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Eye-Tracking Evidence of a Maintenance Bias in Social Anxiety

Published online by Cambridge University Press:  22 June 2017

Catarina Fernandes
Department of Psychology and Educational Sciences, University of Algarve, Faro, Portugal
Susana Silva
Center for Biomedical Research - CBMR/Center for Psychology at the University of Porto, Portugal
Joana Pires
Department of Psychology and Educational Sciences, University of Algarve, Faro, Portugal
Alexandra Reis
Center for Biomedical Research - CBMR, Department of Psychology and Educational Sciences, University of Algarve, Faro, Portugal
Antónia Jimenez Ros
Department of Psychology and Educational Sciences, University of Algarve, Faro, Portugal
Luís Janeiro
Department of Psychology and Educational Sciences, University of Algarve, Faro, Portugal
Luís Faísca
Center for Biomedical Research - CBMR, Department of Psychology and Educational Sciences, University of Algarve, Faro, Portugal
Ana Teresa Martins*
Center for Biomedical Research - CBMR, Department of Psychology and Educational Sciences, University of Algarve, Faro, Portugal
Correspondence to Ana Teresa Martins, Department of Psychology and Educational Sciences, University of Algarve Campus de Gambelas, 8005-000 Faro, Portugal. E-mail:


Background: The mechanisms and triggers of the attentional bias in social anxiety are not yet fully determined, and the modulating role of personality traits is being increasingly acknowledged. Aims: Our main purpose was to test whether social anxiety is associated with mechanisms of hypervigilance, avoidance (static biases), vigilance-avoidance or the maintenance of attention (dynamic biases). Our secondary goal was to explore the role of personality structure in shaping the attention bias. Method: Participants with high vs low social anxiety and different personality structures viewed pairs of faces (free-viewing eye-tracking task) representing different emotions (anger, happiness and neutrality). Their eye movements were registered and analysed for both whole-trial (static) and time-dependent (dynamic) measures. Results: Comparisons between participants with high and low social anxiety levels did not yield evidence of differences in eye-tracking measures for the whole trial (latency of first fixation, first fixation direction, total dwell time), but the two groups differed in the time course of overt attention during the trial (dwell time across three successive time segments): participants with high social anxiety were slower in disengaging their attention from happy faces. Similar results were obtained using a full-sample, regression-based analysis. Conclusion: Our results speak in favour of a maintenance bias in social anxiety. Preliminary results indicated that personality structure may not affect the maintenance (dynamic) bias of socially anxious individuals, although depressive personality structures may favour manifestations of a (static) hypervigilance bias.

Research Article
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

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Abramowitz, J. Fabricant, L., Taylor, S., Deacon, B. J., McKay, D. and Storch, E. A. (2014). The relevance of analogue studies for understanding obsessions and compulsions. Clinical Psychology Review, 34, 206217.CrossRefGoogle ScholarPubMed
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, fifth edition, DSM-V. England: New School Library.Google Scholar
Amir, I., Zvielli, A. and Bernstein, A. (2016). (De) coupling of our eyes and our mind's eye: a dynamic process perspective on attentional bias. Emotion, 16, 978986. CrossRefGoogle Scholar
Amir, N., Elias, J., Klumpp, H. and Przeworski, A. (2003). Attentional bias to threat in social phobia: facilitated processing of threat or difficulty disengaging attention from threat? Behavior Research and Therapy, 41, 13251335.Google Scholar
Armstrong, T. and Olantunji, B. (2012). Eye tracking of attention in the affective disorders: a meta-analytic review and synthesis. Clinical Psychology Review, 32, 704723.CrossRefGoogle ScholarPubMed
Bantin, T., Stevens, S., Gerlach, A. L. and Hermann, C. (2016). What does the facial dot-probe task tell us about attentional processes in social anxiety? A systematic review. Journal of Behavior Therapy and Experimental Psychiatry, 50, 4051.CrossRefGoogle ScholarPubMed
Beck, A. T. (1967). Depression: Clinical, Experimental, and Theoretical Aspects. New York: Harper and Row.Google Scholar
Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. New York: International Universities Press.Google Scholar
Benjamini, Y. and Hochberg, Y. (1995). Controlling the false discovery rate: a practical and powerful approach to multiple testing. Journal of the Royal Statistical Society – Series B, 57, 289300.Google Scholar
Binelli, C., Muñiz, A., Sanches, S., Ortiz, A., Navines, R., Egmond, E. and Nartín-Santos, R. (2015). New evidence of heterogeneity in social anxiety disorder: defining two qualitatively different personality profiles taking into account clinical environmental and genetic factors. European Psychiatry, 30, 160165.CrossRefGoogle ScholarPubMed
Bögels, S. M. and Mansell, W. (2004). Attention processes in the maintenance and treatment of social phobia: hypervigilance, avoidance and self-focused attention. Clinical Psychology Review, 24, 827856.Google Scholar
Buckner, J. D., Maner, J. K. and Schmidt, N. B. (2010). Difficulty disengaging attention from social threat in social anxiety. Cognitive Therapy and Research, 34, 99105.CrossRefGoogle ScholarPubMed
Budescu, D. V. (1993). Dominance analysis: a new approach to the problem of relative importance of predictors in multiple regression. Psychological Bulletin, 114, 542551.CrossRefGoogle Scholar
Calvo, M. G. and Avero, P. (2005). Time course of attentional bias to emotional scenes in anxiety: gaze direction and duration. Cognition and Emotion, 19, 433451.CrossRefGoogle ScholarPubMed
Chen, N. T. M., Clarke, P. J. F., MacLeod, C. and Guastella, A. J. (2012). Biased attentional processing of positive stimuli in social anxiety disorder: an eye movement study. Cognitive Behavior Therapy, 41, 96107.Google Scholar
Cisler, J. M. and Koster, E. H. W. (2010). Mechanisms of attentional biases towards threat in anxiety disorders: an integrative review. Clinical Psychology Review, 30, 203216.Google Scholar
Clark, D. M. and Wells, A. (1995). A cognitive model of social phobia, in Heimberg, R. G., Liebowitz, M. R., Hope, D. A. and Schnieder, F. R. (eds), Social Phobia: Diagnosis, Assessment, and Treatment (pp. 6993). New York, NY: Guilford Press.Google Scholar
Clarke, P. J. F., MacLeod, C. and Guastella, A. J. (2013). Assessing the role of spatial engagement and disengagement of attention in anxiety-linked attentional bias: a critique of current paradigms and suggestions for future research directions. Anxiety, Stress and Coping, 26, 119.Google Scholar
Dearing, K.F. and Gotlib, I.H. (2009). Interpretation of ambiguous information in girls at risk for depression. Journal of Abnormal Child Psychology, 37, 7991.CrossRefGoogle ScholarPubMed
Duque, A. and Vazquez, C. (2015). Double attention bias for positive and negative emotional faces in clinical depression: evidence from an eye-tracking study. Journal of Behavioral Therapy and Experimental Psychiatry, 16, 107114.CrossRefGoogle Scholar
Fan, C., Zhang, D. and Zhang, C.H. (2011). On sample size of the Kruskal–Wallis test with application to a mouse peritoneal cavity study. Biometrics, 67, 213224.CrossRefGoogle ScholarPubMed
Faul, F., Erdfelder, E., Lang, A.G. and Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175191.CrossRefGoogle ScholarPubMed
Fernandes, S. and Bramão, I. (2013). Hemispheric lateralization for chimeric faces in autistic spectrum disorders. Masters dissertation, Universidade do Algarve, Portugal.Google Scholar
Fox, E., Russo, R., Bowles, R. and Dutton, K. (2001). Do threatening stimuli draw or hold visual attention in subclinical anxiety? Journal of Experimental Psychology, 130, 681700.Google Scholar
Fox, E., Zougkou, K., Ashwin, C. and Cahill, S. (2015). Investigating the efficacy of attention bias modification in reducing high spider fear: the role of individual differences in initial bias. Journal of Behavior Therapy and Experimental Psychiatry, 49, 8493.CrossRefGoogle ScholarPubMed
Gamble, A. L. and Rapee, R. M. (2010). The time-course of attention to emotional faces in social phobia. Journal of Behavior Therapy and Experimental Psychiatry, 41, 3944.Google Scholar
Garner, M., Clarke, G., Graystone, H. and Baldwin, D. S. (2011). Defensive startle response to emotional social cues in social anxiety. Psychiatry Research, 186, 150152.Google Scholar
Garner, M., Mogg, K. and Bradley, B. (2006). Orienting and maintenance of gaze to facial expressions in social anxiety. Journal of Abnormal Psychology, 115, 760770.CrossRefGoogle ScholarPubMed
Gotlib, I. H. and Joormann, J. (2010). Cognition and depression: current status and future directions. Annual Review of Clinical Psychology, 6, 285312.CrossRefGoogle ScholarPubMed
Horley, K., Williams, L. M., Gonsalvez, C. and Gordon, E. (2003). Social phobics do not see eye to eye: a visual scanpath study of emotional expression processing. Journal of Anxiety Disorders, 17, 3344.Google Scholar
Kashdan, B. T., Weeks, W. J. and Savostyanova, A. A. (2011). Whether, how, and when social anxiety shapes positive experiences and events: a self-regulatory framework and treatment implications. Clinical Psychology Review, 31, 786799.Google Scholar
Kaspar, K. and König, P. (2012). Emotions and personality traits as high-level factors in visual attention: a review. Frontiers in Human Neuroscience, 6, 321.CrossRefGoogle ScholarPubMed
Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R. and Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617627.CrossRefGoogle ScholarPubMed
Kircanski, K., Joorman, J. and Gotlib, I. (2015). Attention to emotional information in social anxiety disorder with and without co-occurring depression. Cognitive Therapy Research, 39, 153161.CrossRefGoogle Scholar
Lange, W.-G., Heuer, K., Langner, O., Keijsers, G. P. J., Becker, E. S. and Rinck, M. (2011). Face value: eye movements and the evaluation of facial crowds in social anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 42, 355363.Google Scholar
Lazarov, A., Abend, R. and Bar-Haim, Y. (2016). Social anxiety is related to increased dwell time on socially threatening faces. Journal of Affective Disorders, 193, 282288.Google Scholar
Lundqvist, D., Flykt, A. and Öhman, A. (1998). The Karolinska Directed Emotional Faces – KDEF. Department of Clinical Neuroscience, Psychology Section, Karolinksa Institutet, Stockholm, Sweden.Google Scholar
McManus, F., Sacadura, C. and Clark, D. (2008). Why social anxiety persists: an experimental investigation of the role of safety behaviours as a maintaining factor. Journal of Behaviour Therapy and Experimental Psychiatry, 39, 147161.Google Scholar
McTeague, L. M., Shumen, J. R., Wieser, M. J., Lang, P. J. and Keil, A. (2011). Social vision: sustained perceptual enhancement of affective facial cues in social anxiety. Neuroimage, 54, 16151624.Google Scholar
Millon, T., Millon, C., Davis, R. and Grossman, S. (2009). MCMI-III Manual (fourth edition). Minneapolis, MN: Pearson Education.Google Scholar
Mogg, K., Bradley, B. P., De Bono, J. and Painter, M. (1997). Time course of attentional bias for threat information in non-clinical anxiety. Behaviour Research and Therapy, 35, 297303.Google Scholar
Mogg, K., Bradley, B., Miles, F. and Dixon, R. (2004). Brief report time course of attentional bias for threat scenes: testing the vigilance-avoidance hypothesis. Cognition and Emotion, 18, 689700.Google Scholar
Morgan, H. and Raffle, C. (1999). Does reducing safety behaviours improve treatment response in patients with social phobia? Australia and New Zealand Journal of Psychiatry, 33, 503510.CrossRefGoogle ScholarPubMed
Morrison, A. S. and Heimberg, R. G. (2013). Social anxiety and social anxiety disorder. Annual Review of Clinical Psychology, 9, 249274.Google Scholar
Peckham, A. D., McHugh, R. K. and Otto, M. W. (2010). A meta-analysis of the magnitude of biased attention in depression. Depression and Anxiety, 27, 11351142.CrossRefGoogle ScholarPubMed
Perlman, S. B, Morris, J. P., Vander, W. B. C., Green, S. R. and Doyle, J. L. (2009). Individual differences in personality predict how people look at faces. PLOS ONE, 4, 5952.CrossRefGoogle Scholar
Pinto-Gouveia, J., Cunha, M. I. and Salvador, M. C. (2003). Assessment of social phobia by self-report questionnaires: the social interaction and performance anxiety and avoidance scale and the social phobia safety behaviors scale. Behavior and Cognitive Psychotherapy, 31, 291311.Google Scholar
Preacher, K. J., Rucker, D. D., MacCallum, R. C. and Nicewander, W. A. (2005). Use of the extreme groups approach: a critical reexamination and new recommendations. Psychological Methods, 10, 178192.CrossRefGoogle ScholarPubMed
Premack, D. and Woodruff, G. (1978). Does the chimpanzee have a theory of mind?. Behavioural and Brain Sciences, 1, 515526.Google Scholar
Purdon, C., Antony, M., Monteiro, S. and Swinson, R.P. (2001). Social anxiety in college students. Journal of Anxiety Disorders, 15, 203215.Google Scholar
Rapee, R. M. and Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behavior Research and Therapy, 35, 741756.CrossRefGoogle ScholarPubMed
Rauthmann, J. F., Seubert, C. T., Sachse, P. and Furtner, M. R. (2012). Eyes as windows to the soul: gazing behaviour is related to personality. Journal of Research Personality, 46, 147156.CrossRefGoogle Scholar
Raven, J., Raven, J. C. and Court, J. H. (1998). Manual for Raven's Progressive Matrices and Vocabulary Scales. Section 1. General Overview. San Antonio: The Psychological Corporation.Google Scholar
Reitan, R. M. (1958). Validity of the trail making test as an indicator of organic brain damage. Perceptual Motor Skills, 8, 271276.CrossRefGoogle Scholar
Roelofs, K., Putman, P., Schouten, S., Lange, W. G., Volman, I. and Rinck, M. (2010). Gaze direction differentially affects avoidance tendencies to happy and angry faces in socially anxious individuals. Behavior Research and Therapy, 48, 290294.Google Scholar
Russell, G.C. and Shaw, S. (2009). A study to investigate the prevalence of social anxiety in a sample of higher education students in the United Kingdom. Journal of Mental Health, 18, 198206.CrossRefGoogle Scholar
Schmidt, N., Richey, A., Buckner, J. and Timpano, K. (2009). Attention training for generalized social anxiety disorder. Journal of Abnormal Psychology, 118, 514.Google Scholar
Schofield, C. A., Johnson, A. L., Inhoff, A. W. and Coles, M. E. (2012). Social anxiety and difficulty disengaging threat: evidence from eye-tracking. Cognition and Emotion, 26, 300311.CrossRefGoogle ScholarPubMed
Shechner, T., Jarcho, J., Britton, J., Leibenluft, E., Pine, D. and Nelson, E. (2013). Attention bias of anxious youth during extend exposure of emotional face pairs: an eye tracking study. Depression and Anxiety, 30, 1421.CrossRefGoogle ScholarPubMed
Stangier, U., Heidenreich, T. and Schermelleh-Engel, K. (2006). Safety behaviors and social performance in patients with generalized social phobia. Journal of Cognitive Psychotherapy, 20, 1731.Google Scholar
Talati, A., Pantazatos, S. P., Schneier, F. R., Weissman, M. M. and Hirsch, J. (2013). Gray matter abnormalities in social anxiety disorder: primary, replication, and specificity studies. Biological Psychiatry, 73, 7584.Google Scholar
Vassilopoulos, S. P. (2005). Social anxiety and the vigilance-avoidance pattern of attentional processing. Behavioral and Cognitive Psychotherapy, 33, 1324.Google Scholar
Wechsler, D. (1945). A standardized memory scale for clinical use. Journal of Psychology, 19, 8795.Google Scholar
Weeks, J. W., Heimberg, R. G. and Rodebaugh, T. L. (2008a). The fear of positive evaluation scale: assessing a proposed cognitive component of social anxiety disorder. Journal of Anxiety Disorders, 22, 4455.Google Scholar
Weeks, J. W., Heimberg, R. G., Rodebaugh, T. L. and Norton, P. J. (2008b). Exploring the relationship between fear of positive evaluation and social anxiety. Journal of Anxiety Disorders, 22, 386400.Google Scholar
Weeks, J. W. and Howell, A. N. (2012). The bivalent fear of evaluation model of social anxiety: further integrating findings on fears of positive and negative evaluation. Cognitive Behavioral Therapy, 41, 8395.Google Scholar
Weierich, M. R., Treat, T. A. and Hollingworth, A. (2008). Theories and measurement of visual attentional processing in anxiety. Cognition and Emotion, 22, 9851018.CrossRefGoogle Scholar
Wieser, M. J., Pauli, P., Alpers, G. W. and Mühlberger, A. (2009a). Is eye to eye contact really threatening and avoided in social anxiety? An eye-tracking and psychophysiology study. Journal of Anxiety Disorders, 23, 93103.Google Scholar
Wieser, M. J., Pauli, P., Weyers, P., Alpers, G. W. and Mühlberger, A. (2009b). Fear of negative evaluation and the hypervigilance-avoidance hypothesis: an eye-tracking study. Journal of Neural Transmission, 116, 717723.Google Scholar
Wu, L., Pu, J., Allen, J. J. B. and Pauli, P. (2012). Recognition of facial expressions in individuals with elevated levels of depressive symptoms: an eye-movement study. Depression Research and Treatment, doi: 10.1155/2012/249030 CrossRefGoogle ScholarPubMed
Yekutieli, D. and Benjamini, Y. (1999). Resampling-based false discovery rate controlling multiple test procedures for correlated test statistics. Journal of Statistical Planning and Inference, 82, 171196.CrossRefGoogle Scholar
Zvielli, A., Bernstein, A. and Koster, E. H. W. (2014). Dynamics of attentional bias to threat in anxious adults: bias towards and/or away? PLOS ONE, 9, 19.CrossRefGoogle ScholarPubMed
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