Sadia Najmi

Attentional bias toward suicide-related stimuli predicts suicidal behavior.

A long-standing challenge for scientific and clinical work on suicidal behavior is that people often are motivated to deny or conceal suicidal thoughts. The authors proposed that people considering suicide would possess an objectively measurable attentional bias toward suicide-related stimuli and that this bias would predict future suicidal behavior. Participants were 124 adults presenting to a psychiatric emergency department who were administered a modified emotional Stroop task and followed for 6 months. Suicide attempters showed an attentional bias toward suicide-related words relative to neutral words, and this bias was strongest among those who had made a more recent attempt. Importantly, this suicide-specific attentional bias predicted which people made a suicide attempt over the next 6 months, above and beyond other clinical predictors. Attentional bias toward more general negatively valenced words did not predict any suicide-related outcomes, supporting the specificity of the observed effect. These results suggest that suicide-specific attentional bias can serve as a behavioral marker for suicidal risk, and ultimately improve scientific and clinical work on suicide-related outcomes.

The effect of attention training on a behavioral test of contamination fears in individuals with subclinical obsessive-compulsive symptoms.

In the current study, we evaluated the effectiveness of attention training in individuals with subclinical obsessive-compulsive symptoms. We hypothesized that after completing attention training, participants would be more likely to complete steps in a hierarchy approaching their feared contaminant compared with participants in the control condition. Participants completed a probe detection task by identifying letters replacing one member of a pair of words (neutral or contamination related). We trained attention by building a contingency between the location of the contamination-related word in the active condition and not in the control condition. Participants in the active group showed a significant reduction in attention bias for threat and completed significantly more steps when approaching their feared objects compared with participants in the control group. Our results suggest that attention disengagement training may facilitate approaching feared objects in individuals with obsessive-compulsive symptoms.

Attention Training for Reducing Spider Fear in Spider-Fearful Individuals

Cognitive theorists propose that attentional biases for threatening information play an important role in the development and maintenance of anxiety disorders. If attentional biases for threat figure in the maintenance of anxiety, then the experimental reduction of the bias for threat (attention training) should reduce anxiety. We randomly assigned 41 spider-fearful individuals to receive either attention training (n=20) or control procedures (n=21). We used a modified dot-probe discrimination paradigm with photographs of spiders and cows to train attention. Training reduced attentional bias for spiders, but only temporarily. Although both groups declined in spider fear and avoidance, reduction in attentional bias did not produce significantly greater symptom reduction in the training group than in the control group. However, reduction in attentional bias predicted reduction in self-reported fear for the training group. The reduction in attentional bias for threat may have been insufficiently robust to produce symptom reduction greater than that produced by exposure to a live spider and spider photographs alone. Alternatively, attention training may be an unsuitable intervention for spider fear.

Attenuation of attention bias in obsessive-compulsive disorder

Cognitive theories of obsessive-compulsive disorder (OCD) suggest that the disorder is characterized by an attention bias towards personally relevant threatening material. However, existing research on attention bias in OCD has yielded conflicting findings. One possibility that might account for the null findings is that attention bias may diminish over the course of the experiment. The present study tested this hypothesis using a visual dot-probe task with idiographic word selection. Results from our study confirmed that individuals with OC symptoms show an attention bias towards idiographically selected, threatening information in the first block of trials, and that the degree of this bias is correlated with the severity of OC symptoms. The temporal pattern of attention bias over the course of the experiment was consistent with our hypothesis. A comparison of early and late blocks of trials revealed an attenuation of attention bias in individuals with OC symptoms, potentially reflecting habituation to threatening information over the course of the experiment.

The Effect of Modifying Automatic Action Tendencies on Overt Avoidance Behaviors

We used the Approach-Avoidance Task (AAT) to examine the role of automatic action tendencies. We hypothesized that, after manipulation of automatic action tendencies, participants would be more likely to approach feared objects when compared with participants in a control condition. Participants were instructed to push or pull a joystick, resulting in contamination-related and neutral pictures moving progressively away from or toward them, respectively. We manipulated approach by building a contingency between the arm movement and the picture type in the active condition but not in the control condition. Consistent with our hypothesis, participants in the active manipulation group showed facilitated automatic approach tendencies and reduced avoidance tendencies for contamination-related stimuli and completed more steps approaching their feared objects in a behavioral approach test compared with participants in the control group. Our results suggest that automatic action tendencies may play an important role in the maintenance of fear-related behavioral avoidance.

Automatic avoidance tendencies in individuals with contamination-related obsessive-compulsive symptoms

We used an approach-avoidance task (AAT) to examine response to threatening stimuli in 20 individuals high in contamination-related obsessive-compulsive symptoms (HCs) and 21 individuals low in contamination-related obsessive-compulsive symptoms (LCs). Participants were instructed to respond to contamination-related and neutral pictures by pulling a joystick towards themselves or by pushing it away from themselves. Moving the joystick changed the size of the image to simulate approaching or distancing oneself from the object. Consistent with our hypothesis, the HC group was significantly slower in pulling contamination-related pictures than in pulling neutral pictures, whereas in the LC group there was no difference between speed of pulling contamination-related pictures and neutral pictures. Contrary to our hypothesis, we did not find support for faster pushing away of contamination-related pictures than neutral pictures by the HC group. Moreover, the degree of avoidance of contamination-related stimuli when pulling - but not when pushing - was significantly correlated with self-reported contamination-related obsessive-compulsive symptoms. These results suggest a biased behavioral response for threatening objects in individuals high in contamination fears only when inhibiting the prepotent response to avoid threatening stimuli and not when performing a practiced avoidance response. Thus, our results validate the use of the AAT as a measure of inhibited and uninhibited automatic avoidance reactions to emotional information in individuals with contamination-related obsessive-compulsive symptoms.

The Gravity of Unwanted Thoughts: Asymmetric Priming Effects in Thought Suppression

An unwanted thought appears to be cued easily by reminders in the environment but often the thought itself seems to cue nothing more than the desire to eliminate it from consciousness. This unusual asymmetry in the way unwanted thoughts are linked to other thoughts was the focus of the present research. Participants who were asked to suppress a thought or to concentrate on it completed a task assessing the influence of priming on reaction time (RT) for word/non-word judgments. Results revealed that suppression under cognitive load produced asymmetric priming: Priming with the associate of a suppressed word speeded RT for the suppressed word, but priming with a suppressed word did not speed RT for associated words. These findings suggest that thought suppression induces an unusual form of cognitive accessibility in which movement of activation toward the suppressed thought from associates is facilitated but movement of activation away from the suppressed thought to associates is undermined.

Interpretation of Ambiguity in Individuals with Obsessive-Compulsive Symptoms

In two experiments we examined the psychometric properties of a new measure of interpretation bias in individuals with obsessive-compulsive symptoms (OCs). In Experiment 1, 38 individuals high in OC symptoms, 34 individuals high in anxiety and dysphoric symptoms, and 31 asymptomatic individuals completed the measure. Results revealed that the Word Sentence Association Test for OCD (WSAO) can differentiate those with OC symptoms from both a matched anxious/dysphoric group and a non-anxious/non-dysphoric group. In a second experiment, we tested the predictive validity of the WSAO using a performance-based behavioral approach test of contamination fears, and found that the WSAO was a better predictor of avoidance than an established measure of OC washing symptoms (Obsessive Compulsive Inventory-Revised, washing subscale). Our results provide preliminary evidence for the reliability and validity of the WSAO as well as its usefulness in predicting response to behavioral challenge above and beyond OC symptoms, depression, and anxiety.

ATTENTIONAL IMPAIRMENT IN ANXIETY: INEFFICIENCY IN EXPANDING THE SCOPE OF ATTENTION

The ability to attend to relevant visual information in a proficient manner is central to most day‐to‐day tasks. Research suggests, however, that this ability is compromised by anxiety such that anxiety results in narrowing the focus of visual attention.

Executive control of attention in individuals with contamination-related obsessive-compulsive symptoms.

Background: In this study, we examined executive control of attention in individuals with contamination‐related obsessive–compulsive (OC) symptoms using a modified version of the Eriksen flanker task. The task indexes ones ability to resolve attentional conflict between different responses and to ignore task distracters. Methods: For this study, we modified the original flanker task using affective words to examine the effect of threat‐relevant stimuli on executive control of attention. Consistent with research on information processing biases in individuals with OC symptoms, we hypothesized that the flanker interference effect (i.e., difference in response latencies between incongruent and congruent flanker trials) will be greater for threat‐related flankers in individuals with OC symptoms (n=32), relative to a control group (n=36). Results: Results of our study were consistent with our hypothesis: The interference effect for threat flankers was greater in individuals with OC symptoms than in those low in symptoms. Moreover, there was no differential interference effect in the low and high symptom groups for neutral flankers. Conclusions: These findings suggest that the presence of threat‐relevant distracters disrupts executive control of attention in individuals with contamination‐related OC symptoms. These results are consistent with extant research on attentional biases in individuals with clinical and subclinical symptoms of OCD. Depression and Anxiety, 2010.