Davis Michelle L, Rosenfield David, Bernstein Amit, Zvielli Ariel, Reinecke Andrea, Beevers Christopher G, Koster Ernst H W, Smits Jasper A J
Department of Psychology.
Department of Psychology, Southern Methodist University.
J Consult Clin Psychol. 2016 Sep;84(9):795-802. doi: 10.1037/ccp0000125.
Threat-related attention bias figures prominently in contemporary accounts of the maintenance of anxiety disorders, yet longitudinal intervention research relating attention bias to anxiety symptom severity is limited. Capitalizing on recent advances in the conceptualization and measurement of attention bias, we aimed to examine the relation between attention bias, indexed using trial-level bias scores (TLBSs) to quantify temporal dynamics reflecting dysregulation of attentional processing of threat (as opposed to aggregated mean bias scores) and social anxiety symptom severity over the course of cognitive-behavioral therapy (CBT) and 1-month follow-up.
Adults with social anxiety disorder (N = 39) assigned to either yohimbine- or placebo-augmented CBT completed measures of attention bias and social anxiety symptom severity weekly throughout CBT (5 sessions) and at 1-week and 1-month posttreatment.
TLBSs of attention bias temporal dynamics showed stronger psychometric properties than mean aggregated scores and were highly interrelated, in line with within-subject temporal variability fluctuating in time between attentional overengagement and strategic avoidance from threat. Attention bias toward threat and temporal variability in attention bias (i.e., attentional dysregulation), but not attention bias away from threat, significantly reduced over the course of CBT. Cross-lag analyses revealed no evidence of a causal relation between reductions in attentional dysregulation leading to symptom severity reduction, or vice versa. Observed relations did not vary as a function of time.
We found no evidence for attentional dysregulation as a causal mechanism for symptom reduction in CBT for social anxiety disorders. Implications for future research are discussed. (PsycINFO Database Record
与威胁相关的注意偏向在当代焦虑障碍维持机制的描述中占据显著地位，但将注意偏向与焦虑症状严重程度相关联的纵向干预研究却很有限。利用注意偏向概念化和测量方面的最新进展，我们旨在考察注意偏向（使用试验水平偏差分数（TLBSs）进行索引，以量化反映威胁性注意加工失调的时间动态变化，而非汇总平均偏差分数）与社交焦虑症状严重程度在认知行为疗法（CBT）过程及1个月随访期间的关系。
患有社交焦虑障碍的成年人（N = 39）被分配接受育亨宾增强或安慰剂增强的CBT，在整个CBT过程（5次疗程）中每周完成注意偏向和社交焦虑症状严重程度的测量，并在治疗后1周和1个月进行测量。
注意偏向时间动态的TLBSs显示出比平均汇总分数更强的心理测量特性，且高度相关，这与个体内部时间变异性在对威胁的注意过度投入和策略性回避之间随时间波动一致。在CBT过程中，对威胁的注意偏向和注意偏向的时间变异性（即注意失调）显著降低，但对威胁的注意偏向则没有。交叉滞后分析没有发现注意失调减少导致症状严重程度降低，或反之亦然的因果关系证据。观察到的关系不随时间变化。
我们没有发现注意失调是社交焦虑障碍CBT中症状减轻的因果机制的证据。讨论了对未来研究的启示。（PsycINFO数据库记录
