Mechanisms of selective attention in generalized anxiety disorder

Probably not a substantial claim: may not pass S3 (load-bearing).

In Experiment 1, the high trait anxiety group was significantly younger than both the GAD and control groups.

“Finally, the high trait anxiety group was significantly younger than both the GAD and control groups, Fs > 11.95, ps < .01, η2p > .78.”

May combine two claims.

In Experiment 1, the GAD and high trait anxiety groups were matched on trait and state anxiety, whereas the GAD group reported higher levels of depression on the BDI-II.

“The GAD and high trait anxiety groups were matched on trait and state anxiety, Fs < 1, η2p < .04, whereas the GAD group reported higher levels of depression on the BDI-II, F(1, 26) = 4.53, p < .05, η2p = .15.”

May combine two claims.

In Experiment 1, the high trait anxiety group reported higher levels of trait anxiety, state anxiety, and depression on the BDI-II in comparison with the control group.

“The high trait anxiety group also reported higher levels of trait anxiety, state anxiety, and depression on the BDI-II in comparison with the control group, Fs > 94.69, ps < .01, η2p > .78.”

May combine two claims.

In Experiment 1, the GAD and control groups were matched on age and MHVS scores, whereas the GAD group reported higher levels of trait and state anxiety and depression on the BDI-II.

“As expected the GAD and control groups were matched on age and MHVS scores, Fs < 1, η2p < .02, whereas the GAD group reported higher levels of trait and state anxiety and depression on the BDI-II, Fs > 29.91, ps < .01, η2p > .53.”

May combine two claims.

In Experiment 1, the Group × Valence of Face interaction was statistically significant, whereas there were no main effects for Group or Valence of Face.

“There were no main effects for either Group, F(2, 39) = 1.99, η2p = .09 or Valence of Face, F < 1, η2p = .02, whereas the Group × Valence of Face interaction did reach statistical significance, F(4, 78) = 3.56, MSE = 1828.83, p < .01, η2p = .16.”

May combine two claims.

In Experiment 1, individuals with GAD were faster to respond to a peripheral target letter when a centrally presented face was angry relative to happy or neutral, a pattern not found in matched healthy volunteers.

“Individuals with GAD were faster to respond to a peripheral target letter when a centrally presented face was angry relative to happy or neutral, a pattern not found in matched healthy volunteers.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In this sample, patients and healthy volunteers differed significantly on all measures of mood state, trait, and symptoms, but not on age.

“Patients and healthy volunteers differed significantly on all measures of mood state, trait, and symptoms, but not on age.”

May combine two claims.

In the GAD patient sample alone, there was a significant Validity × Facial Expression interaction in the peripheral cueing task, with means following the same pattern as the main findings.

“This revealed a significant Validity × Facial Expression interaction, F(3, 60) = 2.98, p = .04, η2p = .13, as previously, with means following the same pattern as the main findings, reported earlier.”

May combine two claims.

In the peripheral cueing task, there was no significant main effect of Group and no significant interactions involving Group.

“No interactions involving Group approached significance, (all Fs < 2.5, largest η2p = .06), nor was there a main effect of Group (F < 1, η2p = .02).”

May combine two claims.

In the central cueing task, there was no significant main effect of Group and no significant interactions involving Group.

“No interactions involving Group approached significance (all Fs < 1.5, largest η2p = .03), nor was there a main effect of Group (F < 0.5, η2p < .01).”

May combine two claims.

In the central cueing task, there was a congruency or cue validity effect, but it did not interact with the emotional expression of the facial cue or participant group.

“There was, as expected, a congruency or cue validity effect, but this did not interact with the emotional expression of the facial cue or participant group.”

May combine two claims.

In the central cueing task, reaction times were faster on congruent than central trials and on central than incongruent trials.

“There was a main effect of Cue Congruency, F(2, 80) = 20.11, p < .01, η2p = .34, reflecting faster reaction times on congruent than central trials (556 ms, SE = 13.30 vs. 568 ms, SE = 13.70) and on central than incongruent trials (568 ms, SE = 13.70 vs. 572 ms, SE = 13.94).”

The quote only partly states this claim.

In the central cueing task, there was no evidence that spatial attentional orienting was influenced by the valence of the central cue.

“On the second task, an emotional adaptation of an eye gaze cuing task, there was no evidence that spatial attentional orienting was influenced by the valence of the central cue.”

May combine two claims.

The present data found faster disengagement and slower engagement with threat, a pattern indicative of attentional avoidance of threat-relevant material.

“Rather than delayed disengagement and faster engagement with fear-relevant stimuli as expected, we found faster disengagement and slower engagement with threat, a pattern indicative of attentional avoidance of threat-relevant material.”

May combine two claims.

Both GAD patients and healthy volunteers showed avoidance of fearful expressions, being faster to disengage from and slower to engage to fearful compared with neutral or happy facial cues.

“Both groups showed avoidance of fearful expressions, being faster to disengage from, and slower to engage to, fearful compared with neutral or happy facial cues.”

Classified as probably not a substantial claim.

When a negative attention bias is successfully modified, a congruent impact on emotional reactivity occurs.

“In a useful overview, it has been noted that when a negative attention bias is successfully modified, a congruent impact on emotional reactivity occurs (Clarke, Notebaert, & MacLeod, 2014).”

• cites Clarke, Notebaert, & MacLeod, 2014Not checked yet

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May combine two claims.

The majority of studies of ABM in clinical groups have failed to shift attentional biases (7 out of 11), and the overall impact of ABM on clinical symptoms is inconsistent.

“However, the majority of studies of ABM in clinical groups have failed to shift attentional biases (7 out of 11), and therefore it is not surprising that the overall impact of ABM on clinical symptoms is inconsistent (Clarke et al., 2014).”

• cites Clarke et al., 2014Not checked yet

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In Amir et al. (2009), active ABM training reduced negative attention bias from pre- to post-training in GAD patients, whereas control training did not.

“Following eight sessions of training, there was a significant reduction in negative attention bias from pre- to post-ABM training in the active training group but not in the control group.”

• cites Amir, Beard, Burns, & Bomyea, 2009Not checked yet

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May combine two claims.

Anxiety-related attentional biases may be associated with problems in disengaging attention from negative material as well as enhanced engagement with threat.

“This suggests that anxiety-related attentional biases may be associated with problems in disengaging attention from negative material as well as enhanced engagement with threat (Fox, Mathews, Calder, & Yiend, 2007; Mathews, Fox, Yiend, & Calder, 2003).”

• cites Fox, Mathews, Calder, & Yiend, 2007Not checked yet

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• cites Mathews, Fox, Yiend, & Calder, 2003Not checked yet

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May combine two claims.

Social phobia can show attentional effects at odds with those of other anxiety disorders, so attentional orienting results from social phobia may not be generalizable to GAD.

“Attentional orienting mechanisms have already been investigated in social phobia (Amir, Elias, Klumpp, & Przeworski, 2003), but this disorder can show attentional effects at odds with those of other anxiety disorders (Staugaard, 2010), therefore results may not be generalizable to GAD.”

• cites Staugaard, 2010Not checked yet

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May combine two claims.

The position that cognitive biases play a causal role is supported by empirical evidence using longitudinal and manipulation designs supporting a bidirectional causal model and by pharmacological studies.

“This position is supported by empirical evidence using longitudinal and manipulation designs, supporting a bidirectional causal model (Van Bockstaele et al., 2014) as well as pharmacological studies (e.g. Murphy et al 2008).”

• cites Van Bockstaele et al., 2014Not checked yet

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• cites Murphy et al 2008Not checked yet

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May combine two claims.

In an earlier pilot study, 12 undergraduate students rated the faces; 100% categorized the angry face as angry, 100% categorized the happy face as happy, and 83.3% categorized the neutral face as neutral.

“It was found that 100% categorized the angry face as “angry,” 100% categorized the happy face as “happy,” and 83.3% categorized the neutral face as “neutral,” whereas 16.7% categorized this face as “sad.””

Probably not a substantial claim: may not pass S3 (load-bearing).

In Experiment 1, 3.5% of reaction time data were excluded (2.4% errors, 1.1% outliers).

“In total, 3.5% of the data were excluded on this basis (errors were made on 2.4% of trials, and outliers represented 1.1% of trials).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Each participant in Experiment 1 received a different randomized order of trials.

“Each participant received a different randomized order of trials.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The State-Trait Anxiety Inventory (STAI) is a well-validated self-report questionnaire.

“The State-Trait Anxiety Inventory (STAI; Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983) is a well-validated self-report questionnaire.”

• cites Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983Not checked yet

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Classified as probably not a substantial claim. May combine two claims.

In a previous study using the same task, a subclinical group with high trait anxiety took longer to categorize a peripheral target letter when it was presented with a fearful face relative to happy, sad, or neutral expressions, implying high trait anxiety is linked with a delay in disengaging from fear-related material.

“In a previous study with this task we reported that a subclinical group with high trait anxiety took longer to categorize the peripheral target letter when it was presented with a fearful face relative to when the centrally located face conveyed happiness, sadness, or a neutral expression (Georgiou et al., 2005), implying that high trait anxiety is linked with a delay in disengaging from fear-”

• cites Georgiou et al., 2005Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The Beck Depression Inventory-II (BDI-II) is a well-validated 21-item questionnaire that provides a measure of depression severity.

“The Beck Depression Inventory–II (BDI-II; Beck, Steer, & Brown, 1996) is a well-validated 21-item questionnaire that provides a measure of depression severity.”

• cites Beck, Steer, & Brown, 1996Not checked yet

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May combine two claims.

GAD patients and high trait anxious groups in Experiment 1 were matched on self-reported trait anxiety but differed on clinical status.

“GAD patients and high trait anxious groups were matched on self-reported trait anxiety (although not on depression), but differed on clinical status.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Initial telephone screening for Experiment 1 was conducted using the Structured Clinical Interview for DSM-IV (SCID) by a researcher trained in clinical interviewing and SCID use.

“Initial telephone screening was conducted using the Structured Clinical Interview for DSM–IV (SCID; First, Spitzer, Gibbon, & Williams, 1996) by a researcher trained in clinical interviewing and the use of the SCID by an approved local trainer (M.L.).”

• cites First, Spitzer, Gibbon, & Williams, 1996Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Response mappings were counterbalanced across participants in Experiment 1.

“Response mappings were counterbalanced across participants so that half pressed the red button for X whereas half pressed the green button for X and vice versa.”

May combine two claims.

In Experiment 1, with only 14 participants per group, power to detect small effects was low, and the possibility of false positives was relatively high.

“With only 14 participants per group, power to detect small effects was low, and the possibility of false positives relatively high.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In Experiment 2, 4 control participants reported levels of trait anxiety within the clinical range (50 or above on the STAI-trait) and were replaced on a priori grounds before data analysis.

“Despite screening procedures, 4 control participants reported levels of trait anxiety within the clinical range (50 or above on the STAI–trait; Spielberger et al., 1983). These participants were therefore ineligible to be included in the healthy control group and were replaced.”

• cites Spielberger et al., 1983Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Using 21 participants in each group, Experiment 2 had 80% power to detect a small effect size (f = 0.1) on the Trial Type (2) × Cue Type (2) within-between interaction, assuming six levels of repeated measurement.

“Using 21 participants in each group this study had 80% power to detect a small effect size (f = 0.1) on the Trial Type (2) × Cue Type (2) within–between interaction, assuming six levels of repeated measurement (Erdfelder, Faul, & Buchner, 1996).”

• cites Erdfelder, Faul, & Buchner, 1996Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

In Experiment 2, participants received the two computerized experimental tasks in counterbalanced order.

“Participants then received the following two computerized experimental tasks in counterbalanced order.”

Classified as probably not a substantial claim. May combine two claims.

Experiment 2 was based on an a priori power calculation and tested groups of 21 GAD and 21 matched healthy volunteers.

“Experiment 2 was therefore based on an a priori power calculation and tested groups of 21 GAD and 21 matched healthy volunteers.”

Probably not a substantial claim: may not pass S3 (load-bearing).

In Experiment 2, trials in the peripheral cuing task were presented in a randomized order generated automatically by the computer software.

“Trials were presented in a randomized order generated automatically by the computer software with optional rest breaks.”

Probably not a substantial claim: may not pass S3 (load-bearing).

In Experiment 2, initial telephone screening using the GAD-Q was used to confirm likely GAD diagnosis.

“Initial telephone screening using the GAD-Q (Roemer, Borkovec, Posa, & Borkovec, 1995) was used to confirm likely GAD diagnosis.”

• cites Roemer, Borkovec, Posa, & Borkovec, 1995Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

In Experiment 2, patients were given the SCID by a researcher experienced in clinical interviewing and specifically trained in its use by an approved local trainer.

“Patients were given the SCID (First et al., 1996) by a researcher experienced in clinical interviewing and specifically trained in its use by an approved local trainer.”

• cites First et al., 1996Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

The general effect of spatial attentional cuing on the central cueing task was as expected.

“Thus the general effect of spatial attentional cuing on this task was as expected.”

May combine two claims.

Previous findings in subclinical anxiety showed that the facial expression of the cue influenced the allocation of attention and that this enhancement was influenced by the degree of self-reported trait anxiety.

“These results are in marked contrast to our previous findings in subclinical anxiety where the facial expression of the cue did influence the allocation of attention and this enhancement was influenced by the degree of self-reported trait anxiety.”

• cites Fox et al., 2007Not checked yet

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• cites Mathews et al., 2003Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

The absence of attentional avoidance of mild threat is considered an important cognitive component associated with high levels of trait anxiety.

“Of importance, however, the absence of this attentional avoidance of mild threat is considered to be an important cognitive component associated with high levels of trait anxiety (e.g., Fox et al., 2001; Yiend & Mathews, 2001).”

• cites Fox et al., 2001Not checked yet

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• cites Yiend & Mathews, 2001Not checked yet

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May combine two claims.

Attentional avoidance of relatively mild threat-relevant material has been reported elsewhere and is integral to two current models of attentional orienting toward fear-relevant stimuli.

“Attentional avoidance of relatively mild levels of threat-relevant material has been reported elsewhere (Mogg et al., 2000; Wilson & MacLeod, 2003) and is integral to two current models of attentional orienting toward fear-relevant stimuli (Mathews & Mackintosh, 1998; Mogg & Bradley, 1998).”

• cites Mogg et al., 2000Not checked yet

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• cites Wilson & MacLeod, 2003Not checked yet

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• cites Mathews & Mackintosh, 1998Not checked yet

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May combine two claims.

Impaired disengagement from threatening information may be a specific attentional marker of vulnerable, subclinical samples, but does not extend to, or may even be reversed in, clinical anxiety.

“Taken together, these studies could be taken to indicate that impaired disengagement from threatening information is a specific attentional marker of vulnerable, subclinical samples, but does not extend to, or may even be reversed in, clinical anxiety.”

• AssumptionRests on an assumption: There are insufficient published studies in clinical anxiety groups to validate the assumption that subclinical findings generalize to clinical anxiety.

May combine two claims.

The original finding of attentional bias in GAD used word stimuli, as have some successful GAD attentional training studies.

“Indeed the original finding of attentional bias in GAD (MacLeod et al., 1986) used word stimuli, as have some successful GAD attentional training studies (Amir et al., 2009).”

• cites MacLeod et al., 1986Not checked yet

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• cites Amir et al., 2009Not checked yet

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May combine two claims.

In patients with social phobias, threats are typically represented as images of oneself performing poorly in social situations, whereas in GAD patients, future threats are more often represented in quasi-verbal form.

“For example, in patients with social phobias, threats are typically represented in the form of images of oneself performing poorly in social situations, whereas in GAD patients, future threats are more often represented in quasi-verbal form (Hirsch, Hayes, Mathews, Perman, & Borkovec, 2012).”

• cites Hirsch, Hayes, Mathews, Perman, & Borkovec, 2012Not checked yet

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May combine two claims.

The present data challenge the assumption and suggest that generalizing conclusions from subclinical to clinical anxiety may be premature.

“The present data challenge this assumption and suggest that generalizing conclusions from subclinical to clinical anxiety may be premature.”

• AssumptionRests on an assumption: There are insufficient published studies in clinical anxiety groups to validate the assumption that subclinical findings generalize to clinical anxiety.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Socially phobic patients are particularly likely to attend to socially threatening words, whereas panic disorder patients are more likely to attend to physically threatening words.

“For example, socially phobic patients are particularly likely to attend to socially threatening words, whereas panic disorder patients are more likely to attend to physically threatening words.”

May combine two claims.

The expected general-emotion-related spatial orienting effects in Experiment 2 suggest the tasks were appropriately sensitive, but the pattern previously observed in subclinical anxiety was not observed in a GAD sample.

“In addition, demonstration of the expected general-emotion-related spatial orienting effects found in Experiment 2 suggests that those tasks were appropriately sensitive, but that the pattern of attentional processing on these tasks previously observed in subclinical anxiety (Fox et al., 2001; Fox et al., 2007; Mathews et al., 2003) was not observed in a GAD sample.”

• cites Fox et al., 2001Not checked yet

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• cites Fox et al., 2007Not checked yet

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• cites Mathews et al., 2003Not checked yet

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Classified as probably not a substantial claim. May combine two claims.

Ellenbogen and Schwartzman (2009) reported that 36 patients with a variety of anxiety disorders (11 with GAD as a primary diagnosis) were fast to disengage from supraliminal threatening pictures and that impaired disengagement was limited to pictures presented subliminally.

“They tested 36 patients with a variety of anxiety disorders (11 had GAD as a primary diagnosis) and reported that they were fast to disengage from supraliminal threatening pictures (similar to the effects seen in the present data) and that impaired disengagement was limited to pictures presented subliminally.”

• cites Ellenbogen and Schwartzman (2009)Not checked yet

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May combine two claims.

The data suggest selective attentional avoidance of threat-related facial expressions in GAD, instead of impaired disengagement.

“Specifically, instead of impaired disengagement from threatening expressions, the data suggest selective attentional avoidance of threat-related facial expressions in GAD.”

May combine two claims.

The results challenge assumptions about the generic nature of attentional biases in GAD and indicate it may be premature to generalize from existing subclinical studies of attentional biases.

“These results pose a challenge to assumptions made to date about the generic nature of attentional biases in GAD, indicating that it may be premature to generalize from existing subclinical studies of attentional biases.”

• AssumptionRests on an assumption: There are insufficient published studies in clinical anxiety groups to validate the assumption that subclinical findings generalize to clinical anxiety.