Attention bias variability and symptoms of posttraumatic stress disorder

Examining attentional avoidance in post-traumatic stress disorder: an exploratory 'Face in the Crowd' paradigm using eye-tracking

Background: Maladaptive patterns of attention to emotional stimuli are a clinical feature of posttraumatic stress disorder (PTSD). Using eye-tracking-based methodology, research points out the presence of sustained attention to threatening stimuli in individuals with PTSD. However, most eye-tracking studies in this field used free-viewing tasks on negative stimuli.Methods: PTSD patients (n = 38), trauma-exposed healthy controls (TEHC; n = 30), and non-trauma-exposed healthy controls (HC; n = 33) performed a Face in the Crowd (FiC) task. The FiC task was chosen to explore specific responses to emotional stimuli within a competitive visual environment, thus providing insights into visual search patterns. Both reaction time and gaze patterns (dwell time, scanpath length, first fixation duration, and latency) were recorded.Results: Individuals with a provisional PTSD diagnosis presented decreased dwell time on both positive and negative targets in comparison with HC and TEHC, as well as shorter scanpath length for all matrixes when no targets were present. No evidence of attentional bias was observed in the TEHC group based on reaction times or eye-tracking measures in response to positive, negative, or neutral cues.Discussion: We found an attentional avoidance pattern among PTSD patients, along with indexes of lowered perceptual threshold for all emotional information. This study allows raising the question of cognitive load on the emergence of differential attentional strategies presented by PTSD participants. We discuss the generalization of fear processes across different emotional stimuli and underscore the need for incorporating a variety of emotional stimuli in PTSD research.

Attention bias variability as a cognitive marker of PTSD: A comparison of eye-tracking and reaction time methodologies

Identification of reliable behavioral markers for posttraumatic stress disorder (PTSD) can offer objective measures beyond self-reports to aid in diagnosis, treatment, and prevention. Attention bias variability (ABV), defined as fluctuations in attention toward or away from threat-related stimuli, has been associated with PTSD. Reaction time-based ABV (RT-ABV) has been extensively studied and shown to be linked with PTSD symptomatology. An eye-tracking-based ABV index (ET-ABV) was only recently introduced, and results show that it may be associated with trauma exposure rather than with PTSD symptoms. However, these two ABV types have yet to be studied within the same sample. The current study explored the association between trauma exposure, PTSD symptom severity, and ABV measures, applying both the classic RT-ABV and the new ET-ABV in the same sample. Participants with PTSD (n = 41), trauma-exposed healthy controls (TEHC; n = 71), and non-trauma-exposed healthy controls (HC; n = 38) completed an eye-tracking free-viewing matrix task and a response-based dot-probe task using the same threat-related stimuli (angry faces) across tasks. Results indicate that both RT-ABV and ET-ABV were significantly higher in participants with PTSD compared to participants in the TEHC and HC groups, with no significant difference between the latter groups. Additional analyses indicate that although moderately correlated, each of the ABV measures explains unique portions of the variance in PTSD severity. This study replicates and extends prior findings on the association between ABV and PTSD and highlights the potential of ET-ABV as a novel and reliable marker for PTSD severity.

Hyperarousal, Dissociation, Emotion Dysregulation and Re-Experiencing-Towards Understanding Molecular Aspects of PTSD Symptoms

Approximately 70% of people will experience a traumatic event in their lifetime, but post-traumatic stress disorder (PTSD) will only develop in 3.9% and complex post-traumatic stress disorder (CPTSD) in 1-8% of the population worldwide, although in some countries (e.g., Poland and Northern Ireland) it will develop in a much higher percentage. Stress-related disorders have a complex pathogenesis involving neurophysiological, genetic, epigenetic, neuroendocrine and environmental factors. This article reviews the current state of knowledge on the molecular aspects of selected PTSD symptoms: hypervigilance, re-experiencing, emotion dysregulation and dissociation, i.e., the symptoms with strong neurobiological components. Among analysed susceptibility factors are specific gene polymorphisms (e.g., FKBP5, COMT, CHRNA5, CRHR1, 5-HTTLPR, ADCY8 and DRD2) and their interactions with the environment, changes in the HPA axis, adrenergic hyperactivity and disturbances in the activity of selected anatomical structures (including the amygdala, prefrontal cortex, corpus callosum, anterior cingulate gyrus and hippocampus). It is worth noting that therapeutic methods with proven effectiveness in PTSD (TF-CBT and EMDR) have a substantial neurobiological rationale. Molecular aspects seem crucial when searching for effective screening/diagnostic methods and new potential therapeutic options.

Neurocognitive Intraindividual Variability in Veterans with Mild Traumatic Brain Injury History and Posttraumatic Stress Disorder

OBJECTIVE

Veterans with a history of blast-related mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) may be at risk for greater cognitive concerns and worse functional outcomes compared to those with either condition in isolation. However, traditional neuropsychological assessment approaches have yielded equivocal results in these populations. The present study examined an alternative method for detecting subtle cognitive inefficiencies: neurocognitive intraindividual variability (IIV), a measure of within-person performance consistency.

METHOD

Participants were 79 male Veterans with a history of blast-related mTBI and current PTSD (mTBI/PTSD group; n = 54) or neither diagnosis (controls; n = 25). Mean T-scores and IIV scores were calculated from neuropsychological measures of attention and speed of information processing (A/SoP) as well as executive functioning (EF).

RESULTS

Global IIV was significantly higher in the mTBI/PTSD group compared to controls (p = .047, Cohen's d = 0.49). At the domain level, larger effect sizes were observed for EF IIV (Cohen's d = 0.46) compared to A/SoP IIV (d = 0.32), although neither were statistically significant. Within the mTBI/PTSD group, higher Global IIV was associated with worse self-reported executive dysfunction, psychological quality of life, and cognitive post-concussive symptoms; at the domain level, these clinical outcomes were generally associated with greater A/SoP IIV (but not EF IIV).

CONCLUSION

Findings extend previous investigations of neurocognitive IIV in individuals with a history of mTBI across PTSD status. Among Veterans with a history of mTBI and comorbid PTSD, neurocognitive variability may be a better indicator of self-reported cognitive inefficiencies and Veteran experience of daily cognitive functioning than mean neuropsychological performances.

Biased Information Routing Through the Basolateral Amygdala, Altered Valence Processing, and Impaired Affective States Associated With Psychiatric Illnesses

Accumulating evidence supports a role for altered circuit function in impaired valence processing and altered affective states as a core feature of psychiatric illnesses. We review the circuit mechanisms underlying normal valence processing and highlight evidence supporting altered function of the basolateral amygdala, valence processing, and affective states across psychiatric illnesses. The mechanisms controlling network activity that governs valence processing are reviewed in the context of potential pathophysiological mechanisms mediating circuit dysfunction and impaired valence processing in psychiatric illnesses. Finally, we review emerging data demonstrating experience-dependent, biased information routing through the basolateral amygdala promoting negative valence processing and discuss the potential relevance to impaired affective states and psychiatric illnesses.

Attentional Processing Biases in Young People With Binging and Purging Behavior

OBJECTIVE

Binging and purging are transdiagnostic features of eating disorders (EDs). Attentional biases (ABs) toward food and body shape cues and negative affect (NA) are associated with ED psychopathology. These ABs might also be present in people with subthreshold ED not meeting full diagnostic criteria. We investigated ABs to food and body shape cues and the interaction between ABs and NA in young people with binge/purge behavior (B/P group) and healthy controls (HC group). Our B/P sample consisted of individuals with threshold and subthreshold ED, including participants with BN, AN-R, and AN-B/P.

METHOD

We conducted two studies. Study 1 recruited n = 54 HC and n = 53 B/P participants aged 16-25, and Study 2 recruited n = 73 HC and n = 72 B/P participants. In Study 1, ABs toward food and body shape cues were compared between B/P versus HC participants using a pictorial dot-probe task. In Study 2, ABs were compared between B/P versus HC participants after NA induction using the Cyberball social exclusion task. Indexes of attentional engagement and disengagement were computed.

RESULTS

There was a main effect of cue type on attentional engagement at 0.2 s (p = 0.006,η p 2 $\eta _p^2$  = 0.075) and 2 s (p = 0.040,η p 2 $\eta _p^2$  = 0.043), and attentional disengagement at 2 s (p = 0.006,η p 2 $\eta _p^2$  = 0.077) in Study 1. Findings were not replicated following NA induction in Study 2. No main effect of group or group × cue type interaction was found.

DISCUSSION

Our results disagree with previous research supporting the importance of ABs toward food and body shape cues in young people with threshold and subthreshold EDs and suggest these might not constitute a relevant target in the treatment of ED behavior. However, due to a heterogeneous approach to measuring ABs and multiple types of AB being described in EDs, further research is needed to clarify whether ABs map onto transdiagnostic models of behavioral dysregulation.

Measuring and Modifying Threat-Related Attention Bias in Posttraumatic Stress Disorder: An Attention Bias Modification Study

Background: Dominant models of posttraumatic stress disorder (PTSD) implicate threat-related attention biases in both the development and maintenance of posttraumatic stress symptoms. However, the ability to better understand and modify threat-related attention biases in PTSD has been hampered by the low reliability of attention bias measures more generally. Methods: The current study adopts a new approach to calculate attention bias from a dot-probe task, response-based attention bias (RB-AB) computation, in a sample of 689 individuals reporting significantly elevated PTSD symptoms who participated in a clinical trial of threat-related attention bias modification training. Results: RB-AB is a reliable strategy for deriving threat-related attention bias scores that correlate with both PTSD severity and anxiety. On the other hand, scores from the traditional approach were unreliable and not associated with clinical symptoms. Attention training led to reductions in RB-AB indices of attention bias, but not the traditional index, although attention bias training conditions did not appear to moderate these effects. Conclusions: Taken together, these findings support evidence that threat-related attention biases may be a feature of PTSD and that RB-AB computation is a more reliable and valid approach for studying reaction-time-based attentional processes. Using the RB-AB approach to assess attention bias could allow us to better understand threat-related attention biases in PTSD and to ultimately develop more precise interventions to reduce threat-related attentional biases in PTSD and other disorders.

Experience-dependent information routing through the basolateral amygdala shapes behavioral outcomes

It is well established that the basolateral amygdala (BLA) is an emotional processing hub that governs a diverse repertoire of behaviors. Selective engagement of a heterogeneous cell population in the BLA is thought to contribute to this flexibility in behavioral outcomes. However, whether this process is impacted by previous experiences that influence emotional processing remains unclear. Here we demonstrate that previous positive (enriched environment [EE]) or negative (chronic unpredictable stress [CUS]) experiences differentially influence the activity of populations of BLA principal neurons projecting to either the nucleus accumbens core or bed nucleus of the stria terminalis. Chemogenetic manipulation of these projection-specific neurons can mimic or occlude the effects of CUS and EE on behavioral outcomes to bidirectionally control avoidance behaviors and stress-induced helplessness. These data demonstrate that previous experiences influence the responsiveness of projection-specific BLA principal neurons, biasing information routing through the BLA, to drive divergent behavioral outcomes.

Differences in Attentional Bias Toward e-Cigarette Cues Between e-Cigarette Users and Nonusers

ABSTRACT

The use of electronic nicotine delivery systems (ENDS) has increased rapidly in recent years, particularly among young adults. There is a dearth of research on the cognitive factors that contribute to ENDS use. One of the possible cognitive mechanisms involved with addictive behavior is attentional bias (AB). AB can manifest as either facilitated attention engagement toward or delayed attention disengagement from a relevant stimulus. The purpose of this study was to examine the difference in AB toward ENDS-related cues between ENDS users and non-ENDS users. ENDS users (n = 29) and nonusers (n = 24) between the ages of 18 and 29 years participated in the dot-probe and eye-tracking picture-viewing tasks. The results showed that there was a significant difference in the variance of AB between the two groups. In the eye-tracking task, ENDS users displayed significantly greater net dwell time and fixation time at time frames of 6-9, 9-12, and 12-15 seconds, compared to nonusers. It is noteworthy that ENDS users exhibited attentional fluctuation toward ENDS cues as well as difficulties disengaging attention from ENDS cues. The current findings offer insight into the nature of attentional processes associated with ENDS cues and provide useful data to guide the development of a nurse-led cognitive intervention focusing on biased attentional processing related to ENDS cues.

Cognitive simulation along with neural adaptation explain effects of suggestions: a novel theoretical framework

Hypnosis is an effective intervention with proven efficacy that is employed in clinical settings and for investigating various cognitive processes. Despite their practical success, no consensus exists regarding the mechanisms underlying well-established hypnotic phenomena. Here, we suggest a new framework called the Simulation-Adaptation Theory of Hypnosis (SATH). SATH expands the predictive coding framework by focusing on (a) redundancy elimination in generative models using intrinsically generated prediction errors, (b) adaptation due to amplified or prolonged neural activity, and (c) using internally generated predictions as a venue for learning new associations. The core of our treatise is that simulating proprioceptive, interoceptive, and exteroceptive signals, along with the top-down attenuation of the precision of sensory prediction errors due to neural adaptation, can explain objective and subjective hypnotic phenomena. Based on these postulations, we offer mechanistic explanations for critical categories of direct verbal suggestions, including (1) direct-ideomotor, (2) challenge-ideomotor, (3) perceptual, and (4) cognitive suggestions. Notably, we argue that besides explaining objective responses, SATH accounts for the subjective effects of suggestions, i.e., the change in the sense of agency and reality. Finally, we discuss individual differences in hypnotizability and how SATH accommodates them. We believe that SATH is exhaustive and parsimonious in its scope, can explain a wide range of hypnotic phenomena without contradiction, and provides a host of testable predictions for future research.

Attentional bias modification and attention control training in PTSD: a systematic review and meta-analysis

Background

Cognitive models of post-traumatic stress disorder (PTSD) highlighted the effect of maladaptive cognitive processing in the development and maintenance of PTSD. PTSD is related to attentional bias (AB) toward threatening stimuli and greater attentional bias variability (ABV). Attentional bias modification (ABM) and attention control training (ACT) have demonstrated the effect of improving PTSD, but the results of randomized controlled trials (RCTs) are controversial.

Objectives

The current study aimed to evaluate the extent of evidence supporting the efficacy of ABM in the treatment of PTSD.

Design

Systematic review and meta-analysis.

Methods

We searched PUBMED, PsycINFO, EMBASE, ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trials for articles published between 1980 and 2022. RCTs of ABM for adult participants with PTSD symptoms were identified. The primary outcome was changes in PTSD severity, and the second outcome was changes in AB and ABV. Trial quality was assessed using the Cochrane Risk of Bias Tool. Publication bias was assessed using the Doi plot and Luis Furuya-Kanamori (LFK) index.

Results

Eight RCTs comparing the effect of ABM to ACT were included in the review, and six studies were meta-analyzed. Meta-analysis favored ACT in improving PTSD symptoms and ABV, and the effect size was large. ABM and ACT demonstrated similar effects in improving AB.

Conclusion

ACT should not only be seen as a control training condition but also has therapeutic values. However, since the current meta-analysis only included a limited number of studies, further research was still needed to examine the clinical value of ACT in PTSD treatment.

Contamination fear and attention bias variability early in the COVID-19 pandemic

The onset of the COVID-19 pandemic resulted in a dramatic increase in the salience and importance of information relating to both the risk of infection, and factors that could mitigate against such risk. This is likely to have contributed to elevated contamination fear concerns in the general population. Biased attention for contamination-related information has been proposed as a potential mechanism underlying contamination fear, though evidence regarding the presence of such biased attention has been inconsistent. A possible reason for this is that contamination fear may be characterised by variability in attention bias that has not yet been examined. The current study examined the potential association between attention bias variability for both contamination-related and mitigation-related stimuli, and contamination fear during the early stages of the COVID-19 pandemic. A final sample of 315 participants completed measures of attention bias and contamination fear. The measure of average attention bias for contamination-related stimuli and mitigation-related stimuli was not associated with contamination fear (r = 0.055 and r = 0.051, p > 0.10), though both attention bias variability measures did show a small but statistically significant relationship with contamination fear (r = 0.133, p < 0.05; r = 0.147, p < 0.01). These attention bias variability measures also accounted for significant additional variance in contamination fear above the average attention bias measure (and controlling for response time variability). These findings provide initial evidence for the association between attention bias variability and contamination fear, underscoring a potential target for cognitive bias interventions for clinical contamination fear.

Reliability (or lack thereof) of smartphone ecological momentary assessment of visual dot probe attention bias toward threat indices

BACKGROUND AND OBJECTIVES

Cognitive bias theories posit that generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are entwined with attention bias toward threats, commonly indexed by faster response time (RT) on threat-congruent (vs. threat-incongruent) trials on the visual dot probe. Moreover, although smartphone ecological momentary assessment (EMA) of the visual dot probe has been developed, their psychometric properties are understudied. This study thus aimed to assess the reliability of 8 smartphone-delivered visual dot probe attention bias and related indices in persons with and without GAD and SAD.

METHODS

Community-dwelling adults (n = 819; GAD: 64%; SAD: 49%; Mixed GAD and SAD: 37%; Non-GAD/SAD Controls: 24%) completed a five-trial smartphone-delivered visual dot probe for a median of 60 trials (12 sessions x 5 trials/session) and an average of 100 trials (20 sessions x 5 trials/session).

RESULTS

As hypothesized, Global Attention Bias Index, Disengagement Effect, and Facilitation Bias had low-reliability estimates. However, retest-reliability and internal reliability were good for Trial-Level Bias Scores (TLBS) (Bias Toward Treat: intra-class correlation coefficients (ICCs) = 0.626-0.644; split-half r = 0.640-0.670; Attention Bias Variability: ICCs = 0.507-0.567; split-half r = 0.520-0.580) and (In)congruent RTs. Poor retest-reliability and internal reliability estimates were consistently observed for all traditional attention bias and related indices but not TLBS.

LIMITATIONS

Our visual dot probe EMA should have administered ≥320 trials to match best-practice guidelines based on similar laboratory studies.

CONCLUSIONS

Future research should strive to examine attention bias paradigms beyond the dot-probe task that evidenced meaningful test-retest reliability properties in laboratory and real-world naturalistic settings.

Reliability of and associations between cognitive bias measures and response inhibition in smoking

BACKGROUND AND OBJECTIVE

Theoretical models propose that different cognitive biases are caused by a common underlying mechanism (incentive salience/"wanting") and should, therefore, be interrelated. Additionally, stronger impulsive processes should be related to weaker inhibitory abilities. However, these assumptions have hardly been empirically tested and key psychometric information have hardly been reported in samples of smokers. To extent previous research, the present study aimed (1) to estimate the reliability (split-half) of different cognitive bias measures and (2) to investigate associations between attention, approach and associative biases, response inhibition, and smoking-related variables.

METHODS

Eighty current, non-deprived smokers completed the following tasks in random order: Approach-Avoidance Task (AAT), Stimulus-Response Compatibility Task (SRCT), Implicit-Association Tests (IAT, approach-avoid, valence), Dotprobe Task, Go-/NoGo Task (GNGT). Additionally, different smoking-related variables were assessed. Split-half reliabilities of the different cognitive (bias) measures and correlations between them were calculated.

RESULTS

Split-half reliabilities of the AAT, the SRCT, and the Dotprobe Task were unacceptable whereas both IATs and the GNGT showed good to excellent reliability. Smoking-approach associations were significantly related to nicotine dependence; however, none of the cognitive bias measures correlated with response inhibition or smoking-related variables.

LIMITATIONS

Pictorial stimuli were the same across paradigms and might not have been relevant to all participants.

CONCLUSIONS

This is the first study to investigate the association between different cognitive biases, response inhibition, and smoking-related variables. Although findings are at odds with theoretical assumptions, their interpretation is clearly restricted by the low reliability of the cognitive bias measures.

Variability in caregiver attention bias to threat: A Goldilocks effect in infant emotional development?

Attention biases to threat are considered part of the etiology of anxiety disorders. Attention bias variability (ABV) quantifies intraindividual fluctuations in attention biases and may better capture the relation between attention biases and psychopathology risk versus mean levels of attention bias. ABV to threat has been associated with attentional control and emotion regulation, which may impact how caregivers interact with their child. In a relatively diverse sample of infants (50% White, 50.7% female), we asked how caregiver ABV to threat related to trajectories of infant negative affect across the first 2 years of life. Families were part of a multi-site longitudinal study, and data were collected from 4 to 24 months of age. Multilevel modeling examined the effect of average caregiver attention biases on changes in negative affect. We found a significant interaction between infant age and caregiver ABV to threat. Probing this interaction revealed that infants of caregivers with high ABV showed decreases in negative affect over time, while infants of caregivers with low-to-average ABV showed potentiated increases in negative affect. We discuss how both high and extreme patterns of ABV may relate to deviations in developmental trajectories.

Development of Neural Mechanisms Underlying Threat Processing: Associations With Childhood Social Reticence and Adolescent Anxiety

Background

Social reticence in early childhood is characterized by shy and anxiously avoidant behavior, and it confers risk for pediatric anxiety disorders later in development. Aberrant threat processing may play a critical role in this association between early reticent behavior and later psychopathology. The goal of this longitudinal study is to characterize developmental trajectories of neural mechanisms underlying threat processing and relate these trajectories to associations between early-childhood social reticence and adolescent anxiety.

Methods

In this 16-year longitudinal study, social reticence was assessed from 2 to 7 years of age; anxiety symptoms and neural mechanisms during the dot-probe task were assessed at 10, 13, and 16 years of age. The sample included 144 participants: 71 children provided data at age 10 (43 girls, meanage = 10.62), 85 at age 13 (46 girls, meanage = 13.25), and 74 at age 16 (36 girls, meanage = 16.27).

Results

A significant interaction manifested among social reticence, anxiety symptoms, and time, on functional connectivity between the left amygdala and the left dorsolateral prefrontal cortex, voxelwise p < .001, clusterwise familywise error p < .05. Children with high social reticence showed a negative association between amygdala-dorsolateral prefrontal cortex connectivity and anxiety symptoms with age, compared to children with low social reticence, suggesting distinct neurodevelopmental pathways to anxiety.

Conclusions

These findings were present across all conditions, suggesting task-general effects in potential threat processing. Additionally, the timing of these neurodevelopmental pathways differed for children with high versus low social reticence, which could affect the timing of effective preventive interventions.

Attentional bias toward negative stimuli in PTSD: an eye-tracking study

BACKGROUND

Research on biased processing of aversive stimuli in posttraumatic stress disorder (PTSD) has produced inconsistent results between response time (RT) and eye-tracking studies. Recent RT-based results of dot-probe studies showed no attentional bias (AB) for threat while eye-tracking research suggested heightened sustained attention for this information. Here, we used both RT-based and eye-tracking measures to explore the dynamics of AB to negative stimuli in PTSD.

METHODS

Twenty-three individuals diagnosed with PTSD, 23 trauma-exposed healthy controls, and 23 healthy controls performed an emotional dot-probe task with pairs of negative and neutral scenes presented for either 1 or 2 s. Analyses included eye movements during the presentation of the scenes and RT associated with target localization.

RESULTS

There was no evidence for an AB toward negative stimuli in PTSD from RT measures. However, the main eye-tracking results revealed that all three groups showed longer dwell times on negative pictures than neutral pictures at 1 s and that this AB was stronger for individuals with PTSD. Moreover, although AB disappeared for the two groups of healthy controls with prolonged exposure, it persisted for individuals with PTSD.

CONCLUSION

PTSD is associated with an AB toward negative stimuli, characterized by heightened sustained attention toward negative scenes once detected. This study sheds light on the dynamics of AB to negative stimuli in PTSD and encourages us to consider optimized therapeutic interventions targeting abnormal AB patterns.

Experience-dependent information routing through the basolateral amygdala

The basolateral amygdala (BLA) is an emotional processing hub and is well-established to influence both positive and negative valence processing. Selective engagement of a heterogeneous cell population in the BLA is thought to contribute to this flexibility in valence processing. However, how this process is impacted by previous experiences which influence valence processing is unknown. Here we demonstrate that previous positive (EE) or negative (chronic unpredictable stress) experiences differentially influence the activity of specific populations of BLA principal neurons projecting to either the nucleus accumbens core or bed nucleus of the stria terminalis. Using chemogenetic manipulation of these projection-specific neurons we can mimic or occlude the effects of chronic unpredictable stress or enriched environment on valence processing to bidirectionally control avoidance behaviors and stress-induced helplessness. These data demonstrate that previous experiences influence the responsiveness of projection-specific BLA principal neurons, biasing information routing through the BLA, to govern valence processing.

Genetic polymorphisms in the serotonin, dopamine and opioid pathways influence social attention in rhesus macaques (Macaca mulatta)

Behaviour has a significant heritable component; however, unpicking the variants of interest in the neural circuits and molecular pathways that underpin these has proven difficult. Here, we present a comprehensive analysis of the relationship between known and new candidate genes from identified pathways and key behaviours for survival in 109 adult rhesus macaques (Macaca mulatta). Eight genes involved in emotion were analysed for variation at a total of nine loci. Genetic data were then correlated with cognitive and observational measures of behaviour associated with wellbeing and survival using MCMC-based Bayesian GLMM in R, to account for relatedness within the macaque population. For four loci the variants genotyped were length polymorphisms (SLC6A4 5-hydroxytryptamine transporter length-polymorphic repeat (5-HTTLPR), SLC6A4 STin polymorphism, Tryptophan 5-hydroxylase 2 (TPH2) and Monoamine oxidase A (MAOA)) whilst for the other five (5-hydroxytryptamine receptor 2A (HTR2A), Dopamine Receptor D4 (DRD4), Oxytocin receptor (OXTR), Arginine vasopressin receptor 1A (AVPR1a), Opioid receptor mu(μ) 1 (OPRM1)) SNPs were analysed. STin genotype, DRD4 haplotype and OXTR haplotype were significantly associated with the cognitive and observational measures of behaviour associated with wellbeing and survival. Genotype for 5-HTTLPR, STin and AVPR1a, and haplotype for HTR2A, DRD4 and OXTR were significantly associated with the duration of behaviours including fear and anxiety. Understanding the biological underpinnings of individual variation in negative emotion (e.g., fear and anxiety), together with their impact on social behaviour (e.g., social attention including vigilance for threat) has application for managing primate populations in the wild and captivity, as well as potential translational application for understanding of the genetic basis of emotions in humans.

Impact of depression and post-traumatic stress on manual and oculomotor performance in service members with a history of mild TBI

OBJECTIVE

To determine the impact of depression and post-traumatic stress on an automated oculomotor and manual measure of visual attention, compared to conventional neuropsychological assessment. Setting: Military traumatic brain injury (TBI) rehabilitation program.

PARTICIPANTS

188 Active Duty Service Members (ADSM) with a history of mild TBI.

DESIGN

A cross-sectional and correlational study with data obtained through an IRB-approved data registry study. Main measures: Bethesda Eye & Attention Measure (BEAM); brief neuropsychological battery; self-reported symptom surveys including Neurobehavioral Symptom Inventory (NSI), Patient Health Questionnaire-8 (PHQ-8), and PTSD Checklist-5 (PCL-5).

RESULTS

Small effect sizes were found for partial correlations between both depression and post-traumatic stress and key BEAM metrics. In contrast, small-to-medium effects sizes were found across all traditional neuropsychological test measures.

CONCLUSION

This study illustrates the profile of impairments associated with depression and post-traumatic stress on saccadic eye movements and manual responses to BEAM relative to conventional neuropsychological tests. Results demonstrated that among ADSM seen for mTBI, depression and PTS exert a significant negative impact on measures of processing speed, attention, executive function, and memory across saccadic, manual, and conventional neuropsychological tests. However, the unique psychometric features of each of these assessment approaches may assist in distinguishing the effects of psychiatric comorbidities within this population.

A randomized controlled trial of supervised remotely-delivered attention bias modification for posttraumatic stress disorder

BACKGROUND

Many individuals with posttraumatic stress disorder (PTSD) have limited access to first-line treatments, warranting the development of remotely-delivered treatments. Attention bias modification (ABM), targeting perturbed threat-related attentional patterns, shows promise when delivered in-person. However, previous studies found ABM to be ineffective when delivered remotely. Randomized clinical trials usually applied two variations of ABM: ABM away from threat or attention control training (ACT) balancing attention between threat-related and neutral stimuli. We tested remotely-delivered ACT/ABM with tighter supervision and video-based interactions that resemble in-clinic protocols. We expected to replicate the results of in-clinic trials, in which ACT outperformed ABM for PTSD.

METHODS

In this double-blinded, parallel-group randomized controlled trial, 60 patients diagnosed with PTSD were randomized (ABM n = 30; ACT n = 30). Patients performed eight bi-weekly remotely-delivered supervised ABM/ACT sessions. Symptoms were assessed pre- and post-treatment with Clinician-Administered PTSD Scale 5 (CAPS-5) severity score and PTSD diagnosis as the primary outcomes. Current depressive episode, current anxiety-related comorbidity, and time elapsed since the trauma were examined as potential moderators of treatment outcome.

RESULTS

Significant decrease in CAPS-5 severity scores and PTSD diagnosis was observed following both ACT and ABM with no between-group difference. Patients without depression or whose trauma occurred more recently had greater symptom reduction in the ACT than the ABM group.

CONCLUSIONS

Contrary to our expectation, symptoms decreased similarly following ACT and ABM. Moderator analyses suggest advantage for ACT in non-depressed patients and patients whose trauma occurred more recently. Further refinements in remotely-delivered ABM/ACT may be needed.

Eye-tracking indices of attention allocation and attention bias variability are differently related to trauma exposure and PTSD

Amplified attention allocation to negative information in one's environment has been implicated in posttraumatic stress disorder (PTSD). Attention bias variability (ABV), the magnitude of attention fluctuation between negative and neutral cues, has also been found to be elevated in PTSD. While eye-tracking methodology has been used in research on attention allocation in PTSD, ABV was only explored using manual reaction-time-based indices. Thirty-seven participants with PTSD, 34 trauma-exposed healthy controls (TEHC), and 30 non-exposed healthy controls (HC) completed an eye-tracking free-viewing task in which matrices comprised of neutral and negatively-valenced faces were presented. Threat-related attention allocation was calculated as the proportion of dwell time (DT%) on negatively-valenced faces. Eye-tracking-based ABV was calculated as the standard deviation of DT% across matrices. DT% on negatively-valenced faces was greater in participants with PTSD compared to both TEHC (p = .036, d = 0.50) and HC (p < .001, d = 1.03), with TEHCs showing a greater attentional bias compared to HCs (p = .001, d = 0.84). Controlling for average fixation duration, ABV was higher in both the PTSD and TEHC groups relative to the HC group (p = .004, d = 0.40), with no difference between the two trauma-exposed groups. Biased attention allocation toward negative social information is related to PTSD pathology, whereas elevated ABV measured with eye-tracking appear to be related to trauma-exposure per-se.

Associations between Optimism and Attentional Biases as Measured by Threat-Avoidance and Positive-Search Tasks

Evidence suggests that optimism has a positive impact on health status. Attentional bias modification (ABM) may be beneficial for enhancing optimism, but its effective application requires a detailed investigation of the association between attentional bias and optimism. This study aimed to determine the association between attentional bias and optimism based on different task types. Eighty-four participants completed the attentional bias measures using the dot-probe task (DPT), emotional visual search task (EVST) paradigms, and psychological assessments. Optimism was assessed using the Life Orientation Test-Revised with subscales for optimism and pessimism. Pearson's correlation coefficient and multivariate linear regression analysis were applied to investigate the association between optimism and attentional bias. Neither the attentional bias derived from DPT nor EVST was significantly correlated with optimism total score or subscales. Regression analysis also showed no association between attentional bias and optimism (DPT, β = 0.12; EVST, β = 0.09), optimism subscales (DPT, β = 0.09; EVST, β = 0.17), or pessimism subscales (DPT, β = -0.10; EVST, β = 0.02). Our findings showed no evidence that attentional biases derived from either the DPT or EVST measures are associated with optimism or pessimism. Further studies are needed to effectively adapt the ABM to enhance optimism.

Reliability of attention bias and attention bias variability to climate change images in the dot-probe task

Climate change is one of the most pressing issues of the 21st century, which is perhaps why information about climate change has been found to capture observers' attention. One of the most common ways of assessing individual differences in attentional processing of climate change information is through the use of reaction time difference scores. However, reaction time-based difference scores have come under scrutiny for their low reliability. Given that a primary goal of the field is to link individual differences in attention processing to participant variables (e.g., environmental attitudes), we assessed the reliability of reaction time-based measures of attention processing of climate change information utilizing an existing dataset with three variations of the dot-probe task. Across all three samples, difference score-based measures of attentional bias were generally uncorrelated across task blocks (r = -0.25 to 0.31). We also assessed the reliability of newer attention bias variability measures that are thought to capture dynamic shifts in attention toward and away from salient information. Although these measures were initially found to be correlated across task blocks (r = 0.17-0.67), they also tended to be highly correlated with general reaction time variability (r = 0.49-0.83). When controlling for general reaction time variability, the correlations across task blocks for attention bias variability were much weaker and generally nonsignificant (r = -0.25 to 0.33). Furthermore, these measures were unrelated to pro-environmental disposition indicating poor predictive validity. In short, reaction time-based measures of attentional processing (including difference score and variability-based approaches) have unacceptably low levels of reliability and are therefore unsuitable for capturing individual differences in attentional bias to climate change information.

The questionable validity of attention bias variability: Evidence from two conceptually unrelated cognitive tasks

Background

Attention bias variability is thought to measure fluctuations in attention towards and away from threat-related information and is elevated in affective disorders. However, recent evidence suggests that attention bias variability may quantify general reaction time variability rather than attention bias behavior per se.

Methods

The current study calculated "attention bias variability" from two conceptually unrelated cognitive tasks: the dot-probe task (measuring attentional bias) and the arrow flanker task (measuring cognitive control).

Results

Attention bias variability measures were correlated across these unrelated tasks. Yet, when general reaction time variability was controlled, attention bias variability across tasks was no longer correlated. In addition, the reliability of attention bias variability measures decreased when controlling for general reaction time variability. Finally, although attention bias variability calculated from the dot-probe task initially correlated with anxious symptoms, this association was no longer significant when controlling for general reaction time variability.

Limitations

Our sample was comprised of high trait anxious individuals. Replication in clinical samples is warranted.

Conclusions

These findings collectively provide strong empirical evidence that attention bias variability is not a valid measure of attention-related behavior, but reflective of general reaction time variability more broadly.

Attentional bias in German Armed Forces veterans with and without posttraumatic stress symptoms - An eye-tracking investigation and group comparison

BACKGROUND AND OBJECTIVES

Most eye tracking based paradigms evidence patterns of sustained attention on threat coupled with low evidence for vigilance to or avoidance of threat in posttraumatic stress symptoms (PTSS). Still, eye tracking data on attention bias is particularly limited for military population. This eye tracking study investigated attentional bias in PTSS in a sample of German Armed Forces veterans.

METHODS

Veterans with deployment-related PTSS (N = 24), veterans with deployment-related traumatization without PTSS (N = 28), and never-deployed healthy veterans (N = 18) were presented with pairs of combat and neutral pictures, pairs of general threat and neutral pictures, and pairs of emotional and neutral faces. Their eye gazes were tracked during a free viewing task. 3 x 3 x 2 mixed general linear model analyses were conducted. Internal consistency of attention bias indicators was calculated for the entire sample and within groups.

RESULTS

Veterans with PTSS dwelled longer on general threat AOIs in contrast to non-exposed controls and shorter on general threat and combat associated neutral AOIs in contrast to both control groups. Veterans with PTSS entered faster to general threat AOIs than non-exposed controls. Veterans with PTSS showed circumscribed higher attention fluctuation in contrast to controls. Internal consistency varied across attention bias indicators.

LIMITATIONS

Statistical power was reduced due to recruitment difficulties.

CONCLUSIONS

Evidence is provided for the maintenance hypothesis in PTSS. No robust evidence is provided for hypervigilant behavior in PTSS. Findings on attention bias variability remain unclear, calling for more investigations in this field.

Personalized attention control therapy for PTSD: effectiveness and moderators of outcome in a randomized controlled trial

BACKGROUND

Previous randomized controlled trials (RCTs) suggest that attention control therapy (ACT), targeting aberrant fluctuations of attention toward and away from threats in patients with PTSD, may be effective in reducing symptoms. The current RCT examined whether the use of personalized-trauma stimuli enhances ACT efficacy in patients with PTSD. Additional moderators of treatment outcome were tested on an exploratory basis.

METHODS

Sixty patients with PTSD were randomly assigned to either personalized ACT, non-personalized ACT, or a control condition. Changes in symptoms were examined across pre-treatment, post-treatment, and a 3-month follow-up. Attentional interference was examined pre- and post-treatment. Baseline clinical and cognitive indices as well as the time elapsed since the trauma were tested as potential moderators of treatment outcome.

RESULTS

A significant reduction in clinical symptoms was noted for all three conditions with no between-group differences. Attention bias variability decreased following ACT treatment. Personalized ACT was more effective relative to the control condition when less time had elapsed since the trauma. Baseline clinical and cognitive indices did not moderate treatment outcome.

CONCLUSIONS

In this RCT of patients with PTSD, ACT was no more effective in reducing PTSD symptoms than a control condition. The data also suggest a potential benefit of personalized ACT for patients who experienced their trauma more recently.

Attention-control training as an early intervention for veterans leaving the military: A pilot randomized controlled trial

Transitioning out of the military can be a time of change and challenge. Research indicates that altered threat monitoring in military populations may contribute to the development of psychopathology in veterans, and interventions that adjust threat monitoring in personnel leaving the military may be beneficial. Australian Defence Force personnel (N = 59) transitioning from the military were randomized to receive four weekly sessions of either attention-control training or a placebo attention training. The primary outcome was symptoms of posttraumatic stress disorder (PTSD), as measured using the PTSD Checklist for DSM-5 (PCL-5) at posttreatment. Following training, participants who received attention-control training reported significantly lower levels of PTSD symptoms, Hedges' g = 0.86, 95% CI [0.37, 1.36], p = .004, and significantly improved work and social functioning, Hedges' g = 0.93, 95% CI [0.46, 1.39], p = .001, relative to those in the placebo condition. Moreover, no participants who received attention-control training worsened with regard to PTSD symptoms, whereas 23.8% of those who received the placebo attention training experienced an increase in PTSD symptoms. The preliminary findings from this pilot study add to a small body of evidence supporting attention-control training as a viable indicated early intervention approach for PTSD that is worthy of further research.

Association of attention and memory biases for negative stimuli with post-traumatic stress disorder symptoms

Cognitive models have highlighted the role of attentional and memory biases towards negatively-valenced emotional stimuli in the maintenance of post-traumatic stress disorder (PTSD). However, previous research has focused mainly on attentional biases towards distracting (task-irrelevant) negative stimuli. Furthermore, attentional and memory biases have been examined in isolation and the links between them remain underexplored. We manipulated attention during encoding of trauma-unrelated negative and neutral words and examined the differential relationship of their encoding and recall with PTSD symptoms. Responders to the World Trade Center disaster (N = 392) performed tasks in which they read negative and neutral words and reported the color of another set of such words. Subsequently, participants used word stems to aid retrieval of words shown earlier. PTSD symptoms were associated with slower response times for negative versus neutral words in the word-reading task (r = 0.170) but not color-naming task. Furthermore, greater PTSD symptom severity was associated with more accurate recall of negative versus neutral words, irrespective of whether words were encoded during word-reading or color-naming tasks (F = 4.11, p = 0.044, η_p² = 0.018). Our results show that PTSD symptoms in a trauma-exposed population are related to encoding of trauma-unrelated negative versus neutral stimuli only when attention was voluntarily directed towards the emotional aspects of the stimuli and to subsequent recall of negative stimuli, irrespective of attention during encoding.

Increased Intra-Individual Variability as a Marker of Executive Dysfunction in Generalized Anxiety Disorder

Recent studies suggest that individual difference in intra-individual variability (IIV) of reaction times is an important indicator of attentional executive control. However, there are few existing studies on the executive control of high trait-anxious individuals assessed by using reaction time variability. This study assessed whether executive functions are impaired among clinical and non-clinical trait-anxious individuals indicated by IIV. The cross-reliability and discriminative power of three IIV parameters (raw intra-individual standard deviation, SD; reaction time coefficient of variation, RTCV; and mean absolute deviation, MAD) were compared. Twenty-five non-clinical individuals with low trait anxiety (LTA), 31 non-clinical individuals with high trait anxiety (HTA), and 19 clinical patients diagnosed with generalized anxiety disorder (GAD) finished self-reported measures, an emotional spatial-cuing task, and a non-emotional arrow flanker task. In the emotional task, GAD patients had significantly slower response speed, lower accuracy, and greater IIV parameters than the LTA and HTA groups. In the non-emotional task, the GAD group exhibited poorer processing efficiency, greater SD and RTCV, and intact performance effectiveness. RTCV is suggested to be a better marker of executive dysfunction than SD and MAD due to its good discriminative power and reliability as well as less affected by reaction times.

Ethnic differences in behavioral and physiological indicators of sensitivity to threat

The clinical presentation of anxiety may differ between Hispanics/Latinx (H/L) and non-H/L, although findings on ethnic differences in self-reported anxiety symptoms have been mixed. Fewer studies have focused on ethnic differences in quick and relatively automatic laboratory-assessed indicators of anxiety symptoms, which have the potential to be more objective indicators than self-report. Therefore, the present study examined ethnic differences in two laboratory-assessed indicators of threat sensitivity (an important transdiagnostic mechanism of anxiety): attentional bias to threat and electromyography startle reactivity to threat. White H/L (n = 117) and White non-H/L (n = 168) adults who were matched on demographics and lifetime psychopathology (including anxiety) completed a dot-probe task to assess attentional bias to threat and the No-Predictable-Unpredictable threat (NPU) task to assess startle reactivity to threat. Results indicated that H/L displayed less Slow OrientationRB (β = -0.27, p = 0.032, R2β∗ = 0.02), and increased Slow DisengagementRB (β = 0.31, p = 0.016, R2β∗ = 0.02) compared to non-H/L. H/L exhibited blunted overall startle compared to non-H/L (β = -0.30, p = 0.014, R2β∗ = 0.02), but groups did not differ in startle reactivity to either predictable or unpredictable threat. In summary, H/L and non-H/L may differ in their experience and presentation of anxiety symptoms and such differences may vary across indicators of sensitivity to threat.

The use of trial-level bias scores to examine attention bias and attention bias variability among people with and without social anxiety disorder

BACKGROUND

Cognitive models of anxiety propose that people with anxiety disorders show elevated levels of attention bias toward threat, but the most commonly used index of attention bias, which measures the construct with an aggregate score of multiple trials across an experimental session, shows poor test-retest reliability. Newer indices that measure attention bias dynamically on a trial-to-trial basis show good reliability and enable researchers to measure not only overall attention bias toward threat, but also attention bias variability.

METHODS

The current study tested the hypothesis that people diagnosed with social anxiety disorder would show higher attention bias variability and higher attention bias toward threat when calculated dynamically and when calculated using the traditional aggregate index. Participants diagnosed with social anxiety disorder (n = 47) and controls (n = 57) completed a 160-trial version of the dot-probe task using emotional and neutral images of faces as stimuli.

RESULTS

Relative to controls, participants diagnosed with social anxiety disorder showed higher mean bias toward threat, but only when calculated using trial-level bias scores. There were no differences between groups on attention bias variability.

DISCUSSION

This is the first study to examine differences in attention bias and attention bias variability between people with and without social anxiety disorder using trial-level bias scores. Results suggest that attention bias, but not attention bias variability, is a feature of social anxiety psychopathology and that trial-level bias scores may be more sensitive than aggregated mean scores to detect it. These findings have implications for clinical interventions such as attention bias modification programs, which require precise measures of attention bias to accurately assess treatment outcomes.

Increasing cognitive load attenuates the moderating effect of attentional inhibition on the relationship between posttraumatic stress symptoms and threat-related attention bias variability

Theory and empirical evidence suggest that those with higher posttraumatic stress (PTS) symptoms and better attentional control (i.e., the strategic control of higher-order executive attention in regulating bottom-up, stimulus driven responses to prepotent stimuli; Sarapas et al., 2017) can use that ability to disengage and shift attention away from threat stimuli and reduce threat-related attentional dysregulation (i.e., avoidance/overcontrollers). Those with relatively worse attentional control lack the requisite resources to do this, leading to prolonged attentional engagement with threat stimuli and threat-related attention dysregulation (i.e., maintenance/undercontrollers). Given that attentional control is a limited resource, strategic avoidance of threat information or reduced threat-related attention dysregulation may not be possible among those with relatively higher attentional control when cognitive load is relatively high. To test this hypothesis, the interaction between PTS symptoms, attentional control, and cognitive load was examined as a predictor of threat-related attentional bias and threat-related attention bias variability. Participants (N = 125 undergraduate students) were randomly assigned to high or low load conditions. Participants completed self-report measures of PTS symptoms, a behavioral measure of attentional control, and a novel task that assessed threat-related attentional bias via eye movements and threat-related attention bias variability via button press. The results of a series of hierarchical regressions showed that attentional control moderated the relationship between PTS symptoms and threat-related attention bias variability in the low, but not high, load condition. This moderation effect was not observed for threat-related attentional bias assessed via eye-tracking. Consistent with theory, under conditions of higher cognitive load, overcontrollers may not be able to use attentional control to consistently regulate threat-related attention. Study findings suggest that it may be important to consider contextual factors that increase cognitive load, as well as individual differences in attentional control, when developing attention bias modification interventions to reduce PTS symptomatology.

Emotion information processing as a new component of emotional intelligence: Theoretical framework and empirical evidence

The relationship between emotional intelligence (EI) and emotion information processing (EIP) has received surprisingly little attention in the literature. The present research addresses these gaps in the literature by introducing a conceptualization of emotional intelligence as composed of two distinct components: (1) EIK or emotion Knowledge component, captured by current ability emotional intelligence tests, related to top-down, higher order reasoning about emotions, and which depends more strongly on acquired and culture-bound knowledge about emotions; (2) EIP or emotion information Processing component, measured with emotion information processing tasks, requires faster processing and is based on bottom-up attention-related responses to emotion information. In Study 1 ( N = 349) we tested the factorial structure of this new EIP component within the nomological network of intelligence and current ability emotional intelligence. In Study 2 ( N =111) we tested the incremental validity of EIP in predicting both overall performance and the charisma of a presenter while presenting in a stressful situation. Results support the importance of acknowledging the role of emotion information processing in the emotional intelligence literature and point to the utility of introducing a new EI measure that would capture stable individual differences in how individuals process emotion information.

Cognitive-emotional mechanisms of alcohol intoxication-involved HIV-risk behavior among men who have sex with men (MSM)

Alcohol use is a key risk factor for HIV infection among men who have sex with men (MSM), primarily because it interferes with condom use. However, little is known about the cognitive-emotional mechanisms through which alcohol influences decisions to use condoms with high-risk partners among MSM. In this study, we tested whether alcohol-related deficits in inhibitory control and attention bias toward sexual cues (vs. condoms and neutral cues) accounted for increases in condomless anal sex (CAS) intentions after drinking among MSM. Heavy-drinking, high-risk MSM (N = 83) were randomly assigned to receive (a) alcohol, (b) placebo, or (c) control beverages before behavioral tasks assessing inhibitory control and attention bias, and a video-based sexual risk scenario that assessed several aspects of sexual decision making. Results showed that inhibitory control and attention bias to sexual cues did not mediate associations between intoxication and CAS intentions. Inhibitory control deficits also did not moderate the indirect effects of intoxication on CAS intentions through attention bias. Three-way interactions between alcohol/placebo condition, inhibitory control, and attention bias were also not significant. Together, these findings provide little evidence that these two processes play a significant role in alcohol-involved HIV risk, at least as assessed by the specific tasks used in this study. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Attentional processes and contamination-related intrusion distress

Whilst people with high contamination fear may not experience a greater number of contamination-related intrusions than people with low contamination fear, they tend to experience heightened distress in response to such intrusions. The aim of the present study was to test the hypothesis that attentional bias to contamination-relevant information, and the variability of this attentional bias, moderates the degree to which high contamination fearful but not low contamination fearful individuals experience distress in response to contamination-related intrusions. Individuals with high (n = 31) or low (n = 44) contamination fear completed a lab-based session including questionnaires, a dot-probe measure of contamination-related attentional bias and attentional bias variability, and a contamination stressor video. Participants then completed a week-long contamination intrusions diary. There were significant differences in intrusion distress between those with low and high contamination fear in the anticipated direction, and attentional bias significantly moderated this relationship. Regardless of contamination fear level, greater attentional bias variability was associated with greater intrusion distress. These findings suggest that reducing attentional bias variability could potentially help to reduce distress elicited by contamination-related intrusions, while also highlighting the fact that attentional bias towards threat may protect against such distress in low contamination fearful individuals.

A Pictorial Dot Probe Task to Assess Food-Related Attentional Bias in Youth With and Without Obesity: Overview of Indices and Evaluation of Their Reliability

Several versions of the dot probe detection task are frequently used to assess maladaptive attentional processes associated with a broad range of psychopathology and health behavior, including eating behavior and weight. However, there are serious concerns about the reliability of the indices derived from the paradigm as measurement of attentional bias toward or away from salient stimuli. The present paper gives an overview of different attentional bias indices used in psychopathology research and scrutinizes three types of indices (the traditional attentional bias score, the dynamic trial-level base scores, and the probability index) calculated from a pictorial version of the dot probe task to assess food-related attentional biases in children and youngsters with and without obesity. Correlational analyses reveal that dynamic scores (but not the traditional and probability indices) are dependent on general response speed. Reliability estimates are low for the traditional and probability indices. The higher reliability for the dynamic indices is at least partially explained by general response speed. No significant group differences between youth with and without obesity are found, and correlations with weight are also non-significant. Taken together, results cast doubt on the applicability of this specific task for both experimental and individual differences research on food-related attentional biases in youth. However, researchers are encouraged to make and test adaptations to the procedure or computational algorithm in an effort to increase psychometric quality of the task and to report psychometric characteristics of their version of the task for their specific sample.

Threat Bias and Emotion Recognition in Victims of IPV

Although there is growing evidence of the association between threat bias and psychopathology in many trauma-exposed populations, there are few studies with intimate partner violence (IPV) victims. The present study assessed threat bias in IPV victims. It also examined potential differences in facial recognition ability between victims and nonvictims. Participants were 153 female college students currently in a dating relationship. Participants completed demographic and abuse severity measures. They then completed a dot-probe task to assess threat bias, and a facial expression recognition task to assess speed and accuracy of recognition. Approximately 32% of the students sampled were currently in a physically abusive relationship. Results indicated that IPV victims had a bias toward fearful faces, and showed worse recognition of happy faces than nonvictims. These data suggest that the psychological impact of threat bias might vary temporally. Vigilance during threat may serve as a protective mechanism, whereas postthreat vigilance might be associated with psychopathology. Researchers should carefully consider the presence of threat bias in victim samples and include other victim groups in future assessments of threat bias. It will be important to test these relationships in other IPV victim samples, such as help-seeking victims and other community living victims.

Childhood maltreatment history and attention bias variability in healthy adult women: role of inflammation and the BDNF Val66Met genotype

Childhood maltreatment has been associated with greater attention bias to emotional information, but the findings are controversial. Recently, a novel index of attention bias, i.e., attention bias variability (ABV), has been developed to better capture trauma-related attentional dysfunction. However, ABV in relation to childhood trauma has not been studied. Here, we examined the association of childhood maltreatment history with attention bias/ABV in 128 healthy adult women. Different types of childhood maltreatment were assessed with the Childhood Trauma Questionnaire. Attention bias/ABV was measured by the dot-probe task. Possible mechanisms whereby childhood maltreatment affects attention bias/ABV were also explored, focusing on blood proinflammatory markers and the BDNF Val66Met polymorphism. We observed a significant positive correlation between childhood emotional abuse and ABV (P = 0.002). Serum high-sensitivity tumor necrosis factor-α levels were significantly positively correlated with ABV (P < 0.001), but not with childhood maltreatment. Jonckheere-Terpstra trend test showed a significant tendency toward greater ABV with increasing numbers of the BDNF Met alleles (P = 0.021). A two-way analysis of variance further revealed that the genotype-by-emotional abuse interaction for ABV was significant (P = 0.022); individuals with the Val/Met and Met/Met genotypes exhibited even greater ABV when childhood emotional abuse was present. These results indicate that childhood emotional abuse can have a long-term negative impact on emotional attention control. Increased inflammation may be involved in the mechanism of ABV, possibly independently of childhood maltreatment. The BDNF Met allele may dose-dependently increase ABV by interacting with childhood emotional abuse.

A reciprocal inhibition model of alternations between under-/overemotional modulatory states in patients with PTSD

Patients with posttraumatic stress disorder (PTSD) appear to manifest two opposing tendencies in their attentional biases and symptoms. However, whether common neural mechanisms account for their opposing attentional biases and symptoms remains unknown. We here propose a model in which reciprocal inhibition between the amygdala and ventromedial prefrontal cortex (vmPFC) predicts synchronized alternations between emotional under- and overmodulatory states at the neural, behavioral, and symptom levels within the same patients. This reciprocal inhibition model predicts that when the amygdala is dominant, patients enter an emotional undermodulatory state where they show attentional bias toward threat and manifest re-experiencing symptoms. In contrast, when the vmPFC is dominant, patients are predicted to enter an emotional overmodulatory state where they show attentional bias away from threat and avoidance symptoms. To test the model, we performed a behavioral meta-analysis (total N = 491), analyses of own behavioral study (N = 20), and a neuroimaging meta-analysis (total N = 316). Supporting the model, we found the distributions of behavioral attentional measurements to be bimodal, suggesting alternations between the states within patients. Moreover, attentional bias toward threat was related to re-experiencing symptoms, whereas attentional bias away from threat was related with avoidance symptoms. We also found that the increase and decrease of activity in the left amygdala activity was related with re-experiencing and avoidance symptoms, respectively. Our model may help elucidate the neural mechanisms differentiating nondissociative and dissociative subtypes of PTSD, which usually show differential emotional modulatory levels. It may thus provide a new venue for therapies targeting each subtype.

What is attention bias variability? Examining the potential roles of attention control and response time variability in its relationship with anxiety

The present study examined the underlying role of attention control and response time variability in explaining the relationship between anxiety and two commonly computed measures of attention bias variability: 'moving average' and 'trial-level bias score' measures. Participants (final n = 195) completed measures of anxiety symptomatology, antisaccade performance (attention control), a stand-alone measure of response-time variability, and a probe task measure of attention bias. Average bias and moving average bias variability measures both recorded significant, but low split-half reliability. Both attention bias variability measures and average attention bias were associated with anxiety, and attention control. Both attention bias variability measures correlated with response time variability. Neither attention bias variability measure correlated with average attention bias. Attention control was the single significant mediator of the relationship between anxiety and the trial-level bias score measure of attention bias variability. Neither response time variability nor attention control significantly mediated the relationship between anxiety and the moving average measure of attention bias variability. No evidence was found for the mediating role of response time variability. The present findings suggest that the relationships observed between anxiety and the trial-level bias score measure of attention bias variability in particular may be attributable to the over-arching role of attention control.

Attention control therapy for acute stress disorder: A randomized controlled trial

BACKGROUND

A subset of people exposed to traumatic events develop acute stress disorder (ASD), and approximately half of people with ASD develop posttraumatic stress disorder (PTSD). This randomized controlled trial examined the efficacy of internet-delivered attention control therapy (ACT), previously shown to reduce PTSD symptoms, as an adjuvant to treatment as usual in the community for patients with ASD.

METHODS

About 119 participants with ASD were randomly assigned to ACT or treatment as usual in the community within the first month following their traumatic event. PTSD symptoms and attention patterns were measured.

RESULTS

A significant reduction in stress-related symptoms was noted across participants with no difference between the two groups. Approximately half of the participants developed PTSD 2 months after the trauma. High attention bias variability was associated with elevated PTSD symptoms. However, attention bias variability did not change due to the therapy sessions.

CONCLUSIONS

Internet-delivered ACT was no more effective in reducing risk for PTSD in participants with ASD than treatment as usual in the community. Although elevated attention bias variability was detected in the patients with ASD, ACT failed to engage this cognitive target. Finally, ACT-based prevention research should proceed with caution given the possibility that this intervention might be associated with symptom worsening as indexed by the Clinical Global Impression scale.

Temporal trends in attention disengagement from social threat as a function of social anxiety

BACKGROUND AND OBJECTIVES

Difficulty disengaging attention from threat has been observed in some anxious samples, but the evidence to date is mixed. The current study examines temporal trends in attention disengagement and compares this construct across multiple forms of social threat.

METHODS

Participants (85 adults with a principal diagnosis of social anxiety disorder) completed a spatial cueing task with four image categories (angry faces, disapproving faces, neutral faces, neutral objects). Attention disengagement was assessed via reaction time (RT) over 256 trials.

RESULTS

Participants with greater social anxiety exhibited an initial delay in attention disengagement from disapproving faces that habituated over the course of the task. RTs to angry and neutral stimuli did not differ as a function of social anxiety.

LIMITATIONS

The current task only allowed for examining speed of attention disengagement, and thus we were unable to compare our results to trajectories of speed at which participants orient towards threat. Additionally, disapproving facial images were created for this paradigm and may benefit from further validation.

CONCLUSIONS

Findings suggest that social anxiety is associated with an initial delay in attention disengagement from social threat that resolves over the course of repeated exposures to such stimuli. Treatment implications are discussed.

Randomized Controlled Trial Testing Mobile-Based Attention-Bias Modification for Posttraumatic Stress Using Personalized Word Stimuli

Although behavioral therapies are effective for posttraumatic stress disorder (PTSD), access for patients is limited. Attention-bias modification (ABM), a cognitive-training intervention designed to reduce attention bias for threat, can be broadly disseminated using technology. We remotely tested an ABM mobile app for PTSD. Participants (N = 689) were randomly assigned to personalized ABM, nonpersonalized ABM, or placebo training. ABM was a modified dot-probe paradigm delivered daily for 12 sessions. Personalized ABM included words selected using a recommender algorithm. Placebo included only neutral words. Primary outcomes (PTSD and anxiety) and secondary outcomes (depression and PTSD clusters) were collected at baseline, after training, and at 5-week-follow-up. Mechanisms assessed during treatment were attention bias and self-reported threat sensitivity. No group differences emerged on outcomes or attention bias. Nonpersonalized ABM showed greater declines in self-reported threat sensitivity than placebo (p = .044). This study constitutes the largest mobile-based trial of ABM to date. Findings do not support the effectiveness of mobile ABM for PTSD.

The stability and reliability of attentional bias measures in the dot-probe task: Evidence from both traditional mean bias scores and trial-level bias scores

A new method of calculating attentional bias from the dot-probe task measures fluctuations in bias towards and away from emotional stimuli over time using trial level bias score metrics. We assessed the stability and reliability of traditional attentional bias scores and trial level bias score measures of attentional bias across time in two five-block dot-probe task experiments in non-clinical samples. In experiments 1 and 2, both traditional attentional bias scores and trial level bias score measures of attentional bias did not habituate/decrease across time. In general, trial level bias score metrics (i.e., attention bias variability as well as the mean biases toward and away from threat) were more reliable than the traditional attention bias measure. This pattern was observed across both experiments. The traditional bias score, however, did improve in reliability in the later blocks of the fearful face dot-probe task. Although trial level bias score measures did not habituate and were more reliable across blocks, these measures did not correlate with state or trait anxiety. On the other hand, trial level bias score measures were strongly correlated with general reaction time variability-and after controlling for this effect no longer superior in reliability in comparison to the traditional attention bias measure. We conclude that general response variability should be removed from trial level bias score measures to ensure that they truly reflect attention bias variability.

Attention bias variability and posttraumatic stress symptoms: the mediating role of emotion regulation difficulties

Growing literature has linked attention bias variability (ABV) to the experience and treatment of posttraumatic stress disorder (PTSD). Unlike assessments of attention bias in only one direction, ABV captures dynamic fluctuations in attention toward and away from threat. While mechanisms underlying the ABV-PTSD relations are unclear, some research implicates emotion regulation difficulties. The current study examined in community women with varying PTSD symptom severity, the amount of variance in the association between ABV and PTSD accounted for by emotion regulation difficulties. The full sample (N = 74) was comprised of 59% community women with PTSD due to domestic and/or sexual violence, and 41% community women without PTSD. All participants completed self-report questionnaires including the Difficulties in Emotion Regulation Scale-16, which assessed emotion regulation. ABV was calculated following a computerised dot probe task. The indirect effect of ABV on PTSD symptom severity through emotion regulation difficulties was statistically significant, while the direct effect between ABV and PTSD symptom severity was not significant. Findings replicated after controlling for total trauma exposure. Clinical implications and literature suggesting how ABV may perpetuate emotion regulation difficulties associated with PTSD symptomology are discussed.

Significance of the orexinergic system in modulating stress-related responses in an animal model of post-traumatic stress disorder

Converging evidence indicates that orexins (ORXs), the regulatory neuropeptides, are implicated in anxiety- and depression-related behaviors via the modulation of neuroendocrine, serotonergic, and noradrenergic systems. This study evaluated the role of the orexinergic system in stress-associated physiological responses in a controlled prospective animal model. The pattern and time course of activation of hypothalamic ORX neurons in response to predator-scent stress (PSS) were examined using c-Fos as a marker for neuronal activity. The relationship between the behavioral response pattern 7 days post-exposure and expressions of ORXs was evaluated. We also investigated the effects of intracerebroventricular microinfusion of ORX-A or almorexant (ORX-A/B receptor antagonist) on behavioral responses 7 days following PSS exposure. Hypothalamic levels of ORX-A, neuropeptide Y (NPY), and brain-derived neurotrophic factor (BDNF) were assessed. Compared with rats whose behaviors were extremely disrupted (post-traumatic stress disorder [PTSD]-phenotype), those whose behaviors were minimally selectively disrupted displayed significantly upregulated ORX-A and ORX-B levels in the hypothalamic nuclei. Intracerebroventricular microinfusion of ORX-A before PSS reduced the prevalence of the PTSD phenotype compared with that of artificial cerebrospinal fluid or almorexant, and rats treated with almorexant displayed a higher prevalence of the PTSD phenotype than did untreated rats. Activated ORX neurons led to upregulated expressions of BDNF and NPY, which might provide an additional regulatory mechanism for the modulation of adaptive stress responses. The study indicates that the activated ORX system might promote adaptive responses to PSS probably via stimulation of BDNF and NPY secretion, and early intervention with ORX-A reduces the prevalence of the PTSD phenotype and increases the prevalence of adaptive phenotypes. The findings provide some insights into the mechanisms underlying the involvement of the ORX system in stress-related disorders.

Combining fMRI during resting state and an attention bias task in children

Neuroimaging studies typically focus on either resting state or task-based fMRI data. Prior research has shown that similarity in functional connectivity between rest and cognitive tasks, interpreted as reconfiguration efficiency, is related to task performance and IQ. Here, we extend this approach from adults to children, and from cognitive tasks to a threat-based attention task. The goal of the current study was to examine whether similarity in functional connectivity during rest and an attention bias task relates to threat bias, IQ, anxiety symptoms, and social reticence. fMRI was measured during resting state and during the dot-probe task in 41 children (M = 13.44, SD = 0.70). Functional connectivity during rest and dot-probe was positively correlated, suggesting that functional hierarchies in the brain are stable. Similarity in functional connectivity between rest and the dot-probe task only related to threat bias (puncorr < .03). This effect did not survive correction for multiple testing. Overall, children who allocate more attention towards threat also may possess greater reconfiguration efficiency in switching from intrinsic to threat-related attention states. Finally, functional connectivity correlated negatively across the two conditions of the dot-probe task. Opposing patterns of modulation of functional connectivity by threat-congruent and threat-incongruent trials may reflect task-specific network changes during two different attentional processes.

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.

Levels of early-childhood behavioral inhibition predict distinct neurodevelopmental pathways to pediatric anxiety

BACKGROUND

Anxiety symptoms gradually emerge during childhood and adolescence. Individual differences in behavioral inhibition (BI), an early-childhood temperament, may shape developmental paths through which these symptoms arise. Cross-sectional research suggests that level of early-childhood BI moderates associations between later anxiety symptoms and threat-related amygdala-prefrontal cortex (PFC) circuitry function. However, no study has characterized these associations longitudinally. Here, we tested whether level of early-childhood BI predicts distinct evolving associations between amygdala-PFC function and anxiety symptoms across development.

METHODS

Eighty-seven children previously assessed for BI level in early childhood provided data at ages 10 and/or 13 years, consisting of assessments of anxiety and an fMRI-based dot-probe task (including threat, happy, and neutral stimuli). Using linear-mixed-effects models, we investigated longitudinal changes in associations between anxiety symptoms and threat-related amygdala-PFC connectivity, as a function of early-childhood BI.

RESULTS

In children with a history of high early-childhood BI, anxiety symptoms became, with age, more negatively associated with right amygdala-left dorsolateral-PFC connectivity when attention was to be maintained on threat. In contrast, with age, low-BI children showed an increasingly positive anxiety-connectivity association during the same task condition. Behaviorally, at age 10, anxiety symptoms did not relate to fluctuations in attention bias (attention bias variability, ABV) in either group; by age 13, low-BI children showed a negative anxiety-ABV association, whereas high-BI children showed a positive anxiety-ABV association.

CONCLUSIONS

Early-childhood BI levels predict distinct neurodevelopmental pathways to pediatric anxiety symptoms. These pathways involve distinct relations among brain function, behavior, and anxiety symptoms, which may inform diagnosis and treatment.