Beck’s cognitive model of anxiety
- Argues that based on previous experiences, individuals develop cognitive schemas = memory representations of situations in relation to the self and emotions
- Based on threatening experiences, individuals develop danger schemas that subsequently guide info processing
- proposed that anxious individuals were characterized by overactive danger schemas
- Through the influence of these danger schemas: attention is mainly focused on info that is schema-congruent → leads to confirmation of existing neg beliefs
Bower’s associative network model of memory
- proposed that through the process of co-activation, concepts become associated in memory with specific concepts being stored as nodes
- Emotions are also stored as nodes → based on individual experiences, emotions are linked to a plethora of other concepts
- Once emotions are active, processing of info is mood-dependent and frequently mood-congruent
measuring attentional bias
emotional stroop task
- Based on traditional stroop color-word task
- emotional version: reaction times to name the color of threat-related vs neutral words are compared - to what extent the threatening meaning of a word interferes with the main task
- Typical pattern of findings: individuals with high trait anxiety or an AD require more time to name the color of threatening, disorder-related words
criticism: color-naming interference observed for threatening words could be due to other non-attentional processing - e.g. behavioral interference or avoidance
measuring attentional bias
dichotic listening task
- Presented with auditory info that they have to shadow verbally - occasionally play threatening or neutral works at low volume in other ear
- Findings: individuals with elevated anxiety states were more likely to identify target words with a threatening meaning compared to target words with a neutral meaning
Criticism/issue: has been argued that awareness is influenced by a host of different processes where it is difficult to assure that stimuli cannot be perceived consciously
measuring attentional bias
dot probe task
- Displays two words on a computer screen w one at the top and one at the bottom
- Following a brief stimulus presentation duration - the stimuli disappear & a probe appears in a location previously occupied by one of the stimuli
- participant asked to press a button indicating whether the top or bottom stimulus had been replaced by the probe
- Attentional biases are inferred from different response times to probes that replace threatening vs neutral stimuli
measuring attentional bias
visual search task
- Participants are directed to detect a target stimulus (e.g. ‘spider’) that is embedded in a matrix of distracting stimuli (neutral words)
- conversely, a neutral target word may be embedded in a matrix of spider-related words
- Attentional biases inferred from faster response times to detect a threatening stimulus in a matrix of neutral stimuli relative to response times to detect neutral stimuli in neutral matrices
advantages:
many stimuli are presented simultaneously - requires an active search process of participants
+
speed of the target search in relation to the number of distracting stimuli allows examining whether threatening info “pops out”
measuring attentional bias
spatial cueing task
- p’s focus on a fixation point located between two rectangles - a cue is then presented, followed by the appearance of a target in one of the two rectangles
- p’s are asked to press a key indicating the rectangle in which the target is located
- some trials are valid cues & other trials are invalid cues
- facilitated attentional engagement to threat is indicated by faster responses on valid threat-cued trials relative to neutral-cued trials
- impaired attentional disengagement from threat is indicated by slower responses on invalidly threat-cued trials relative to neutral-cued trials
measuring attentional bias
eye tracking
- eye tracking is often combined with the spatial attention paradigms
- under normal circumstances, visual info is gathered by making rapid eye movements (=saccades)
- in studies using eye tracking - several components of visual attention can be studied, including the speed of initial saccades, the number of fixations made to specific stimuli, and the fixation duration on stimuli
- meta-analytic evidence from eye-tracking studies indicates that anxiety is characterized by attentional bias to threat
nature of attentional bias
the automaticity of attentional bias
AB is an automatic process that is based on a very fast evaluation mechanism that operates at a preconscious level
Other theorists refuted this claim by highlighting that AB to threat occurs because of the link between specific stimuli (e.g., angry faces) and individuals’ goals (e.g., avoiding rejection)
* goals are highly relevant in the deployment of attention
* presence of goal-relevant stimuli can override AB to threat, even in high trait anxious individuals
nature of attentional bias
the time course of attentional bias to threat
at early stages most research seems to suggest that attention is oriented more toward threat in high-anxious individuals
At later processing stages attention is oriented away from threat.
this had been labelled Vigilance-avoidance pattern of attentional bias: is argued to explain how initial AB to threat causes elevated anxiety with the attentional avoidance interfering with subsequent habituation
Eysenck (1992) suggested that high-anxious individuals initially show broad scanning of the env for threat, followed by a narrowed focus of attention to threat upon detection, combined with difficulties to disengage attention away from threat
3 key research lines into AB & developing AD
developmental studies
Anxiety disorders having their origin in childhood is debated
Challenging to study in youth because:
* more variability in response times = RT as outcome variable difficult
* maturational processes in exec functions may influence expression of AB = difficult to include many age ranges
* many studies use slightly different task parameters = makes studies difficult to compare
Abend et al., (2018): Positive correlation was found between attentional bias to threat & severity of overall anxiety symptoms
* Although significant, this correlation was small (r < 0.1), where associations appeared most pronounced for social anxiety and school phobia
3 key research lines into AB & developing AD
developmental studies - behavioral inhibition & effortful control
behavioral inhibition (temperamental factor): several studies found a prospective association between behavioral inhibition & AB on later-stage ADs
Effortful control = the ability to activate or inhibit behavior and voluntarily deploy attention as required to better adaptively fit the context
- Children who are able to efficiently shift attention: can more readily disengage their attention from threat → could help them to counteract or override AB to threat
3 key research lines into AB & developing AD
prospective studies
examine whether AB measured at an initial time point can predict subsequent emotional reactivity & state anxiety
- latter variable serves as a proxy for the vulnerability to develop anxiety disorders
The current data are in line with the idea that attentional bias to threat may increase the vulnerability to anxiety, yet this link needs to be established more definitively in larger-scale studies
3 key research lines into AB & developing AD
experimental manipulation
Attentional bias modification (ABM): results seem to suggest that AB plays a causal role in the maintenance of anxiety disorders
no conclusions can be drawn with regard to AB as an etiological factor since it is not clear whether an induced AB operates in the same way as a naturally occurring AB
major theoretical models for AB in anxiety
Biased attentional directional account (Williams et al)
Stimulus input is initially appraised (automatically) as threatening or nonthreatening through an affective decision mechanism
Outcome of this decision process: feeds into a resource allocation mechanism where the direction of attention to threat is determined
* is influenced by trait mechanism: high trait anxiety individuals have tendency to attend to threat & low have tendency to avoid threat
major theoretical models for AB in anxiety
cognitive-motivational model (mogg & bradley)
Attention to highly threatening stimuli is crucial for survival = proposed that incoming info is appraised with a valence-evaluation system - a crude evaluation of stimuli being either low or highly threatening
* Stimulus appraised as low threatening = current attention to ongoing task & behavior is maintained
* Stimulus appraised as highly threatening = ongoing behavior is interrupted and attention is allocated to threat in order to further process this info
major theoretical models for AB in anxiety
self-regulatory executive function model (wells & matthews)
developed a different view with this model → argue that ABs are linked to top-down processes instead of the more automatic processes in the aforementioned models
Trait anxiety is linked to neg beliefs & problems at the level of exec control - argue that the evidence for unconscious, fully automatic threat bias is very limited
major theoretical models for AB in anxiety
attentional control theory (eysenck et al)
- Stimulus-driven = bottom-up
- Goal-driven = top-down processing
- Anxiety changes this balance (of top-down and bottom-up processing) in favor of stimulus-driven processing when threat is present
- This hampers several of the top-down functions related to executive control
the key role of extinction learning in anxiety disorders
what is extinction of fear
occurs when fear decreases during repeated exposure to a previously CS which is now presented in the absence of the US
the key role of extinction learning in anxiety disorders
extinction learning & return of fear
extinction learning = creating new memory that feared stimulus is actually safe
The og fear association & the extinction association compete → the CS becomes an ambiguous stimulus
Extinction associations are typically weaker compared to the og fear association = recurrence of conditioned fear responding can occur with:
* Representation of the US = reinstatement
* Change of surrounding context = renewal
* Passage of time = spontaneous recovery
People w ADs show impaired extinction learning & memory
strategies to enhance exposure-based treatments
procedural strategies
- may enhance exposure excerises by focusing on maximized violation of threat expectancies, increasing variability & regulating specific emotions
- focus on creating optimal conditions for triggering dysfunctional threat expectancies that are at the core of the anxiety pathology
strategies to enhance exposure-based treatments
flanking strategies
Flanking strategies: aim to provide conditions that support learning during extinction, consolidation of the extinction memory, and retrieval of this memory
* Positive affect induction: recently been discussed as another strategy before extinction training → may be beneficial for extinction learning into therapeutic strategies
* sleep is another strategy
criticisms of early conditioning models for phobias
learning pathways to phobias
criticism: many people with phobias do not appear to have had a history of classical conditioning with their phobic object
* Vicarious threat learning = the acquisition of CRs via observational means
* instructional threat learning might be effective in the acquisition of fears (wagner’s SOP model)
* also, patients often report a conscious knowledge that a feared stimulus is safe, yet they find that this understanding is not sufficient to extinguish their fearful reactions
criticisms of early conditioning models for phobias
individual differences
criticsm: many who endure traumatic experiences do not go on to develop phobias
* some people have a genetic vulnerability to phobias
* Personality could affect individual predisposition to phobias by affecting the speed, strength, and/or extinction of CRs - bheavioral inhibition, trait anxiety & neuroticism all increase likelihood
