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Selective attention and emotional vulnerability: Assessing the causal basis of their association through the experimental manipulation of attentional bias.
Abstract
Although it is well-established that vulnerability to negative emotion is associated with attentional bias toward aversive information, the causal basis of this association remains undetermined. Two studies addressed this issue by experimentally inducing differential attentional responses to emotional stimuli using a modified dot probe task, and then examining the impact of such attentional manipulation on subsequent emotional vulnerability. The results supported the hypothesis that the induction of attentional bias should serve to modify emotional vulnerability, as revealed by participants' emotional reactions to a final standardized stress task. These findings provide a sound empirical basis for the previously speculative proposal that attentional bias can causally mediate emotional vulnerability, and they suggest the possibility that cognitive-experimental procedures designed to modify selective information processing may have potential therapeutic value.
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“An initial study found that subliminal ABM training did not induce attentional changes to threatening stimuli (MacLeod, Rutherford, Campbell, Ebsworthy, 2002).”
From Advancing the treatment of anxiety disorders in transition‐age youth: a review of the therapeutic effects of unconscious exposure. (2025) · cites this paper as MacLeod, Rutherford, Campbell, Ebsworthy, 2002
In the citing paper
“Also, training attentional bias towards negative stimuli increases self-reported distress to a laboratory stressor (MacLeod, Rutherford, Campbell, Ebsworthy, & Holker, 2002)”
From Attentional bias and emotional reactivity as predictors and moderators of behavioral treatment for social phobia (2013) · cites this paper as MacLeod, Rutherford, Campbell, Ebsworthy, & Holker, 2002
In the citing paper
“Selective biases in attention can be modified by a simple computerized technique; the Attention Bias Modification task (ABM), pioneered by Colin MacLeod et al. [19]”
In the citing paper
“These simple, computer-based training tasks have been found to alter processing biases (eg, in attention) in both non-clinical (Browning et al, 2010b; MacLeod et al, 2002) and clinical groups (Amir et al, 2009)”
From Using an Experimental Medicine Model to Explore Combination Effects of Pharmacological and Cognitive Interventions for Depression and Anxiety (2011) · cites this paper as MacLeod et al, 2002
In the citing paper
“In line with previous work, both citalopram (Harmer et al, 2004; Murphy et al, 2009) and positive cognitive bias training (Browning et al, 2010b; MacLeod et al, 2002) on their own produced relatively positive changes in emotional bias, consistent with the idea that this may be a common process in treatments of emotional disorders (Harmer, 2008).”
From Using an Experimental Medicine Model to Explore Combination Effects of Pharmacological and Cognitive Interventions for Depression and Anxiety (2011) · cites this paper as MacLeod et al, 2002
In the citing paper
“After promising preclinical studies (MacLeod et al., 2002), first successful clinical applications have been reported in targeted prevention (See et al., 2009) and in clinically anxious patient groups (Amir et al., 2009;Schmidt et al., 2009), and targeted prevention (See et al., 2009) with maintenance of clinical improvement reported four months after the training (Schmidt et al., 2009).”
From Addiction, adolescence, and the integration of control and motivation (2011) · cites this paper as MacLeod et al., 2002
In the citing paper
“inducing a negative attentional bias in healthy participants increases anxiety (4)”
From Lateral prefrontal cortex mediates the cognitive modification of attentional bias (2010) · cites this paper as [4]
In the citing paper
“Thus, not only is exposure ineffective for those who are negatively biased, training attention toward threat in non-avoidant populations has also been found to increase rather than decrease anxiety in both adults and children [41,43,44].”
From Can mindfulness be too much of a good thing? The value of a middle way (2019) · cites this paper as [43]
In the citing paper
“One such potential intervention is attention bias modification (ABM), a computer-delivered treatment for anxiety that emerged from research in experimental psychopathology (MacLeod & Mathews, 2012;MacLeod, Rutherford, Campbell, Ebsworthy, & Holker, 2002).”
From Anxiety and attention to threat: cognitive mechanisms and treatment with attention bias modification (2016) · cites this paper as MacLeod et al., 2002
In the citing paper
“These differing views point to a potential limitation of ABM-threat-avoidance training which focuses on modifying an automatic bias in initial orienting to threat (MacLeod et al., 2002), rather than other attention mechanisms such as top-down attention control which may support emotion regulation and resilience to anxiety (e.g., Derryberry & Rothbart, 1997).”
From Anxiety and attention to threat: cognitive mechanisms and treatment with attention bias modification (2016) · cites this paper as MacLeod et al., 2002
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Cognitive Remediation and Bias Modification Strategies in Mood and Anxiety Disorders
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Face processing in adolescents with positive and negative threat bias
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“neutral stimuli, may be related to the etiology of anxiety disorders (MacLeod et al. 2002; Bar-Haim et al. 2007, 2010; Eldar et al. 2008, 2012; Shechner et al. 2014).”
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“Since cognitive biases are thought to help cause and/or maintain anxiety (MacLeod et al., 2002), these findings reinforce the idea that weaker attentional control may be a risk factor for anxiety disorders.”
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“Previous researchers (e.g., MacLeod et al. 2002) have found that attentional biases can be trained and that such training can significantly reduce the emotional vulnerabilities of individuals.”
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“stressed), suggesting that attentional biases influence mood through their interaction with the environment [53].”
BackgroundSuffoletto, B. P., Field, M., & Chung, T. A. (2019) · Experimental and Clinical Psychopharmacology · doi:10.1037/pha0000343 · Cited by 10
“AppB score was computed by using the following formula: (RT avoid alcohol – RT approach alcohol) - (RT avoid neutral – RT approach neutral) (MacLeod et al. 2002; Wiers et al., 2009).”
MethodKrieg, A., & Xu, Y. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1132918 · Cited by 11
“While Study 1 focused on one aspect of threat bias that involves appraisal of social threat, Study 2 examined selective attentional bias, using a standardized dot-probe discrimination task (MacLeod et al., 1986; Amir et al., 2008, 2009) and the corresponding Attention Bias Modification Training (ABMT), in which partic…”
BackgroundMethodInfluentialWerle, D., Sablottny, L., Tuschen‐Caffier, B., & Svaldi, J. (2024) · Appetite · doi:10.1016/j.appet.2024.107284 · Cited by 12
“In a number of mental disorders other than BED, a frequently and successfully applied task to target attention allocation is the (modified) dot-probe paradigm (DPP; MacLeod, Rutherford, Campbell, Ebsworthy, & Holker, 2002).”
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Emotional distraction in the context of memory-based orienting of attention.
Raeder, S. M., Bone, J. K., Patai, E. Z., Holmes, E. A., Nobre, A. C., & Murphy, S. E. (2019) · Emotion · doi:10.1037/emo0000506 · Cited by 10
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“For instance, CBM-A can result in reductions in attentional bias towards threat cues and reduction in anxiety and stress reactivity (e.g. MacLeod et al., 2002).”
BackgroundLow self-esteem elicits greater mobilization of attentional resources toward emotional stimuli
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“MacLeod and colleagues introduced the most widely used approach worldwide to modify attentional bias [21].”
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“The applied training task is called a visual probe task [18,19] that consists of the use of pairs of images, where one presents an important stimulus to the alcoholic beverage and another one a neutral stimulus (something nonalcoholic).”
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Cognitive bias modification for energy drink cues
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“The dot probe task [41] was used to measure and manipulate attentional bias for energy drink cues.”
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“Su modificación como tarea de entrenamiento fue introducida por MacLeod et al. (2002) y consiste en la alteración de las contingencias en la aparición del punto para que éste aparezca entre el 80% - 90% de las veces siguiendo a un tipo de estímulo determinado.”
BackgroundChanges in attentional processing and affective reactivity in pregnancy and postpartum
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“Finally, attentional bias to threat-related stimuli has been shown to be causally related to the development of anxiety, 32 although its causal role in perinatal depression is unclear.”
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“, 1996) or even after brief training exercises (MacLeod et al., 2002; Monk et al., 2004).”
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“Participants accomplished the anagram solution task (MacLeod et al., 2002; Watkins et al., 2008; Wemm et al., 2010) that consisted of 15 soluble and 15 insoluble anagrams, each five or six letters long.”
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“That, is variability in regional GMV in this network may be an underlying risk factor for elevated attentional bias to threat, which has been shown to be a causal mechanism for the development of anxiety (MacLeod et al., 2002).”
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“Trait anxiety seems to be associated with greater attentional bias toward dysphoric stimuli when the presentation period is shorter (MacLeod et al., 2002; Mathews and MacLeod, 2005; Haddadi and Besharat, 2010).”
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Uses of Artificial Intelligence in Psychology
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“, [37,38]), that individuals in a more negative state will be more likely to treat ambiguous stimuli “pessimistically” as predicting a negative outcome.”
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“Rating Scale for Word Stimuli: Word stimuli (threat words) for the dotprobe task were adapted from previous attention bias studies (Fleurkens et al., 2011; MacLeod et al., 2002; Pineles et al., 2007).”
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“Indeed, it has been claimed that reducing participants’ tendency to shift attention toward threatening stimuli can reduce anxiety (e.g. MacLeod & Clarke, 2015; MacLeod et al., 2002), but see (e.g. Cristea et al., 2015).”
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“Specifically, the group that was biased toward threat by being presented with threatening words prior to the probe, exhibited a greater increase in negative mood during the following stress task, compared to the group presented with neutral words (MacLeod et al., 2002).”
InfluentialThe 5-HTTLPR polymorphism, early and recent life stress, and cognitive endophenotypes of depression
Kruijt, A., Putman, P., & van der Does, W. A. J. (2014) · Cognition & Emotion · doi:10.1080/02699931.2013.873018 · Cited by 9
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Self-citationSleep-Related Attentional Bias in Insomnia: Time to Examine Moderating Factors?
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“However, attentional bias to threat is a transient process (MacLeod et al., 2002) and emotional tone has differential effects.”
BackgroundCognitive bias modification in the treatment of addiction
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“ABM was based on the concept developed by MacLeod et al. (2002) and used in multiple sessions with positive results by Amir et al. (2009) and Schmidtet al. (2009).”
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“Based on this theory, researchers have developed interventions - termed attention bias modification (ABM) - designed to train attention away from threatening stimuli with the expectation that this will lead to long-term reduction in vigilance to threat and in turn anxiety [41].”
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Webcam-Based Eye-Tracking of Attentional Biases in Alzheimer’s Disease: A Proof-Of-Concept Study
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“Internet-based dot-probe paradigms (MacLeod et al., 2002) include a response-time/button-press task which involves several complex cognitive processes (Gratton et al., 2018).”
BackgroundMethodRumination in dementia and its relationship with depression, anxiety, and attentional biases
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“The AB measure involved a modified dot-probe task (MacLeod et al., 2002), in which each trial began with a blank screen for 500 ms.”
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“The cognitive bias modification literature is rich in studies that have successfully manipulated different cognitive biases to test hypotheses concerning their causal contribution to emotional symptomatology (e.g., see Beard & Peckham, 2020; MacLeod et al., 2002; MacLeod & Graf-ton, 2016).”
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“While common in clinical anxiety and healthy individuals high in trait anxiety, it is inducible in non-anxious individuals by sufficient threat [27,28].”
BackgroundNiles, A. N., & O’Donovan, A. (2018) · Cognitive Therapy and Research · doi:10.1007/s10608-018-9923-8 · Cited by 8
Alcohol attention bias in 14-16 year old adolescents: an eye tracking study
McGivern, C., Curran, D. B., & Hanna, D. (2020) · Psychopharmacology · doi:10.1007/s00213-020-05714-6 · Cited by 8
Harkin, B., & Kessler, K. (2012) · Depression and Anxiety · doi:10.1002/da.21911 · Cited by 9
“For instance, the socalled attentional modification training (AMT) proposed by MacLeod et al.[42] attempts to improve attentional efficiency by targeting and directing attention away from threat/anxiety inducing information to less threatening information not associated with anxiety by using a dotprobe discrimination…”
BackgroundCognitive effects of attentional training depend on attentional control
Paulewicz, B., Blaut, A., & Kłosowska, J. (2012) · Polish Psychological Bulletin · doi:10.2478/v10059-012-0030-5 · Cited by 11
“…to the direction of the induced bias (towards or away from negative stimuli) seems to have limited validity, as in some studies (see for example MacLeod et al., 2002) it has been found that training attention towards negative stimuli does in fact increase vulnerability to stressful events.”
The Causal Role of Attentional Bias in a Cognitive Component of Depression
McDermott, R., & Dozois, D. J. A. (2015) · Journal of Experimental Psychopathology · doi:10.5127/jep.041414 · Cited by 9
“Unlike the MacLeod et al. (2002) study the authors did not include a stress task and this may be why (although able to train a negative attentional bias) the training task did not impact depression indicators (visual analogue mood scale and cognitive triad inventory).”
BackgroundMethodPersistent modification of cognitive control through attention training
Aben, B., Iseni, B., den Bussche, E. V., & Verguts, T. (2018) · Quarterly Journal of Experimental Psychology · doi:10.1177/1747021818757979 · Cited by 8
Boyes, M. E., Clarke, P., & Hasking, P. A. (2019) · Personality and Individual Differences · doi:10.1016/j.paid.2019.109573 · Cited by 8
Attention control therapy for acute stress disorder: A randomized controlled trial
Segal, A., Wald, I., Pine, D. S., Halpern, P., & Bar‐Haim, Y. (2020) · Depression and Anxiety · doi:10.1002/da.23040 · Cited by 9
Training reduces error in rating the intensity of emotions.
Leitzke, B. T., Plate, R. C., & Pollak, S. D. (2020) · Emotion · doi:10.1037/emo0000763 · Cited by 9
Exogenous attention to angry faces in social anxiety: A perceptual accuracy approach
Moriya, J., & Tanno, Y. (2011) · Cognition & Emotion · doi:10.1080/02699931.2010.535695 · Cited by 10
“By facilitating attentional disengagement from the threatening stimuli, socially anxious people could decrease their anxiety (Amir, Beard, Burns, & Bomyea, 2009 ; Amir, Weber, Beard, Bomyea, & Taylor, 2008 ; MacLeod, Rutherford, Campbell, Ebsworthy, & Hoker, 2002 ; Schmidt, Richey, Buckner, & Timpano, 2009 ).”
Amir, N., & Conley, S. L. (2013) · Wiley eBooks · doi:10.1002/9781118528563.wbcbt09 · Cited by 8
The Role of Emotion Regulation in Distinct Measures of Emotional Resilience
Razak, H. A., MacLeod, C. M., Rudaizky, D., & Notebaert, L. (2025) · Cognitive Therapy and Research · doi:10.1007/s10608-025-10581-6 · Cited by 13
“The current study utilised an anagram stressor task with bogus poor performance feedback adapted from MacLeod et al. (2002).”
Self-citationMansueto, A. C., Pan, T., Dessel, P. V., & Wiers, R. W. H. J. (2023) · Journal of Experimental Psychopathology · doi:10.1177/20438087231178123 · Cited by 7
“In the years following the seminal work in anxiety (MacLeod et al., 2002; Mathews &Mackintosh, 2000), first attempts were made to change cognitive biases in addiction, including attentional biases (Field & Eastwood, 2005; Schoenmakers et al.”
BackgroundEmotionale Dysregulation bei der Borderline-Persönlichkeitsstörung
Niedtfeld, I., & Schmahl, C. G. (2012) · Zeitschrift für Psychiatrie Psychologie und Psychotherapie · doi:10.1024/1661-4747/a000115 · Cited by 7
Vedhara, K., Brant, H., Adamopoulos, E., Byrne-Davis, L. M. T., Mackintosh, B., Hoppitt, L., Tovée, M. J., Miles, J. E., & Pennebaker, J. W. (2010) · International Journal of Behavioral Medicine · doi:10.1007/s12529-009-9072-2 · Cited by 7
“Furthermore, while attempts at AB modification have shown some success, it is not clear whether changes persist or revert to their premodified status (see [ 34 ]).”
BackgroundMacLeod, C. (2010) · Applied Cognitive Psychology · doi:10.1002/acp.1697 · Cited by 7
Self-citationTowards A Better Understanding of Hypervigilance in Combat Veterans
Cameron, A., & Mamon, D. (2019) · Military Behavioral Health · doi:10.1080/21635781.2018.1526144 · Cited by 9
Neophytou, K., & Panayiotou, G. (2022) · PLoS ONE · doi:10.1371/journal.pone.0264256 · Cited by 7
“At the same time, attentional bias is believed to moderate the impact of negative life events on stress and anxiety [17,18].”
BackgroundMethodDevelopment and Evaluation of Linguistic Stimuli for Pain Research
Vermeir, J. F., White, M. J., Johnson, D. M., Crombez, G., & Ryckeghem, D. M. L. V. (2023) · Journal of Pain · doi:10.1016/j.jpain.2023.05.011 · Cited by 7
Novel mechanism-based treatments for pediatric anxiety and depressive disorders
Sylvester, C. M., Luby, J. L., & Pine, D. S. (2023) · Neuropsychopharmacology · doi:10.1038/s41386-023-01709-x · Cited by 7
“The fi rst experimental evidence to suggest a causal role for the biases in anxiety again appeared from MacLeod and colleagues [35].”
BackgroundMatthews, G., Deary, I. J., & Whiteman, M. C. (2003) · Cambridge University Press eBooks · doi:10.1017/cbo9780511812736.011 · Cited by 7
Gaze cuing of attention in snake phobic women: the influence of facial expression
Pletti, C., Dalmaso, M., Sarlo, M., & Galfano, G. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.00454 · Cited by 7
“…hypothesis that has been supported by empirical studies that show how anxiety vulnerability increases after the induction of an attentional bias for threat and decreases after a task designed to reduce this bias (MacLeod et al., 2002; Amir et al., 2008; Hakamata et al., 2010; Heeren et al., 2012a).”
InfluentialTowards personalized treatment of depression: A candidate gene approach
Landrø, N. I. (2014) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12124 · Cited by 7
Blankers, M., Salemink, E., & Wiers, R. W. H. J. (2015) · Springer eBooks · doi:10.1007/978-3-319-20852-7_10 · Cited by 7
“In their seminal fi rst study, MacLeod and colleagues [ 50 ] selected students with a medium anxiety level, and randomly assigned them to one of two conditions: one in which their attention was trained towards threatening stimuli, and one in which their attention was trained away from threatening stimuli.”
BackgroundEguchi, A., Walters, D., Peerenboom, N., Dury, H. L., Fox, E., & Stringer, S. M. (2016) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000165 · Cited by 8
“…CBM-Attention (i.e., attentional bias modification - ABM) seeks to shift the attention of subjects away57 from negative stimuli in the environment (MacLeod et al., 2002; Hakamata et al., 2010),58 CBM-Interpretation (CBM-I) aims to reduce the tendency for negative interpretation of events (Grey59…”
BackgroundWhen Aggression Is Out of Control: From One-Person to Two-Person Neuropsychology
Gagnon, J., Quansah, J. E., & Kim, W. S. (2019) · IntechOpen eBooks · doi:10.5772/intechopen.89803 · Cited by 7
Metadata
- Authors
- MacLeod, C., Rutherford, E., Campbell, L., Ebsworthy, G., & Holker, L.
- Affiliations
- The University of Western Australia (AU)
- ORCID
- MacLeod, Colin
- Venue
- Journal of Abnormal Psychology
- Published
- 2002-02
- Volume
- 111
- Issue
- 1
- Pages
- 107-123
- ISSN
- 0021-843X (ISSN-L)
- 1939-1846
- OpenAlex
- W2122758649
- Cited by
- 1,334
- References
- 48
- Citations by year
- 2026: 13 · 2025: 31 · 2024: 41 · 2023: 35 · 2022: 44 · 2021: 80 · 2020: 54 · 2019: 73 · 2018: 65 · 2017: 61 · 2016: 80 · 2015: 96 · 2014: 84 · 2013: 96 · 2012: 83
- FWCI
- 32.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Abnormal Psychology (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- attentional bias, emotional vulnerability, selective attention, negative emotions, dot-probe task, stress reactivity, causal mediation analysis, cognitive bias modification
- MeSH terms
- Adolescent, Psychology, Adolescent, Adult, Affect, Attention, Female, Humans, Male
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