Heterogeneity of the Anxiety-Related Attention Bias: A Review and Working Model for Future Research
Tracy A. Dennis-Tiwary, Amy Krain Roy, Samantha Denefrio, and Sarah Myruski
Anxiety-related attention bias (AB) is characterized by selective or exaggerated attention toward threatening information and seems to be a concept with different aspects and with complex relationships with anxiety. In this review, Dennis-Tiwary and colleagues propose a working model of AB that incorporates subtypes and variability. They say AB should no longer be considered solely a tendency to focus attention on a threat instead of away from it. Behavioral and neurophysiological research indicates, for instance, that AB toward threat is associated with distress-related disorders, such as generalized anxiety disorder. Meanwhile, AB away from threat is associated with fear-related disorders, such as phobias. According to this threat-discrimination and cognitive-control model of AB, four subtypes of AB heterogeneity can be identified: (a) labile, characterized by low threat-safety discrimination (TD; ability to discriminate between safe and threatening cues) and low cognitive control (CC), with high variability in AB; (b) vigilant, characterized by high TD and low CC, with a bias toward threatening information; (c) avoidant, characterized by high TD and high CC, with a bias away from threatening information; and (d) no bias, characterized by low TD and high CC. The authors propose that this model can lead to personalized interventions for anxiety disorders, with treatment tailored to an individual’s AB subtype.