Written threat: Electrophysiological evidence for an attention bias to affective words in social anxiety disorder

Abstract

Social anxiety disorder (SAD) is associated with heightened sensitivity to threat cues, typically represented by emotional facial expressions. To examine if this bias can be transferred to a general hypersensitivity or whether it is specific to disorder relevant cues, we investigated electrophysiological correlates of emotional word processing (alpha activity and event-related potentials) in 20 healthy participants and 20 participants with SAD. The experimental task was a silent reading of neutral, positive, physically threatening and socially threatening words (the latter were abusive swear words) while responding to a randomly presented dot. Subsequently, all participants were asked to recall as many words as possible during an unexpected recall test. Participants with SAD showed blunted sensory processing followed by a rapid processing of emotional words during early stages (early posterior negativity - EPN). At later stages, all participants showed enhanced processing of negative (physically and socially threatening) compared to neutral and positive words (N400). Moreover, at later processing stages alpha activity was increased specifically for negative words in participants with SAD but not in healthy controls. Recall of emotional words for all subjects was best for socially threatening words, followed by negative and positive words irrespective of social anxiety. The present findings indicate that SAD is associated with abnormalities in emotional word processing characterised by early hypervigilance to emotional cues followed by cognitive avoidance at later processing stages. Most importantly, the specificity of these attentional biases seems to change as a function of time with a general emotional bias at early and a more specific bias at later processing stages.

Processing of affective words in adolescent PTSD—Attentional bias toward social threat

“…In line with this, prior studies using the same paradigm did not find any EPN modulation in healthy participants (Wabnitz et al, ; Wabnitz, Martens, & Neuner, ). However, there has been a valence effect with socially threatening words when compared with neutral words leading to stronger EPN amplitudes in patients with social anxiety disorder (Wabnitz et al, ). Lastly, there was a large effect of laterality with larger EPN amplitudes occurring over the left hemisphere.…”

“…Word frequency has been observed to modulate the P3 component (Scott et al, ), where more‐frequent words were found to elicit larger P3 amplitudes. However, in previous studies with the same paradigm, no impact of word frequency on ERP effects has been reported (Wabnitz et al, , ). Additionally, socially threatening words did not have a differential effect at P3 stage.…”

“…Studies reporting strong emotion-related EPN modulations typically presented words for 300-600 ms (Kissler & Herbert, 2013;Kissler et al, 2007;Schindler & Kissler, 2016). In line with this, prior studies using the same paradigm did not find any EPN modulation in healthy participants (Wabnitz et al, 2012;Wabnitz, Martens, & Neuner, 2015). However, there has been a valence effect with socially threatening words when compared with neutral words leading to stronger EPN amplitudes in patients with social anxiety disorder .…”

Semantic and Prosodic Threat Processing in Trait Anxiety

“…Also, overengagement with threat has been observed when people with generalized anxiety disorder respond to threatening images (MacNamara and Hajcak, 2010). Furthermore, recent research has observed that socially anxious people present a right lateralized over-attention response to threatening words (Wabnitz, 2015). Hence, trait anxiety might directly affect the processing of emotional language.…”

Validez factorial de la versión española del Inventario de Ansiedad Geriátrica (GAI): Análisis empírico de su estructura y dimensiones

“…Research demonstrates that anxiety disorders are among the most prevalent psychiatric disorders in late life (Therrien & Hunsley, 2014;Wuthrich & Frei, 2015). Psychological assessment of older adults is a challenging issue due to the frequent comorbidity of mental and physical health problems, agerelated sensory and cognitive deficits, and the presence of multiple medications and medication in teractions (Dismuke & Egede, 2015;Gupta, Ingh, & Grawal, 2014;Sales et al, 2015;Wabnitz, Martens, & Neuner, 2016). There are a great number of instruments dedicated to detect anxiety symptoms, and one of them is the Geriatric Anxiety Inventory (GAI).…”