Department of Psychiatry,Columbia University Medical Center,New York Psychiatric Institute,New York, NY,USA.
New York Psychiatric Institute,New York, NY,USA.
Psychol Med. 2019 Apr;49(5):705-726. doi: 10.1017/S0033291718002313. Epub 2018 Sep 4.
Cognitive models of posttraumatic stress disorder (PTSD) implicate threat-related attentional biases in the etiology and phenomenology of the disorder. However, extant attentional research using reaction time (RT)-based paradigms and measures has yielded mixed results. Eye-tracking methodology has emerged in recent years to overcome several inherent drawbacks of RT-based tasks, striving to better delineate attentional processes.
A systematic review of experimental studies examining threat-related attention biases in PTSD, using eye-tracking methodology and group-comparison designs, was conducted conforming to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies were selected following a systematic search for publications between 1980 and December 2017 in PsycINFO, MEDLINE and the National Center for PTSD Research's Published International Literature on Traumatic Stress (PILOTS) database. Additional records were identified by employing the Similar Articles feature in PubMed, and the Cited Reference Search in ISI Web of Science. Reference sections of review articles, book chapters and studies selected for inclusion were searched for further studies. Ongoing studies were also sought through Clinicaltrials.gov.
A total of 11 studies (n = 456 participants in total) were included in the final review. Results indicated little support for enhanced threat detection, hypervigilance and attentional avoidance. However, consistent evidence emerged for sustained attention on threat (i.e. attention maintenance) in PTSD.
This review is the first to systematically evaluate extant findings in PTSD emanating from eye-tracking studies employing group-comparison designs. Results suggest that sustained attention on threat might serve as a potential target for therapeutic intervention.
创伤后应激障碍（PTSD）的认知模型表明，威胁相关的注意力偏差与该障碍的病因和表现有关。然而，使用基于反应时间（RT）的范式和测量方法的现有注意力研究得出的结果喜忧参半。近年来，眼动追踪方法学的出现克服了基于 RT 任务的几个固有缺陷，努力更好地描绘注意力过程。
根据系统评价和荟萃分析（PRISMA）指南，对使用眼动追踪方法学和组间比较设计来研究 PTSD 中威胁相关注意力偏差的实验研究进行了系统综述。通过在 PsycINFO、MEDLINE 和国家创伤后应激障碍研究中心出版的国际创伤应激文献（PILOTS）数据库中进行系统搜索，选择了符合条件的研究。通过在 PubMed 中使用“相似文章”功能和 ISI Web of Science 中的“被引参考文献搜索”，确定了其他记录。还通过 Clinicaltrials.gov 搜索正在进行的研究。检索了综述文章、章节和入选研究的参考文献部分，以寻找进一步的研究。
最终综述共纳入 11 项研究（共 456 名参与者）。结果表明，几乎没有证据支持增强的威胁检测、过度警惕和注意力回避。然而，一致的证据表明 PTSD 中存在对威胁的持续注意力（即注意力维持）。
这是第一篇系统评估采用组间比较设计的眼动追踪研究中 PTSD 现有发现的综述。结果表明，对威胁的持续注意力可能成为治疗干预的潜在目标。
