RESUMO
Cognitive models of psychosis have stimulated empirical studies on cognitive biases involved in schizophrenia spectrum psychoses and their symptoms. This systematic review aimed to summarize the studies on the role of cognitive biases as assessed in different performance-based tasks in schizophrenia spectrum psychoses and clinical high-risk states. We focused on five cognitive biases linked to psychosis, i.e., aberrant salience, attentional biases, source monitoring biases, jumping to conclusions, and bias against disconfirmatory evidence. We identified N = 324 studies published in N = 308 articles fulfilling inclusion criteria. Most studies have been cross-sectional and confirmed that the schizophrenia spectrum psychoses are related to exaggerated cognitive biases compared to healthy controls. On the contrary, less evidence suggests a higher tendency for cognitive biases in the UHR sample. The only exceptions were source monitoring and jumping to conclusions, which were confirmed to be exaggerated in both clinical groups. Hallucinations and delusions were the most frequent symptoms studied in the context of cognitive biases. Based on the findings, we presented a hypothetical model on the role of interactions between cognitive biases or additive effects of biases in shaping the risk of psychosis. Future research is warranted for further development of cognitive models for psychosis.
Assuntos
Transtornos Psicóticos , Esquizofrenia , Humanos , Transtornos Psicóticos/psicologia , Transtornos Psicóticos/fisiopatologia , Esquizofrenia/fisiopatologia , Psicologia do Esquizofrênico , Viés de Atenção/fisiologia , Delusões/fisiopatologia , Delusões/psicologiaRESUMO
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.
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Viés de Atenção , Fobia Social , Adulto , Humanos , Avaliação Momentânea Ecológica , Reprodutibilidade dos Testes , Smartphone , Transtornos de Ansiedade , Viés de Atenção/fisiologiaRESUMO
Background and aims: Theories posit that the combination of external (e.g. cue exposure) and internal (e.g. attention biases) factors contributes to the development of game craving. Nevertheless, whether different components of attentional biases (namely, engagement bias and disengagement bias) play separate roles on game craving has not been fully elucidated. We aimed to examine the associations between two facets of attentional biases and game craving dynamics under a daily life setting. Methods: Participants (110 regular internet game players) accomplished the modified attentional assessment task in the laboratory, after which they entered a 10-day ecological momentary assessment (EMA) to collect data on their momentary game craving and occurrence of game-related events at five different time points per day. Results: We found that occurrence of game-related events was significantly associated with increased game craving. Moreover, attentional disengagement bias, instead of engagement bias, bore on the occasional level variations of game craving as moderating variables. Specifically, attentional disengagement bias, not engagement bias, was associated with a greater increase in game craving immediately after encountering a game-related event; however, neither attentional engagement bias nor disengagement bias was associated with the craving maintenance after a relatively long period. Discussion and conclusions: The present study highlights the specific attentional processes involved in game craving dynamics, which could be crucial for designing interventions for attentional bias modification (ABM) in Internet Gaming Disorder (IGD) populations.
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Viés de Atenção , Fissura , Humanos , Avaliação Momentânea Ecológica , Atenção , Sinais (Psicologia)RESUMO
The current work aimed to uncover the pattern of attention given to external comparison standards when engaged in social judgments. In a series of 5 experiments (N = 463), a Modified Spatial Cueing Task provided evidence for a general Comparison Induced Delay (CID), but found no signs of visuospatial attention (Pilot, Study 1 & 2). However, the CID did not occur if cues did not remain visually available throughout the trials (Study 3 & 4). Heterogeneity in results prompted the use of a single-paper meta-analysis including all secondary studies. A consistent CID effect was found across studies when standards remained visually available (K = 5), but not when they were masked (K = 2). No direct signs of visuospatial attentional bias were found. These results suggest that the attentional cost of engaging with external comparisons is mainly cognitive in nature, although a minor reoccurring visual component could not be excluded.
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Atenção , Viés de Atenção , Humanos , Sinais (Psicologia)RESUMO
Attentional deficits as well as attentional biases towards negative material are related to major depression and might maintain chronicity. However, studies investigating attentional deficits and attentional biases in chronic, treatment-resistant depressed are lacking. The aim of the current study was to compare measures of attentional deficits and attentional bias between chronic, treatment-resistant depressed outpatients and never-depressed control participants. Attentional deficits were assessed with the attentional control scale (ACS) and the Stroop Color naming task. Attentional bias was measured with the exogenous cueing task (ECT) and an emotional Stroop task. Chronic, treatment-resistant depressed patients (n = 80) showed significantly more attentional deficits than never-depressed controls (n = 113) on the ACS and Stroop color-naming task. However, in contrast with hypotheses, no differences were found between chronic, treatment-resistant depressed patients and never-depressed individuals on the ECT or emotional Stroop task. The current findings indicate that chronic, treatment-resistant depressed patients present attentional deficits. The results however question whether this patient group shows attentional biases for negative material. Future research should include comparisons of chronic, treatment-resistant and non-chronically depressed patients. If replicated, these current results might indicate that focusing on improving attentional deficits could be a more promising target for treatment than addressing attentional biases.
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Viés de Atenção , Transtorno Depressivo Maior , Atenção , Depressão , Transtorno Depressivo Maior/tratamento farmacológico , Emoções , HumanosRESUMO
Contemporary debates about addressing inequality require a common, accurate understanding of the scope of the issue at hand. Yet little is known about who notices inequality in the world around them and when. Across five studies (N = 8,779) employing various paradigms, we consider the role of ideological beliefs about the desirability of social equality in shaping individuals' attention to-and accuracy in detecting-inequality across the class, gender, and racial domains. In Study 1, individuals higher (versus lower) on social egalitarianism were more likely to naturalistically remark on inequality when shown photographs of urban scenes. In Study 2, social egalitarians were more accurate at differentiating between equal versus unequal distributions of resources between men and women on a basic cognitive task. In Study 3, social egalitarians were faster to notice inequality-relevant changes in images in a change detection paradigm indexing basic attentional processes. In Studies 4 and 5, we varied whether unequal treatment adversely affected groups at the top or bottom of society. In Study 4, social egalitarians were, on an incentivized task, more accurate at detecting inequality in speaking time in a panel discussion that disadvantaged women but not when inequality disadvantaged men. In Study 5, social egalitarians were more likely to naturalistically point out bias in a pattern detection hiring task when the employer was biased against minorities but not when majority group members faced equivalent bias. Our results reveal the nuances in how our ideological beliefs shape whether we accurately notice inequality, with implications for prospects for addressing it.
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Viés de Atenção , Política , Discriminação Social/psicologia , Fatores Socioeconômicos , Adulto , Atitude , Feminino , Humanos , MasculinoRESUMO
INTRODUCTION: Altered attention to threatening stimuli at initial and sustained stages of processing may be dissociable dimensions that influence the development and maintenance of transdiagnostic symptoms of anxiety, such as vigilance, and possibly require distinct intervention. Attention bias modification (ABM) interventions were created to implicitly train attention away from threatening stimuli and have shown efficacy in treating anxiety. ABM alters neurocognitive functioning during initial stages of threat processing, but less is known regarding effects of ABM on neural indices of threat processing at sustained (i.e., intermediate and late) stages, or if ABM-related neural changes relate to symptom response. The current study utilized pupillary response as a temporally sensitive and cost-effective peripheral marker of neurocognitive response to ABM. MATERIALS AND METHODS: In a randomized controlled trial, 79 patients with transdiagnostic anxiety provided baseline data, 70 were randomized to receive eight sessions of twice-weekly ABM (n = 49) or sham training (n = 21), and 65 completed their assigned treatment condition and returned for post-training assessment. RESULTS: Among ABM, but not sham, patients, pupillary response to threat words during initial and intermediate stages decreased from pre- to post-training. Pre- to post-training reductions in intermediate and late pupillary response to threat were positively correlated with reductions in patient-reported vigilance among ABM, but not sham, patients. CONCLUSIONS: All measured stages of threat processing had relevance in understanding the neural mechanisms of ABM, with overlapping yet dissociable roles exhibited within a single neurophysiological marker across an initial-intermediate-late time continuum. Pupillometry may be well suited to measure both target engagement and treatment outcome following ABM.
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Transtornos de Ansiedade , Viés de Atenção , Adulto , Ansiedade/diagnóstico , Ansiedade/terapia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/terapia , Análise Custo-Benefício , Feminino , Humanos , Masculino , Resultado do TratamentoRESUMO
Theoretical models propose that attentional biases might account for the maintenance of social anxiety symptoms. However, previous eye-tracking studies have yielded mixed results. One explanation is that existing studies quantify eye-movements using arbitrary, experimenter-defined criteria such as time segments and regions of interests that do not capture the dynamic nature of overt visual attention. The current study adopted the Eye Movement analysis with Hidden Markov Models (EMHMM) approach for eye-movement analysis, a machine-learning, data-driven approach that can cluster people's eye-movements into different strategy groups. Sixty participants high and low in self-reported social anxiety symptoms viewed angry and neutral faces in a free-viewing task while their eye-movements were recorded. EMHMM analyses revealed novel associations between eye-movement patterns and social anxiety symptoms that were not evident with standard analytical approaches. Participants who adopted the same face-viewing strategy when viewing both angry and neutral faces showed higher social anxiety symptoms than those who transitioned between strategies when viewing angry versus neutral faces. EMHMM can offer novel insights into psychopathology-related attention processes.
Assuntos
Ansiedade/psicologia , Viés de Atenção/fisiologia , Emoções/fisiologia , Movimentos Oculares/fisiologia , Expressão Facial , Adulto , Ansiedade/fisiopatologia , Feminino , Hong Kong , Humanos , Masculino , Cadeias de Markov , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Adulto JovemRESUMO
Facilitated attention toward angry stimuli (attention bias) may contribute to anger proneness and temper outbursts exhibited by children with high irritability. However, most studies linking attention bias and irritability rely on behavioral measures with limited precision and no studies have explored these associations in young children. The present study explores irritability-related attention biases toward anger in young children (N = 128; ages 4-7 years) engaged in a dot-probe task with emotional faces, as assessed with event-related brain potential (ERP) indices of early selective attention and multi-method assessment of irritability. Irritability assessed via semi-structured clinical interview predicted larger anterior N1 amplitudes to all faces. In contrast, irritability assessed via a laboratory observation paradigm predicted reduced P1 amplitudes to angry relative to neutral faces. These findings suggest that altered early attentional processing occurs in young children with high irritability; however, the nature of these patterns may vary with methodological features of the irritability assessments. Future investigations using different assessment tools may provide greater clarity regarding the underlying neurocognitive correlates of irritability. Such studies may also contribute to the ongoing debates about how to best define and measure irritability across the developmental spectrum in a manner that is most informative for linkage to neural processes.
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Viés de Atenção/fisiologia , Expressão Facial , Humor Irritável/fisiologia , Ira , Ansiedade , Criança , Pré-Escolar , Eletroencefalografia/métodos , Potenciais Evocados/fisiologia , Feminino , Felicidade , Humanos , Masculino , Tempo de Reação/fisiologiaRESUMO
Generalized Anxiety Disorder (GAD) is a prevalent, impairing, and undertreated psychiatric disorder. We examined if a home-based computerized treatment program can feasibly be delivered and successfully treat GAD symptoms. Using a randomized control trial, we compared three active groups receiving computerized sequenced Attention Bias Modification (ABM) followed by Applied Relaxation psychoeducation (AR-pe), the reversed sequence of AR-pe and ABM, and a simultaneous ABM and AR-pe group to an assessment only control group. The participants comprised 169 adults with a diagnosis of GAD. We asked participants to complete as many as twenty-four 30-min sessions of an at-home computerized treatment program over 12 weeks. The control group received 24 brief assessment questionnaires as well as assessments of attention bias. Results from intent-to-treat analyses show faster rate of improvement for symptoms of anxiety as measured by the Hamilton Anxiety Rating Scale (HAM-A) over time in groups that received active training in contrast to the clinical monitoring (CM) control group. Follow-up analyses revealed that both sequenced groups improved in anxiety when compared to the control group, while the simultaneous group did not outperform the control group. Results suggest that sequenced delivery of ABM and AR, may be a viable home-based treatment option for individuals with GAD who have limited access to resources or are otherwise unable to seek available treatments that require engagement outside of the home. TRIAL REGISTRATION: clinicaltrial. gov Identifier: NCT00602563.
Assuntos
Transtornos de Ansiedade/terapia , Viés de Atenção , Terapia Cognitivo-Comportamental/métodos , Acessibilidade aos Serviços de Saúde , Terapia de Relaxamento/métodos , Terapia Assistida por Computador/métodos , Adulto , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Resultado do TratamentoRESUMO
Socioeconomic disadvantage is associated with higher rates of psychopathology as well as hippocampus, amygdala and prefrontal cortex structure. However, little is known about how variations in brain morphometry are associated with socio-emotional risks for mood disorders in children growing up in families experiencing low income. In the current study, using structural magnetic resonance imaging, we examined the relationship between socioeconomic disadvantage and gray matter volume in the hippocampus, amygdala, and ventrolateral prefrontal cortex in a sample of children (n = 34) in middle childhood. Using an affective dot probe paradigm, we examined the association between gray matter volume in these regions and attentional bias to threat, a risk marker for mood disorders including anxiety disorders. We found that lower income-to-needs ratio was associated with lower bilateral hippocampal and right amygdala volume, but not prefrontal cortex volumes. Moreover, lower attentional bias to threat was associated with greater left hippocampal volume. We provide evidence of a relationship between income-related variations in brain structure and attentional bias to threat, a risk for mood disorders. Therefore, these findings support an environment-morphometry-behavior relationship that contributes to the understanding of income-related mental health disparities in childhood.
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Viés de Atenção , Encéfalo/anatomia & histologia , Substância Cinzenta/anatomia & histologia , Fatores Socioeconômicos , Tonsila do Cerebelo/anatomia & histologia , Tonsila do Cerebelo/fisiologia , Viés de Atenção/fisiologia , Encéfalo/fisiologia , Criança , Feminino , Substância Cinzenta/fisiologia , Hipocampo/anatomia & histologia , Hipocampo/fisiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Tamanho do Órgão , Pobreza/psicologia , Córtex Pré-Frontal/anatomia & histologia , Córtex Pré-Frontal/fisiologiaRESUMO
Experiment 1 aimed to establish "fearful" and "pleasant" functions for arbitrary stimuli (geometric shapes) by relating those stimuli to pictures of spiders and pets using a training version of the Implicit Relational Assessment Procedure (IRAP). The transformation of these functions for the arbitrary stimuli was assessed by exposing participants to a 'traditional' version of the IRAP, the Fear-IRAP employed by Leech et al. (2016, 2017). A broadly similar pattern of response biases was recorded for the Fear-IRAP as had been observed in the previously published studies. Experiment 1 thus supported the assumed but untested assumption that the relational context provided by the IRAP may both serve to establish and reveal fear-related response biases in arbitrary stimuli. A second experiment attempted to replicate the effects observed in Experiment 1 but using pictures of 'unfamiliar' Australian marsupials as arbitrary stimuli. The pattern of results obtained in Experiment 2 failed to replicate the pattern observed in Experiment 1, or that reported in the previously published studies by Leech et al. Overall, the findings suggest a possibly important boundary condition for the IRAP as a training and/or testing context for establishing fear-related response biases for arbitrary stimuli.
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Viés de Atenção , Aprendizagem da Esquiva , Medo/psicologia , Testes Psicológicos , Transferência de Experiência , Animais , Sinais (Psicologia) , Feminino , Humanos , Masculino , Aranhas , Adulto JovemRESUMO
Prior research has shown that loneliness is associated with hypervigilance to social threats, with eye-tracking research showing lonely people display a specific attentional bias when viewing social rejection and social exclusion video footage (Bangee, Harris, Bridges, Rotenberg & Qualter, 2014; Qualter, Rotenberg, Barrett et al., 2013). The current study uses eye-tracker methodology to examine whether that attentional bias extends to negative emotional faces and negative social non-rejecting stimuli, or whether it could be explained only as a specific bias to social rejection/exclusion. It is important to establish whether loneliness relates to a specific or general attention bias because it may explain the maintenance of loneliness. Participants (N = 43, F = 35, Mage = 20 years and 2 months, SD = 3 months) took part in three tasks, where they viewed different social information: Task 1 - slides displaying four faces each with different emotions (anger, afraid, happy and neutral), Task 2 - slides displaying sixteen faces with varying ratios expressing happiness and anger, and Task 3 - slides displaying four visual scenes (socially rejecting, physically threatening, socially positive, neutral). For all three tasks, eye movements were recorded in real time with an eye-tracker. Results showed no association between loneliness and viewing patterns of facial expressions, but an association between loneliness and hypervigilant viewing of social rejecting stimuli. The findings indicate that lonely adults do not have a generalised hypervigilance to social threat, but have, instead, a specific attentional bias to rejection information in social contexts. Implications of the findings for interventions are discussed.
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Viés de Atenção/fisiologia , Reconhecimento Facial/fisiologia , Solidão/psicologia , Distância Psicológica , Percepção Social , Adulto , Feminino , Humanos , Masculino , Adulto JovemRESUMO
Objective This study aimed to analyse the psychological conditions and behaviour of a group of Chinese children and adolescents with obesity, and to develop an intervention for these young patients. Methods A group of 72 patients aged from 4 to 15 years were recruited from an obesity clinic. Patients, or the parents of children younger than 12 years, filled out a series of self-report questionnaires, and the responses were recorded and analysed. Results The 72 children and adolescents with obesity had a mean age of 9.14 ± 2.18 years. The body mass index-z scores of children with obesity showed a significant positive correlation with the level of impulsive behaviour, motivational impulses, and cognitive instability (inattention). Children with obesity quickly responded with extreme emotions, and these responses were positively correlated with the degree of obesity (slight, intermediate, or severe obesity). Conclusion Children and adolescents being treated for obesity have many underlying psychological problems, including emotional instability and impulsivity, and are prone to extreme emotional-psychological problems. These difficulties are positively correlated with the degree of obesity. Therefore, clinical treatment of these problems requires not only use of medication, improved nutrition, and healthy exercise, but also addressing underlying psychologic problems.
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Sintomas Afetivos/psicologia , Viés de Atenção , Comportamento Impulsivo , Humor Irritável , Obesidade/psicologia , Adolescente , Sintomas Afetivos/fisiopatologia , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Obesidade/fisiopatologia , Pais/psicologia , Inquéritos e QuestionáriosRESUMO
This article reviews the trajectory of our research program on selective attention, which has moved from basic research on the neural processes underlying selective attention to translational studies using selective attention as a neurobiological target for evidence-based interventions. We use this background to present a promising preliminary investigation of how genetic and experiential factors interact during development (i.e., gene × intervention interactions). Our findings provide evidence on how exposure to a family-based training can modify the associations between genotype (5-HTTLPR) and the neural mechanisms of selective attention in preschool children from lower socioeconomic status backgrounds.
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Atenção/fisiologia , Potenciais Evocados/fisiologia , Plasticidade Neuronal/genética , Proteínas da Membrana Plasmática de Transporte de Serotonina/genética , Viés de Atenção/fisiologia , Pré-Escolar , Medicina Baseada em Evidências/métodos , Humanos , Fatores SocioeconômicosRESUMO
Reinforcing efficacy of food, or the relationship between food prices and purchasing, is related to obesity status and energy intake in adults. Determining how to allocate resources for food is a decision making process influenced by executive functions. Attention to appetitive cues, as well as working memory capacity, or the ability to flexibly control attention while mentally retaining information, may be important executive functions involved in food purchasing decisions. In two studies, we examined how attention bias to food and working memory capacity are related to reinforcing efficacy of both high energy-dense and low energy-dense foods. The first study examined 48 women of varying body mass index (BMI) and found that the relationship between attentional processes and reinforcing efficacy was moderated by working memory capacity. Those who avoid food cues and had high working memory capacity had the lowest reinforcing efficacy, as compared to those with low working memory capacity. Study 2 systematically replicated the methods of study 1 with assessment of maintained attention in a sample of 48 overweight/obese adults. Results showed the relationship between maintained attention to food cues and reinforcing efficacy was moderated by working memory capacity. Those with a maintained attention to food and high working memory capacity had higher reinforcing efficacy than low working memory capacity individuals. These studies suggest working memory capacity moderated the relationship between different aspects of attention and food reinforcement. Understanding how decision making process are involved in reinforcing efficacy may help to identify future intervention targets.
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Viés de Atenção , Memória de Curto Prazo , Reforço Psicológico , Adulto , Índice de Massa Corporal , Comportamento de Escolha , Cognição , Sinais (Psicologia) , Ingestão de Alimentos/psicologia , Função Executiva , Feminino , Preferências Alimentares/psicologia , Humanos , Obesidade/metabolismo , Obesidade/psicologia , Sobrepeso/metabolismo , Sobrepeso/psicologia , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto JovemRESUMO
The "organic" claim explicitly informs consumers about the food production method. Yet, based on this claim, people often infer unrelated food attributes. The current research examined whether the perceived advantage of organic over conventional food generalizes across different organic food types. Compared to whole organic foods, processed organic foods are less available, familiar and prototypical of the organic food category. In two studies (combined N = 258) we investigated how both organic foods types were perceived in healthfulness, taste and caloric content when compared to their conventional alternatives. Participants evaluated images of both whole (e.g., lettuce) and processed organic food exemplars (e.g., pizza), and reported general evaluations of these food types. The association of these evaluations with individual difference variables - self-reported knowledge and consumption of organic food, and environmental concerns - was also examined. Results showed that organically produced whole foods were perceived as more healthful, tastier and less caloric than those produced conventionally, thus replicating the well-established halo effect of the organic claim in food evaluation. The organic advantage was more pronounced among individuals who reported being more knowledgeable about organic food, consumed it more frequently, and were more environmentally concerned. The advantage of the organic claim for processed foods was less clear. Overall, processed organic (vs. conventional) foods were perceived as tastier, more healthful (Study 1) or equally healthful (Study 2), but also as more caloric. We argue that the features of processed food may modulate the impact of the organic claim, and outline possible research directions to test this assumption. Uncovering the specific conditions in which food claims bias consumer's perceptions and behavior may have important implications for marketing, health and public-policy related fields.
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Comportamento do Consumidor , Dieta Saudável , Ingestão de Energia , Manipulação de Alimentos , Preferências Alimentares , Alimentos Orgânicos/análise , Paladar , Adolescente , Adulto , Viés de Atenção , Comportamento do Consumidor/economia , Dieta Saudável/economia , Feminino , Rotulagem de Alimentos , Alimentos Orgânicos/efeitos adversos , Alimentos Orgânicos/economia , Alimentos em Conserva/efeitos adversos , Alimentos em Conserva/análise , Alimentos em Conserva/economia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Internet , Masculino , Inquéritos Nutricionais , Valor Nutritivo , Cooperação do Paciente , Portugal , Adulto JovemRESUMO
Arousing stimuli, either threat-related or pleasant, may be selected for priority at different stages within the processing stream. Here we examine the pattern of processing for non-task-relevant threatening (spiders: arousing to some) and pleasant stimuli (babies or chocolate: arousing to all) by recording the gaze of a spider Fearful and Non-fearful group while they performed a simple "follow the cross" task. There was no difference in first saccade latencies. Saccade trajectories showed a general hypervigilance for all stimuli in the Fearful group. Saccade landing positions corresponded to what each group would find arousing, such that the Fearful group deviated towards both types of images whereas the Non-fearful group deviated towards pleasant images. Secondary corrective saccade latencies away from threat-related stimuli were longer for the Fearful group (difficulty in disengaging) compared with the Non-fearful group. These results suggest that attentional biases towards arousing stimuli may occur at different processing stages.
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Viés de Atenção/fisiologia , Emoções/fisiologia , Movimentos Oculares/fisiologia , Motivação/fisiologia , Alocação de Recursos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estimulação Luminosa , Adulto JovemRESUMO
BACKGROUND: Despite the range of available, evidence-based treatment options for Major Depressive Disorder (MDD), the rather low response and remission rates suggest that treatment is not optimal, yet. Computerized attention bias modification (ABM) trainings may have the potential to be provided as cost-effective intervention as adjunct to usual care (UC), by speeding up recovery and bringing more patients into remission. Research suggests, that a selective attention for negative information contributes to development and maintenance of depression and that reducing this negative bias might be of therapeutic value. Previous ABM studies in depression, however, have been limited by small sample sizes, lack of long-term follow-up measures or focus on sub-clinical samples. This study aims at evaluating the long-term (cost-) effectiveness of internet-based ABM, as add-on treatment to UC in adult outpatients with MDD, in a specialized mental health care setting. METHODS/DESIGN: This study presents a double-blind randomized controlled trial in two parallel groups with follow-ups at 1, 6, and 12 months, combined with an economic evaluation. One hundred twenty six patients, diagnosed with MDD, who are registered for specialized outpatient services at a mental health care organization in the Netherlands, are randomized into either a positive training (towards positive and away from negative stimuli) or a sham training, as control condition (continuous attentional bias assessment). Patients complete eight training sessions (seven at home) during a period of two weeks (four weekly sessions). Primary outcome measures are change in attentional bias (pre- to post-test), mood response to stress (at post-test) and long-term effects on depressive symptoms (up to 1-year follow-up). Secondary outcome measures include rumination, resilience, positive and negative affect, and transfer to other cognitive measures (i.e., attentional bias for verbal stimuli, cognitive control, positive mental imagery), as well as quality of life and costs. DISCUSSION: This is the first study investigating the long-term effects of ABM in adult outpatients with MDD, alongside an economic evaluation. Next to exploring the mechanism underlying ABM effects, this study provides first insight into the effects of combining ABM and UC and the potential implementation of ABM in clinical practice. TRIAL REGISTRATION: Trialregister.nl, NTR5285 . Registered 20 July 2015.
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Viés de Atenção , Terapia Cognitivo-Comportamental/métodos , Análise Custo-Benefício , Transtorno Depressivo Maior/terapia , Adolescente , Adulto , Idoso , Assistência Ambulatorial/métodos , Protocolos Clínicos , Terapia Cognitivo-Comportamental/economia , Transtorno Depressivo Maior/economia , Transtorno Depressivo Maior/psicologia , Método Duplo-Cego , Emoções , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Países Baixos , Pacientes Ambulatoriais/psicologia , Qualidade de Vida , Resultado do Tratamento , Adulto JovemRESUMO
Since the programmatic Rosenhan study, there is a broad discussion of how to actively construct clinical realities on both "insane" and "sane" perspectives. To inform patients about the output of the psychometric questionnaires assessed at intake is a required task in many clinical routines. Information processing bias toward psychopathology may impact many clinical communications and thus lead to clinical errors. Based on an output of the commonly used Symptom Check List 90, case examples demonstrate various grades of balanced and unbalanced alternatives of how to consider the psychopathological as well as the unproblematic poles of Likert scales in discussing psychometric questionnaires at Session 1. We provide one clinical error related to client information at intake assessments and offer four therapeutic tasks that can serve as observable quality indicators of how to facilitate a balanced picture of the patients' burdens and capabilities: (1) validate individual problems, (2) isolate individual problems, (3) validate individual strengths, and (4) break through black and white thinking. (PsycINFO Database Record