Free-viewing multi-stimulus eye tracking task to index attention bias for alcohol versus soda cues:Satisfactory reliability and criterion validity

Cognitive -motivational models point to attention bias (AB) as an important factor in the persistence of problematic drinking behavior. Unfortunately, the measures that have been used to examine AB in addiction typically showed poor psychometric properties. To bring research on AB a critical step further it would be crucial to develop tasks with acceptable reliability and construct validity. Recently, Lazarov and colleagues (2016) developed a multi-stimulus free-viewing task (participants were free to look at any part of the screen and there was no secondary task involved) that showed excellent psychometric properties in the context of social anxiety as well as depression. We, therefore, adapted this task and examined its psychometric quality within the context of alcohol use. Participants with varying levels of alcohol use (N = 100) were presented with 54 matrices each containing 8 alcoholic and 8 non-alcoholic drinks. Each matrix was presented for 6 s. First fixation (100 ms) location and latency and total dwell time were assessed for alcohol and soda pictures. Assessment of AB, craving, and alcohol use (problems) was repeated after 3–8 days. Specifically, the dwell-time based AB-measure showed excellent internal reliability and considerable stability. Supporting the validity of the current AB-measures, it was found that participants with higher scores on craving and alcohol problems (i) dwelt longer on alcohol stimuli, and (ii) more often showed a first fixation on alcohol, whereas (iii) stronger craving was associated with shorter latency of first alcohol fixations. The AB-measure showed promising psychometric properties. Thus, this free-viewing eye-tracking task seems a welcome new tool for being used in future research on AB in addiction

A pictorial dot probe task to assess food-related attentional bias in youth with and without obesity : overview of indices and evaluation of their reliability

Several versions of the dot probe detection task are frequently used to assess maladaptive attentional processes associated with a broad range of psychopathology and health behavior, including eating behavior and weight. However, there are serious concerns about the reliability of the indices derived from the paradigm as measurement of attentional bias towards or away from salient stimuli. The present paper gives an overview of different attentional bias indices used in psychopathology research and scrutinizes three types of indices (the traditional attentional bias score, the dynamic trial-level base scores and the probability index) calculated from a pictorial version of the dot probe task to assess food-related attentional biases in children and youngsters with and without obesity. Correlational analyses reveal that dynamic scores (but not the traditional and probability indices) are dependent on general response speed. Reliability estimates are low for the traditional and probability indices. The higher reliability for the dynamic indices is at least partially explained by general response speed. No significant group differences between youth with and with obesity are found, and correlations with weight are also non-significant. Taken together, results cast doubt on the applicability of this specific task for both experimental and individual differences research on food-related attentional biases in youth. However, researchers are encouraged to make and test adaptations to the procedure or computational algorithm in an effort to increase psychometric quality of the task and to report psychometric characteristics of their version of the task for their specific sample

Evaluating Changes in Error-Monitoring Electrocortcial Responses as an Outcome of Attention Bias Modification Training

Anxiety disorders are among one of the most debilitating and prevalent mental disorders. Maladaptive anxiety has been associated with enhanced attention bias to threat as well as heightened error-monitoring following an erroneous response. In an effort to reduce an anxious individual’s attention bias to threat, an attention training paradigm known as attention bias modification (ABM) was developed. While ABM training has demonstrated the ability to reduce attention bias and anxiety symptoms, there are inconsistencies in the magnitude of symptom reduction and there is a lack of neuroimaging support in regards to ABM outcome. Therefore, this study evaluated the outcome of ABM training using error-related negativity (ERN) an event-related potential (ERP) that is associated with an error-monitoring response after an individual commits an error. To elicit an erroneous response a modified flanker task paradigm was used. The ERN has the potential to be used as a measure of ABM outcome due to the common neural structures that both processes recruit – in particular, the anterior cingulate cortex (ACC). The results demonstrate no reduction in anxiety following ABM, but reductions in attention bias in both the ABM and control groups. There were also no significant relationships between ERN and ABM outcome, suggesting that ERN is not an effective measure of functional outcome. Limitations and future directions involving multi-session ABM and functional outcomes are discussed

Measuring food-related attentional bias

Objective: Food-related attentional bias has been defined as the tendency to givepreferential attention to food-related stimuli. Attentional bias is of interest as studies havefound that increased attentional bias is associated with obesity; others, however, havenot. A possible reason for mixed results may be that there is no agreed upon measureof attentional bias: studies differ in both measurement and scoring of attentional bias.Additionally, little is known about the stability of attentional bias over time. The presentstudy aims to compare attentional bias measures generated from commonly usedattentional bias tasks and scoring protocols, and to test re-test reliability.Methods: As part of a larger study, 69 participants (67% female) completed two food-related visual probe tasks at baseline: lexical (words as stimuli), and pictorial (picturesas stimuli). Reaction time bias scores (attentional bias scores) for each task werecalculated in three different ways: by subtracting the reaction times for the trials whereprobes replaced (1) neutral stimuli from the trials where the probes replaced all foodstimuli, (2) neutral stimuli from the trials where probes replaced high caloric food stimuli,and (3) neutral stimuli from low caloric food stimuli. This resulted in three separateattentional bias scores for each task. These reaction time results were then correlated.The pictorial visual probe task was administered a second time 14-days later to assesstest-retest reliability.Results: Regardless of the scoring use, lexical attentional bias scores were minimal,suggesting minimal attentional bias. Pictorial task attentional bias scores were larger,suggesting greater attentional bias. The correlation between the various scores wasrelatively small (r= 0.13–0.20). Similarly, test-retest reliability for the pictorial task waspoor regardless of how the test was scored (r = 0.20–0.41).Conclusion: These results suggest that at least some of the variation in findingsacross attentional bias studies could be due to differences in the way that attentionalbias is measured. Future research may benefit from either combining eye-trackingmeasurements in addition to reaction times

The relationship between trait eating behaviours and food-related attentional biases

Attentional bias (AB) refers to the tendency to selectively attend to (orientation towards) and/or hold attention on (slowed disengagment from) disorder-relevant stimuli. Females with eating-related concerns are thought to preferentially process threatening stimuli, which in turn is thought to maintain and exacerbate eating concerns. The aim of the present thesis was to explore AB for threatening stimuli in females characterised by restrained, external or emotional eating, and those with high levels of (non-clinical) eating psychopathology. This was carried out with the intention of identifying cognitive processes that contribute to eating behaviours in females, in order to assess the relevance of an attention training (AT) programme for reducing such biases. A pilot study assessed orientation/slowed disengagement, for mood and food words amongst females with high/low levels of restraint. Forty females completed a modified Stroop task with three conditions. Food and mood conditions included sequences of five words ( target food/mood followed by four neutral). The neutral condition consisted of all neutral words. Performance did not significantly differ according to high/low restraint groups. All participants took longest to colour-name word position 2 (demonstrating slowed disengagement lasting one consecutive trial). However, this pattern was also found in the neutral condition. Methodological limitations were then addressed in study one. High/low restrained eaters (n=48) completed a modified Stroop where targets (food, interpersonal threat, animal) were presented prior to four neutral words. Participants were slow to disengage from targets (slowest for word position 2) in all conditions. Patterns of responding indicated that restrained eaters might take longer to disengage (i.e. the carry-over effect from the food word seemed to last longer than one trial). However, more neutral words in the sequence were needed to assess this. As slowed disengagement from animals also arose, a categorical effect may have occurred. Study two explored attention processing of food using modified Stroop and dot probe tasks. In the Stroop task targets (food, interpersonal threat, household objects) were presented prior to six matched neutral words. This task revealed no evidence of AB. No significant pattern of differences between restrained (n=29)/unrestrained eaters (n=31) emerged; however, binge eating scores were significantly negatively correlated with response times. A dot probe task with food/neutral picture pairs also revealed no evidence of AB. Both restrained/unrestrained eaters had negative mean interference scores indicating avoidance of food. None of the following eating behaviours significantly correlated with AB: restraint, disinhibition, external eating, emotional eating and non-clinical eating psychopathology. Study three employed a further modified dot probe task based on image ratings. There was no evidence of AB, and no significant relation between task performance and restrained, emotional or external eating. 2000ms bias scores (assessing disengagement) were significantly negatively correlated with eating psychopathology and age, suggesting that those with high levels of non-clinical eating psychopathology attentionally avoid food stimuli and that younger females are slower to disengage attention from food (although found within a limited age range). Study four employed further modified Stroop and dot probe tasks, and assessed whether AB mediates the negative mood-eating relationship. Participants were allocated to negative or neutral mood conditions. No evidence of AB was found with the dot probe, but greater levels of emotional eating were associated with slower responding. In the Stroop task, all participants displayed an orientation bias towards food. Emotional eating and drive for thinness (DFT) scores were significantly positively correlated with food word colour-naming times but only amongst participants in a negative mood. However, those with high levels of external eating showed greater AB towards food when in a neutral mood. Highly emotional eaters in a negative mood showed a greater desire to eat than those in a neutral mood but did not increase in food intake. Furthermore, those with a high DFT (in a negative mood) showed no evidence of increased desire to eat or food intake. AB was not significantly related to subjective appetite or food intake. Therefore, AB does not seem to mediate the negative-mood eating relationship. The present thesis provides important suggestions for modifications of Stroop and dot probe tasks targeting orientation and disengagement. A modified Stroop has been more sensitive at detecting food AB than the dot probe. Implications of biased attention processing are discussed in relation to the development of harmful eating behaviours, and the present findings have important implications for developing programmes to prevent eating disorders amongst at-risk females (e.g. through AT or training at-risk females how to effectively cope with negative mood)

Stability, reliability and cross-mode correlations of tests in a recommended 8-minute performance assessment battery

A need exists for an automated performance test system to study drugs, agents, treatments, and stresses of interest to the aviation, space, and environmental medical community. The purpose of this present study is to evaluate tests for inclusion in the NASA-sponsored Automated Performance Test System (APTS). Twenty-one subjects were tested over 10 replications with tests previously identified as good candidates for repeated-measure research. The tests were concurrently administered in paper-and-pencil and microcomputer modes. Performance scores for the two modes were compared. Data from trials 1 to 10 were examined for indications of test stability and reliability. Nine of the ten APT system tests achieved stability. Reliabilities were generally high. Cross-correlation of microbased tests with traditional paper-and-pencil versions revealed similarity of content within tests in the different modes, and implied at least three cognition and two motor factors. This protable, inexpensive, rugged, computerized battery of tests is recommended for use in repeated-measures studies of environmental and drug effects on performance. Identification of other tests compatible with microcomputer testing and potentially capable of tapping previously unidentified factors is recommended. Documentation of APTS sensitivity to environmental agents is available for more than a dozen facilities and is reported briefly. Continuation of such validation remains critical in establishing the efficacy of APTS tests

The Effects of Stress Induction on Pre-attentive and Attentional Bias for Threat in Social Anxiety

The current investigation is a test of the vigilance-avoidance model of attentional processing in a socially anxious sample (Mogg, Bradley, de Bono, & Painter, 1997). The theory proposes that individuals with social phobia possess a pre-attentive bias for social threat cues in their environment, however, they subsequently fail to process this information due to strategic cognitive avoidance, that is, conscious efforts to disengage attention from threatening information. A combined subliminal/supraliminal emotional Stroop paradigm was employed in order to examine patterns of pre-attentive and attentional processing of threat cues in an analogue sample of undergraduate students with high versus low levels of social anxiety. Attentional patterns were assessed both prior to and after the initiation of an anxiety induction procedure. It was predicted that, when subjected to stress, socially anxious individuals would automatically orient their attention to social threat cues, however, they would not maintain their attentional focus on the cues sufficiently to allow objective evaluation of them. Thus, theoretically, habituation to the anxiety produced by the social threat cues would be prevented and anxiety would be maintained over the long term. Socially anxious individuals demonstrated pre-attentive vigilance for both social and physical threat cues, followed by avoidance of such cues in later, voluntary stages of attention (i.e., the vigilance-avoidance pattern) in the absence of stress. However, when subjected to an anxiety induction procedure, the attentional pattern of the socially anxious individuals was altered. The initial pre-attentive vigilance for threat appeared to continue into later, strategic stages of attention. That is, they did not appear to be capable of overriding their pre-attentive bias for threat and attention remained engaged on the threat cues. Contrastingly, under stress, the non-anxious control group demonstrated a pattern of avoidance of threat cues in pre-attentive and attentional stages. The these findings are discussed in light of the vigilance-avoidance model and another recently-proposed theory of attentional bias (Fox et. al., 2001, 2002)

EXAMINING THE BEHAVIORAL MECHANISM OF COCAINE CUE ATTENTIONAL BIAS

Heightened attentional bias towards cocaine-related stimuli relative to neutral stimuli is a characteristic observed in cocaine-use disorders. Response time is an indirect measure of attention and research has failed to consistently demonstrate evidence of clinical relevance. Eye tracking presents a novel tool for directly measuring attentional allocation. The aim of this dissertation was to assess the sensitivity, reliability, and specificity of attentional bias through fixation and response time during the visual probe task. In the visual probe task, substance-related and matched neutral images were presented side-by-side on a computer screen. Eye-tracking technology measured time spent fixating on each image. A probe then replaced one image and time to respond was measured. Attentional bias was defined as the difference between neutral and substance-related images for fixation time and response time. A programmatic series of experiments was conducted using the visual probe task to demonstrate the sensitivity, reliability, and specificity of attentional bias as measured by fixation time during the visual probe task. Cocaine users displayed a robust and reliable cocaine cue attentional bias as measured by fixation time. Non-cocaine-using controls did not display a cocaine cue attentional bias. Fixation time was specific to substance use history. Individuals dependent on both cocaine and alcohol displayed an attentional bias to both substances, whereas individuals dependent on cocaine only displayed an attentional bias towards cocaine, but not alcohol. Fixation time also correlated with craving and deprivation. Cigarette cue attentional bias correlated positively with self-reported cigarette craving. Response time was a less sensitive measure of attentional bias, displayed low reliability, and did not correlate with substance use severity. Unlike response time, eye tracking applied to the visual probe task is a sensitive, reliable, and specific measure of attentional bias in cocaine users. Importantly, fixation time during the visual probe task is sensitive to clinically relevant differences in substance abuse. This outcome is consistent with incentive motivational hypotheses, proposing that reward-paired cues obtain incentive salience. These findings provide future directions for attentional bias research, such as applying eye tracking to treatment-related outcomes

Is attentional bias a cause of persistent low back pain?

Low back pain is the leading cause of disability worldwide. Attentional bias has been hypothesised to underlie the development of persistent low back pain, however this has not been investigated using reliable outcome measures and with appropriate consideration for confounding. Researchers have recently begun to use eyetracking technology to assess attentional bias in painful conditions, however the reliability of eye tracking to assess the different stages of attentional bias (early, late, overall) is unclear. The primary research questions were: (1) What is the reliability of eye tracking to assess attentional bias? (2) Is there evidence that people with acute low back pain have an attentional bias to threat words? (3) Does attentional bias cause persistent low back pain? A systematic review and a test-retest reliability study were conducted to investigate the reliability of eye tracking to assess attentional bias. Reliable eye-tracking attentional bias outcomes were compared in people with and without acute low back pain. The causal relationship between attentional bias of people with acute low back pain and persistent low back pain (persistent pain, disability and pain intensity at three and six months) was determined. Directed acyclic graphs were used to identify confounding variables that may bias the causal role of attentional bias in the development of persistent low back pain. The results of the systematic review were inconclusive. The results of the test-retest reliability study indicated that eye tracking outcome measures that assess late and overall stages of attentional bias are reliable for investigating attentional bias. There was no evidence that people with acute low back pain have an attentional bias to threat words. An attentional bias away from emotionally threatening words was identified a causal factor in the development of low back pain related disability, but not in the development of persistent pain or pain intensity related to low back pain. Reliable eye tracking outcome measures that assess the early stage of attentional bias are not available and require further investigation. Future research should include attentional bias in causal models that seek to explore why some people develop persistent low back pain

Identifying and Intervening on Neural Markers of Attention to Threat in Children with Anxiety Disorders

Objective: Attention Bias Modification Training (ABMT) for anxiety aims to train attention away from threatening stimuli and toward neutral stimuli. Although ABMT shows promising anxiety reduction effects in children and adolescents, no study has examined its influence on neural indicators of attention measured using event-related potentials (ERPs) in children or adolescents (i.e., youths). The present study examined the influence of ABMT on the P1, N170, P2 and P3 ERP components during completion of the emotional faces dot probe task in youths with anxiety disorders who failed to respond to cognitive behavioral therapy. Method: Thirty youths (M age = 11.97, SD = 2.89) with primary DSM-IV-TR anxiety disorders completed the dot probe task while undergoing electroencephalogram (EEG) to obtain ERPs before, immediately after, and eight weeks after eight sessions of either ABMT (n = 14) or a control task regimen (CT), (n = 16). Results: At post-treatment, statistically significant effects were found for P1 and P3 mean amplitudes: P1 was significantly higher during trials showing neutral-neutral (NN) face pairs in the ABMT arm than in the CT arm; P3 was significantly higher during trials showing NN face pairs than during trials showing neutral-threat (NT) face pairs in the ABMT arm, but not the CT arm. At eight-week follow-up, participants in both arms showed significantly higher (more negative) N170 responses for NN trials than for NT trials. Conclusions: Attention Bias Modification Treatment led to increases in neural processing of neutral stimuli in early and late stage attentional processing, as measured by the P1 and P3 components, respectively. These components during the dot probe task are promising neural markers of ABMT’s effects on attentional processing in youth with anxiety disorders