The Relationship between Attentional Bias and Anxiety in Chronic Disease Patients and High- and Low-Trait Anxiety
Date Issued
2010
Date
2010
Author(s)
Huang, Yun-Hsin
Abstract
Being over anxious about health can be harmful for patients with hypertension, diabetes mellitus, or hyperlipidemia. Attentional bias toward threat stimuli, especially mild threatening ones, has been found important in generating anxiety. However some researches have suggested that high trait-anxiety participants tend to consciously avoid high threatening stimuli. Bias toward threat stimuli could be further divided into over-engagement and/or disengagement difficulty. The present study proposed integrating model of two previous models. This model suggested that internal representation of a threat stimulus receives input from both preattentive and guided/conscious threat evaluation system. In contrast, voluntary effort strengthens target representation. The representations compete with each other for attention. It was hypothesized that over-engagement reflects low threshold of threat evaluation system, and disengagement difficulty reflects insufficient effort. Accordingly, these two indexes both have contribution in generating anxiety. The objective of this study is to investigate if the proposed integrative model is supported by examining the predictiveness of those indexes on anxiety response (including self-report and psychophysiological indexes).
Thirty subjects recruited from two local family medicine clinics were grouped based on diagnosis of chronic diseases (the three diseases described above). Sixteen of them are male. Mean age is 53.23. Another 27 subjects without chronic disease were recruited and served as control group. Five of them were male. Mean age is 40.11. Each subject completed two self-report anxiety questionnaires: Spielberger’s State-Trait Anxiety Inventory-Trait version, and Anxiety Sensitivity Index. Then the spatial cueing task would be done while his/her electrodermal activity(EDA) and electromyography(EMG) was measured, which reflect arousal level of autonomic nervous system. The spatial cueing task was designed with three kinds of materials: threat, ambiguous, and neutral words. Words presented in pair for 100 or 1500 millisecond(ms), reflecting the preattentive and conscious system respectively. Therefore three indexes are concerned: 1) 100ms engagement, as indicator of preattentive threat evaluation system (PTES); 2) 1500ms engagement, reflecting function of guided, including prior preattentive, threat evaluation system (GTES); 3) 1500 ms disengagement, indicating the input from guided effort toward target. Participants are divided into 1) chronic disease vs. non-chronic disease; 2) high trait anxiety vs. low trait anxiety. Multiple regression analyses were conducted with three attentional bias indexes as predictor and different anxiety responses indexes as dependent variables in each group.
The results implicated: 1) GTES and insufficient guided effort are able to predict multiple anxious psychophysiological indexes, especially EDA-related ones; 2) Trait anxiety of chronic disease patients could be predicted by PTES; 3) Tendency to avoid ambiguous stimuli in chronic disease and low trait anxiety groups predicts stronger immediate EMG responses. The results suggested that two conscious processes in the hypothesized model are related to anxiously psychophysiological responses, but the relationship to trait anxiety might be influenced by coping. Furthermore, the result implicated that EDA responses are related to attentional bias, and EMG is related to avoidant bias in chronic disease and low trait anxiety groups, thus different components in emotion might be related to different tendency in attention process.
Subjects
Chronic disease
Attentional bias
Anxiety
Emotion
Psychophysiology
Spatial cueing task
Preattentive threat evaluation
Guided threat evaluation
SDGs
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