Department of Psychology, The University of Texas at Austin, TX, USA; Department of Psychology, Palo Alto University, CA, USA.
Center for Perceptual Systems, The University of Texas at Austin, TX, USA.
Behav Res Ther. 2024 Feb;173:104461. doi: 10.1016/j.brat.2023.104461. Epub 2023 Dec 17.
There is some evidence for heterogeneity in attentional processes among individuals with social anxiety. However, there is limited work considering how attentional processes may differ as a mechanism in a naturalistic task-based context (e.g., public speaking). In this secondary analysis we tested attentional heterogeneity among individuals diagnosed with social anxiety disorder (N = 21) in the context of a virtual reality exposure treatment study. Participants completed a public speaking challenge in an immersive 360°-video virtual reality environment with eye tracking at pre-treatment, post-treatment, and at 1-week follow-up. Using a Hidden Markov Model (HMM) approach with clustering we tested whether there were distinct profiles of attention pre-treatment and whether there were changes following the intervention. As a secondary aim we tested whether the distinct attentional profiles at pre-treatment predicted differential treatment outcomes. We found two distinct attentional profiles pre-treatment that we characterized as audience-focused and audience-avoidant. However, by the 1-week follow-up the two profiles were no longer meaningfully different. We found a meaningful difference between HMM groups for fear of public speaking at post-treatment b = -8.54, 95% Highest Density Interval (HDI) [-16.00, -0.90], Bayes Factor (BF) = 8.31 but not at one-week follow-up b = -5.83, 95% HDI [-13.25, 1.81], BF = 2.28. These findings provide support for heterogeneity in attentional processes among socially anxious individuals, but our findings indicate that this may change following treatment. Moreover, our results offer preliminary mechanistic evidence that patterns of avoidance may be specifically related to poorer treatment outcomes for virtual reality exposure therapy.
有一些证据表明，社交焦虑症患者的注意力过程存在异质性。然而，考虑到注意力过程如何作为一种机制在自然任务为基础的情境（例如，公开演讲）中有所不同的工作还很有限。在这项二次分析中，我们在虚拟现实暴露治疗研究的背景下，测试了被诊断为社交焦虑症的个体（N=21）的注意力异质性。参与者在沉浸式 360°视频虚拟现实环境中完成了一次公开演讲挑战，在治疗前、治疗后和 1 周随访时进行眼动追踪。我们使用隐马尔可夫模型（HMM）方法和聚类来测试治疗前是否存在注意力的明显特征，并测试干预后是否存在变化。作为次要目标，我们测试了治疗前的明显注意力特征是否可以预测不同的治疗结果。我们发现治疗前存在两种明显的注意力特征，可以将其描述为关注观众和避免观众。然而，到 1 周随访时，这两种特征不再有明显区别。我们发现 HMM 组在治疗后公开演讲恐惧方面存在有意义的差异 b=-8.54，95%最高密度区间（HDI）[-16.00，-0.90]，贝叶斯因子（BF）=8.31，但在 1 周随访时没有差异 b=-5.83，95%HDI[-13.25，1.81]，BF=2.28。这些发现为社交焦虑个体注意力过程的异质性提供了支持，但我们的研究结果表明，这可能在治疗后发生变化。此外，我们的结果提供了初步的机制证据，表明回避模式可能与虚拟现实暴露治疗的较差治疗结果有关。
