Lisa M McTeague1, Marie-Claude Laplante2, Hailey W Bulls3, Joshua R Shumen4, Peter J Lang4, Andreas Keil4. 1. Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina. Electronic address: mcteague@musc.edu. 2. Women's Health Center, James A. Haley Veterans' Hospital, Tampa. 3. Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa. 4. Center for the Study of Emotion and Attention at the University of Florida, Gainesville, Florida.
Abstract
BACKGROUND: Theories of aberrant attentional processing in social anxiety, and anxiety disorders more broadly, have postulated an initial hypervigilance or facilitation to clinically relevant threats and consequent defensive avoidance. However, existing objective measurements utilized to explore this phenomenon lack the resolution to elucidate attentional dynamics, particularly covert influences. METHODS: We utilized a continuous measure of visuocortical engagement, the steady-state visual evoked potential in response to naturalistic angry, fearful, happy, and neutral facial expressions. Participants were treatment-seeking patients with principal diagnoses of social anxiety circumscribed to performance situations (n = 21) or generalized across interaction contexts (n = 42), treatment-seeking patients with panic disorder with agoraphobia (n = 25), and 17 healthy participants. RESULTS: At the principal disorder level, only circumscribed social anxiety patients showed sustained visuocortical facilitation to aversive facial expressions. Control participants as well as patients with panic disorder with agoraphobia and generalized social anxiety showed no bias. More finely stratifying the sample according to clinical judgment of social anxiety severity and interference revealed a linear increase in visuocortical bias to aversive expressions for all but the most severely impaired patients. This group showed an opposing sustained attentional disengagement. CONCLUSIONS: Rather than shifts between covert vigilance and avoidance of aversive facial expressions, social anxiety appears to confer a sustained bias for one or the other. While vigilant attention reliably increases with social anxiety severity for the majority of patients, the most impaired patients show an opposing avoidance. These distinct patterns of attentional allocation could provide a powerful means of personalizing neuroscience-based interventions to modify attention bias and related impairment.
BACKGROUND: Theories of aberrant attentional processing in social anxiety, and anxiety disorders more broadly, have postulated an initial hypervigilance or facilitation to clinically relevant threats and consequent defensive avoidance. However, existing objective measurements utilized to explore this phenomenon lack the resolution to elucidate attentional dynamics, particularly covert influences. METHODS: We utilized a continuous measure of visuocortical engagement, the steady-state visual evoked potential in response to naturalistic angry, fearful, happy, and neutral facial expressions. Participants were treatment-seeking patients with principal diagnoses of social anxiety circumscribed to performance situations (n = 21) or generalized across interaction contexts (n = 42), treatment-seeking patients with panic disorder with agoraphobia (n = 25), and 17 healthy participants. RESULTS: At the principal disorder level, only circumscribed social anxietypatients showed sustained visuocortical facilitation to aversive facial expressions. Control participants as well as patients with panic disorder with agoraphobia and generalized social anxiety showed no bias. More finely stratifying the sample according to clinical judgment of social anxiety severity and interference revealed a linear increase in visuocortical bias to aversive expressions for all but the most severely impairedpatients. This group showed an opposing sustained attentional disengagement. CONCLUSIONS: Rather than shifts between covert vigilance and avoidance of aversive facial expressions, social anxiety appears to confer a sustained bias for one or the other. While vigilant attention reliably increases with social anxiety severity for the majority of patients, the most impairedpatients show an opposing avoidance. These distinct patterns of attentional allocation could provide a powerful means of personalizing neuroscience-based interventions to modify attention bias and related impairment.
Authors: Julia D Buckner; Norman B Schmidt; Alan R Lang; Jason W Small; Robert C Schlauch; Peter M Lewinsohn Journal: J Psychiatr Res Date: 2007-02-23 Impact factor: 4.791
Authors: C Binelli; S Subirà; A Batalla; A Muñiz; G Sugranyés; J A Crippa; M Farré; L Pérez-Jurado; R Martín-Santos Journal: Neuropsychologia Date: 2014-09-04 Impact factor: 3.139
Authors: Rafaela R Campagnoli; Matthias J Wieser; L Forest Gruss; Maeve R Boylan; Lisa M McTeague; Andreas Keil Journal: Cortex Date: 2018-10-16 Impact factor: 4.027