Problematic attention processing and fear learning in adolescent anxiety: Testing a combined cognitive and learning processes model

Abstract

Background and Objectives: Anxiety in adolescence is characterised by disturbances in attentional processes and the overgeneralisation of fear, however, little is known about the combined and reciprocal effects of and between these factors on youth anxiety. The present study investigated whether attention (attention allocation and control) and fear generalisation processes together predict more variance on adolescent anxiety symptoms than each factor in isolation, and explored their interrelations.Methods: 197 adolescents completed a novel conditioning task, which paired balloon cues with mildly aversive or neutral outcomes. A spatial cueing task, and self-report measures of emotional attentional control and anxiety, were also completed.Results: Threat-avoidant attention allocation biases, impaired attention control, and exaggerated fear generalisation together predicted greater variance in anxiety symptoms (55.3%), than each set of fear and attention processes in isolation. Results also provided evidence of an interplay between these factors. Individual differences in threat-avoidant attention allocation biases predicted variability in the generalisation of fear, whilst the association between heightened anxiety and the overgeneralization of fear was moderated by poor attention control. Conclusions:This study provides unique evidence of the combined effects of attention and fear generalisation mechanisms in explaining youth anxiety, and interrelations between these factors. Importantly, results suggested that deficiencies in attention control may bring out anxiety-associated impairments in fear generalisation. Limitations:We relied on self-reported ratings of fear during generalization and also of attention control. Thus demand effects cannot be discounted. Reaction-time measures of attention focus are also indirect assessments of attention that may lack precision.

Brief Training to Modify the Breadth of Attention Influences the Generalisation of Fear

“…No such difference in the fear magnitude on skin conductance response was found between the two training groups. Our findings contribute to existing studies that have examined the correlation between individual differences in attentional focus (e.g., towards or away from threats; Baker et al 2019) or which have modified attention using instructions (Vervliet et al 2010). The findings presented here additionally suggest that the breadth of attentional focus might also influence the generalisation of fear, as evidenced by significantly higher self-reported fear ratings for GSs by the Local group.…”

“…Researchers have also found that instructing people to direct their attentional focus (via verbal instruction) to similar features between a fear-evoking and a neutral stimulus increases fear generalisation between these stimuli (Vervliet et al 2010). Also, individual differences in the extent to which people focus their attention on specific stimuli (e.g., threats vs. neutral stimuli) has been associated with differences in fear generalisation (Baker et al 2019). Attention is thought to differ between individuals in terms of both the location of its focus (where one attends to) and its breadth (whether it is broad/global or narrow/local; Yoon et al 2015).…”

Contextual generalization of social stress learning is modulated by orexin receptors in basolateral amygdala

“…Fear learning plays an important role in many psychological disorders, including anxiety, depression, and post-traumatic stress disorder (PTSD). In these disorders, particularly PTSD (and related animal models), fear-associated memories and behavior are often expressed in contexts and/or environments that are distinctively different from those in which they are generated, a learning process known as generalization or transference ( Armony et al, 1995 , 1997 ; Baker et al, 2019 ; Baldi et al, 2004 ; Kaczkurkin et al, 2017 ; Thome et al, 2018 ).…”

Heterogeneity of the Anxiety-Related Attention Bias: A Review and Working Model for Future Research

“…Because ours is a working model, however, we are not prepared to recommend throwing out the construct of AB before the model is tested, or before the field as a whole can examine whether these individual differences have unique or overlapping clinical predictive power when compared with measures of AB. AB may indeed remain an independent and clinically meaningful construct (Baker et al, 2019).…”

“…In the case of anxiety-related AB, if AB serves to bias perception toward threat-related stimuli, TD could be directly affected or work in concert with AB to create more entrenched patterns of habitual responses to threat (e.g., arousal, cognitions, and behavior). Indeed, a recent study with adolescents (Baker et al, 2019) examined whether AB, overgeneralized fear, and attention control accounted for unique or interactive variance in anxiety symptoms. The researchers found that avoidant AB combined with impaired attention control and exaggerated fear generalization predicted greater variance in anxiety symptoms than each variable in isolation.…”