attention bias modification training. We suggest that the field may need to "take a step back" from developing interventions and focus research efforts on improving the methodology of studying attention bias itself, particularly in a developmental context. We summarize a neurocognitive model that addresses the issue of heterogeneity by broadly incorporating biases toward and away from threat, linking this variation to key neurodevelopmental factors, and providing a basis for future research aimed at improving the utility of threat bias measures and interventions in clinical practice.

Temperament and Attention as Core Mechanisms in the Early Emergence of Anxiety

Anxiety is a pervasive, impairing, and early appearing form of psychopathology. Even when anxiety remits, children remain at a two- to threefold increased risk for the later emergence of a mood disorder. Therefore, it is imperative to identify and examine underlying mechanisms that may shape early emerging patterns of behavior that are associated with anxiety. One of the strongest and first visible risk factors is childhood temperament. In particular, children who are behaviorally inhibited or temperamentally shy are more likely to exhibit signs of anxiety by adolescence. However, not all shy children do so, despite the early risk. We know that attention mechanisms, particularly the presence of attention biases toward or away from threat, can play a critical role in the emergence of anxiety. The current chapter will bring together these separate lines of research to examine the ways in which attention can modulate the documented link between early temperament and later anxiety. In doing so, the chapter will highlight multiple levels of analysis that focus on the behavioral, cognitive, and neural mechanisms in the temperament-attention-anxiety network. The chapter will help identify both markers and mechanisms of risk, supporting future work aimed at improving theory and intervention by focusing on attention biases to environmental threat.