Attentional biases of vigilance and maintenance in obsessive-compulsive disorder: An eye-tracking study

Abstract Background and objectives Attentional biases play an important role in the development and maintenance of obsessive-compulsive disorder (OCD). Previous studies using reaction time tasks in OCD have produced inconsistent results. This is the first study to measure attentional biases in patients with several subtypes of OCD using eye tracking. Methods Twenty-eight patients with OCD and 21 healthy controls were assessed using a free-viewing paradigm, incorporating contamination-related, checking-related, and neutral stimuli. Attentional patterns were measured using an eye tracker. A possible vigilance bias was assessed using entry time, and a possible maintenance bias was assessed using dwell time. Results Patients with checking-related symptoms of OCD showed a maintenance bias but no vigilance bias in regard to checking-related compared to neutral stimuli. No differences in attention were found in patients with contamination-related symptoms. Limitations Internal validity is restricted due to a high overlap between subgroups, the lack of negative (not OCD-related) control stimuli, and the absence of a clinical control group. Conclusions Patients with checking-related symptoms of OCD showed a maintenance bias to checking-related stimuli. Due to methodological limitations, the results should be considered preliminary and need to be replicated before firm conclusions can be drawn.

[1]  A. Radomsky,et al.  A novel cognitive intervention for compulsive checking: Targeting maladaptive beliefs about memory. , 2016, Journal of behavior therapy and experimental psychiatry.

[2]  E. Foa,et al.  Inflated perception of responsibility for harm in OCD patients with and without checking compulsions: a replication and extension. , 2002, Journal of anxiety disorders.

[3]  M. Kyrios,et al.  Automatic and strategic processing in obsessive-compulsive disorder: attentional bias, cognitive avoidance or more complex phenomena? , 1998, Journal of anxiety disorders.

[4]  J. Hyönä,et al.  Eye movement assessment of selective attentional capture by emotional pictures. , 2006, Emotion.

[5]  T. Dalgleish,et al.  The emotional Stroop task and psychopathology. , 1996, Psychological bulletin.

[6]  M. Hautzinger,et al.  Reliabilität und Validität des revidierten Beck-Depressions-inventars (BDI-II). Befunde aus deutschsprachigen Stichproben , 2007 .

[7]  A. Pickering,et al.  Attentional bias in obsessional compulsive disorder. , 1996, Behaviour research and therapy.

[8]  Thomas Armstrong,et al.  Attentional bias toward threat in contamination fear: overt components and behavioral correlates. , 2012, Journal of abnormal psychology.

[9]  David Mataix-Cols,et al.  A multidimensional model of obsessive-compulsive disorder. , 2005, The American journal of psychiatry.

[10]  M. Hautzinger,et al.  Reliabilität und Validität des revidierten Beck-Depressionsinventars (BDI-II) , 2007, Der Nervenarzt.

[11]  J. Abramowitz,et al.  Obsessive-compulsive and related disorders: a critical review of the new diagnostic class. , 2015, Annual review of clinical psychology.

[12]  P. Vivekananda-Schmidt,et al.  Viewing behaviour of spider phobics and non-phobics in the presence of threat and safety stimuli. , 2004, The British journal of clinical psychology.

[13]  Edna B. Foa,et al.  Information processing in obsessive—compulsive disorder , 1993, Cognitive Therapy and Research.

[14]  Thomas Armstrong,et al.  Eye tracking of attention in the affective disorders: a meta-analytic review and synthesis. , 2012, Clinical psychology review.

[15]  T. Heidenreich,et al.  Mindfulness-based cognitive therapy in obsessive-compulsive disorder: protocol of a randomized controlled trial , 2014, BMC Psychiatry.

[16]  G. Venkatasubramanian,et al.  Emotional interference in obsessive–compulsive disorder: A neuropsychological study using optimized emotional Stroop test , 2010, Psychiatry Research.

[17]  P. Lang,et al.  International Affective Picture System (IAPS): Instruction Manual and Affective Ratings (Tech. Rep. No. A-4) , 1999 .

[18]  A. von Mühlenen,et al.  Evidence for an attentional bias for washing- and checking-relevant stimuli in obsessive–compulsive disorder , 2009, Journal of the International Neuropsychological Society.

[19]  M. Bloch,et al.  Obsessive-Compulsive Disorder: Advances in Diagnosis and Treatment , 2017, JAMA.

[20]  E. Erdfelder,et al.  Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses , 2009, Behavior research methods.

[21]  Henk J Groenewegen,et al.  Disorder-specific neuroanatomical correlates of attentional bias in obsessive-compulsive disorder, panic disorder, and hypochondriasis. , 2005, Archives of general psychiatry.

[22]  Y. Bar-Haim,et al.  Content specificity of attention bias to threat in anxiety disorders: a meta-analysis. , 2015, Clinical psychology review.

[23]  Rebecca M. Todd,et al.  Affective Salience Can Reverse the Effects of Stimulus-Driven Salience on Eye Movements in Complex Scenes , 2012, Front. Psychology.

[24]  S. Rachman,et al.  Cognitive-Behavior Therapy for Compulsive Checking in OCD. , 2010 .

[25]  T. Hergueta,et al.  The mini international neuropsychiatric interview , 1998, European Psychiatry.

[26]  Paul Wilson,et al.  Obsessive-compulsive symptoms and attentional bias: An eye-tracking methodology. , 2016, Journal of behavior therapy and experimental psychiatry.

[27]  N. Amir,et al.  Attenuation of attention bias in obsessive-compulsive disorder. , 2009, Behaviour research and therapy.

[28]  A. Fritzsche,et al.  The approach-avoidance task as an online intervention in cigarette smoking: a pilot study. , 2015, Journal of behavior therapy and experimental psychiatry.

[29]  S. Stevens,et al.  Eye movement assessment in individuals with social phobia: differential usefulness for varying presentation times? , 2011, Journal of behavior therapy and experimental psychiatry.

[30]  Mike Rinck,et al.  Spider fearful individuals attend to threat, then quickly avoid it: evidence from eye movements. , 2006, Journal of abnormal psychology.

[31]  I. Hand,et al.  Reliabilität der deutschen Version der Yale-Brown Obsessive Compulsive Scale , 2003, Verhaltenstherapie.

[32]  I. Hand,et al.  Die Yale-Brown Obsessive Compulsive Scale (Y-BOCS): Ein halbstrukturiertes Interview zur Beurteilung des Schweregrades von Denk- und Handlungszwängen , 1991 .

[33]  Y. Bar-Haim,et al.  Social anxiety is related to increased dwell time on socially threatening faces. , 2016, Journal of affective disorders.

[34]  Mairwen K. Jones,et al.  No evidence of attentional bias in obsessive compulsive checking on the dot probe paradigm. , 2009, Behaviour research and therapy.

[35]  R. Leonhart,et al.  [The German version of the obsessive-compulsive inventory-revised: a brief self-report measure for the multidimensional assessment of obsessive-compulsive symptoms]. , 2007, Psychotherapie, Psychosomatik, medizinische Psychologie.

[36]  M. Corbetta,et al.  Control of goal-directed and stimulus-driven attention in the brain , 2002, Nature Reviews Neuroscience.

[37]  T. Rodebaugh,et al.  Unreliability as a threat to understanding psychopathology: The cautionary tale of attentional bias. , 2016, Journal of abnormal psychology.

[38]  S. Waechter,et al.  Measuring Attentional Bias to Threat: Reliability of Dot Probe and Eye Movement Indices , 2014, Cognitive Therapy and Research.

[39]  R. Leonhart,et al.  The Obsessive-Compulsive Inventory-Revised (OCI-R): validation of the German version in a sample of patients with OCD, anxiety disorders, and depressive disorders. , 2008, Journal of anxiety disorders.

[40]  J. Norberto Pires,et al.  Eye-Tracking Evidence of a Maintenance Bias in Social Anxiety. , 2017, Behavioural and cognitive psychotherapy.

[41]  Andrew Hollingworth,et al.  Theories and measurement of visual attentional processing in anxiety , 2008 .

[42]  D. Marazziti,et al.  THE ROLE OF GUILT SENSITIVITY IN OCD SYMPTOM DIMENSIONS , 2017, European Neuropsychopharmacology.

[43]  S. Rachman.  A cognitive theory of compulsive checking. , 2002, Behaviour research and therapy.

[44]  J. Abramowitz,et al.  Obsessive-compulsive disorder , 2006, The Lancet.

[45]  M. Verbraak,et al.  The emotional Stroop: a comparison of panic disorder patients, obsessive-compulsive patients, and normal controls, in two experiments. , 2002, Journal of anxiety disorders.

[46]  A. V. van Balkom,et al.  Obsessive-compulsive disorder; chronic versus non-chronic symptoms. , 2014, Journal of affective disorders.

[47]  S. Moritz,et al.  Examination of emotional Stroop interference in obsessive-compulsive disorder. , 2004, Behaviour research and therapy.

[48]  M. Coles,et al.  Social anxiety and difficulty disengaging threat: Evidence from eye-tracking , 2012, Cognition & emotion.

[49]  Jie-Li Tsai,et al.  Sustained visual attention for competing emotional stimuli in social anxiety: An eye tracking study. , 2017, Journal of behavior therapy and experimental psychiatry.

[50]  C. MacLeod,et al.  Attentional bias in emotional disorders. , 1986, Journal of abnormal psychology.

[51]  Thomas Armstrong,et al.  Orienting and maintenance of gaze in contamination fear: Biases for disgust and fear cues. , 2010, Behaviour research and therapy.

[52]  E. Fox,et al.  Do threatening stimuli draw or hold visual attention in subclinical anxiety? , 2001, Journal of experimental psychology. General.

[53]  C. Pittenger,et al.  Meta-analysis of the symptom structure of obsessive-compulsive disorder. , 2008, The American journal of psychiatry.

[54]  N. Kathmann,et al.  A pilot study on the validity of using pictures and videos for individualized symptom provocation in obsessive–compulsive disorder , 2012, Psychiatry Research.

[55]  D. Sheehan,et al.  The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. , 1998, The Journal of clinical psychiatry.

[56]  S. Chong,et al.  Obsessive–compulsive disorder: prevalence, correlates, help-seeking and quality of life in a multiracial Asian population , 2012, Social Psychiatry and Psychiatric Epidemiology.