Heterogeneity of the Anxiety-Related Attention Bias: A Review and Working Model for Future Research

Abstract

Anxiety-related attention bias (AB) has been studied for several decades as a clinically relevant output of the dynamic and complex threat-detection and -response system. Despite research enthusiasm for the construct of AB, current theories and measurement approaches cannot adequately account for the growing body of mixed, contradictory, and null findings. Drawing on clinical, neuroscience, and animal models, we argue that the apparent complexity and contradictions in the empirical literature can be attributed to the field’s failure to clearly conceptualize AB heterogeneity and the dearth of studies on AB that consider additional cognitive mechanisms in anxiety, particularly disruptions in threat-safety discrimination and cognitive control. We review existing research and propose a working model of AB heterogeneity, positing that AB may be best conceptualized as multiple subtypes of dysregulated processing of, and attention to, threat anchored in individual differences in threat-safety discrimination and cognitive control. We review evidence for this working model and discuss how it can be used to advance knowledge of AB mechanisms and inform personalized prevention and intervention approaches.