The role of context in eliciting and modifying anxiety-linked attentional biases in social anxiety

Individuals with heightened social anxiety have the tendency to selectively attend to socially-threatening information, referred to as attentional bias. Cognitive models propose that this attentional bias plays a role in the etiology and maintenance of social anxiety. To examine whether modifying attentional bias leads to reductions in social anxiety, Attentional Bias Modification (ABM) paradigms were developed. Although ABM can be effective in reducing attentional bias and anxiety symptoms, the effects are often small and inconsistent. The main aims of thesis were to investigate (1) under which conditions attentional biases are elicited and (2) under which conditions ABM is more effective in modifying attentional bias. Specifically, the role of state anxiety and arousal prior or during the assessment and modification of attentional bias was examined. The results suggest that state anxiety moderates the expression of attentional bias such that individuals with heightened social anxiety only exhibit an attentional bias when experiencing elevated state anxiety. However, the results provide little evidence that elevated state anxiety and arousal improve the effectiveness of ABM in reducing attentional bias and social anxiety symptoms. As this thesis provides a first step in examining the role of emotional context during assessment and modification of attentional bias, replication is needed to confirm these preliminary conclusions. Besides the need to delineate the optimal conditions to elicit and modify attentional biases, the often small and short-term effects of ABM call for an evaluation of the relative importance of attentional biases and ABM compared to other social anxiety-related processes and interventions.