The inter-dependency of hypervigilance and avoidance to threat in anxiety

Abstract

Anxiety problems are associated with a disturbed pattern of attention in which threat stimuli attract immediate hypervigilance followed by strategic avoidance. The nature of the interplay between hypervigilance and avoidance, and how this interplay affects emotional reactivity, however remains unclear. Five studies addressed this issue by experimentally inducing and manipulating a hypervigilant-avoidant gaze style in response to aversely conditioned faces (CS+). Experiment 1 showed that anxious participants exposed to the conditioning procedure displayed differential trend of skin conductance reactivity (GSR) and temporal sequencing of hypervigilance and avoidance bias to the eyes of conditioned versus unconditioned faces, relative to nonanxious participants. Experiment 2 found that retraining anxious participants to process the eyes of CS+ using featural sampling of the critical stimuli had no effect on the interplay between hypervigilance and avoidance to threat, nor on GSR to CS+. Experiment 3 found that retraining anxious participants to reappraise the emotional significance of the previously avoided stimuli determined a reduction in hypervigilance to the eyes of CS+, and reductions in GSR. Experiment 4 revealed that reappraisal manipulations affected cyclical hypervigilance-avoidance to the eyes of CS+ and GSR, even though gaze deployment to the stimuli was disrupted immediately after initial saccades towards the stimuli were initiated. Experiment 5 revealed that anxious participants trained to reorient gaze during early saccadic movements but impeded to make use of any useful controlled coping strategy at later stages of attentional processing did not reverse the hypervigilant-avoidant pattern of attentional biases and the SCR in response to the CS+. Overall, the results suggest that cyclical hypervigilance-avoidance in anxiety may be due to a failure to effortfully appraise the emotionally significant aspects of the fear material. Attentional training that focuses on reappraisal of these aspects is influential in reversing the hypervigilant-avoidant pattern of attentional biases and the exaggerated emotional response to the threat. Additionally, the results suggest that attentional deployment is not the key factor by which attentional training affects fear processing and emotion vulnerability. Finally, the results show that maladaptive processing of fear stimuli, despite sometime considered automatic, needs to include some sort of evaluative processing in order to impact on patterns of attentional bias, presumably because biased attention is driven by an interpretative-evaluative component that acts in regard of one’s goals and motivational states.