Karin Mogg

A cognitive-motivational analysis of anxiety.

Evidence of preattentive and attentional biases in anxiety is evaluated from a cognitive-motivational perspective. According to this analysis, vulnerability to anxiety stems mainly from a lower threshold for appraising threat, rather than a bias in the direction of attention deployment. Thus, relatively innocuous stimuli are evaluated as having higher subjective threat value by high than low trait anxious individuals, and it is further assumed that everyone orients to stimuli that are judged to be significantly threatening. This account is contrasted with other recent cognitive models of anxiety, and implications for the etiology, maintenance and treatment of anxiety disorders are discussed.

Amygdala and Ventrolateral Prefrontal Cortex Activation to Masked Angry Faces in Children and Adolescents with Generalized Anxiety Disorder

CONTEXT Vigilance for threat is a key feature of generalized anxiety disorder (GAD). The amygdala and the ventrolateral prefrontal cortex constitute a neural circuit that is responsible for detection of threats. Disturbed interactions between these structures may underlie pediatric anxiety. To date, no study has selectively examined responses to briefly presented threats in GAD or in pediatric anxiety. OBJECTIVE To investigate amygdala and ventrolateral prefrontal cortex activation during processing of briefly presented threats in pediatric GAD. DESIGN Case-control study. SETTING Government clinical research institute. PARTICIPANTS Youth volunteers, 17 with GAD and 12 without a psychiatric diagnosis. MAIN OUTCOME MEASURES We used functional magnetic resonance imaging to measure blood oxygenation level-dependent signal. During imaging, subjects performed an attention-orienting task with rapidly presented (17 milliseconds) masked emotional (angry or happy) and neutral faces. RESULTS When viewing masked angry faces, youth with GAD relative to comparison subjects showed greater right amygdala activation that positively correlated with anxiety disorder severity. Moreover, in a functional connectivity (psychophysiological interaction) analysis, the right amygdala and the right ventrolateral prefrontal cortex showed strong negative coupling specifically to masked angry faces. This negative coupling tended to be weaker in youth with GAD than in comparison subjects. CONCLUSIONS Youth with GAD have hyperactivation of the amygdala to briefly presented masked threats. The presence of threat-related negative connectivity between the right ventrolateral prefrontal cortex and the amygdala suggests that the prefrontal cortex modulates the amygdala response to threat. In pediatric GAD, amygdala hyperresponse occurs in the absence of a compensatory increase in modulation by the ventrolateral prefrontal cortex.

Selective attention to angry faces in clinical social phobia

This study investigated the time course of attentional responses to emotional facial expressions in a clinical sample with social phobia. With a visual probe task, photographs of angry, happy, and neutral faces were presented at 2 exposure durations: 500 and 1250 ms. At 500 ms, the social phobia group showed enhanced vigilance for angry faces, relative to happy and neutral faces, in comparison with normal controls. In the 1250-ms condition, there were no significant attentional biases in the social phobia group. Results are consistent with a bias in initial orienting to threat cues in social anxiety. Findings are discussed in relation to recent cognitive models of anxiety disorders.

Subliminal processing of emotional information in anxiety and depression.

The study investigated selective processing of emotional information in anxiety and depression using a modified Stroop color naming task. Anxious (n = 19), depressed (n = 18), and normal control (n = 18) subjects were required to name the background colors of anxiety-related, depression-related, positive, categorized, and uncategorized neutral words. Half of the words were presented supraliminally, half subliminally. Anxious subjects, compared with depressed and normal subjects, showed relatively slower color naming for both supraliminal and subliminal negative words. The results suggest a preattentive processing bias for negative information in anxiety.

Attentional Bias for Threatening Facial Expressions in Anxiety: Manipulation of Stimulus Duration

The study investigated the time course of attentional biases for emotional facial expressions in high and low trait anxious individuals. Threat, happy, and neutral face stimuli were presented at two exposure durations, 500 and 1250msec, in a forced-choice reaction time (RT) version of the dot probe task. There was clear evidence of an attentional bias favouring threatening facial expressions, but not emotional faces in general, in high trait anxiety. Increased dysphoria was associated with a tendency to avoid happy faces. No evidence was found of avoidance following initial vigilance for threat in this nonclinical sample. Methodological and theoretical implications of the results are discussed.

Attentional Bias in Generalized Anxiety Disorder Versus Depressive Disorder

This review evaluates evidence of attentional biases in generalized anxiety disorder (GAD) and depressive disorder from studies using modified Stroop and visual probe tasks. There appears to be fairly consistent evidence for an attentional bias for external negative cues in GAD, and for the involvement of non-conscious processes in this bias. By contrast, in clinical depression, the evidence for an attentional bias is less robust, despite depressive disorder being commonly associated with high levels of co-morbid anxiety. Where an attentional bias has been found in depressed patients, it seems to occur mainly for self-relevant negative information which is presented under conditions that allow or encourage elaborative processing. Possible explanations for this discrepant pattern of results, and their theoretical and clinical implications are discussed.

Selective orienting of attention to masked threat faces in social anxiety.

The aims of the study were two-fold: to examine whether previous evidence of a pre-attentive bias for masked threat faces in anxious individuals could be replicated, and to assess the relationship between the predicted bias and measures of trait and social anxiety. Pairs of face stimuli were briefly displayed and masked in a modified version of the visual probe task. Results indicated that high anxious individuals were faster to respond to probes occurring in the spatial location of masked threat rather than neutral faces; consistent with their attention being automatically captured by sub-threshold threat cues. Furthermore, this vigilance effect for masked threat faces appeared to be primarily a function of social anxiety and social avoidance, rather than trait anxiety. It was also more apparent when threat faces were presented in the left visual field, suggestive of right hemisphere involvement.

Orienting of Attention to Threatening Facial Expressions Presented under Conditions of Restricted Awareness

Three studies investigated whether individuals preferentially allocate attention to the spatial location of threatening faces presented outside awareness. Pairs of face stimuli were briefly displayed and masked in a modified version of the dot-probe task. Each face pair consisted of an emotional (threat or happy) and neutral face. The hypothesis that preattentive processing of threat results in attention being oriented towards its location was supported in Experiments 1 and 3. In both studies, this effect was most apparent in the left visual field, suggestive of right hemisphere involvement. However, in Experiment 2 where awareness of the faces was less restricted (i.e. marginal threshold conditions), preattentive capture of attention by threat was not evident. There was evidence from Experiment 3 that the tendency to orient attention towards masked threat faces was greater in high than low trait anxious individuals.

Time course of attentional bias for threat information in non-clinical anxiety.

A modified version of the probe detection task was used to investigate the effect of stimulus exposure duration on attentional bias for threat stimuli in a non-clinical sample of subjects. Stimulus duration was manipulated in order to examine different components of the anxiety-related attentional bias, i.e. initial orienting versus maintenance of attention to threat. Word pairs were presented on a computer screen for 100, 500 or 1,500 msec, and immediately after the termination of the display of each pair, a dot probe appeared in the position of one of the words. Higher levels of state anxiety were associated with faster response latencies for probes that replaced threat words, rather than neutral words (i.e. attentional vigilance for threat). This bias was not significantly affected by the exposure duration of the word stimuli. Thus, the attentional bias for threat does not appear to vary significantly over this range (100-1,500 msec) in non-clinical anxiety; it is recommended that the time course of the attentional bias be investigated further in clinical anxiety.

Biases in eye movements to threatening facial expressions in generalized anxiety disorder and depressive disorder

The study investigated biases in selective attention to emotional face stimuli in generalized anxiety disorder (GAD) and depressive disorder, using a modified probe detection task. There were 4 face types: threatening, sad, happy, and neutral. Measures of attentional bias included (a) the direction and latency of the initial eye movement in response to the faces and (b) manual reaction time (RT) to probes replacing the face stimuli 1,000 ms after their onset. Results showed that individuals with GAD (without depressive disorder) were more likely to look first toward threat faces rather than neutral faces compared with normal controls and those with depressive disorder. They also shifted their gaze more quickly toward threat faces, rather than away from them, relative to the other two groups. There were no significant findings from the manual RT data. Implications of the results for recent theories of clinical anxiety and depression are discussed.