Attention

Question 1

How the components of attentional bias can be meaningfully measured/used in the context of empirical lab research

Answer 1

1. Attentional bias (AB)
   - Non-intentional (Automatic/bottom-up initial orienting)
   - Attention is directed away from the task at hand (priority/interrupt/interference)
   - Difficult to redirect attention/maintained attention (difficulty to disengage or top-down orienting)
   - Individual differences (goal/concern relevance)
   - Can be avoidance-related or approach-related motivational states
2. Binocular Rivalry (Competition)
   - Gerdes: You see what you fear, Binocular Rivalry, comparison people with/out
   spider phobia, spider phobia participants saw spiders first
3. Exogenous Cueing Task (ECT) -> reaction time task (see Koster)
4. Free viewing task: eye-tracking (see Lazarov)
5. Stroop task (Blocked vs Mixed)= Color Naming
6. Color-Naming Interference Task (Processing Priority)
7. Visual probe task -> speeded reaction time task

Question 2

Dysfunctional Fears and Attentional Bias (social anxiety) (avoidant attentional bias)

Answer 2

1. Lazarov
   - Free viewing task of a matrix of faces: eye-tracking, groups: healthy and people with social anxiety
   - CONCLUSION: socially anxious people dwell longer on socially threatening stimuli, first fixation measures do not differ between anxious and non-anxious participants
   -> dwelling on concerns might lead to concern (persistence?)
2. Duque
   - “Double Attention bias for positive and negative emotional faces in clinical depression: eye-tracking”
   - One happy, one sad face next to each other
   - CONCLUSION: less dwell time on happy faces and more on sad faces => double attention bias -> might lead to the persistence of their depressed state
   = mood-congruent (or schema congruent) information processing
3. Color-Naming Interference Task (Processing Priority)
   - Name the color of the words, the content of words that might concern disorder (spider)
   - CONCLUSION: people are slower at naming the color for disorder-relevant words, even subliminally presented words had an influence on response time for spider phobic individuals

Question 3

Attentional bias following threat-conditioning (Koster)

Answer 3

• Exogenous Cueing Task (ECT): cues = green, and pink (CS+, CS-non-threatening) followed by UCS= white noise, reaction time task
• CONCLUSION: people are even quicker on CS+ (now threat signal), people have an inclination to attentional capture AND a difficulty to engage
  => add to seeing the world as a threatful place, the priority of processing confirms threat signal -> might lead to escape/avoidance
• Extinction procedure: no white noise -> gradual learning that the “catastrophe” does not occur -> extinction (not easy, reaction to CS+ decreases)

Question 4

Attentional bias in mental disorders

Answer 4

• Discriminative power: patients vs controls (GAD, OCD, PD, PTSS, phobia, eating disorders..)
• Specificity: word “rejection” more relevant for people with social phobia
• Subliminal/Supoptimal? (see color naming-spider)
• Predictive validity:
  1. MacLeod
  Subli-Stroop: general threat words, women awaiting colposcopy
  Assumption: people might vary in their habitual inclination to give a priority to certain stimuli, inclination to negative stimulation -> might be a risk factor
  CONCLUSION: Interference (scores on Stroop-task) = single best predictor for emotional distress
  2. Nay
  Masked and unmasked Stroop: focus on panic-related threat words, biological challenge (CO2)
  Differences in initial interference by panic words
  CONCLUSION: Interference predicted emotional responding
  Is AB for threatening information a vulnerability factor?

    => predictive validity for life stress, PD symptoms

• Malleability (capability of being shaped): pre-post treatment: Interference decreases after treatment, automatic uncontrollable biases disappear (but not for all), but some remain with residual bias which could lead to fear

Question 5

Explain both intra-individual variations in attentional bias and inter-individual differences in attentional bias on the basis of the motivational (“goal”) account of attention

Answer 5

• Intra-individual differences
• Inter-Individual differences
  Interference baseline (see MacLeod, Nay)
  Difference of control on attention

Conflicting goals:

• Visual probe task:
• Speeded reaction time task: identify probe, detect the location of dot, preceded by task-irrelevant stimuli
• CONCLUSION: orientation to threat ´-> reaction time for congruent (probe on threat location) fast, slow RT for incongruent (probe on neutral location), other way for avoidance to threat
• Longer presentation of stimuli
• > increasing influence of top-down cognitive control
• > the longer the stimuli is shown, the less attention/avoidance of threat signal
• > the longer the stimuli is shown, still attention/no avoidance in appetitive cues

Question 6

Explain how attentional bias(es) may contribute to the development and persistence of substance use disorders, eating disorders, chronic pain, depression, anxiety disorders

Answer 6

ATTENTIONAL BIAS AS CAUSAL AGENT
Experimental bias induction (Macleod) ->increased stress sensitivity?

• Experimental group: 100% on threat location, learn to approach threat
• Control group: 100% on neutral location, approach away from the threat

=> AB is modifiable, AB towards threat -> more distress
=> bias possibly has a causal impact on the vulnerability to develop distress
-> bias possibly leads to the persistence of the mental disorder

Question 7

Explain what type of interventions might be helpful to reduce the impact of attentional bias(es) in patients with mental disorders

Answer 7

1. Attentional training (to enhance strategic control)
   - Example: TCT (long-term effect of TCT on fear of showing bodily symptoms is explained by lasting changes in attentional focus)
   - Mindfulness (to reduce the impact of attentional bias, fostering non-reactivity)
   - > Decrease in AB -> enhanced perceived control over pain
2. Bias Reduction (reduce stress sensitivity)

2.1 Avoidance
- Social Anxiety
High socially anxious students, unlearned their threat bias by visual probe task, then public speaking task, measured subjective anxiety/behavior
CONCLUSION: reduction of subjective anxiety/behavior

• Depression
  Training self-protective bias through matrixes (finding the happy face)
  LEARN TO: Attentional orientation target emotion and Ignore task-irrelevant threat cures (approach happy, ignore negative)
  12 sessions: produced a happy-face attention bias, reduced diagnostic severity and number of diagnoses, 50 % of children no longer met criteria for their original diagnosis

2.2Approach

• Eating disorders and addiction
  Bouncing image task (BIT) for eating disorders and addiction
  -> reduce the difficulty to disengage, inhibit distraction (attentional control)
  -> focus on neutral, immediately disengage when it turns into alcohol/food

=> could be used for prevention (a kind of vaccine for young people)

Question 8

Summary

Answer 8

• AB for both appetitive and aversive (internal/external) cues
• Differential pattern attentional processes anxiety/pain vs. addiction vs depression
• Evidence for causal status
• Promising clues for clinical/preventative interventions