The time course of attentional disengagement from angry faces in social anxiety

The effect of working memory load on selective attention to emotional faces for social anxiety individuals

Research has confirmed that individuals with social anxiety (SA) show an attentional bias towards threat-related stimuli. However, the extent to which this attentional bias depends on top-down cognitive control processes remains controversial. The present study investigated the effect of working memory (WM) load on selective attention to emotional faces in both high social anxiety (HSA) and low social anxiety (LSA) groups by manipulating WM load through the inclusion of forward counting in multiples of two (low load) or backward counting in multiples of seven (high load) within a modified flanker task. In the flanker task, emotional faces (angry, happy, or neutral faces) were used as targets and distractors. A total of 70 participants (34 HSA participants; 36 LSA participants) completed the flanker task in the laboratory. The results showed that the HSA individuals performed worse when responding to angry targets. Relative to LSA individuals, HSA individuals showed interference from angry distractors in the flanker task, resulting in significantly lower accuracy in identifying angry targets compared to happy targets. These results were unaffected by the manipulation of WM load. The findings imply HSA individuals have impaired attentional control, and that their threat-related attentional bias relies more on the bottom-up automatic attentional process.

Attentional bias modification in male college smokers: The changes of facilitated attention, difficulty in disengagement and the transfer effects of training

BACKGROUND

Attentional bias modification (ABM) has been used to modify the attentional bias (AB) towards smoking-related cues. Still, the effects of ABM are extensively controversial. The present study aimed to investigate the effects of ABM on AB and its two sub-processes named facilitated attention and difficulty in disengagement at two different stimulus durations, as well as test whether the effects of ABM could transfer to new measures of AB.

METHOD

Forty-six male college smokers were allocated to either ABM group using a modified visual probe task (n = 24), or the corresponding placebo training (PT) group (n = 22). Participants performed three sessions of training in one week. The pre- and post-training AB and its sub-processes were measured using visual probe task. Cue-target task and pictorial Stroop task were used for testing the transfer effects of ABM.

RESULTS

The AB in ABM group was significantly decreased compared with the PT group. Specifically, the facilitated attention was significantly reduced at 200 ms stimulus duration, while the difficulty in disengagement was significantly decreased at 500 ms stimulus duration. The benefit of ABM training could transfer to the cue-target task, but not to the pictorial Stroop task. Meanwhile, no effects of ABM were observed on smoking craving and nicotine dependence.

CONCLUSIONS

These findings suggested that the stimulus duration is a crucial factor for the efficacy of ABM on the facilitated attention and the difficulty in disengagement in male college smokers and detected the transfer effects between different measures of AB to some extent. Future studies need to further explore the influence mechanism in distinct stimulus durations.

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.

Incongruent gestures slow the processing of facial expressions in university students with social anxiety

In recent years, an increasing number of studies have examined the mechanisms underlying nonverbal emotional information processing in people with high social anxiety (HSA). However, most of these studies have focused on the processing of facial expressions, and there has been scarce research on gesture or even face-gesture combined processing in HSA individuals. The present study explored the processing characteristics and mechanism of the interaction between gestures and facial expressions in people with HSA and low social anxiety (LSA). The present study recruited university students as participants and used the Liebowitz Social Anxiety Scale scores to distinguish the HSA and LSA groups. We used a 2 (group: HSA and LSA) × 2 (emotion valence: positive, negative) × 2 (task: face, gesture) multifactor mixed design, and videos of a single face or gesture and combined face-gesture cues were used as stimuli. We found that (1) there is a distinction in the processing of faces and gestures, with individuals recognizing gestures faster than faces; (2) there is an attentional enhancement in the processing of gestures, particularly for negative gestures; and (3) when the emotional valence of faces and gestures align, it facilitates the recognition of both. However, incongruent gestures have a stronger impact on the processing of facial expressions compared to facial expressions themselves, suggesting that the processing of facial emotions is more influenced by environmental cues provided by gestures. These findings indicated that gestures played an important role in emotional processing, and facial emotional processing was more dependent on the environmental cues derived from gestures, which helps to clarify the reasons for biases in the interpretation of emotional information in people with HSA.

Vigilance or avoidance: How do autistic traits and social anxiety modulate attention to the eyes?

Introduction

Social anxiety disorder (SAD) and autism spectrum disorder (ASD) are highly overlapping in symptoms and have a high rate of comorbidity, posing challenges in diagnosis and intervention for both disorders. Both disorders are linked to abnormal attention to the eyes, yet how they interactively modulate the attentional process to the eyes remains unclear.

Methods

In this study, we explored how autistic traits and social anxiety in college students separately and together affected different temporal stages of attention to the eyes. Participants were instructed to view virtual faces for 10 s and make an emotional judgment, while their eye movements were recorded.

Results

We found that social anxiety and autistic traits affected different temporal stages of eye-looking. Social anxiety only affected the first fixation duration on the eyes, while autistic traits were associated with eye avoidance at several time points in the later stage. More importantly, we found an interactive effect of autistic traits and social anxiety on the initial attention to the eyes: Among people scoring high on autistic traits, social anxiety was related to an early avoidance of the eyes as well as attention maintenance once fixated on the eyes.

Discussion

Our study suggests the separate and interactive roles of social anxiety and autistic traits in attention to the eyes. It contributes to a deeper understanding of the mechanisms of social attention in both SAD and ASD and highlights the application of psychiatric diagnoses using eye-tracking techniques.

Am I really seeing what's around me? An ERP study on social anxiety under speech induction, uncertainty and social feedback

Cognitive models of social anxiety propose that socially anxious individuals engage in excessive self-focusing attention when entering a social situation. In the present study, speech anxiety was induced to socially anxious and control participants. Event-related potentials were recorded while participants performed a perceptual judgment task using distinct or ambiguous stimuli, before and after social feedback. Disputed feedback led to more revisions and decreased levels of confidence, especially among socially anxious individuals. Prior feedback, greater occipital P1 amplitudes in both groups for ambiguous probes indicated heightened sensory facilitation to ambiguous information, and greater anterior N1 amplitudes for ambiguous stimuli in highly anxious participants suggested anticipation of negative feedback in this group. Post-feedback, P1, N1 and LPP amplitudes were reduced overall among socially anxious individuals indicating a reduction in sensory facilitation of visual information. These results suggest excessive self-focusing among socially anxious individuals, possibly linked to anticipation of an anxiety-provoking social situation.

Social anxiety and attentional bias variability: electrophysiological evidence of attentional control deficits

Attentional control has an important role in attentional bias in social anxiety. This study aimed to investigate whether attentional bias in social anxiety was caused by attentional control deficit. Event-related potentials and behavioural attentional bias index (trial-level attentional bias variability) were recorded as participants completed the dot-probe task. The behaviour result showed that compared with the low socially anxious individuals, the high socially anxious individuals had a marginally higher score of attentional bias variability. For event-related potentials results, target-locked frontocentral N2 amplitude was significantly larger under the incongruent condition than the congruent condition in the low socially anxious group, whereas there was no significant difference between these two conditions in the high socially anxious group. The low socially anxious group also exhibited reduced target-locked P2 amplitude from the congruent condition to the incongruent condition. Our findings provide electrophysiological evidence of attentional control dysregulation in socially anxious individuals, which contributes to modifying social anxiety-related attentional bias.

Effects of working memory training on EEG, cognitive performance, and self-report indices potentially relevant for social anxiety

Social anxiety (SA) is quite common and associated with multiple comorbidities. Here, we examined the effects of working memory (WM) training on various indices potentially related to SA. Pre-selected university students with elevated self-reported SA symptoms were assigned to a WM training (n = 21) or an active control treatment condition (n = 21). Pre- and post-treatment assessments were made using questionnaires related to (social) anxiety and depression, and tasks measuring WM, interference control, and attentional biases towards, and event-related potentials (ERPs) elicited by, angry faces. The training enhanced WM transfer task performance, reduced SA symptoms, and changed the amplitude of the P1, N170, P2, and N2 ERP components. However, the latter changes did not mediate the effect of WM training on SA symptoms. These data provide preliminary evidence of the usefulness of WM trainings to reduce potential indices of SA, but further research is necessary to unravel the causal relation among these indices.

Visual attention to emotional faces in adolescents with social anxiety disorder receiving cognitive behavioral therapy

Social anxiety disorder (SAD) is a psychiatric condition that often onsets in childhood. Cognitive models underline the role of attention in the maintenance of SAD, but studies on youth populations are few, particularly those using eye tracking to measure attention. Cognitive behavioral therapy (CBT) for SAD includes interventions targeting attention, like exposure to eye contact, but the link between CBT and attention bias is largely unexplored. This study investigated attention bias in youth with SAD and the association with outcome from CBT. Latency to attend to pictures of faces with different emotions (vigilance) and latency to disengage from social stimuli (avoidance) was examined in N = 25 adolescents (aged 13–17) with SAD in relation to treatment outcome. Vigilance was operationalized as the time it took to relocate the gaze from a central position to a peripherally appearing social stimulus. The latency to disengage from a centrally located social stimulus, when a non-social stimulus appeared in the periphery, was used as a proxy for avoidance. Attention characteristics in the SAD group were compared to non-anxious (NA) controls (N = 22). Visual attention was measured using eye tracking. Participants in both the SAD and NA groups were vigilant towards angry faces, compared to neutral and happy faces. Similarly, both groups disengaged attention faster from angry faces. Adolescents with SAD who disengaged faster from social stimuli had less social anxiety after CBT. The results indicate that anxious youth display a vigilant-avoidant attention pattern to threat. However, partly inconsistent with previous research, the same pattern was observed in the NA group.

The Role of Attention in Therapy for Children and Adolescents Who Stutter: Cognitive Behavioral Therapy and Mindfulness-Based Interventions

METHOD

This clinical discussion paper will explore two aspects of attention in relation to young people who stutter and their parents: (a) what we attend to as human beings and (b) how we attend. It will draw on research and clinical practice informed by CBT and MBIs. Specifically, information-processing theory in CBT explains psychological well-being partly in terms of what individuals focus their attention on, whereas MBIs focus on the relationship between how individuals attend to their internal experiences and their psychological well-being.

CONCLUSIONS

Although a nascent field, MBIs may be useful as a part of therapy for children and adolescents who stutter. The concepts highlighted by MBIs may also help to resolve some clinical issues.

Attentional control deficits in social anxiety: Investigating inhibition and shifting functions using a mixed antisaccade paradigm

BACKGROUND AND OBJECTIVES

Attentional control has recently been assumed to play a critical role in the generation and maintenance of threat-related attentional bias and social anxiety. The present study aimed to investigate whether socially anxious (SA) individuals show impairments in attentional control functions, particularly in inhibition and shifting.

METHODS

Forty-two SA and 41 non-anxious (NA) participants completed a mixed antisaccade task, a variant of the antisaccade task that is used to investigate inhibition as well as shifting functions.

RESULTS

The results showed that, overall, SA participants had longer antisaccade latencies than NA participants, but the two groups did not differ in their antisaccade error rates. Moreover, in the single-task block, SA participants had longer latencies than NA participants for antisaccade but not prosaccade trials. In the mixed-task block, the SA participants had longer latencies than the NA participants for both task types. The two groups did not differ in their latency switch costs in the mixed-task blocks.

LIMITATIONS

First, this study was conducted using a non-clinical sample of undergraduate students. Second, the antisaccade task measures primarily oculomotor inhibition. Third, this study did not include the measure of state anxiety to rule out the effects of state anxiety on the present findings.

CONCLUSIONS

This study suggests that SA individuals demonstrate diminished efficiency of inhibition function but show no significant impairment of shifting function. However, in the mixed-task condition, SA individuals may exhibit an overall reduction in processing efficiency due to the higher task difficulty.

Sustained visual attention for competing emotional stimuli in social anxiety: An eye tracking study

BACKGROUND AND OBJECTIVES

Numerous studies have supported attentional biases toward social threats in socially anxious individuals. The aim of the present study was to investigate the time-course of sustained attention for multiple emotional stimuli using a free-viewing paradigm in social anxiety.

METHODS

Thirty-two socially anxious (SA) and 30 non-anxious (NA) participants completed the free-viewing task. Participants were presented with a face array composed of angry, sad, happy and neutral faces for 10 s in each trial. Eye movements were recorded throughout the trial to assess the time-course of attentional processing.

RESULTS

Although SA participants did not exhibit initial orienting bias, they had higher fixation probability for angry faces during the 250-1000 ms time intervals, relative to NA participants. SA participants also maintained their attention longer than NA participants did when angry faces were initially fixated upon. Moreover, NA participants showed higher fixation probability for happy faces during the 6-8 s after stimulus onset. We failed to observe attentional avoidance of threat in SA participants.

LIMITATIONS

First, this study used a non-clinical sample. Second, the stimuli used in this study were static.

CONCLUSIONS

The present findings suggest that, relative to non-anxious individuals, socially anxious individuals are characterized by enhanced engagement with social threat at an early stage of processing and difficulty in disengaging from social threat once their initial attention is located on it. Conversely, non-anxious individuals are characterized by enhanced engagement with positive stimuli at a later stage of processing.

Learning from other people's fear: amygdala-based social reference learning in social anxiety disorder

BACKGROUND

Social anxiety disorder involves fear of social objects or situations. Social referencing may play an important role in the acquisition of this fear and could be a key determinant in future biomarkers and treatment pathways. However, the neural underpinnings mediating such learning in social anxiety are unknown. Using event-related functional magnetic resonance imaging, we examined social reference learning in social anxiety disorder. Specifically, would patients with the disorder show increased amygdala activity during social reference learning, and further, following social reference learning, show particularly increased response to objects associated with other people's negative reactions?

METHOD

A total of 32 unmedicated patients with social anxiety disorder and 22 age-, intelligence quotient- and gender-matched healthy individuals responded to objects that had become associated with others' fearful, angry, happy or neutral reactions.

RESULTS

During the social reference learning phase, a significant group × social context interaction revealed that, relative to the comparison group, the social anxiety group showed a significantly greater response in the amygdala, as well as rostral, dorsomedial and lateral frontal and parietal cortices during the social, relative to non-social, referencing trials. In addition, during the object test phase, relative to the comparison group, the social anxiety group showed increased bilateral amygdala activation to objects associated with others' fearful reactions, and a trend towards decreased amygdala activation to objects associated with others' happy and neutral reactions.

CONCLUSIONS

These results suggest perturbed observational learning in social anxiety disorder. In addition, they further implicate the amygdala and dorsomedial prefrontal cortex in the disorder, and underscore their importance in future biomarker developments.

The aetiology and maintenance of social anxiety disorder: A synthesis of complimentary theoretical models and formulation of a new integrated model

BACKGROUND

Within maintenance models of social anxiety disorder (SAD), a number of cognitive and behavioural factors that drive the persistence of SAD have been proposed. However, these maintenance models do not address how SAD develops, or the origins of the proposed maintaining factors. There are also models of the development of SAD that have been proposed independently from maintenance models. These models highlight multiple factors that contribute risk to the onset of SAD, but do not address how these aetiological factors may lead to the development of the maintaining factors associated with SAD.

METHODS

A systematic review of the literature was conducted to identify aetiological and maintenance models of SAD. We then united key factors identified in these models and formulated an integrated aetiological and maintenance (IAM) model of SAD. A systematic review of the literature was then conducted on the components of the IAM model.

RESULTS

A number of aetiological and maintaining factors were identified in models of SAD. These factors could be drawn together into the IAM model. On balance, there is empirical evidence for the association of each of the factors in the IAM model with social anxiety or SAD, providing preliminary support for the model.

LIMITATIONS

There are relationships between components of the IAM model that require empirical attention. Future research will need to continue to test the IAM model.

CONCLUSIONS

The IAM model provides a framework for future investigations into the development and persistence of SAD.

Effects of attention bias modification with short and long stimulus-duration: A randomized experiment with individuals with subclinical social anxiety

This study investigated the differential effects of two attention bias modification (ABM) with different stimulus durations. Seventy-two undergraduates with subclinical social anxiety were randomly assigned to one of four conditions: an ABM condition with either a 100-ms or a 500-ms stimulus duration (ABM-100/ ABM-500) or an attention placebo (AP) condition with either a 100-ms or a 500-ms stimulus duration (AP-100/ AP-500). Participants completed the pre-assessments, eight attentional training sessions, and post-assessments. A modified Posner paradigm was used to assess changes in attentional processing. After completion of attentional training, the ABM-100 group significantly speeded up their responses to 100-ms invalid trials, regardless of the word type. The ABM-100 group also exhibited significant reduced latencies to 500-ms invalid social threat trials and a marginally significant reduced latencies to 500-ms invalid neutral trials. The ABM-500 group showed significant reduced latencies to 500-ms invalid social threat trials. Both ABMs significantly reduced participants' fear of negative evaluations and interactional anxiousness relative to their comparative AP. The effects on social anxiety did not differ between the two ABMs. This study suggests that although both ABMs using short and long stimulus durations reduce some aspects of social anxiety, they influence participants' attentional disengagement in different ways.

Barking up the wrong tree in attentional bias modification? Comparing the sensitivity of four tasks to attentional biases

BACKGROUND AND OBJECTIVES

Attentional bias modification (ABM) is a potentially exciting new development in the treatment of anxiety disorders. However, reported therapeutic benefits have not always been replicated. To gauge the sensitivity of tasks used in ABM treatment and assessment, we used a counterbalanced within-subject design to measure their discriminant sensitivity to neutral and threatening facial expressions, comparing them with other well-known tasks that measure visual attention.

METHODS

We compared two tasks often used in the assessment and treatment of attention bias (the dot-probe and the spatial cueing paradigms) with two well-known visual attention tasks (the irrelevant singleton and attentional blink paradigms), measuring their sensitivity to processing differences between threatening and neutral expressions for non-clinical observers.

RESULTS

The dot-probe, spatial cueing and irrelevant singleton paradigms showed little or no sensitivity to processing differences between facial expressions while the attentional blink task proved very sensitive to such differences. Furthermore, the attentional blink task provided an intriguing picture of the temporal dynamics of attentional biases that the other paradigms cannot do.

LIMITATIONS

These results need to be replicated with larger samples, including a comparison of a group of individuals diagnosed with social anxiety disorder and normal controls.

CONCLUSIONS

Our results indicate that the sensitivity of putative attentional bias measures should be assessed experimentally for more powerful assessment and treatment of such biases. If the attentional blink task is indeed particularly sensitive to attentional biases, as our findings indicate, it is not unreasonable to expect that interventions based on this task may be more effective than those based on the tasks that are currently used.

Difficulty in disengaging attention from threatening facial expressions in anxiety: a new approach in terms of benefits

BACKGROUND AND OBJECTIVES

Recent work suggests that the ability to disengage attention from threatening information is impaired in anxiety. The present study compared the difficulty to disengage from angry, fearful and neutral faces in Low Trait Anxious individuals (LTA) versus High Trait Anxious individuals (HTA) at two stages of facial expression processing (i.e., initial and later face processing).

METHODS

HTA and LTA individuals performed an attentional shifting task to assess attentional disengagement. Participants had to classify a peripheral target letter, appearing 200 or 500 ms after a face was displayed.

RESULTS

LTA individuals were quicker when the letter appears after 500 ms compared to 200 ms regardless of the emotion of the face. An impaired disengagement in HTA individuals was observed for fearful and angry faces (i.e., no reaction differences between 200 and 500 ms) but not for neutral faces. These results suggest that it is particularly difficult for anxious individuals to switch attention from one stimulus to another if the engaged stimulus is a threatening face.

LIMITATIONS

Generalisation of our results is restricted to trait anxiety and emotional facial expression processing.

CONCLUSIONS

LTA individuals can benefit from the emotional processing (i.e., from 200 to 500 ms) to make a rapid attentional shift and engagement to the target stimuli whereas HTA individuals did not and continue to process the threatening facial expression. These results also point out the role of top down processes on the regulation of disengagement from threatening information in anxiety.

More than a face: a unified theoretical perspective on nonverbal social cue processing in social anxiety

Processing of nonverbal social cues (NVSCs) is essential to interpersonal functioning and is particularly relevant to models of social anxiety. This article provides a review of the literature on NVSC processing from the perspective of social rank and affiliation biobehavioral systems (ABSs), based on functional analysis of human sociality. We examine the potential of this framework for integrating cognitive, interpersonal, and evolutionary accounts of social anxiety. We argue that NVSCs are uniquely suited to rapid and effective conveyance of emotional, motivational, and trait information and that various channels are differentially effective in transmitting such information. First, we review studies on perception of NVSCs through face, voice, and body. We begin with studies that utilized information processing or imaging paradigms to assess NVSC perception. This research demonstrated that social anxiety is associated with biased attention to, and interpretation of, emotional facial expressions (EFEs) and emotional prosody. Findings regarding body and posture remain scarce. Next, we review studies on NVSC expression, which pinpointed links between social anxiety and disturbances in eye gaze, facial expressivity, and vocal properties of spontaneous and planned speech. Again, links between social anxiety and posture were understudied. Although cognitive, interpersonal, and evolutionary theories have described different pathways to social anxiety, all three models focus on interrelations among cognition, subjective experience, and social behavior. NVSC processing and production comprise the juncture where these theories intersect. In light of the conceptualizations emerging from the review, we highlight several directions for future research including focus on NVSCs as indexing reactions to changes in belongingness and social rank, the moderating role of gender, and the therapeutic opportunities offered by embodied cognition to treat social anxiety.

Socially anxious individuals with low working memory capacity could not inhibit the goal-irrelevant information

Socially anxious individuals are interfered by distractors. Recent work has suggested that low working memory capacity and inappropriate temporary goal induce attention to distractors. We investigated the effects of working memory capacity and temporary goal on attention to distractors in social anxiety. Participants viewed a rapid serial visual presentation, in which participants reported the identity of a single target letter drawn in red. Distractors appeared before the target was presented. When the color of distractors was red (i.e., goal-relevant stimuli), low-capacity individuals were strongly interfered by the distractors compared to high-capacity individuals regardless of social anxiety. When the color of distractors was goal-irrelevant, low-capacity and high socially anxious individuals were strongly interfered by the distractors. These results suggest that socially anxious individuals with low working memory capacity could not inhibit the goal-irrelevant information and direct attention to distractors.

Social reward and rejection sensitivity in eating disorders: an investigation of attentional bias and early experiences

OBJECTIVES

People with eating disorders (EDs) have difficulties with social functioning. One explanatory mechanism is a problem with over-sensitivity to rejection and/or low sensitivity to social reward. The aim of this study is to investigate attentional bias to facial stimuli in people with a lifetime diagnosis of EDs and healthy controls (HCs) and to test whether these attentional biases are linked to adverse early experiences.

METHODS

Forty-six participants with a current diagnosis of EDs (29 with anorexia nervosa (AN) and 17 with bulimia nervosa (BN)), 22 participants recovered from an eating disorder (13 with past AN and nine with past BN) and 50 HCs completed a dot-probe task with faces expressing rejection and acceptance. Participants reported on parental style and adverse early experiences.

RESULTS

People with a lifetime diagnosis of EDs show an attentional bias to rejecting faces and a difficulty disengaging attention from these stimuli. Also, they had a sustained attentional avoidance of accepting faces. HCs demonstrated the opposite attentional pattern. The attentional bias to rejection was correlated with adverse childhood experiences.

CONCLUSIONS

People with an EDs show vigilance to rejection and avoidance of social reward. This may contribute to the causation or maintenance of the illness.

Time-course of attention biases in social phobia

Theoretical models of social phobia implicate preferential attention to social threat in the maintenance of anxiety symptoms, though there has been limited work characterizing the nature of these biases over time. The current study utilized eye-movement data to examine the time-course of visual attention over 1500ms trials of a probe detection task. Nineteen participants with a primary diagnosis of social phobia based on DSM-IV criteria and 20 non-clinical controls completed this task with angry, fearful, and happy face trials. Overt visual attention to the emotional and neutral faces was measured in 50ms segments across the trial. Over time, participants with social phobia attend less to emotional faces and specifically less to happy faces compared to controls. Further, attention to emotional relative to neutral expressions did not vary notably by emotion for participants with social phobia, but control participants showed a pattern after 1000ms in which over time they preferentially attended to happy expressions and avoided negative expressions. Findings highlight the importance of considering attention biases to positive stimuli as well as the pattern of attention between groups. These results suggest that attention "bias" in social phobia may be driven by a relative lack of the biases seen in non-anxious participants.

Reduced processing of facial and postural cues in social anxiety: insights from electrophysiology

Social anxiety is characterized by fear of evaluative interpersonal situations. Many studies have investigated the perception of emotional faces in socially anxious individuals and have reported biases in the processing of threatening faces. However, faces are not the only stimuli carrying an interpersonal evaluative load. The present study investigated the processing of emotional body postures in social anxiety. Participants with high and low social anxiety completed an attention-shifting paradigm using neutral, angry and happy faces and postures as cues. We investigated early visual processes through the P100 component, attentional fixation on the P2, structural encoding mirrored by the N170, and attentional orientation towards stimuli to detect with the P100 locked on target occurrence. Results showed a global reduction of P100 and P200 responses to faces and postures in socially anxious participants as compared to non-anxious participants, with a direct correlation between self-reported social anxiety levels and P100 and P200 amplitudes. Structural encoding of cues and target processing were not modulated by social anxiety, but socially anxious participants were slower to detect the targets. These results suggest a reduced processing of social postural and facial cues in social anxiety.

Fear of negative evaluation and attentional bias for facial expressions: an event-related study

Numerous studies have shown an exacerbation of attentional bias towards threat in anxiety states. However, the cognitive mechanisms responsible for these attentional biases remain largely unknown. Further, the authors outline the need to consider the nature of the attentional processes in operation (hypervigilance, avoidance, or disengagement). We adapted a dot-probe paradigm to record behavioral and electrophysiological responses in 26 participants reporting high or low fear of evaluation, a major component of social anxiety. Pairs of faces including a neutral and an emotional face (displaying anger, fear, disgust, or happiness) were presented during 200 ms and then replaced by a neutral target to discriminate. Results show that anxious participants were characterized by an increased P1 in response to pairs of faces, irrespective of the emotional expression included in the pair. They also showed an increased P2 in response to angry-neutral pairs selectively. Finally, in anxious participants, the P1 response to targets was enhanced when replacing emotional faces, whereas non-anxious subjects showed no difference between the two conditions. These results indicate an early hypervigilance to face stimuli in social anxiety, coupled with difficulty in disengaging from threat and sustained attention to emotional stimuli. They are discussed within the framework of current models of anxiety and psychopathology.

Impaired attentional disengagement from stimuli matching the contents of working memory in social anxiety

Although many cognitive models in anxiety propose that an impaired top-down control enhances the processing of task-irrelevant stimuli, few studies have paid attention to task-irrelevant stimuli under a cognitive load task. In the present study, we investigated the effects of the working memory load on attention to task-irrelevant stimuli in trait social anxiety. The results showed that as trait social anxiety increased, participants were unable to disengage from task-irrelevant stimuli identical to the memory cue under low and high working memory loads. Impaired attentional disengagement was positively correlated with trait social anxiety. This impaired attentional disengagement was related to trait social anxiety, but not state anxiety. Our findings suggest that socially anxious people have difficulty in disengaging attention from a task-irrelevant memory cue owing to an impaired top-down control under a working memory load.

Attentional control moderates fearful responding to a 35% CO(2) challenge

Attentional control (AC) is an individual difference variable indexing the ability to voluntarily focus attention and shift attention when desired. AC is thought to impact the experience of fear by facilitating the disengagement of attention from threat and promoting the deployment of attentional resources toward regulatory or coping strategies. Whereas previous research has focused on visual threat cues, in the current study we examined whether this model also applies to interoceptive threat by evaluating the extent to which individual differences in AC moderated the relationship between trait anxiety and self-reported fear in response to a single vital capacity inhalation of a 35% CO(2), 65% balanced O(2) gas mixture. The sample comprised a large nonclinical group of young adults (N=128). Results indicated that AC moderated the relationship between trait anxiety and fearful responding to the challenge. Findings suggest that AC plays a significant and clinically important role in modulating self-reported fear.

Competition effects of threatening faces in social anxiety

Threatening faces involuntarily grab attention in socially anxious individuals. It is unclear, however, whether attention capture is at the expense of concurrent visual processing. The current study examined the perceptual cost effects of viewing fear-relevant stimuli (threatening faces) relative to a concurrent change-detection task. Steady-state visual evoked potentials (ssVEPs) were used to separate the neural response to 2 fully overlapping types of stimuli flickering at different frequencies: Task-irrelevant facial expressions (angry, neutral, happy) were overlaid with a task-relevant Gabor patch stream, which required a response to rare phase reversals. Groups of 17 high and 17 low socially anxious observers were recruited through online prescreening of 849 students. A prominent competition effect of threatening faces was observed solely in elevated social anxiety: When an angry face, relative to a neutral or happy face, served as a distractor, heightened ssVEP amplitudes were seen at the tagging frequency of that facial expression. Simultaneously, the ssVEP evoked by the task-relevant Gabor grating was reliably diminished compared with conditions with neutral or happy distractor faces. Thus, threatening faces capture and hold low-level perceptual resources in viewers symptomatic for social anxiety at the cost of a concurrent primary task. It is important to note that this competition in lower tier visual cortex was maintained throughout the viewing period and was unaccompanied by competition effects on behavioral performance.