Background: Maladaptive patterns of attention to emotional stimuli are a clinical feature of posttraumatic stress disorder (PTSD). Using eye-tracking-based methodology, research points out the presence of sustained attention to threatening stimuli in individuals with PTSD. However, most eye-tracking studies in this field used free-viewing tasks on negative stimuli.Methods: PTSD patients (n = 38), trauma-exposed healthy controls (TEHC; n = 30), and non-trauma-exposed healthy controls (HC; n = 33) performed a Face in the Crowd (FiC) task. The FiC task was chosen to explore specific responses to emotional stimuli within a competitive visual environment, thus providing insights into visual search patterns. Both reaction time and gaze patterns (dwell time, scanpath length, first fixation duration, and latency) were recorded.Results: Individuals with a provisional PTSD diagnosis presented decreased dwell time on both positive and negative targets in comparison with HC and TEHC, as well as shorter scanpath length for all matrixes when no targets were present. No evidence of attentional bias was observed in the TEHC group based on reaction times or eye-tracking measures in response to positive, negative, or neutral cues.Discussion: We found an attentional avoidance pattern among PTSD patients, along with indexes of lowered perceptual threshold for all emotional information. This study allows raising the question of cognitive load on the emergence of differential attentional strategies presented by PTSD participants. We discuss the generalization of fear processes across different emotional stimuli and underscore the need for incorporating a variety of emotional stimuli in PTSD research.

Identification of reliable behavioral markers for posttraumatic stress disorder (PTSD) can offer objective measures beyond self-reports to aid in diagnosis, treatment, and prevention. Attention bias variability (ABV), defined as fluctuations in attention toward or away from threat-related stimuli, has been associated with PTSD. Reaction time-based ABV (RT-ABV) has been extensively studied and shown to be linked with PTSD symptomatology. An eye-tracking-based ABV index (ET-ABV) was only recently introduced, and results show that it may be associated with trauma exposure rather than with PTSD symptoms. However, these two ABV types have yet to be studied within the same sample. The current study explored the association between trauma exposure, PTSD symptom severity, and ABV measures, applying both the classic RT-ABV and the new ET-ABV in the same sample. Participants with PTSD (n = 41), trauma-exposed healthy controls (TEHC; n = 71), and non-trauma-exposed healthy controls (HC; n = 38) completed an eye-tracking free-viewing matrix task and a response-based dot-probe task using the same threat-related stimuli (angry faces) across tasks. Results indicate that both RT-ABV and ET-ABV were significantly higher in participants with PTSD compared to participants in the TEHC and HC groups, with no significant difference between the latter groups. Additional analyses indicate that although moderately correlated, each of the ABV measures explains unique portions of the variance in PTSD severity. This study replicates and extends prior findings on the association between ABV and PTSD and highlights the potential of ET-ABV as a novel and reliable marker for PTSD severity.

Cognitive theories suggest that biased suicide-related attentional processing confers risk for suicide ideation (SI) and attempts (SAs), but studies to date, which have been mixed, have not compared lower- and higher-order measures of attentional processes. The present study examined attention fixation, attention disengagement, and semantic interference as predictors of future SI and SA among adolescents, a high-risk age group for onset of SI and SAs. Adolescents (N = 135) (75 % female), ages 12-19 (M = 15.4, SD = 1.9), who presented to emergency or outpatient departments with SI (n = 84) or a SA (n = 51) completed an attention disengagement task (ADT), Suicide Stroop task, and the Attentional Fixation on Suicide Experiences Questionnaire (AFSEQ). A subsample of adolescents completed 3-month (n = 98) and 12-month follow-up assessments (n = 96) of SI severity and SA (n = 118) (based on adolescent or caregiver report). AFSEQ score predicted SI severity at 3- and 12-months, respectively, b = 0.47, p < .05; b = 0.44, p < .01, adjusting for ADT and relevant covariates, and also predicted SA at follow up, OR = 1.06, 95 % CI = 1.00-1.12, p < .05, adjusting for SA history, but not after adjusting for SI. Greater suicide-related attention disengagement difficulty predicted greater SI severity at 12 months, b = 0.03, p < .05, but not at 3 months. Self-reported, higher-order, attentional fixation may better predict future suicide-related risk among diverse adolescents than lower-order cognitive tasks assessing suicide-related attention disengagement or semantic interference.

During competition, athletes must suppress task-irrelevant stimuli to effectively attend to performance-related information. Understanding how emotional stimuli capture attention and consume cognitive resources is vital for studying attention regulation in athletes. This study assessed athletes' ability to inhibit emotional distractions using the Sport Emotional Stroop Task in English (SEST-E). Administered to 66 English-speaking athletes, the task revealed significantly longer reaction time for negative valence sports words and shorter reaction time for positive valence words compared to neutral valence words. These results support the valence hypothesis and the negativity bias. Emotional valence distinctly influences attentional processing, with negative stimuli prolonging distraction by task-irrelevant information and positive stimuli facilitating traction to task-relevant information. The latter findings provide evidence for the mood-as-information theory. Incorporating negative valence stimuli into training to improve attention control and emphasizing positive aspects of training and competition are practical applications from the present findings. Overall, the SEST-E appears to be a valuable tool for researchers and practitioners to assess and address emotional influence on athlete performance.

Generalised anxiety disorder (GAD) is associated with cognitive and physiological symptoms including uncontrollable worry, inhibitory control deficits, and low heart rate variability (HRV). Literature linking HRV and inhibition in GAD is predominantly correlational. The present experiment investigated whether HRV has a causal role in maintaining inhibitory control. Participants (N = 135, 111 female) aged 18-37 reporting high levels of symptoms associated with GAD (GAD-7 scores ≥ 10; Penn State Worry Questionnaire scores ≥ 56) were assigned to an experimental or active control condition and completed baseline measures of HRV, respiration rate, and inhibitory control. The experimental condition completed resonance frequency breathing (RFB) training, and the control condition practiced breathing at their mean breathing rate before repeating the inhibitory control assessment. Participants also completed the breathing training before a behavioural worry task. The experimental condition was predicted to show increased HRV, alongside improved inhibitory control and better ability to stop worrying as compared to the control condition. HRV increased during the experimental condition, as compared to the control condition. However, there were no significant effects of RFB on inhibitory control or worry, or on HRV during the inhibitory control tasks. In conclusion, RFB can increase HRV in high GAD scorers, but further research is required to determine whether there is a relationship between increased HRV and symptoms of GAD in a single session experiment.

Contextual cues and emotional states carry expectations and biases that are used to attribute meaning to what we see. In addition, emotional states, such as anxiety, shape our visual systems, increasing overall, and particularly threat-related, sensitivity. It remains unclear, however, how anxiety interacts with additional cues when categorising sensory input. This is especially important in social scenarios where ambiguous gestures are commonplace, thus requiring the integration of cues for a proper interpretation. To this end, we decided to assess how states of anxiety might bias the perception of potentially aggressive social interactions, and how external cues are incorporated in this process. Participants (N = 71) were tasked with signalling the presence of aggression in ambiguous social interactions. Simultaneously, an observer (facial expression) reacted (by showing an emotional expression) to this interaction. Importantly, participants performed this task under safety and threat of shock conditions. Decision measures and eye-tracking data were collected. Our results showed that threat of shock did not affect sensitivity nor criterion when detecting aggressive interactions. The same pattern was observed for response times. Drift diffusion modelling analysis, however, suggested quicker evidence accumulation when under threat. Finally, dwell times over the observer were higher when under threat, indicating a possible association between anxiety states and a bias towards potentially threat-related indicators. Future probing into this topic remains a necessity to better explain the current findings.

Non-invasive brain stimulation (NIBS) has the potential to treat generalized anxiety disorder (GAD). To assess the efficacy (response/remission/post-treatment continuous anxiety severity scores) and acceptability (failure to complete treatment for any reason) of NIBS, we searched PubMed, Web of Science, and the Cochrane Library (as of April 2024) for articles on NIBS for GAD and conducted a network meta-analysis of eight randomized trials (20 treatment arms, 405 participants). Data were pooled using standardized mean difference (SMD) and odds ratio (OR) with 95 % confidence interval (CI). Repetitive transcranial magnetic stimulation (rTMS) was the most widely studied treatment for GAD. The right dorsolateral prefrontal cortex (DLPFC) was the most common treatment target for GAD. High-frequency rTMS showed higher response rates (OR 291.40, 95 % CI 13.08 to 6490.21) and remission rates (OR 182.14, 95 % CI 8.72 to 3805.76) compared with other active therapies. Continuous theta burst stimulation (cTBS) greatly improved continuous post-treatment anxiety severity scores (SMD -2.56, 95 % CI -3.16 to -1.96). No significant differences in acceptability were found between the treatment strategies and the sham stimulation group. These findings provide evidence to consider NIBS techniques as alternative or adjunctive treatments for GAD.

Fear generalization has been identified as an important mechanism that might contribute to the etiology and maintenance of anxiety disorders. It is, however, yet unclear to what degree attentional processes contribute to overgeneralization of fear in clinical samples. To address this issue, we utilized a set of facial photographs that was meticulously created such that pairs of faces could either be distinguished by looking into the eyes or the region around mouth and nose, respectively. These pairs were then employed as CS+ and CS- in a differential fear conditioning paradigm followed by a generalization test with morphs in steps of 20 %, creating a continuum between CS+ and CS-. In a sample with diverse levels of social and general anxiety (N = 87), we demonstrated that the amount of fear generalization depends on attentional orienting towards diagnostic facial features. While social anxiety did not affect the shape of generalization gradients, we observed altered visual exploration patterns and a distinct multi-phasic heart rate modulation in participants with higher social anxiety. General anxiety symptomatology was also related to these characteristics of visual exploration and additionally predicted a broad elevation of threat ratings. In summary, fear generalization depends on attentional deployment. Future work should build on these findings to further explore these processes in clinical populations.

Increased support for oral health during young adulthood is needed to address trends in oral disease over the life course. Executive functioning (EF) may play a role in supporting oral health but has received little attention. EF represents the capacity to control cognitive information, feelings and behaviour. The current study aimed to explore the association between EF and oral health among young adults and investigate potential mediators.

Young adults aged 18-30 years were recruited from five universities within Norway to take part in a cross-sectional digital survey. Participants self-reported EF, toothbrushing, flossing, dental fear and anxiety (DFA), and provided ratings on two measures of oral health: self-rated oral health (SROH) and self-reported oral health-related quality of life (OHRQoL). Separate analyses were conducted for each outcome. Linear regression was used to test the association between EF and oral health, and whether toothbrushing, flossing, or DFA mediated this effect.

Data from 344 participants were analysed. Average SROH was quite good (M = 4.13), several participants (60.5%) reported some impact on OHRQoL. In the SROH model, EF difficulties directly predicted oral health (β = -0.26), and DFA mediated the relationship (ab = -0.03, p < 0.05). In the OHRQoL model, EF difficulties again predicted performances impacted (β = 0.27), and DFA mediated the relationship (ab = 0.04, p < 0.05).

EF is related to oral health outcomes among young adults and the relationship is mediated by DFA. Studies are encouraged to continue exploring these relationships, with longitudinal studies needed to provide more insight into the potential role of EF as a protective factor for the development of DFA and oral health problems.

Posttraumatic stress disorder (PTSD) is characterized by exaggerated responses to trauma-relevant cues and impairments in relation to contextual information. However, it is not clear whether this dysfunction is related only to memory processes, or whether early perceptual and attentional processing is already dysfunctional. We examined early processing and retrieval of trauma-related cues and neutral contexts in 20 individuals diagnosed with PTSD (PTSD) and 20 trauma-exposed controls without diagnosis of PTSD (NPTSD) using simultaneous high-density electroencephalography and eye-tracking. A group of 20 non-trauma-exposed healthy controls (HC) was employed to test for responses to trauma-unrelated cues and contexts. The earliest visual event-related potential (C1) was positive for individuals diagnosed with PTSD and negative for NPTSD, suggesting enhanced early visual processing of the cue. Eye-tracking showed that PTSD but not NPTSD displayed significantly longer latencies before looking at contexts than at trauma-related cues. The PTSD group performed significantly worse than the NPTSD group in correctly retrieving rearranged cue/context associations compared to consistent associations. Memory strength for rearranged cue-context pairs was significantly predicted by the early processing measures of the context. Perception of traumatic cues in neutral contexts is biased in PTSD at early processing stages and contributes significantly to the impairment in context-relational memories. For trauma-unrelated cues and contexts no significant differences emerged between PTSD and trauma-exposed as well as non-trauma-exposed controls. Treatments for individuals diagnosed with PTSD should focus on early processing, perception and attention of cue/context traumatic associations in addition to contextual memory.

Individuals with anxiety and social anxiety direct their attention toward emotionally neutral task-irrelevant distractors. However, what happens after attention is paid to neutral distractors remains unknown. This study examined whether attention to distractors enhances long-term memory (LTM) of distractors in individuals with anxiety and social anxiety. Participants performed a visual-search task using real-world objects under either anxiety induction (Experiment 1) or no anxiety induction (Experiment 2). Subsequently, in the surprise-recognition task, participants were required to indicate whether an object had been shown in the visual-search task. The results showed that anxiety and social anxiety, especially the fear of negative evaluation, positively correlated with attentional bias toward neutral distractors. Moreover, mediation analysis showed significant indirect effects of anxiety and social anxiety on LTM through attentional bias. These results suggest that individuals with anxiety and social anxiety involuntarily direct their attention to distractors, which enhances their LTM.

Neurostimulation techniques, such as continuous theta-burst stimulation (cTBS), over the dorsolateral prefrontal cortex (DLPFC) have been associated with improvements in anxiety symptoms and emotion processing. The aim of this feasibility study was the evaluation of the effectiveness of cTBS over the right DLPFC combined with Attention Modification Training (AMT) on reducing levels of anxiety and attentional bias. A 40s-cTBS session (real or sham) over the right DLPFC was administrated at 8 treatment sessions over a 2-week period, and each cTBS treatment was followed by computer-based AMT (real or control). Eighty-nine participants (Mage = 21.29, SD = 2.06, 50.56% females) differentiated on levels of anxiety were randomly assigned to the following treatment groups (i) cTBS and AMT, (ii) cTBS and control AMT, and (iii) sham cTBS and AMT. Findings suggested that cTBS combined with AMT treatment was not superior to sham cTBS and AMT on reducing self-reported anxiety symptoms. However, combined cTBS and AMT was associated with increased attention towards positive stimuli and increased gaze fixation in the mouth region of happy facial expressions. Current results provide promising evidence for the effectiveness of AMT in reducing anxiety symptoms and contribute to existing knowledge on how inhibitory stimulation over the right DLPFC combined with AMT may influence emotion processing. Present findings can inform future treatments designed to address the attention mechanisms leading to anxiety symptoms.

The present study assessed whether dementia worry is associated with adults' subjective cognitive difficulties, and whether any associations are moderated by age. Participants were 477 adults aged 18-90 years. They completed standard, subjective measures of dementia worry and everyday cognitive difficulties (i.e. attention, language, verbal and visual-spatial memory, and visual-perceptual ability). Moderated regression analyses included dementia worry as a predictor of specific cognitive difficulties, and age as a moderator. Covariates included gender, trait cognitive and somatic anxiety, general aging-related anxiety, depression, stress, mental health treatment status, and health status. Greater overall dementia worry, and specifically more frequent dementia worry, were both associated with greater attentional difficulty in middle-aged and older adults, but not in young adults. Cognitions about developing dementia in reaction to memory lapses were also associated with greater cognitive difficulties across the adult lifespan for multiple cognitive domains. Results highlight a robust relationship between dementia worry and subjective attentional difficulties, especially in middle-aged and older adults. Worry frequency is also more influential with adult aging. A cognitive or meta-cognitive mechanism may underlie subjective cognitive concerns across the adult lifespan.

Natural disasters have a devastating impact on children. Parents' perception and awareness of the symptoms of mental disorders in children following a disaster event is an important element for early diagnosis and treatment. The study focused on developing the Turkish version of the Parents' Cognitive Perception Inventory on the Effects of Disasters on Children's Well-Being (PCP-DCWB-TR), ensuring cultural and linguistic adaptation and maintaining its reliability and validity.

A methodological approach was adopted, and 213 parents were included in the study. Data collection was conducted online between March and June 2023 using the Socio-Demographic Characteristics Questionnaire and the PCP-DCWB-TR. Statistical analysis included descriptive statistics, and reliability was assessed using Cronbach's alpha, test-retest, and item-total score analysis.

Exploratory and confirmatory factor analyses were conducted and revealed 16 items in two subscales, explaining 55.43 % of the total variance. The scale showed high reliability with a Cronbach's alpha of 0.89, while confirmatory factor analysis confirmed the model with a mean error of approximation of 0.080. Test-retest results showed a strong correlation (Pearson correlation 0.78, p < 0.001).

The adapted PCP-DCWB-TR is a valid and reliable instrument for assessing parents' cognitive perceptions of the impact of disasters on children's well-being in the context of Turkish society.

All healthcare professionals can use this scale in interventional studies aiming at assessing parents' cognitive perceptions of the impact of disasters on children's well-being.

Recent research has focused on the spatial attention bias toward pain-related cues in individuals with fear of pain (FOP), but our understanding of its temporal attention features, particularly regarding emotional faces, is limited. To address this gap, 39 individuals with high fear of pain (H-FOP) and 37 with low fear of pain (L-FOP) completed a rapid serial visual presentation dual task. Participants viewed a series of rapidly presented pictures, first identified neutral building images as the first target (T1) and then emotional faces (painful, neutral, and happy) as the second target (T2). T1 and T2 presented at time intervals of 232 ms (lag 2) and 696 ms (lag 6), respectively. Results indicate that H-FOP group members were less accurate in recognizing faces at lag 2 shortly after correctly identifying T1 compared to those L-FOP group members. Notably, all participants were more accurate in recognizing painful faces at lag 2 than in identifying neutral and happy faces, suggesting a negative bias toward pain stimuli when attentional resources were limited. In contrast, at lag 6, when attentional resources were more abundant, participants showed greater accuracy in recognizing neutral faces than emotional faces. These findings underscore the influence of fear of pain and available cognitive resources on the attentional processing of emotional faces over time, providing insights into how fear of pain affects the temporal dynamics of emotional face recognition and the role of attentional resources.

Even though some recent research revealed individuals with HSA typically display enhanced processing in the early stages of emotional information processing due to hypervigilance and vulnerability to negative stimuli, it is still unclear whether social anxiety affects the time course underlying processing bias for emotional stimuli. Therefore, the present study aimed to explore the early stage of processing social threat stimuli in high social anxiety (HSA) individuals by recording RTs and EEG data in the emotional Stroop task. Behavioral data showed that the HSA group responded to the threat words faster than neutral words (i.e. negative bias), but no emotional effects in the low social anxiety (LSA) group. Although the P1 component did not show any early effects, ERP data exhibited an enhanced N170 for HSA than for LSA groups. Threat words elicited larger N170 than neutral words in the LSA group only; this emotion effect was not evident in the HSA group. These findings indicated that social anxiety modulates early processing for social threat words. This study revealed the neural mechanisms underlying early emotional processing in individuals with social anxiety, providing insights for the evaluation and intervention of social anxiety.

This study examines the impact of emotional distraction on sustained attention using a novel gradual onset continuous performance task (gradCPT). Sustained attention is a foundational cognitive process, vulnerable to both internal (endogenous) and external (exogenous) disruptions. Reliable, validated paradigms to assess internal sources of variation in sustained attention have been used to characterize basic aspects of attention as well as individual differences and neurobiological mechanisms. However, sustained attention can also be disrupted by external distraction, especially highly salient distractors, due to their affective and/or arousing nature. Markedly less work has been conducted to develop reliable and validated paradigms to study these effects on sustained attention. This study introduces a novel task, the emogradCPT, to characterize the impact of emotional distractors (background images) on the ability to sustain attention during an emotionally neutral task (digit discrimination task). Across two experiments and three rounds of data collection, we demonstrate that emotionally negative distractors robustly and reliably disrupt ongoing ability to sustain attention, reflected in reduced accuracy, and slower RTs, relative to neutral, positive, and no distractor conditions. Further, we validated the task by correlating objective and subjective measures of distraction, as well as demonstrating the impact of these distractors on downstream memory encoding and affect. Making these data and tools publicly available, we encourage the use of this paradigm to inform future basic, clinical, and neuroimaging studies of affective interactions with ongoing goal-directed attentional processes.

Although threat-related stimuli can capture attention automatically, recent findings have challenged this assumption by showing that goal rather than threat can be prioritized and eventually guide attentional control. In this study, we used high density electroencephalography (EEG) in 40 participants while peripheral emotional faces (either fear or happiness) were either goal-relevant or irrelevant during a dot-probe task (DPT). The use of peripheral vision was established by eye-tracking. Both the face specific N170 component and the subsequent Early Posterior Negativity (EPN) were enhanced by fear at the cue level, yet the latter one only when fear was goal relevant. Importantly, we found that early on following target onset at the P1 level, both value and goal relevance drove spatial attention and interacted with each other such that when they were goal-relevant, fearful faces captured attention less than when they were not. These results suggest that emotional attention is flexible and it can be influenced by the goal relevance of emotion. Moreover, they shed light on the electrophysiological manifestations of this flexibility and dovetail with the assumption that sensory gain control effects occurring in the visual cortex depending on attentional control are multiplexed and determined by both value and goal.

Contesting the viewpoint that personality impressions are spontaneously extracted from triggering facial cues, recent research suggests that such inferences emerge only when instructions are given to judge individuals in terms of the trait characteristics of interest. Notwithstanding this demonstration, however, it is possible that faces displaying fundamental character traits may exert influence over lower-level aspects of cognition that precede-and serve as the foundation for-impression formation. For example, paralleling work on emotional expressions, faces conveying important traits may automatically attract attentional resources. Accordingly, employing a dot-probe task, the current research explored whether faces varying in dominance (Experiments 1 & 2) and trustworthiness (Experiment 3) trigger attentional capture. The results were consistent across all three experiments. Using both naturalistic and computer-generated faces of women and men, neither dominance nor trustworthiness captured attention. The theoretical implications of these findings are considered.

The objective of this study was to determine if a novel game-based digital therapeutic intervention reduced anxiety symptom severity in adults with clinically elevated symptoms of social anxiety disorder (SAD). Participants were randomly allocated (1:1) to receive four weeks of either the active intervention, a game-based form of attention bias modification (Active ABM) for anxiety, or the sham control training (Control). Between June 2022 to June 2023, 104 participants were enrolled with 93 completing the trial per-protocol and 104 included in the final intention-to-treat analysis (54 intervention, 50 control); mean age was 38.08 (10.56) years and 79 were female. The dependent variable was reduction in SAD symptoms, measured via the Liebowitz SAD Scale (LSAS). Participants were classified as having clinically elevated SAD symptoms only, or both SAD and Generalized Anxiety Disorder (GAD) symptoms (comorbid). The Active condition induced significantly greater reductions in SAD symptoms compared to the Control condition between Baseline and Post-Treatment [Active: M = -29.71, SD = 23.68; Control: M = -14.59, SD = 21.52, d = .67, t(102) = -3.40, p < .001] across the four-week study period. While no significant between-groups differences emerged at each timepoint individually, the Active condition induced significantly greater change over time in SAD symptoms compared to the Control condition. Use of this game-based digital ABM intervention showed benefits in the reduction of anxiety symptoms.

While attentional biases towards negative stimuli have previously been linked to the development and maintenance of anxiety disorders, a current limitation of this research involves the use of static images for stimuli, as they cannot adequately depict the dynamic nature of real-life interactions. Since attentional biases in those with elevated anxiety remain understudied using more naturalistic stimuli, such as dynamic social videos, the purpose of this explorative study was to use novel dynamic stimuli and modern eye-tracking equipment to further investigate negative attentional biases in anxious emerging, female adults. Non-clinical participants (N = 62; mean age = 20.44 years; biologically female) completed validated questionnaires regarding their anxiety symptoms and completed a free-viewing task by watching 30-s video clips while having their eye movements tracked. The video clips were shown in side-by-side pairs (i.e., positive-neutral, negative-neutral, and positive-negative) on a split screen without audio. Overall, participants fixated more quickly on emotional videos (i.e., positive and negative) over neutral ones, with more anxious participants orienting their gaze faster to the videos, regardless of content. Moreover, individuals with greater self-reported anxiety spent more time gazing at negative videos in negative-neutral pairings, highlighting that emerging female adults with increased anxiety symptoms may show a negative attention bias when viewing social interactions. Importantly, by incorporating novel, dynamic stimuli, we expand upon prior research on attentional biases, with the potential to adapt this approach for novel interventions that may ultimately help those suffering from anxiety.

A welfare assessment tool in development must satisfy several criteria before it is considered ready for general use. Some tools that meet many of these criteria have been criticized for their negative effect on welfare. We conducted a preliminary assessment of the impact of attention bias (AB) trials using threat-neutral conspecific face pairs followed by presumed neutral-positive filler stimuli on the behavior of 21 rhesus macaques (Macaca mulatta; 15 female). Behavioral observations were conducted following AB trials and repeated two weeks later when no AB trials had occurred (no trial: NT). The association between observation period and behavior was assessed using linear mixed-effects models in R. Trials did not impact any observed behavior except for fear, which was displayed by five monkeys over six trials (four NT). For this sample, there was a significant reduction in fear behavior following AB trials. We, therefore, found no evidence suggesting that AB trials negatively affect behaviour. AB protocols may be suitable for continued development for primate welfare assessment and we encourage researchers to include assessing test impact on welfare in their AB protocols.

In anxiety disorders, approach-avoidance behavior is typically biased towards excessive, maladaptive avoidance despite costs and impairments (i.e., costly avoidance). Yet, little is known about the underlying decision dynamics that may contribute to such imbalanced behavior. The current study tested for altered temporal decision dynamics in patients with anxiety disorders compared to matched healthy controls in a task where avoiding an aversive stimulus conflicted with obtaining rewards. Participants chose repeatedly between a fixed safe/low reward and a threat/high reward option with varying threat (probability of an aversive stimulus presentation) and reward information (reward magnitude). Structured computer mouse movements required for choosing between options were tracked to capture the temporal dynamics of the decision process (i.e., when and how strongly threat and reward information influenced decision preference). The current study replicated elevated costly threat avoidance in patients with anxiety disorders compared to matched controls. Importantly, time-continuous multiple regression of mouse movements revealed altered temporal dynamics: patients showed a faster (but not stronger) impact of threat and a weaker impact of competing rewards. These findings highlight that not only biases in threat processes but also competing rewards may guide excessive avoidance and could be important treatment targets in anxiety disorders. Future research may support the external validity of these findings in real-life decisions and try to identify therapeutic strategies that allow to specifically target the attenuated impact of rewards and the accelerated impact of threat in patients.

While the highly evolutionarily conserved hypothalamic neuropeptide, oxytocin (OT) can influence cognitive, emotional and social functions, and may have therapeutic potential in disorders with social dysfunction, it is still unclear how it acts. Here, we review the most established findings in both animal model and human studies regarding stimuli which evoke OT release, its primary functional effects and the mechanisms whereby exogenous administration influences brain and behavior. We also review progress on whether OT administration can improve social symptoms in autism spectrum disorder and schizophrenia and consider possible impediments to translational success. Importantly, we emphasize that OT acting via its extensive central or peripheral receptors primarily influences behavior indirectly through neuromodulatory interactions with classical transmitters and other peptides which themselves can independently influence behavior. We also emphasize that exogenous administration studies increasingly demonstrate peripheral effects of OT may be of greater importance than originally thought, especially involving the vagus. Overall, we propose a hierarchical model whereby OT's neuromodulatory actions influence behavior across interconnected functional domains and ultimately help to promote survival, security and sociability. Initially, OT potently facilitates attention to salient social and other important stimuli and additionally modulates cognitive, emotional and reward processing in a person- and context-dependent manner to promote interpersonal social understanding, attraction and bonds on the one hand and social group cohesion through increased conformity, altruistic punishment and moral emotions on the other. OT also increases co-operation and protection across both social domains. We hope this review and model will promote further research and help aid future translation success.

Social anxiety is associated with an intense fear of social evaluation and rejection, often leading to avoidance behaviors and distress. In this review, we summarize the current understanding of how various cognitive biases may lead to the development and maintenance of social anxiety. While early models of social anxiety have focused on negative biases in perception, attention, memory and emotion regulation, more recent literature has started to characterize biases in information-seeking and information-integration, especially in the context of self-referential information and social feedback. We also highlight directions for future work, including characterizing how different biases in social anxiety relate to each other, and how they may help dissociate social anxiety symptoms from co-occurring conditions such as generalized anxiety and depression.

This study examines how attachment styles influence cognitive load during a dot counting task with varying difficulty levels and feedback types. From an initial pool of 96 participants, 27 were selected based on attachment classifications from the Experiences in Close Relationships-Revised (ECR-R) questionnaire. These participants completed the task while receiving personal and group-based feedback, and EEG recordings monitored cognitive load using the theta/beta ratio (TBR). Results show that negative personal feedback consistently elevated cognitive load across all attachment styles. Avoidant and fearful-avoidant individuals did not exhibit significant differences in cognitive load between positive and negative group feedback, suggesting a relatively stable response regardless of feedback valence. In contrast, securely attached individuals showed increased cognitive load under negative feedback conditions. Furthermore, individuals with higher attachment-related anxiety or avoidance experienced more pronounced increases in cognitive load as task difficulty increased. These findings suggest that attachment-related differences shape cognitive responses to feedback and task complexity level. The study highlights the role of adaptive feedback strategies in optimizing cognitive engagement across different attachment profiles.

The aim of the present research was to examine the role of affective information in the functioning of attentional networks in individuals with high vs. low trait or state anxiety. Previous studies suggest that anxiety can influence attentional processes, but the impact of affective information, such as alerting emotional stimuli, on these attentional networks remains unclear.

We conducted a set of experiments using negative or neutral faces as alerting stimuli, presented either alone or together with a neutral sound, within a modified version of the Attention Network Test-Interactions (ANT-I). Additionally, data from previous experiments with similar anxiety groups and without affective manipulations of alertness were analyzed for comparative insights (378 participants in total).

Results showed three main effects on the functioning of attentional networks when affective alerting signals were introduced: (1) the alertness effect is increased, (2) the interference effect is increased, and (3) the orienting effect is decreased. These effects occurred regardless of the valence of the alerting stimuli on a given trial. Importantly, the presence of affective information on some trials eliminated the group differences regarding the functioning of the attentional networks that are usually found when no affective information is presented. Specifically, the larger interference effect commonly observed in individuals with high trait-anxiety and the larger alertness and orienting effects seen in those with high state-anxiety, disappeared when emotional alerting stimuli were included.

The findings suggest that emotional information can significantly impact the functioning of attentional networks, particularly in relation to anxiety. The presence of affective stimuli seems to modulate attentional biases associated with anxiety, potentially neutralizing the usual effects seen in individuals with high trait or state anxiety. The role of affective information on the functioning of the attentional networks is discussed within the framework of anxiety and attention.

Using spatial mapping processes to discriminate between threat and safety is crucial for survival. Little is known why some fail to discriminate during contextual conditioning. We used a virtual reality (VR) contextual conditioning paradigm to elucidate the effects of state and trait anxiety on contextual threat learning. Participants (n = 70) "picked" flowers in a VR environment. Dangerous zone flowers predicted an electric shock, while safe zone flowers did not. Between trials, participants completed a spatial memory task. Galvanic skin response (GSR) and State Trait Anxiety Inventory scores were recorded. Participants were considered learners for correctly identifying both zones. Non-learners, compared to learners, performed worse during the spatial memory task and demonstrated higher state anxiety scores and GSR. Learners showed higher skin conductance response (SCR) in the dangerous compared to the safe zone, while non-learners showed no SCR differences between zones. Results indicate state anxiety may impair spatial mapping, disrupting contextual threat learning.

Mindfulness-based interventions (MBIs) effectively treat anxiety symptoms across different anxiety and related disorders (ARDs), including panic disorder, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. In this systematic review and meta-analysis, we investigate whether MBIs also lead to improvements in the quality of life (QoL) of patients with ARDs. A systematic review was performed through electronic search in PUBMED, PsycINFO, Embase, Web of Science, and Clinical Trials databases. The inclusion criteria comprised randomized controlled trials (RCTs) investigating individuals diagnosed with ARDs who underwent MBIs with QoL as an outcome. The review included 15 RCTs, encompassing 1.465 participants. Broadly speaking, we found that MBIs were more effective than control groups in improving QoL for individuals with ARDs (Standardized Mean Difference, SDM = 0.175, 95 % CI 0.048 to 0.303). Upon classifying studies by control group types, MBIs demonstrated greater effectiveness than non-gold standard interventions (SDM = 0.213, 95 % CI 0.053 to 0.372). Notably, no significant difference was found between MBIs and gold standard interventions (SDM = 0.061, 95 % CI -0.175 to 0.297). MBIs may effectively improve QoL in individuals with ARDs. Further studies with larger samples are needed for more robust conclusions.

Attention performance in chronic migraine remains unclear. The present study aimed to explore the pre-attentive detection and attention orienting ability in individuals with chronic migraine (CM) measured by mismatch negativity (MMN) and P3a components and assess their associations with migraine characteristics.

This cross-sectional observational study recruited 25 individuals with episodic migraine (EM), 25 individuals with CM and 25 healthy controls (HC) matched for age, sex, and educational level. The MMN and P3a components were measured using event-related potential (ERPs) tools with auditory oddball paradigms and migraine characteristics were collected.

Individuals with CM exhibited a longer MMN latency (p = 0.010) and a lower P3a amplitude than HC (p = 0.004) and EM (p = 0.002). Correlation analysis showed that P3a amplitude was negatively correlated with headache attack frequency and the Migraine Disability Assessment Scale (MIDAS), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) scores.

Individuals with CM showed deficits in pre-attentive detection and attention orientation. Moreover, attention-oriented dysfunction is associated with headache attack frequency, headache-related disability, anxiety and depression.

Stimuli perceived as threatening subtly influence how individuals orient their attention, a phenomenon labelled as attentional bias. According to literature, individuals with negatives attitudes toward math would exhibit attentional bias when presented with math-related stimuli. However, attentional bias and its relationships with math anxiety, math self-efficacy, and math skills are understudied, particularly when considering developmental samples. For this reason, the aim of the present study was to assess attentional bias toward math stimuli (i.e., math vs. neutral words) and to evaluate its relationship with math anxiety, math self-efficacy and math skills in fifth and sixth grade students (Mmonths = 135.84; SDmonths = 7.53) tested in January 2023. Findings indicated that children who were more anxious and had lower levels of math self-efficacy and math skills appeared to avoid math stimuli in an attentional bias task. Furthermore, dominance analysis showed that math self-efficacy made the largest average contribution in attentional bias scores, suggesting that motivational constructs would play a central role in the observed attentional bias avoidance patterns. Results could potentially generalize developmental age samples, providing new insight into how avoidance behaviors, even for stimuli that are not purely numerical, would influence children's attentional processes rapidly and automatically, posing a risk factor for maintaining negative attitudes toward math.

The observer-rated Social Performance Rating Scale (SPRS) indexes anxious behaviors exhibited in social contexts. Although the SPRS has been used almost exclusively to study social anxiety disorder (SAD), other emotional disorders are also characterized by heightened responses to social stressors, hinting that the SPRS could serve as a transdiagnostic state measure of behavioral anxiety. To explore this possibility, adults with generalized anxiety disorder or major depressive disorder (n = 105) and adults with no psychopathology (n = 35) delivered a speech to a committee of mock behavioral experts. Behavioral anxiety observed during the speech was rated using the SPRS, then examined in relation to clinical and state measures of anxiety and depression. Contrary to our hypotheses, behavioral anxiety was not associated with clinician- or self-rated anxiety or depression severity. Instead, behavioral anxiety was heightened among individuals who specifically fear and avoid public speaking; who perceived the speech task to be more stressful; and who reported more emotional distress, somatic hyperarousal, and anxious and pessimistic thoughts at the time of the speech. The SPRS is a valid measure of anxious behavior in the many individuals, with and without SAD, who experience acute anxiety in social-evaluative contexts. As behavioral measures are resource-intensive to collect, research is needed to establish whether the SPRS predicts anxious behavior and functional impairment in real-world settings, over and above easier-to-obtain self-report measures.

A proposed strategy for attenuating the return of fear is conducting exposure therapy in multiple contexts (e.g., different locations), which is believed to enhance the generalizability of safety learning. Although conducting exposure in multiple contexts can be differentiated from conducting exposure with multiple stimuli, the two strategies are often conflated. Furthermore, researchers have not yet determined whether one of these strategies, or a combination thereof, is most effective in attenuating fear renewal.

Accordingly, the present treatment-analogue study examined the unique and combined effects of multiple-context and multiple-stimulus imagery-based exposure manipulations on threat expectancy, behavioral approach/anxiety, and attentional bias for threat over Zoom. Community adults (N = 134) who met diagnostic criteria for snake phobia were randomized to exposure to a single snake in multiple environmental contexts (MC), exposure to multiple snakes in a single environmental context (MS), or exposure to multiple snakes in multiple environmental contexts (MS/MC).

Results revealed significant reductions in threat expectancy and behavioral anxiety, but not attentional bias for threat in all three groups. However, behavioral approach declined over the course of exposure in the MS/MC condition but remained stable in the MC and MS conditions. There were no significant group differences in behavioral approach/anxiety or attentional bias at a one-week follow-up. However, participants in the MC condition reported lower threat expectancy at a one-week follow-up than the other groups and this group difference was partially mediated by lower mean distress during exposure.

Implications of these findings for the inhibitory retrieval theory are discussed.

The emotional dot-probe task is a widely used measure of attentional bias to threat. Recent work suggests, however, that subtraction-based behavioral measures of emotional dot-probe performance may not be appropriate for measuring such attentional biases due to poor reliability. In the two current studies, we systematically tested thirty-six versions of the emotional dot-probe that varied in stimuli (faces, scenes, snakes/spiders), timings (stimulus onset asynchrony of 100, 500, 900 milliseconds), stimulus orientations (horizontal, vertical), and trial types (e.g., threat congruent and threat incongruent). Across 9,600 participants, none of the 36 versions demonstrated internal reliability greater than zero. Reliability was similarly poor in anxious participants (based on Generalized Anxiety Disorder 7 Items or Brief Hypervigilance Scale). We conclude that the standard behavioral scores (reaction time- or accuracy-based difference scores) derived from the emotional dot-probe are not adequately reliable measures of attentional biases to threat in anxious or nonanxious populations.

Cognitive biases have been implicated in the etiology and maintenance of depression and anxiety, but their utility in predicting future symptoms remains debated. This meta-analysis aimed to estimate the overall effect size of their predictive effects and to identify moderators relevant to theory and methodology. The study protocol was pre-registered on PROSPERO (record number: CRD42021232236). Searches of PsycINFO, Web of Science, PubMed, PsyArXiv Preprints, and ProQuest Dissertations yielded 81 studies with 621 contrasts and 17,709 participants through December 2024. The methodological quality of the included studies was evaluated using the Quality In Prognosis Studies (QUIPS) tool. Results from a three-level meta-analysis revealed a small overall effect size (β = 0.04, 95 %-CI [0.02, 0.06], p < .001) and significant between- and within-study variance after removal of outliers. Equivalent effect sizes were found for the predictive utility of cognitive biases in children/adolescents and adults, for increased negative bias and decreased positive bias, and for anxiety and depression outcomes. The magnitude of the overall effect was moderated by the cognitive process, with significant effect sizes for interpretation bias and memory bias but not for attention bias. These findings support the predictive role of cognitive biases in anxiety and depression, with interpretation and memory biases emerging as key markers. These findings have implications for cognitive theories of depression and anxiety and for clinical interventions.

It is a well-established fact that experiences of interparental violence (IPV) affect children's attentional bias. However, existing research has solely investigated the relations between IPV and children's attentional bias toward either negative (ANI) or positive information (API); little research has examined the distinct associations between IPV and such two types of attentional bias simultaneously. Moreover, parental harsh discipline may mediate above associations, but few studies have investigated this issue to date.

This study examined the associations between IPV and children's attentional bias (including API and ANI) in the same model and the mediating roles of fathers' and mothers' harsh discipline-specifically, psychological aggression (PA) and corporal punishment (CP) in China.

A total of 505 Chinese elementary school students (Mage = 9.82 years; 51 % girls) and their parents participated in this study.

Participants were asked to complete paper questionnaires measuring IPV, parental harsh discipline and children's attentional bias. Structural equation models were employed to test the mediating roles of parental harsh discipline in the associations between IPV and children's attentional bias.

IPV was positively related to children's ANI, while was negatively related to children's API. Additionally, IPV was related to higher level of ANI through the PA of fathers but lower level of API through that of mothers. Moreover, IPV was related to higher level of API through mothers' CP.

These findings suggest the linkage between IPV and children's attentional bias varies with the valence of information-positive or negative-and is differentially mediated by the harsh discipline of fathers and mothers within the Chinese cultural context.

What we pay attention to is influenced by both reward learning and aversive conditioning. Although early attention tends to be biased toward aversively conditioned stimuli, sustained ignoring of such stimuli is also possible. How aversive conditioning influences how a person chooses to search, or the strategic control of attention, has not been explored. In the present study, participants learned an association between a colour and an aversive outcome during a training phase, and in a subsequent test phase searched for one of two targets presented on each trial; one target was rendered in the aversively conditioned colour (CS+) and the other in a neutral colour (CS-). Given the distribution of colour stimuli in the search array, it was more optimal to search for and report a target in one of the two colours on some trials. Our results demonstrate that participants were biased away from the CS+ target, which resulted in non-optimal search on some trials. Surprisingly, rather than accentuate this bias, greater state anxiety was associated with a stronger tendency to find and report the CS+ target. Our findings have implications for our understanding of the learning-dependent control of attention and abnormal attentional biases observed in high-anxious individuals.

Phylogenetically salient stimuli such as spiders are commonly reported threats in the general population and the most common object of specific phobias in clinical populations. Several theories have hypothesized that our perceptual systems prioritize such stimuli in an "automatic" or "bottom-up" manner due to their evolutionary salience. However, empirical research on the perceptual processing of these stimuli as well as the influence of "top-down" goal-driven and bottom-up stimulus-driven factors is lacking. Here, we used perceptual psychophysics to determine absolute perceptual thresholds for the detection of spider and crab images. Subsequently, participants used spider and crab cues (that imposed a top-down perceptual set) to detect spiders and crab images presented at their predetermined perceptual threshold in a two-alternative forced-choice perceptual decision-making task. While spiders were detected at lower perceptual thresholds than crabs, they were not immune to top-down influence. Indeed, compared to top-down crab cues, spider cues improved the speed and accuracy of detection of spiders vs crabs. Using a hierarchical drift diffusion model, we found that spider cues biased decision-making not only by shifting the starting point of evidence accumulation towards the spider decision, but also by increasing the efficiency with which sensory evidence accumulated, more so for spider than crab perceptual decisions. Overall, these findings provide evidence for the perceptual prioritization of phylogenetically salient stimuli and highlight the computational mechanisms by which this prioritization is facilitated by bottom-up and top-down factors.

The online version contains supplementary material available at 10.1007/s42761-024-00271-z.

Obsessive-compulsive disorder (OCD) and anxiety disorders are early-onset mental disorders characterized by selective attention and strong emotional reactions. Attentional bias has been proposed to play a role in the development, onset, and maintenance of the disorders, but few studies have included youth with mental disorders, and no study has included more than one clinical group, making it unclear whether biased attention is disorder-specific or transdiagnostic in nature. In the present study, 65 youths with OCD (Mage = 13.6 [2.4], 57% girls), 52 youths with anxiety disorders (Mage = 14.5 [2.6] 83% girls), and 45 youths without a psychiatric disorder (Mage = 13.9 [3.1], 67% girls) completed a modified dot-probe task that included threat, incompleteness, and disgust cues. Contrary to our hypotheses, no group exhibited any attentional bias to any emotional cue, no group differences were present, and individual differences in attentional bias were not associated with individual differences in any symptom type. Disgust cues produced slower response times compared to the other emotional cues, but this effect was consistent across all type of trials and present in all three groups. In this study, no support for biased attention in treatment-seeking youth with OCD or anxiety disorders was found, which is in line with recent findings in adults using the dot-probe task. As attentional processes are clearly implicated in the clinical manifestation of these disorders, future research should try to better operationalize and measure relevant processes.

During the perinatal period, risk of depression and anxiety (D&A) increases. As in other crisis events, the COVID-19 pandemic, imposed social distancing measures, diminished social support and changes in perinatal healthcare provision which heightened this risk. This study aimed to examine how changes in social and healthcare provider support during the pandemic affected coping strategies and depression and anxiety symptoms (D&As) among perinatal women.

A cross-sectional international study included 7,368 pregnant and postpartum women up to six months postpartum from 12 countries (Albania, Brazil, Bulgaria, Chile, Cyprus, Greece, Israel, Malta, Portugal, Spain, Turkey, and the United Kingdom). Between June and October 2020, women answered an online survey regarding D&As (measured by the Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder-7), level of social and healthcare providers' support, changes to these types of support and coping strategies.

Main findings show that 24.6% of women had symptoms of depression and 20.2% of anxiety. Higher levels of D&A were associated with lower social and provider support, negative changes to social support and use of negative internal coping strategies. Positive coping strategies mediated the relationship between increased social and provider support and decreased D&As, while negative coping strategies mediated the relationship between negative changes to social support and increased D&As.

Social and provider support can promote coping strategies and reduce emotional distress. Healthcare providers should screen perinatal women for D&A, discuss ways to improve their coping strategies and social support as a preventive measure, and offer initial emotional well-being support.

This study sought to evaluate the effectiveness of a serious game, that embeds cognitive bias modification for interpretation (CBM-I), in altering the negative interpretive bias of early aged adolescents diagnosed with Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, and Specific Learning Disorders. The difficulties that adolescents with neurodevelopmental disorders (NDDs) experience navigating the social nuances of everyday environments make them prone to the cognitive biases that lead to the development of negative thought patterns. Directly tackling the biased interpretive processes that give rise to negative thinking may be effective in reducing negative bias and mental health problems.

Minds Online, a 10-episode 3-D animated serious game that embeds CBM-I was introduced using a three-phase multiple baseline design in a school setting. Eight adolescents diagnosed with an NDD completed the 10 episodes.

Real-time data revealed that seven of the eight adolescents altered their negative interpretive bias to a benign bias. However, pre- and post-test standardized measures revealed non-significant changes in the desired direction for mental health. Visual analyses of 308 daily self-reported ratings about worry about schoolwork, worry about peer relationships, and feelings of loneliness did not demonstrate a replicated intervention effect. However, when these interrupted time series data were analyzed statistically, significant individual improvements were evident. Engagement with Minds Online was excellent, as was adherence to daily data collection.

Minds Online seems to be highly effective in altering the negative interpretive biases of adolescents with NDDs, which is promising because such cognitive biases are involved in the onset and maintenance of psychopathology.

Generalized anxiety disorder (GAD) frequently emerges during childhood or adolescence, yet few studies have examined functional connectivity differences in youth with GAD. Functional magnetic resonance imaging (fMRI) studies of adults with GAD have implicated multiple brain regions; however, frequent examination of individual brain seed regions and/or networks has limited a holistic view of GAD-associated differences. The current study therefore used resting-state fMRI data from the Adolescent Brain Cognitive Development (ABCD) Study to investigate connectivity in youths with GAD across multiple cortical networks and subcortical regions implicated in adult GAD, considering diagnosis changes across 2 assessment periods.

In 164 youths with GAD and 3158 healthy control participants, within- and between-network connectivity for 6 cortical networks and 6 subcortical regions was assessed using linear mixed-effect models. Changes in GAD-associated connectivity between baseline and 2-year follow-up were then compared for participants with continuous GAD, GAD at baseline and not follow-up (GAD remitters), and GAD at follow-up and not baseline (GAD converters) versus control participants.

Youths with GAD showed greater within-ventral attention network (VAN) connectivity and hyperconnectivity between the amygdala and cingulo-opercular network and between striatal regions and the cingulo-opercular, default mode, and salience networks (false discovery rate p < .05). Within-VAN connectivity decreased for GAD remitters between baseline and follow-up. Sensitivity analyses revealed that these hyperconnectivity patterns were not observed in youths with major depressive disorder (n = 19), separation anxiety (n = 33), or social anxiety disorder (n = 111) who did not have GAD.

Results indicate that GAD in childhood and adolescence is associated with altered subcortical to cortical network connectivity and that within-VAN hyperconnectivity, in particular, is associated with clinically significant GAD-specific symptoms.

Deaf people experience ableism (able-bodied oppression), audism (hearing-ability oppression), and linguicism (sign language-use oppression) and this study investigated if internalizing these oppressive experiences predicts their mental health. Deaf participants (N = 134) completed a 54-item Deaf Oppression Scale, developed for this study with Ableism, Audism, and Linguicism Subtests, along with the Beck Depression Inventory-II and the State and Trait Anxiety Inventory. The Deaf Oppression Scale and its Ableism, Audism, and Linguicism Subscales carry good reliability and the model fit indices for a confirmatory factor analysis indicated a good fit. Sixteen (16%) percent (n = 22) of the sample had depression, 36% (n = 48) had state anxiety, and 64% (n = 86) had trait anxiety. Internalized ableism predicted greater characteristics and symptoms of depression, internalized ableism and linguicism predicted greater state anxiety, and internalized audism predicted greater trait anxiety. This is the first empirical evidence dissociating three types of oppression that deaf people experience and their separate and different effects on their psychological well-being.

Mental health service users often have sensory processing difficulties hampering their ability to cope with mental health problems and occupational engagement. However, there is little knowledge of sensory processing and its relation to these factors. Hence, this current study aims to investigate sensory processing patterns in relation to coping and occupational engagement for the target group.

This cross-sectional study involved 97 mental health service users. Sociodemographic information and self-rated questionnaires were administered; Adolescent/Adult Sensory Profile (AASP), Coping Orientation to Problems Experienced Inventory scale (short version) (Brief-COPE), and Profiles of Occupational Engagement among people with Severe mental illness (POES). Statistical analysis included descriptive statistics and multiple linear regression models.

This study sits within an RCT project where parts were designed collaboratively with research-educated service users.

The result showed strong relationships between sensory processing patterns and occupational engagement. Low levels of occupational engagement were related to high levels of sensory sensitivity, sensation avoiding, and low registration. Whereas, high levels of occupational engagement were related to high levels of sensation-seeking. Concerning coping styles, high levels of emotion-focused coping were related to high levels of low registration, while high levels of avoidant coping styles were related to high levels of sensation-seeking.

The findings indicate that occupational engagement and coping styles are related to outcomes of the sensory profile and thus affect how a person with severe mental health problems interprets and reacts to sensory stimuli in daily life.