Attention and interpretation processes and trait anger experience, expression, and control.

This study explored attention and interpretation biases in processing facial expressions as correlates of theoretically distinct self-reported anger experience, expression, and control. Non-selected undergraduate students (N = 101) completed cognitive tasks measuring attention bias, interpretation bias, and Spielberger's State-Trait Anger Expression Inventory (STAXI-2). Attention bias toward angry faces was associated with higher trait anger and anger expression and with lower anger control-in and anger control-out. The propensity to quickly interpret ambiguous faces as angry was associated with greater anger expression and its subcomponent of anger expression-out and with lower anger control-out. Interactions between attention and interpretation biases did not contribute to the prediction of any anger component suggesting that attention and interpretation biases may function as distinct mechanisms. Theoretical and possible clinical implications are discussed.

Drug rash with eosinophilia and systemic symptoms syndrome: sex and the causative agent.

The study was conducted to determine whether there is a sex difference in the causative agent of drug rash with eosinophilia and systemic symptoms (DRESS) syndrome. A retrospective review of hospital records from 1999 to 2006 in the dermatology department of a large municipal medical center found 8 patients who met the criteria for DRESS syndrome: drug-induced generalized eruption, associated systemic involvement (lymph node or visceral), and presence of eosinophilia (eosinophil count > or =1500/microL and/or circulating atypical lymphocytes). There were 4 men and 4 women, aged 19 to 53 years, with a mean age of 38 years. A sex difference was found in 3 parameters: (1) age, younger age in women; (2) time interval between drug intake and rash, shorter in women; and (3) the culprit drug: carbamazepine in 2 men and 2 women, salazopyrin in 2 women, and phenytoin in 2 men. While the sample is small, there is an indication of sex differences in the DRESS syndrome.

Angry-happy interpretations of ambiguous faces in social anxiety disorder.

Social Anxiety Disorder (SAD) is characterized by a tendency to interpret ambiguous social cues as negative. Here we tested whether interpretation of ambiguous faces differs between participants with SAD and non-anxious controls. Twenty-seven individuals with SAD and 21 non-anxious control participants completed an emotion recognition task in which they judged ambiguous morphed faces as happy or angry. Participants with SAD judged a higher proportion of the faces as angry compared to non-anxious participants, and were slower to judge faces as angry compared to happy, while no such reaction time bias manifested in the control group. Finally, happy judgments were slower in the SAD group compared to the control group, while angry judgments were faster in the SAD group compared to the control group. These findings provide evidence for a negative bias in resolving emotional ambiguity in facial expressions among individuals with SAD.

An Open Pilot Study of Training Hostile Interpretation Bias to Treat Disruptive Mood Dysregulation Disorder.

OBJECTIVE: Irritability in disruptive mood dysregulation disorder (DMDD) may be associated with a biased tendency to judge ambiguous facial expressions as angry. We conducted three experiments to explore this bias as a treatment target. We tested: 1) whether youth with DMDD express this bias; 2) whether judgment of ambiguous faces can be altered in healthy youth by training; and 3) whether such training in youth with DMDD is associated with reduced irritability and associated changes in brain function. METHODS: Participants in all experiments made happy versus angry judgments of faces that varied along a happy to angry continuum. These judgments were used to quantify a "balance point," the facial expression at which a participant's judgment switches from predominantly happy to predominantly angry. We first compared balance points in youth with DMDD (n = 63) versus healthy youth (n = 26). We then conducted a double-blind, randomized controlled trial of active versus sham balance-point training in 19 healthy youth. Finally, we piloted open, active balance-point training in 14 youth with DMDD, with 10 completing an implicit functional MRI (fMRI) face-emotion processing task. RESULTS: Relative to healthy youth, DMDD youth manifested a shifted balance point, expressed as a tendency to classify ambiguous faces as angry rather than happy. In both healthy and DMDD youth, active training is associated with a shift in balance point toward more happy judgments. In DMDD, evidence suggests that active training may be associated with decreased irritability and changes in activation in the lateral orbitofrontal cortex. CONCLUSIONS: These results set the stage for further research on computer-based treatment targeting interpretation bias of angry faces in DMDD. Such treatment may decrease irritability and alter neural responses to subtle expressions of happiness and anger.

Reliability, validity and sensitivity of a computerized visual analog scale measuring state anxiety.

BACKGROUND AND OBJECTIVES: Assessment of state anxiety is frequently required in clinical and research settings, but its measurement using standard multi-item inventories entails practical challenges. Such inventories are increasingly complemented by paper-and-pencil, single-item visual analog scales measuring state anxiety (VAS-A), which allow rapid assessment of current anxiety states. Computerized versions of VAS-A offer additional advantages, including facilitated and accurate data collection and analysis, and applicability to computer-based protocols. Here, we establish the psychometric properties of a computerized VAS-A. METHODS: Experiment 1 assessed the reliability, convergent validity, and discriminant validity of the computerized VAS-A in a non-selected sample. Experiment 2 assessed its sensitivity to increase in state anxiety following social stress induction, in participants with high levels of social anxiety. RESULTS: Experiment 1 demonstrated the computerized VAS-A's test-retest reliability (r = .44, p < .001); convergent validity with the State-Trait Anxiety Inventory's state subscale (STAI-State; r = .60, p < .001); and discriminant validity as indicated by significantly lower correlations between VAS-A and different psychological measures relative to the correlation between VAS-A and STAI-State. Experiment 2 demonstrated the VAS-A's sensitivity to changes in state anxiety via a significant pre- to during-stressor rise in VAS-A scores (F(1,48) = 25.13, p < .001). LIMITATIONS: Set-order administration of measures, absence of clinically-anxious population, and gender-unbalanced samples. CONCLUSIONS: The adequate psychometric characteristics, combined with simple and rapid administration, make the computerized VAS-A a valuable self-rating tool for state anxiety. It may prove particularly useful for clinical and research settings where multi-item inventories are less applicable, including computer-based treatment and assessment protocols. The VAS-A is freely available: http://people.socsci.tau.ac.il/mu/anxietytrauma/visual-analog-scale/.

Subliminal attention bias modification training in socially anxious individuals.

Anxious individuals demonstrate threat-related attention biases both when threat stimuli are presented within conscious awareness and when presented below awareness threshold. Nevertheless, attention bias modification (ABM) research has rarely utilized sub-awareness protocols in an attempt to modify attention patterns and reduce anxiety. Exploring the potential of subliminal ABM is of interest, as it may target attention processes related to anxiety that are distinct from those engaged by supraliminal ABM. Here we examined the effect of a subliminal ABM training protocol on levels of social anxiety and stress vulnerability. Fifty-one socially anxious students were randomly assigned to either ABM or placebo condition, and completed a pre-training assessment, four training sessions, a social stressor task, and a post-training assessment. Results indicate that the subliminal ABM used here did not induce detectable changes in threat-related attention from pre- to post-training as measured by two independent attention tasks. Furthermore, the ABM and placebo groups did not differ on either self-reported social anxiety post-training or state anxiety following stress induction. Post-hoc auxiliary analyses suggest that ABM may be associated with smaller elevations in state anxiety during the stressor task only for participants who demonstrate attention bias toward threat at baseline. Implications and future research directions are discussed.

Orienting response elicitation by personally significant information under subliminal stimulus presentation: demonstration using the concealed information test.

Considerable evidence suggests that subliminal information can trigger cognitive and neural processes. Here, we examined whether elicitation of orienting response by personally significant (PS) verbal information requires conscious awareness of the input. Subjects were exposed to the Concealed Information Test (CIT), in which autonomic responses for autobiographical items are typically larger than for control items. These items were presented subliminally using two different masking protocols: single or multiple presentation of the masked item. An objective test was used to verify unawareness to the stimuli. As predicted, PS items elicited significantly stronger skin conductance responses than the control items in both exposure conditions. The results extend previous findings showing that autonomic responses can be elicited following subliminal exposure to aversive information, and also may have implications on the applied usage of the CIT.

Interstimulus intervals for skin conductance response measurement.

This study examined, using the Concealed Information paradigm, whether interstimulus intervals (ISI) typically used for electrodermal measurement can be shortened. An ISI ranging from 16 s to 24 s (with a mean of 20 s) was compared with an ISI shortened by 50% using a within-participants design. It was demonstrated that this shortening had no effect on the differential skin conductance responses to the personally significant details and nearly identical detection efficiency was observed under the 2 ISIs. However, overall responses were attenuated with the shorter ISI. The implications of these results for various types of studies, using skin conductance responses, were discussed.

Personally-significant information affects performance only within the focus of attention: a direct manipulation of attention.

It has been suggested that personally significant (PS) information interferes with performance only when presented within the focus of attention. However, this claim was never tested by a systematic manipulation of attention, but only by using correlative measures of its locus. We addressed this issue in two experiments, utilizing a cued visual search paradigm that allowed us to directly manipulate attention and to measure behavioral and physiological responses. One of the stimuli in the search display had a higher luminance value (i.e., was cued), and, orthogonally, one of the stimuli could be a PS or neutral name. When the cue did not predict target location, PS distractors mildly interfered with task performance, regardless of the cue's location. However, when the cue predicted target location, responses were facilitated for cued targets, indicating that attention was shifted to the cue. Importantly, PS distractors interfered with task performance and elicited enhanced orienting responses only when they were cued. This implies that PS information affects performance only when presented within but not outside the focus of attention.