FPCEE Blanquerna, University of Ramon-Llull, Barcelona, Spain
Received: 06 October, 2015; Accepted: 17 December, 2015; Published: 19 December, 2015
Alvaro Frías, Faculty of Psicologia, Ciencies de l´Educació i l´Esport Blanquerna, c/ Císter, 34, 08022, Barcelona, Spain, Tel: 0034 937417700; Fax: 0034 937417711; E-mail:
Frías A (2016) Different Patterns of Attentional Bias in Subjects with Spider Phobia: A Dot Probe Task using Virtual Reality Environment. Presentation of Two Cases. Arch Depress Anxiety 2(1): 001-006. DOI: 10.17352/2455-5460.000006
© 2015 Frías A. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Attentional bias; Spider phobia; Virtual reality; Hypervigilance; Avoidance
Background: Cognitive theories posit that small animal phobics develop a hypervigilance-avoidance attentional pattern when coping with threat. However, empirical research has failed to obtain consistent results. We aimed at addressing this issue by diminishing the methodological flaws that hinder the internal and ecological validity of previous studies.
Methods: In this research, 34 spider fearful and 33 non-fearful participants completed a probe dot task using virtual reality environments. A subjective threshold for each participant was established. Position of the probe (low vs. up) and interval between trials (regular vs. irregular) were controlled.
Results: Compared to non-fearful individuals, spider phobics showed preconscious attentional bias towards threat in unexpected (low and irregular) trials. Moreover, phobics tended to display conscious attentional bias away from threat in unexpected (irregular) trials. Severity of fear did not correlate with attentional bias.
Limitations: We did not use eye movement tracking as well as potential biomarkers for attentional bias (e.g., event-related potentials). The risk of type-I error cannot be ruled out.We did not use eye movement tracking as well as potential biomarkers for attentional bias (e.g., event-related potentials). The risk of type-I error cannot be ruled out.
Conclusions: These findings partly support the hyper vigilance-avoidance pattern by considering some contextual factors that may enhance uncertainty in phobics. The alleged role of attentional bias in phobias is also questioned.
Cognitive theories posit that attentional bias may play a role in the onset and maintenance of specific phobias [1,2]. Specifically, it has been postulated that patients’ attentional processes are characterized by a hyper vigilance-avoidance pattern [3,4]. Accordingly, attentional bias towards threatening stimuli occurs when threat processing is automatic/preconscious and is away from them when threat processing is strategic/conscious. This implies that phobics initially direct their attention towards fear-relevant stimuli, followed by avoidance that is thought to prevent objective evaluation and habituation.
Because spiders are among the most common specific phobias, various experimental studies have been conducted in order to test this tentative model, most of them using a change detection paradigm . Concerning this issue, empirical research has failed to show consistent findings regarding the time course of processing emotional stimuli so far [6-12]. It has been postulated that some contextual variables may account for these divergences, either the position of the dot or the regularity among trials. Preliminary data suggest that both factors may alter attentional bias by increasing the degree of uncertainty when individuals cannot predict the appearance of threats . Moreover, research usually relies on an accurate threshold presentation (e.g., 100/200 milliseconds) to determine whether stimuli are detected by covert (preconscious) and/or overt (conscious) processing [7,14]. This methodological flaw precludes the determination of subjective threshold for each subject by assuming a generalized (objective) awareness threshold for the whole sample. Furthermore, the ecological validity of these studies is still inadequate, and most of them employ threatening pictures to assess phobia to spider rather than more realistic environments [5,7,15]. In this framework, virtual reality may be considered an alternative approach to enhancing the ecological validity from these studies by using more realistic, immersive, and interactive scenarios. To date, virtual reality has been mainly adapted to treat individuals diagnosed with different mental disorders such as anxiety disorders or eating disorders [16-18]. However, its application in basic cognitive research is lacking.
Aims and hypotheses
Based on previous research, our study aimed at elucidating the time course of emotional processing of threat in individuals with spider phobia by increasing the internal and ecological validity of the results obtained. We hypothesized that phobic individuals, relative to non-phobic controls, will display a preconscious attentional bias towards threatening stimuli as well as a conscious attentional bias away from threatening stimuli. In addition, we postulate that this result will be altered by the degree of uncertainty and uncontrollability concerning the appearance and position of the threatening stimuli. That is, phobic individuals will exhibit enhanced preconscious attentional bias towards as well as increased conscious attentional bias away from threatening stimuli when these appear at irregular (vs. regular) intervals. Similarly, the position of the threatening stimuli will affect phobic individuals by enhancing both types of attentional bias when the threat appears more away from the straight view. As indicated by some authors, threats located on the “lower” side would appear more away from the straight view than threats located on the “upper” side [3,19]. In addition, there will be a positive relationship between the severity of phobia and attentional bias according to cognitive theories of anxiety disorders. Overall, we expect that our results will confirm the hypervigilance-avoidance pattern.
The participants were undergraduate and postgraduate students recruited via advertisements at local universities placed in Valencia and Castellon (Spain) over two academic courses. The clinical sample was comprised of individuals diagnosed with spider phobia (N=34) according to DSM-IV criteria , and were compared with non-phobic control individuals (N=33). Diagnostic confirmation was made by independent researchers (clinical psychologists) who were blind to the hypothesis. Individuals (n=2) with visual deficits affecting task performance (e.g., hypermetropia) were ruled out. Mean age for the whole sample was 25.93 (SD=4.77, range=19-35 years), and most of them (88%) were women. There were no between-group differences regarding age (t=.47, df=49, p=.39, Cohen´s d=.42), gender (ﭏ2=2.78, df=1, p=.35, Cramer´s V=.25), marital status (ﭏ2=3.01, df=3, p=.21, Cramer´s V=.32), or educational attainment (ﭏ2=3.45, df=3, p=.13, Cramer´s V=.35)
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- The State-Trait Anxiety Inventory (STAI) , is a self-report inventory based on a 4-point Likert-type response options. The STAI consists of 40 questions that measure transient (STAI-E) and permanent (STAI-R) anxiety. The STAI presents adequate psychometric properties .
- The Fear of Spiders Questionnaire (FSQ) is an 18-item self-report questionnaire assessing spider phobia based on a 7-point Likert-type response options . The FSQ has excellent psychometric properties .
The Pentium III with 600x400 pixels was used. After completing the questionnaires, individuals were sitting 30 centimetres away from the monitor. The virtual scenario used was an uninhabited house in which the individuals may initially move anywhere inside (living, kitchen, restroom) through the keyboard buttons over 5 minutes. Some objects could be manipulated and heard when moved (e.g., closing/opening doors). Before starting the experiments, individuals were asked to follow a signal that guided them to a lighted room with some antique objects (e.g., woods, table) (Figure 1). The objective of all these was to increase the feeling of familiarity and absorption (realism) within the virtual environment.
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