Working Memory Training and CBT Reduces Anxiety Symptoms and Attentional Biases to Threat: A Preliminary Study.

Research indicates that cognitive processes linked to the detection of threat stimuli are associated with poor attentional control, placing children and adolescents at increased risk for the development of anxious affect. The current study aimed to provide preliminary data to assess whether an intervention designed to improve attentional control (via working memory; WM) would lead to better performance in tests of WM and would be associated with positive changes in symptoms of trait and test anxiety, increased inhibitory control and reduced attention to threat. Forty adolescents aged 11-14 years who reported elevated anxiety and low attentional control were randomly allocated to a WM training or an active cognitive behavioural therapy (CBT) control group. Post intervention, WM training was associated with greater improvements (versus. CBT) in trained WM tasks. Both groups, however, reported fewer anxiety symptoms, demonstrated increased inhibitory control and a reduction in attentional biases to threat post intervention and these results were maintained at follow up. The study provides indicative evidence which suggests that WM training has similar benefits to a more traditional CBT intervention on reduced anxiety and attentional biases for threat. Future research should aim to replicate the findings in a large sample size and explore the broader impact of training on day-to-day functioning. In addition, further research is needed to identify which participants benefit most from different interventions (using baseline characteristics) on treatment compliance and outcome.

Exploring the function of selective attention and hypervigilance for threat in anxiety.

Theoretical frameworks of anxiety propose that attentional biases to threat-related stimuli cause or maintain anxious states. The current paper draws on theoretical frameworks and key empirical studies to outline the distinctive attentional processes highlighted as being important in understanding anxiety. We develop a conceptual framework to make a distinction between two attentional biases: selective attention to threat and hypervigilance for threat. We suggest that these biases each have a different purpose and can account for the typical patterns of facilitated and impaired attention evident in anxious individuals. The framework is novel in its specification of the eye movement behavior associated with these attentional biases. We highlight that selective attention involves narrowing overt attention onto threat to ensure that these stimuli receive processing priority, leading to rapid engagement with task-relevant threat and delayed disengagement from task-irrelevant threat. We show that hypervigilance operates in the presence and absence of threat and involves monitoring for potential dangers via attentional broadening or excessive scanning of the environment with numerous eye movements, leading to improved threat detection and increased distraction from task-irrelevant threat. We conclude that future research could usefully employ eye movement measures to more clearly understand the diverse roles of attention in anxiety.

An electrophysiological monetary incentive delay (e-MID) task: a way to decompose the different components of neural response to positive and negative monetary reinforcement.

BACKGROUND: The ability to anticipate and then secure future rewards and avoid future punishments by responding effectively to environmental demands is at the core of successful decision making. Disruptions to these processes have been shown to be implicated in a number of psychiatric conditions. In the current paper we use the electrophysiological monetary incentive delay task (e-MID) to decompose the neural response to (i) reinforcement anticipation, (ii) reinforcement-contingent target processing and (iii) reinforcement-related feedback. METHODS: Thirty-eight adolescents and young adults performed an ERP-based analogue of the monetary incentive delay task. ERP components previously associated with motivationally salient cue (cue-P3 and contingent negative variation, CNV), target (P3) and feedback (success vs. failure; feedback-related negativity; FRN and the late positive potential; LPP) stimuli were examined. RESULTS: Response times were shorter and less variable in the monetary gain and loss conditions. Distinctive ERP components were observed for each phase of reinforcement processing. First, cue-P3 was enhanced to monetary gain cues. Predicted alterations in cue-P3 following monetary loss cues and the CNV following cues of either monetary loss or gain were not observed. Target P3 was enhanced in both incentive conditions. The FRN was greater following monetary loss feedback. LPP amplitude was enhanced following feedback denoting monetary gain and the avoidance of monetary loss. CONCLUSION: Although behaviourally the effects of monetary loss and gain were similar, the e-MID task differentiated neural processing in terms of anticipation and feedback-related brain potentials. The e-MID task and the results of the current study provide a valuable complement to fMRI-based approaches to studying normal and abnormal brain correlates of reinforcement processing.

The attentional processes underlying impaired inhibition of threat in anxiety: the remote distractor effect.

The current study explored the proposition that anxiety is associated with impaired inhibition of threat. Using a modified version of the remote distractor paradigm, we considered whether this impairment is related to attentional capture by threat, difficulties disengaging from threat presented within foveal vision, or difficulties orienting to task-relevant stimuli when threat is present in central, parafoveal and peripheral locations in the visual field. Participants were asked to direct their eyes towards and identify a target in the presence and absence of a distractor (an angry, happy or neutral face). Trait anxiety was associated with a delay in initiating eye movements to the target in the presence of central, parafoveal and peripheral threatening distractors. These findings suggest that elevated anxiety is linked to difficulties inhibiting task-irrelevant threat presented across a broad region of the visual field.

Electrophysiological markers of the motivational salience of delay imposition and escape.

BACKGROUND: The ubiquitous tendency to choose immediate over delayed rewards can, in extremis, lead to maladaptive preferences for smaller sooner over larger later rewards (i.e., impulsive choice) in certain pathological groups. The delay aversion hypothesis provides one possible account of impulsive choice and argues that this tendency is motivated by the avoidance of the negative affective states associated with delay imposed prior to the delivery of a large reward. This model also predicts that on non-choice tasks individuals will be motivated to work harder and more efficiently, when given the opportunity to avoid delay. In the current paper we studied the neural markers of the motivational salience of the imposition and escape from delay using a simple reaction time task under two conditions: First where fast responses were expected to lead to delay escape and second where delay was inescapable. METHODS: Forty participants performed the Escape Delay Incentive (EDI) task during which they were asked to respond as quickly as they could to a target stimulus. The EDI task included two conditions: first, a Delay Escape condition where fast responses led to the avoidance of delay and a Delay No-Escape condition in which a delay was presented on every trial irrespective of response speed. EEG was recorded from 66 equidistant electrode sites across the scalp. The neural response in these two conditions was compared in terms of contingent negative variation (CNV; preparation of motivated responses) and late positive potential, LPP; evaluation of performance feedback). RESULTS: As predicted individuals responded more quickly and showed enhanced CNV amplitude to Delay Escape compared with Delay No-Escape trials. Enhanced LPP amplitude was also observed when participants were not able to avoid the delay in the Delay Escape condition. ADHD symptoms were associated with larger CNV differences between Delay Escape and Delay No-Escape conditions. An association between ADHD symptoms and the LPP in the Delay Escape condition did not reach significance. CONCLUSION: The results of the current study suggest that delay escape is a potent reinforcer at both behavioural and neural levels. Future research should extend this analysis to clinical samples using a broader range of delays and across imaging modalities.

The influence of anxiety on processing capacity for threat detection.

In the present study, we explored the proposition that an individual's capacity for threat detection is related to his or her trait anxiety. Using a redundant signals paradigm with concurrent measurements of reaction times and eye movements, participants indicated the presence or absence of an emotional target face (angry or happy) in displays containing no targets, one target, or two targets. We used estimates of the orderings on the hazard functions of the RT distributions as measures of processing capacity (Townsend & Ashby, 1978; Wenger & Gibson, Journal of Experimental Psychology. Human Perception and Performance, 30,708-719, 2004) to assess whether self-reported anxiety and the affective state of the face interacted with the level of perceptual load (i.e., the number of targets). Results indicated that anxiety was associated with fewer eye movements and increased processing capacity to detect multiple (vs. single) threatening faces. The data are consistent with anxiety influencing threat detection via a broadly tuned attentional mechanism (Eysenck, Derakshan, Santos, & Calvo, Emotion, 7,336-353, 2007).