Cited by 1,049Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesVisual Attention and Saliency DetectionNeural and Behavioral Psychology Studies

The DOI matches its Crossref record; 144 of the 144 references it cites were found in a registry or an index; none of the 103 sources its claims cite is checked for support yet.

Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis

Open access

Armstrong, Thomas, Olatunji, Bunmi O.·2012·Clinical Psychology Review

DOI 10.1016/j.cpr.2012.09.004PMC PMC3556338

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Abstract

A large body of research has demonstrated that affective disorders are characterized by attentional biases for emotional stimuli. However, this research relies heavily on manual reaction time (RT) measures that cannot fully delineate the time course and components of attentional bias. Eye tracking technology, which allows relatively direct and continuous measurement of overt visual attention, may provide an important supplement to RT measures. This article reviews eye tracking research on anxiety and depression, evaluating the experimental paradigms and eye movement indicators used to study attentional biases. Also included is a meta-analysis of extant eye tracking research (33 experiments; N=1579) on both anxiety and depression. Relative to controls, anxious individuals showed increased vigilance for threat during free viewing and visual search, and showed difficulty disengaging from threat in visual search tasks, but not during free viewing. In contrast, depressed individuals were not characterized by vigilance for threat during free viewing, but were characterized by reduced orienting to positive stimuli, as well as reduced maintenance of gaze on positive stimuli and increased maintenance of gaze on dysphoric stimuli. Implications of these findings for theoretical accounts of attentional bias in anxiety and depression are discussed, and avenues for future research using eye-tracking technology are outlined.

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TL;DR

This meta-analytic review synthesizes 33 eye-tracking experiments (N = 1579) on attentional biases in anxiety and depression. Anxiety was linked to increased vigilance for threat, while depression was linked to reduced orienting to and maintenance of positive stimuli and increased maintenance of dysphoric stimuli.

Key findings

Anxious individuals showed an orienting bias toward threat in free viewing compared with non-anxious individuals (k = 20; g = .47, p < .001, CI = .25, .69; FSN = 203), but no significant orienting bias toward pleasant stimuli (k = 11; g = .11, p = .38).
Depressed individuals did not show an orienting bias toward threat (k = 4; g = −.01, p = .95), but showed reduced orienting toward pleasant stimuli (k = 6; g = −.24, p < .05, CI = −.47, −.004; FSN = 6).
In free viewing, anxious individuals did not differ overall in initial maintenance of gaze on threat (k = 16; g = −.17, p = .26), though spider phobia showed decreased maintenance (k = 3; g = −1.02, p < .001) and PTSD showed marginally increased maintenance (k = 2; g = .60, p = .05).
In visual search, anxious individuals fixated threatening targets faster (k = 4; g = −.59, p < .04) and maintained attention longer on threatening distractors (k = 5; g = .54, p < .01); depressed individuals showed longer extended maintenance of gaze on dysphoric stimuli (k = 6; g = .46, p < .01) and less on positive stimuli (k = 6; g = −.80, p < .001).

Methods

PsycINFO and PubMed were searched for eye-tracking studies of anxiety or depression in adults; inclusion required eye tracking (video-based infrared or electro-oculography), adult anxiety/depression, and simultaneous emotional and neutral stimuli in regular arrays competing for attention.
The meta-analysis included 33 experiments with 1579 participants (anxious N = 563; non-anxious N = 532; depressed N = 162; non-depressed N = 257; unselected N = 65); 28 experiments used free viewing (N = 1337) and 5 used visual search in anxiety (N = 242).
Effect sizes used Hedges’s g with random-effects models; heterogeneity was tested with Q and I², moderators with categorical and meta-regression analyses, and publication bias with fail-safe N.

Limitations

The paper states that eye tracking measures overt attention only and may miss covert attentional allocation, especially for the maintenance hypothesis; free viewing studies may fail to observe maintenance biases if they occur covertly before initial fixation.
The paper states that several analyses relied on small numbers of studies, including depression orienting (k = 4), depression positive orienting (k = 6), depression extended maintenance (k = 6), and visual search (k = 5, mostly spider phobia k = 4), limiting generalizability.
The paper states that few studies examined threat beyond 3 seconds, so the full time course of attentional bias could not be realized; evident from the text, anxiety analyses showed significant heterogeneity and moderator analyses provided limited explanation.

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Registry

Crossref · 10.1016/j.cpr.2012.09.004

Cites

144 of 144 references verified0 citation errors · 0 not checkable

Statistics

19 tests recomputed · 1 with the reported and recomputed p on opposite sides of .05

Claims the paper makes

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Show all 132 claims

It may state two separate claims as one. 56
Probably not a substantial claim. 33

In the paper
“This bias appears to be specific to threatening stimuli, as anxious individuals did not show an orienting bias towards positive stimuli compared to non-anxious individuals, as would be predicted under the emotionality hypothesis (Calvo & Avero, 2005).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Implications for the Vigilance hypothesis
What the sources say
- Not checked yetcites Calvo & Avero, 2005
Load-bearingStrength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The present review integrates a total of 33 eye tracking experiments with 1579 participants”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Results
Load-bearingStrength:plain· not yet calibratedn = 1,579
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
- Rests on an assumption: Eye tracking has the potential to address enduring questions in research on attentional biases.
None of the sources cited for this claim have been checked yet.
In the paper
“This finding is also consistent with Peckham et al.’s (2010) recent review, which found reduced initial attention allocation to positive stimuli in depressed individuals (c.f., Derakshan et al., 2009b).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Gaze biases in anxiety compared to depression
What the sources say
- Not checked yetcites Peckham et al.’s (2010) source
- Not checked yetcites Derakshan et al., 2009b
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The sustained maintenance of gaze on real spiders found byLange et al. (2004) contrasts with the sustained avoidance of gaze on mere images of spiders found over 3 s (Hermans et al., 1999; Rinck & Becker, 2006), 9 s (Pflugshaupt et al., 2007) and 60 s (Rinck & Becker, 2006) trials.”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Implications for the maintenance hypothesis
What the sources say
- Not checked yetcites Hermans et al., 1999 source
- Not checked yetcites Rinck & Becker, 2006
- Not checked yetcites Pflugshaupt et al., 2007 source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“This finding is consistent with a recent meta-analysis of RT studies of attentional bias in depression, which found no bias for threatening stimuli in depressed compared to non-depressed individuals (Peckham et al., 2010; see also Mogg & Bradley, 2005).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Gaze biases in anxiety compared to depression
What the sources say
- Not checked yetcites Peckham et al., 2010 source
- Not checked yetcites Mogg & Bradley, 2005 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“However, effect sizes were mostly consistent across studies of depression, and the combined effects were largely consistent with RT research on attentional biases in depression (Peckham et al., 2010).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Limitations
What the sources say
- Not checked yetcites Peckham et al., 2010 source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“a smaller literature suggesting an attentional bias for dysphoric stimuli and possible neglect of positive stimuli in depression (Peckham, McHugh, & Otto, 2010)”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Overview
What the sources say
- Not checked yetcites Peckham, McHugh, & Otto, 2010 source
Load-bearingStrength:hedged· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“In research on anxiety disorders, it is still unclear to what extent increased processing of threat reflects facilitated orienting toward threat versus difficulty disengaging attention from threat (Weierich, Treat, & Hollingworth, 2008).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Overview
What the sources say
- Not checked yetcites Weierich, Treat, & Hollingworth, 2008
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“in naturalistic viewing, EMs are the primary means of attentional selection, with covert attention largely relegated to guiding EMs (Hayhoe & Ballard, 2005; Findlay & Gilchrist, 2003).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Overview
What the sources say
- Not checked yetcites Hayhoe & Ballard, 2005
- Not checked yetcites Findlay & Gilchrist, 2003
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“An orienting bias for threat in free viewing did not characterize depressed individuals compared to non-depressed individuals, suggesting that vigilance for threat is specific to anxiety (Mogg & Bradley, 2005).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion
What the sources say
- Not checked yetcites Mogg & Bradley, 2005 source
Load-bearingStrength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“The within-groups effects alone were not interpretable, as the search conditions without threatening stimuli were not always matched for difficulty with the conditions containing distractors (e.g., Miltner et al., 2004).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Methods > Operational definition of vigilance and maintenance
What the sources say
- Not checked yetcites Miltner et al., 2004 source
Load-bearingStrength:plain· not yet calibrated
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It may state two separate claims as one.
In the paper
“Whereas emotional stimuli can undermine endogenous control in the initial maintenance of gaze, such stimulus-driven effects appear to wane quickly in the later maintenance of gaze (Nummenmaa, et al., 2006).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Advancing theoretical accounts of attentional bias with eye tracking > EM indicators of attentional bias in depression
What the sources say
- Not checked yetcites Nummenmaa, et al., 2006 source
Load-bearingStrength:hedged· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“Whereas an exogenous orienting bias for threatening targets would result in fewer fixations on neutral distractors, facilitated detection of threatening targets could also be achieved through shorter fixations on neutral distractors (c.f. Rinck & Becker, 2006).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Implications for the Vigilance hypothesis
What the sources say
- Not checked yetcites Rinck & Becker, 2006
Strength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Threats related to traumatic events (combat: Kimble et al., 2012; physical assault: Felmingham et al., 2011) present greater urgency and danger compared to spiders, and thus may be more difficult to ignore.”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Implications for the maintenance hypothesis
What the sources say
- Not checked yetcites Kimble et al., 2012
- Not checked yetcites Felmingham et al., 2011 source
Load-bearingStrength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“As Nummenmaa and colleagues (2006) note, reflexive saccades typical of purely exogenous capture (e.g., resulting from the sudden onset of a stimulus with a sharply contrasting basic feature) have a latency of 150 to 175 ms (Rayner, 1998).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Implications for the Vigilance hypothesis
What the sources say
- Not checked yetcites Nummenmaa and colleagues (2006)
- Not checked yetcites Rayner, 1998 source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Gaze avoidance may be particularly strong in spider phobia because spider fearful individuals find spiders disgusting (e.g., Mulkens, de Jong, & Merckelbach, 1996), and may be revolted by the perceptual features of spiders (Royzman & Sabini, 2001).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Implications for the maintenance hypothesis
What the sources say
- Not checked yetcites Mulkens, de Jong, & Merckelbach, 1996
- Not checked yetcites Royzman & Sabini, 2001
Strength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, an alternative explanation is that anxious individuals decide whether or not to sustain attention on threat according to a cost-benefit analysis.”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Implications for the maintenance hypothesis
Strength:hedged· not yet calibratedCausal:direct· not yet calibrated
Tests✗ Asserted: fails✓ Checkable: passes✗ Load-bearing: fails✗ Based: fails
Probably not a substantial claim. The authors may not put it forward as true. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
- Rests on an assumption: Threatening stimuli, as danger cues, likely occur on a continuum of urgency.
In the paper
“Inhibitory control deficits related to anxiety (Eysenck et al., 2007) may be more threat-specific in the engagement of attention compared to the shifting of attention because more information is available once a stimulus is engaged, reducing ‘false alarms.’”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Implications for the maintenance hypothesis
What the sources say
- Not checked yetcites Eysenck et al., 2007 source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“This finding is consistent with RT research suggesting that when spider phobics anticipate the possibility of a spider distractor, the stimulus-driven system becomes dominant, leading to increased exogenous shifting to all distractors (Devue, Belopolsky, & Theeuwes, 2011).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Implications for the maintenance hypothesis
What the sources say
- Not checked yetcites Devue, Belopolsky, & Theeuwes, 2011
Strength:hedged· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, these individuals may feel compelled to continue monitoring more urgent danger cues (e.g., a live tarantula in a nearby box) at the cost of increased anxiety.”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Implications for the maintenance hypothesis
Strength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: fails
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
- Rests on an assumption: Threatening stimuli, as danger cues, likely occur on a continuum of urgency.
In the paper
“Although this finding could reflect more frequent shifting of gaze to threatening distractors (Miltner et al., 2008), rather than difficulty disengaging gaze from these distractors (Rinck & Becker, 2006), Gerdes, Alpers, and Pauli (2008) found that spider phobics were slower to detect a neutral target due to longer fixations rather than more frequent fixations on a spider distractor, suggesting”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Implications for the maintenance hypothesis
What the sources say
- Not checked yetcites Gerdes, Alpers, and Pauli (2008)
Load-bearingStrength:hedged· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In tripartite structural theories of internalizing disorders (e.g., Clark & Watson, 1991), the development of anxiety and depression can be understood in terms of a general factor (e.g., negative affect or neuroticism) that confers risk for both disorders, as well as disorder-specific factors, such as anxious arousal or low positive affect, which specifically confer risk for anxiety or depression,”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Gaze biases in anxiety compared to depression
What the sources say
- Not checked yetcites Clark & Watson, 1991 source
- Not checked yetcites Oehlberg, Revelle, & Mineka, 2011
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
In the paper
“Derakshan, Ansari, Hansard, Shoker, and Eysenck (2009) found that anxious individuals were able to execute saccades away from a threatening face as effectively as non-anxious individuals (i.e., with similar error rates); however, their correct saccades away from threatening faces had longer latencies, suggesting less efficiency disengaging covert attention from threatening faces in order to”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Implications for the maintenance hypothesis
What the sources say
- Not checked yetcites Derakshan, Ansari, Hansard, Shoker, and Eysenck (2009)
Load-bearingStrength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“As Berggren and Derakshan (in press) explain, anxious individuals may be able to disengage attention as effectively as non-anxious individuals in certain contexts, but such disengagement is less efficient, as anxious individuals apply more effort in order to compensate for attentional control deficits.”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Implications for the maintenance hypothesis
What the sources say
- Not checked yetcites Berggren and Derakshan (in press)
Strength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“This additional effort may compensate for, and thus conceal, difficulty disengaging attention from threat in anxious individuals (Ansari & Derakshan, 2011b), reducing the sensitivity of free viewing tasks in detecting this bias.”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Implications for the maintenance hypothesis
What the sources say
- Not checked yetcites Ansari & Derakshan, 2011b
Load-bearingStrength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Given that anxious individuals rate threatening stimuli as more unpleasant (e.g., Rinck & Becker, 2006), and have been observed to voluntarily terminate exposure to threatening images sooner compared to non-anxious individuals (Tolin, Lohr, Lee, & Sawchuk, 1999), it follows that anxious individuals have a greater affective incentive to disengage attention from threat, and may exert more effort”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Implications for the maintenance hypothesis
What the sources say
- Not checked yetcites Rinck & Becker, 2006
- Not checked yetcites Tolin, Lohr, Lee, & Sawchuk, 1999
Load-bearingStrength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Indeed, training attention over longer viewing windows (e.g., 3 s, 4.5 s; Wells & Beevers, 2010) appears to be more effective at modifying attentional bias in depression and reducing symptoms of depression, compared to training over a shorter viewing period (1.5 s; Baert, De Raedt, Schacht, & Koster, 2010).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Clinical implications: Eye tracking and attention modification procedures
What the sources say
- Not checked yetcites Wells & Beevers, 2010
- Not checked yetcites Baert, De Raedt, Schacht, & Koster, 2010 source
Load-bearingStrength:hedged· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“A positivity bias appears to promote resilience (see Wadlinger & Isaacowitz, 2011), and initial evidence suggests that biases for positive stimuli can be induced through training and may have beneficial effects (Wadlinger & Isaacowitz, 2008).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Clinical implications: Eye tracking and attention modification procedures
What the sources say
- Not checked yetcites Wadlinger & Isaacowitz, 2011 source
- Not checked yetcites Wadlinger & Isaacowitz, 2008
Strength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“These authors cite Fox et al.’s (2001) spatial cueing study, which found greater difficulty disengaging covert attention from incongruent threat cues presented at 100 ms or 250 ms SOAs in anxious individuals compared to controls.”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Limitations
What the sources say
- Not checked yetcites Fox et al.’s (2001) source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Concerns have been raised about training attention away from threat in anxiety, as it could engender attentional avoidance of threat, which is believed to impair emotional processing and maintain anxiety (Koster, Baert, Bockstaele, & De Raedt, 2010).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Clinical implications: Eye tracking and attention modification procedures
What the sources say
- Not checked yetcites Koster, Baert, Bockstaele, & De Raedt, 2010
Load-bearingStrength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“Indeed, Koster et al., (2010) found that training attention away from threat did not affect vigilance for threat in the modified dot probe (100 ms SOA); however, it did lead to later avoidance of threat (1500 ms SOA), a bias similar to that observed in spider phobia in the present meta-analysis.”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Clinical implications: Eye tracking and attention modification procedures
What the sources say
- Not checked yetcites Koster et al., (2010) source
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“Deldin, Deveney, Kim, Casas, and Best (2001) found that individuals with major depressive disorder show a reduced slow wave (SW) component while maintaining positive adjectives in working memory, compared to controls.”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Gaze biases in anxiety compared to depression
What the sources say
- Not checked yetcites Deldin, Deveney, Kim, Casas, and Best (2001)
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Recently there have been a number of studies demonstrating that training attention away from threat leads to functional improvement in anxiety (Hallion & Ruscio, 2011), and one study suggests an analogous effect related to dysphoric stimuli in depression (Wells & Beevers, 2010).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Clinical implications: Eye tracking and attention modification procedures
What the sources say
- Not checked yetcites Hallion & Ruscio, 2011 source
- Not checked yetcites Wells & Beevers, 2010
Strength:boosted· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“In the unweighted version of the dot probe (which is used as a control condition in training studies), EMs to either cue have been found to occur on 30% of trials overall; some individuals make EMs on more than half of trials, whereas others hardly make any EMs (Bradley, Mogg, & Millar, 2000).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Clinical implications: Eye tracking and attention modification procedures
What the sources say
- Not checked yetcites Bradley, Mogg, & Millar, 2000
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“Behavioral research has also found that depression is characterized by decreased maintenance of positive stimuli in working memory relative to controls (Levens & Gotlib, 2010).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Gaze biases in anxiety compared to depression
What the sources say
- Not checked yetcites Levens & Gotlib, 2010
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Likewise, shorter fixations on threat, but not increased overall dwell time, has been found in contamination fear (Armstrong et al., 2012)”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Future Directions
What the sources say
- Not checked yetcites Armstrong et al., 2012 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“In the analysis of vigilance for threat in visual search tasks, the absence of an initial orienting bias for threat in anxiety suggests that such boundary conditions are present, and likely depend on one of these factors or their interaction (Acunzo & Henderson, 2011).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Future Directions
What the sources say
- Not checked yetcites Acunzo & Henderson, 2011
Strength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Basic research suggests that the ability of threatening stimuli to capture gaze is affected by how many competing stimuli are present (perceptual load; Yates et al., 2010) and how far into the periphery stimuli are presented (eccentricity; Calvo, Nummenmaa, & Hyönä, 2006).”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Future Directions
What the sources say
- Not checked yetcites Yates et al., 2010 source
- Not checked yetcites Calvo, Nummenmaa, & Hyönä, 2006
Load-bearingStrength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“Pflugshaupte et al. (2005) embedded spiders in images of household scenes and found evidence of avoidance in the distance between a fixation’s coordinates and the nearest spider; further, they examined this relationship as a function of the ordinal number of the fixation”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Future Directions
What the sources say
- Not checked yetcites Pflugshaupte et al. (2005)
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“Sears et al. (2010) found that depressed individuals were slower initiating saccades away from dysphoric images, but not other image types (i.e., threatening, pleasant, neutral) compared to non-depressed individuals, a maintenance bias that was not revealed in a free viewing condition of their study.”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Future Directions
What the sources say
- Not checked yetcites Sears et al. (2010) source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The present meta-analytic findings suggest that increased maintenance of gaze on threat in anxiety is best observed in a task in which all participants are explicitly required to disengage attention from threat.”
§ Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis > Discussion > Future Directions
Strength:hedged· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: fails
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
- Rests on an assumption: In free viewing tasks, participants are not required to resist orienting to threat.

81 of 81

The paper relies on this without support.
Eye tracking has the potential to address enduring questions in research on attentional biases.
“Given the potential of eye tracking to address enduring questions in research on attentional biases, a meta-analysis was conducted on the extant literature.”
The paper relies on this without support.
Threatening stimuli, as danger cues, likely occur on a continuum of urgency.
“Threatening stimuli, as danger cues, likely occur on a continuum of urgency.”
The paper relies on this without support.
In free viewing tasks, participants are not required to resist orienting to threat.
“In free viewing tasks, participants are not required to resist orienting to threat”

3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Statistics that don’t add up

Each reported p-value recomputed from its test statistic and degrees of freedom.

Inconsistent p-value across alpha = .05: Q (4) = 4.54, p < .05
Major
The paper reports p < .05 here; recomputing from the test statistic and its degrees of freedom gives p = .338. The two fall on opposite sides of alpha = .05. The check cannot tell whether the statistic or the p-value is the misprint.
Reported p < .05 · recomputed p = .338
Inconsistent p-value: Q (5) = .66, p = .97
Minor
The paper reports p = .97 here; recomputing from the test statistic and its degrees of freedom gives p = .985. The check cannot tell whether the statistic or the p-value is the misprint.
Reported p = .97 · recomputed p = .985
Inconsistent p-value: Q (3) = .55, p = .95
Minor
The paper reports p = .95 here; recomputing from the test statistic and its degrees of freedom gives p = .908. The check cannot tell whether the statistic or the p-value is the misprint.
Reported p = .95 · recomputed p = .908
Inconsistent p-value: Q (5) = 4.75, p = .55
Minor
The paper reports p = .55 here; recomputing from the test statistic and its degrees of freedom gives p = .447. The check cannot tell whether the statistic or the p-value is the misprint.
Reported p = .55 · recomputed p = .447
Inconsistent p-value: Q (1) = 3.54, p = .05
Minor
The paper reports p = .05 here; recomputing from the test statistic and its degrees of freedom gives p = .060. The check cannot tell whether the statistic or the p-value is the misprint.
Reported p = .05 · recomputed p = .060
Inconsistent p-value: Q (2) = .05, p = .79
Minor
The paper reports p = .79 here; recomputing from the test statistic and its degrees of freedom gives p = .975. The check cannot tell whether the statistic or the p-value is the misprint.
Reported p = .79 · recomputed p = .975

6 of 6

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

Doesn’t add upQ(4) = 4.54reported p < .05 · recomputed p = .338The two fall on opposite sides of .05
“Q (4) = 4.54, p < .05”
Doesn’t add upQ(3) = 0.55reported p = .95 · recomputed p = .908
“Q (3) = .55, p = .95”
Doesn’t add upQ(5) = 4.75reported p = .55 · recomputed p = .447
“Q (5) = 4.75, p = .55”
Doesn’t add upQ(1) = 3.54reported p = .05 · recomputed p = .060
“Q (1) = 3.54, p = .05”
Doesn’t add upQ(2) = 0.05reported p = .79 · recomputed p = .975
“Q (2) = .05, p = .79”
Doesn’t add upQ(5) = 0.66reported p = .97 · recomputed p = .985
“Q (5) = .66, p = .97”
ConsistentQ(19) = 47.09reported p < .001 · recomputed p < .001
“Q (19) = 47.09, p < .001”
ConsistentQ(10) = 17.66reported p = .06 · recomputed p = .061
“Q (10) = 17.66, p = .06”
ConsistentQ(1) = 6.72reported p = .01 · recomputed p = .010
“Q (1) = 6.72, p = .01”
ConsistentQ(5) = 8.78reported p = .12 · recomputed p = .118
“Q (5) = 8.78, p = .12”
ConsistentQ(15) = 58.08reported p < .001 · recomputed p < .001
“Q (15) = 58.08, p < .001”
ConsistentQ(4) = 24.13reported p < .001 · recomputed p < .001
“Q (4) = 24.13, p < .001”
ConsistentQ(4) = 23.45reported p < .001 · recomputed p < .001
“Q (4) = 23.45, p < .001”
ConsistentQ(1) = 0.1reported p = .76 · recomputed p = .752
“Q (1) = .10, p = .76”
ConsistentQ(5) = 1.9reported p = .86 · recomputed p = .863
“Q (5) = 1.9, p = .86”
ConsistentQ(5) = 9.77reported p = .08 · recomputed p = .082
“Q (5) = 9.77, p = .08”
ConsistentQ(1) = 4.4reported p < .05 · recomputed p = .036
“Q (1) = 4.40, p < .05”
ConsistentQ(3) = 10.89reported p < .02 · recomputed p = .012
“Q (3) = 10.89, p < .02”
ConsistentQ(4) = 8.28reported p = .08 · recomputed p = .082
“Q (4) = 8.28, p = .08”

19 of 19

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

Incorrect heterogeneity degrees of freedom for social anxiety studies
Minor
A heterogeneity Q test across seven studies has k − 1 = 6 degrees of freedom, not the reported 4.
Reported 4 · recomputed 6
Discussion calls a nonsignificant overall result marginal
Minor
The discussion describes an overall marginal tendency to avoid maintaining gaze on threat, but the results state that the overall group difference was not significant (p = .26).
PTSD confidence interval is inconsistent with its effect size
Minor
The two reported confidence limits have a midpoint of −.60 and do not contain the reported effect size of +.60.
Reported 0.6 · recomputed -0.6
Incorrect heterogeneity degrees of freedom for OCD studies
Minor
A heterogeneity Q test across two studies has k − 1 = 1 degree of freedom, not the reported 4.
Reported 4 · recomputed 1
Dysphoric-orienting confidence interval is not centered on its effect size
Minor
The reported confidence limits have a midpoint of .045, not the reported Hedges's g of .18. This difference exceeds rounding to the printed precision.
Reported 0.18 · recomputed 0.045
Conflicting counts of orienting-variable types
Minor
The methods count 17 event-related and 3 epoch-related vigilance analyses, while the results count 16 and 4, respectively, for the 20-study anxiety orienting analysis.

6 of 6

Statistical Power Analysis for the Behavioral Sciences
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Statistical Power Analysis for the Behavioral Sciences (2nd ed.).
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Quantifying heterogeneity in a meta‐analysis
Higgins, J. P. T., & Thompson, S. G. (2002) · Statistics in Medicine · doi:10.1002/sim.1186 · Cited by 36,763 · cited 2×
“…that variance in effect sizes around the combined effect size cannot be completely accounted for by sampling error; the I2 statistic estimates the percentage of this variance that is due to between-studies variability (25%=low, 50%=medium, and 75%=high heterogeneity; Higgins & Thompson, 2002).”
BackgroundMethod
Conducting Meta-Analyses in R with the metafor Package
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“Forest plots were generated using the metafor package for R statistical software (Viechtbauer, 2010).”
Method
Control of goal-directed and stimulus-driven attention in the brain
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“The stimulus-driven system responds to unattended, motivationally-relevant events, enabling their detection through automatic shifts in attention (Corbetta & Shulman, 2002).”
Background
Book Reviews: Statistical Methods for Meta-Analysis Larry V. Hedges and Ingram Olkin New York: Academic Press, 1985. xxii + 369 pp
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Emotion circuits in the brain
LeDoux, J. E. (2000) · Annual Review of Neuroscience · doi:10.1146/annurev.neuro.23.1.155 · Cited by 8,444
The attention system of the human brain
Posner, M. I., & Petersen, S. E. (1990) · Annual Review of Neuroscience · doi:10.1146/annurev.ne.13.030190.000325 · Cited by 8,070 · cited 2×
“An abundance of behavioral and neuropsychological research suggests a fundamental distinction between a stimulus-driven system and a goal-directed system in the control of attention (Corbetta & Shulman, 2002; Posner & Peterson, 1990).”
Background
Eye movements in reading and information processing: 20 years of research
Rayner, K. (1998) · Psychological Bulletin · doi:10.1037/0033-2909.124.3.372 · Cited by 7,979 · cited 1×
“, resulting from the sudden onset of a stimulus with a sharply contrasting basic feature) have a latency of 150 to 175 ms (Rayner, 1998).”
Background

Flagged first, then by citations

Show all 140 references

Sorted by citations

Poverty, depression, and anxiety: Causal evidence and mechanisms
Ridley, M., Rao, G., Schilbach, F., & Patel, V. (2020) · Science · doi:10.1126/science.aay0214 · Cited by 1,220
Depression: A cognitive perspective
LeMoult, J., & Gotlib, I. H. (2019) · Clinical Psychology Review · doi:10.1016/j.cpr.2018.06.008 · Cited by 792
Best practices in eye tracking research
Carter, B. T., & Luke, S. G. (2020) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2020.05.010 · Cited by 659
The Status of Irritability in Psychiatry: A Conceptual and Quantitative Review
Vidal‐Ribas, P., Brotman, M. A., Valdivieso, I., Leibenluft, E., & Stringaris, A. K. (2016) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2016.04.014 · Cited by 493
“The bias toward threatening faces is not unique to SMD but is also present in people with depression and anxiety.(87,88) Finally, compared with HV, youth with SMD have deficits in reversal learning,(89) performing even worse than youth with BD when attentional demands increase.”
Result
Measuring attentional bias to threat: reliability of dot probe and eye movement indices
Waechter, S., Nelson, A. L., Wright, C., Hyatt, A., & Oakman, J. (2014) · Cognitive Therapy and Research · doi:10.1007/s10608-013-9588-2 · Cited by 324
“In the existing literature, eye movement studies use different indices to measure attention to threat (see Armstrong and Olatunji 2012 and Cisler et al. 2009).”
BackgroundMethodInfluential

See all 1,049

Görsel dikkat araştırmalarında göz izleme teknolojilerinin kullanımı üzerine bir derleme çalışması
EFETÜRK, Ö. A., TURGUT, G., Dereshgi, H. A., & YILMAZ, A. (2022) · DergiPark (Istanbul University)
Effects of Trait Anxiety and Trait Depression on the Temporal Dynamics of Attentional Bias to Negative Stimuli Relative to Positive Stimuli: Development of New Temporal Attentional Bias Pattern Endophenotypes
Wiggs, K. A. (2013) · OpenSIUC (Southern Illinois University Carbondale)
Attentional bias for emotional faces in depressed and non-depressed individuals: an eye-tracking study
Figueiredo, G. R., Ripka, W. L., Romaneli, E. F. R., & Ulbricht, L. (2019) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc.2019.8857878 · Cited by 19
Eye Tracking Technique in the Diagnosis of Depressive Disorder: a systematic review
Lima, E. S. H., de Andrade, M. J. O., Bonifácio, T. A. D. S., Rodrigues, S. J., de Almeida, N. L. P., de Oliveira, M. E. C., Gonçalves, L. M., & dos Santos, N. A. (2021) · Contextos Clínicos · doi:10.4013/ctc.2021.142.13 · Cited by 5
Attentional biases to emotional information in clinical depression: A systematic and meta-analytic review of eye tracking findings
Suslow, T., Hußlack, A., Kersting, A., & Bodenschatz, C. M. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.05.140 · Cited by 213
Attention Allocation for Dysphoric Information in Adults with Depression Symptoms Using Eye-tracking and Mouse-tracking
McNamara, M. E., Shumake, J., & Beevers, C. G. (2025) · PLoS ONE · doi:10.1371/journal.pone.0318923 · Cited by 2
Evaluation of a free-viewing task to measure distinct negative and positive biases in depression
McNamara, M. E. (2020) · doi:10.26153/tsw/14154
Attentional Bias for Faces in Relation to Severity of Depressive Symptoms: An Eye-Tracking Study
Figueiredo, G. R., Campos, D. P., Ripka, W. L., & Ulbricht, L. (2019) · World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany · doi:10.1007/978-981-13-2119-1_63 · Cited by 6
The Attentional Blink Paradigm in Individuals with High and Low Levels of Depression and Anxiety
Skinner, H. K., & Ferguson, H. J. (2014) · Journal of European Psychology Students · doi:10.5334/jeps.cm · Cited by 1
Eye tracking evidence of threat-related attentional bias in anxiety- and fear-related disorders: A systematic review and meta-analysis
Clauss, K. E., Gorday, J. Y., & Bardeen, J. R. (2022) · Clinical Psychology Review · doi:10.1016/j.cpr.2022.102142 · Cited by 121

Authors: Armstrong, T., & Olatunji, B. O.
Affiliations: Vanderbilt University (US)
Corresponding author: Armstrong, Thomas
ORCID: Armstrong, Thomas
Olatunji, Bunmi O.
Venue: Clinical Psychology Review
Publisher: Elsevier BV
Published: 2012-12
Volume: 32
Issue: 8
Pages: 704-723
ISSN: 0272-7358 (ISSN-L)
DOI: 10.1016/j.cpr.2012.09.004
PMC: PMC3556338
OpenAlex: W2104609554
Cited by: 1,049
References: 140
Citations by year: 2026: 71 · 2025: 80 · 2024: 69 · 2023: 87 · 2022: 85 · 2021: 105 · 2020: 148 · 2019: 92 · 2018: 84 · 2017: 54 · 2016: 58 · 2015: 56 · 2014: 39 · 2013: 16 · 2012: 1
FWCI: 5.24
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Clinical Psychology Review (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (F31MH087018)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Visual Attention and Saliency Detection
Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Keywords: eye tracking, attentional bias, mood disorders, anxiety, depression, threat vigilance, visual search, free viewing, emotional stimuli
MeSH terms: Anxiety Disorders, Arousal, Attention, Depressive Disorder, Emotions, Eye Movements, Facial Expression, Fixation, Ocular, Humans, Pattern Recognition, Visual, Reaction Time

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A second model labelled each claim on 2026-10-09 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis

Abstract

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TL;DR

Key findings

Methods

Limitations

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Statistics that don’t add up

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Self-check

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