Yıl: 2015 Cilt: 52 Sayı: 1 Sayfa Aralığı: 4 - 7 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Attentional Bias and Training in Social Anxiety Disorder

Öz:
Bilişsel davranışçı terapi (BDT) sosyal anksiyete bozukluğunda (SAB ) kanıt düzeyi yüksek, en iyi sonuç alınan tedavi yöntemlerinden biridir. Öte yandan, bazı hastalarda bu tedaviden istenilen yararın elde edilememesi, yeni teknikler arayışının devamına neden olmaktadır. SAB'da son araştırmalar dikkat yanlılığına ve dikkat eğitimine odaklanmıştır. SAB'da dikkat süreçleri rahatsızlığın bir bilişsel bozukluk olarak açıklandığı ilk modellerden bu yana araştırmaların hedefi olmuştur. İlk modelde, dikkatin kişinin kendi üzerine odaklı olduğu vurgulanmıştır. Tehdit edici uyaranlar ve dikkat arasındaki ilişki daha sonraki modellerde kabul edilmiştir.Tehdite yönelik dikkat yanlı-lığı tehditin kolaylaştırılmış işlenmesi, dikkatin tehditten uzaklaştırılmasında zorlanma, dikkatin tehditten kaçırılması şeklinde oluşabilir. Hastalık süreci-ne getirilen bu açıklamalar sonrasında, dikkat süreçlerini değiştirmek için tedaviler geliştirilmiştir. Çelişkili sonuçlara rağmen, dikkat eğitimi araştırma-ları ümit vericidir. Bu derlemede SAB'da dikkat süreçleri, dikkat yanlılıkları ve dikkat eğitimi konuları tartışılmıştı
Anahtar Kelime:

Konular: Nörolojik Bilimler Psikiyatri

Sosyal Anksiyete Bozukluğunda Dikkat Yanlılığı ve Eğitimi

Öz:
Cognitive behavioral therapy (CBT) is one of the most effective treatment modalities for social anxiety disorder (SAD), showing a high level of clinical evidence supporting its effectiveness. On the other hand, lack of the desired benefit from this treatment in some patients causes continuation of the search for new techniques. Recent research studies have focused on attentional bias and attention training in SAD. Attention processes in SAD have been a major target of interest and investigation since the introduction of the first cognitive models explaining SAD. In the first model, it was highlighted that attention was self-focused. The relationship between threatening stimuli and attention was considered in the subsequent models. Attentional bias towards threat may take place in several ways, such as facilitated processing of threat, difficulty in disengaging attention from the threat and avoidance of attention from the threat. After these descriptions regarding the phenomenology of the disorder, treatments to modify attention, processes were developed. In spite of conflicting results, investigations on attentional training are promising. Attention processes, attentional bias and attentional training in SAD are discussed in this review
Anahtar Kelime:

Konular: Nörolojik Bilimler Psikiyatri
Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
  • Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prev- alence and age-of-onset distributions of DSM-IV disorders in the national comor- bidity survey replication. Arch Gen Psychiatry 2005; 62:593-602. [CrossRef]
  • Stein M, Kean Y. Disability and quality of life in social phobia: Epidemiologic findings. Am J Psychiatry 2000; 157:1606-1613. [CrossRef]
  • Özgüven HD, Sungur MZ. Sosyal fobi. Turk Psikiyatri Derg 1998; 9:128-138.
  • Norton PJ, Price EC. A meta-analytic review of adult cognitive-behavior- al treatment outcome across the anxiety disorders. J Nerv Ment Dis 2007; 195:521-531. [CrossRef]
  • Clark DM, Wells A. A cognitive model of social phobia. Heimberg RG, Li- ebowitz MR, Hope DA, Schneier FR, (eds). Social Phobia: Diagnosis, Assess- ment, and Treatment. New York: Guilford Press; 1995; s.69-93.
  • Davidson JR, Foa EB, Huppert JD, Keefe FJ, Franklin ME, Compton JS, Connor KM, Lynch TR, Gadde KM. Fluoxetine, comprehensive cognitive behavioral therapy, and placebo in generalized social phobia. Arch Gen Psychiatry 2004; 61:1005-1013. [CrossRef]
  • Beck AT. Cognitive Therapy and the Emotional Disorders. New York: Interna- tional Universities Press; 1976.
  • Eysenck MW. Anxiety: The Cognitive Perspective. Hove, UK: Psychology Press; 1992.
  • Beck AT, Clark DA. An information processing model of anxiety: Automatic and strategic processes. Behav Res Ther 1997; 35:49-58. [CrossRef]
  • Wells A, Matthews G. Attention and emotion: A clinical perspective. Hove, England: Lawrence Erlbaum Associates; 1994.
  • Williams JMG, Watts FN, MacLeod C, Mathews A. Cognitive psychology and emotional disorders. Chichester, UK: Wiley; 1988.
  • Mogg K, Bradley BP. A cognitive-motivational analysis of anxiety. Behav Res Ther 1998; 36:809-848. [CrossRef]
  • Eysenck MW, Derakshan N, Santos R, Calvo MG. Anxiety and cognitive perfor- mance: Attentional control theory. Emotion 2007; 7:336-353. [CrossRef]
  • Bar-Haim Y, Lamy D, Pergamin L, Bakermans-Kranenburg MJ, van IJzendoorn MH. Threat-related attentional bias in anxious and nonanxious individuals: a meta-analytic study. Psychol Bull 2007; 133:1-24. [CrossRef]
  • Yiend J, Mathews A. Anxiety and attention to threatening pictures. Q J Exp Psychol A 2001; 3:665-681. [CrossRef]
  • MacLeod C, Mathews A, Tata P. Attentional bias in emotional disorders. J Abnorm Psychol 1986; 95:15-20. [CrossRef]
  • De Ruiter C, Brosschot JF. The emotional Stroop interference effect in anx- iety: Attentional bias or cognitive avoidance? Behav Res Ther 1994; 32:315- 319. [CrossRef]
  • Navon D, Margalit B. Allocation of attention according to informativeness in visual recognition. Q J Exp Psychol A 1983; 35:497-512. [CrossRef]
  • Fox E, Russo R, Bowles R, Dutton K. Do threatening stimuli draw or hold visual at- tention in subclinical anxiety? J Exp Psychol Gen 2001; 130:681-700. [CrossRef]
  • Rapee RM, Heimberg RG. A model of social phobia. Behav Res Ther 1997; 35:741-756. [CrossRef]
  • Pineles SL, Mineka S. Attentional biases to internal and external sources of potential threat in social anxiety. J Abnorm Psychol 2005; 114:314-318. [CrossRef]
  • Pishyar R, Harris L, Menzies R. Attentional bias for words and faces in social anxiety. Anxiety Stress Coping 2004; 17:23-36. [CrossRef]
  • Hope DA, Rapee RM, Heimberg RG, Dombeck MJ. Represent of the self in social phobia: Vulnerability to social threat. Cognit Ther Res 1990; 14:177- 189. [CrossRef]
  • Lundh LG, Ost LG. Recognition bias for critical faces in social phobics. Behav Res Ther 1996; 34:787-794. [CrossRef]
  • Gilboa-Schechtman E, Foa EB, Amir N. Attentional biases for facial expres- sions in social phobia: The face-in-the-crowd paradigm. Cogn Emot 1999; 13:305-318. [CrossRef]
  • Mansell W, Clark DM, Ehlers A, Chen YP. Social anxiety and attention away from emotional faces. Cogn Emot 1999; 13:673-690. [CrossRef]
  • Bradley BP, Mogg K, Falla SJ, Hamilton LR. Attentional bias for threatening facial expressions in anxiety: Manipulation of stimulus duration. Cogn Emot 1998; 12:737-753. [CrossRef]
  • Mogg K, Bradley BP. Some methodological issues in assessing attentional biases for threatening faces in anxiety: A replication study using a modified version of the probe detection task. Behav Res Ther 1999; 37:595-604. [CrossRef]
  • Mogg K, Mathews A, Weinman J. Memory bias in clinical anxiety. J Abnorm Psychol 1987; 96:94-98. [CrossRef]
  • McNaughton N, Gray JA. Anxiolytic action on the behavioural inhibition sys- tem implies multiple types of arousal contribute to anxiety. J Affect Disord 2000; 61:161-176. [CrossRef]
  • Amir N, Elias J, Klumpp H, Przeworski A. Attentional bias to threat in social phobia: Facilitated processing of threat or difficulty disengaging attention from threat? Behav Res Ther 2003; 41:1325-1335. [CrossRef]
  • Buckner J, Maner JK, Schmidt NB. Difficulty disengaging attention from social threat in social anxiety. Cognit Ther Res 2010; 34:99-105. [CrossRef]
  • Pineles SL, Mineka S. Attentional biases to internal and external sources of poten- tial threat in social anxiety. J Abnorm Psychol 2005; 114:314-318. [CrossRef]
  • Hofmann SG. Cognitive factors that maintain social anxiety disorder: A com- prehensive model and its treatment implications. Cogn Behav Ther 2007; 36:195-209. [CrossRef]
  • Heeren A, Lievens L, Philippot P. How does attention training work in social phobia: Disengagement from threat or re-engagement to non-threat? J Anxi- ety Disord 2011; 25:1108-1115. [CrossRef]
  • Koster EHW, Crombez G, Verschuere B, De Houwer J. Attention to threat in anxiety-prone individuals: Mechanisms underlying attentional bias. Cognit Ther Res 2006; 30:635-643. [CrossRef]
  • Asmundson GJ, Stein MB. Selective processing of social threat in patients with generalized social phobia: Evaluation using a dot-probe paradigm. J Anxiety Disord 1994; 8:107-117. [CrossRef]
  • Maidenberg E, Chen E, Craske M, Bohn P, Bystritsky A. Specificity of atten- tional bias in panic disorder and social phobia. J Anxiety Disord 1996; 10:529- 541. [CrossRef]
  • Mogg K, Bradley BP. Selective orienting of attention to masked threat faces in social anxiety. Behav Res Ther 2002; 40:1403-1414. [CrossRef]
  • Chen YP, Ehlers A, Clark DM, Mansell W. Patients with generalized social pho- bia direct their attention away from faces. Behav Res Ther 2002; 40:677-687. [CrossRef]
  • Stirling LJ, Eley TC, Clark DM. Preliminary evidence for an association be- tween social anxiety symptoms and avoidance of negative faces in school-age children. J Clin Child Adolesc Psychol 2006; 35:431-439. [CrossRef]
  • Pishyar R, Harris LM, Menzies RG. Responsiveness of measures of attention- al bias to clinical change in social phobia. Cogn Emot 2008; 22:1209-1227. [CrossRef]
  • Lundh LG, Öst LG. Attentional bias, self-consciousness and perfectionism in social phobia before and after cognitive-behaviour therapy. Scand J Behav Ther 2001; 30:4-16. [CrossRef]
  • Amir N, Beard C, Taylor CT, Klumpp H, Elias J, Burns M, Chen X. Attention training in individuals with generalized social phobia: a randomized controlled trial. J Consult Clin Psychol 2009; 77:961-973. [CrossRef]
  • Heeren A, Reese HE, McNally RJ, Philippot P. Attention training toward and away from threat in social phobia: Effects on subjective, behavioral, and phys- iological measures of anxiety. Behav Res Ther 2012; 50:30-39. [CrossRef]
  • Hakamata Y, Lissek S, Bar-Haim Y, Britton JC, Fox NA, Leibenluft E, Ernst M, Pine DS. Attention bias modification treatment: A meta-analysis toward the establishment of novel treatment for anxiety. Biol Psychiatry 2010; 68:982- 990. [CrossRef]
  • Amir N, Taylor CT, Donohue MC. Predictors of response to an attention modification program in generalized social phobia. J Consult Clin Psychol 2011; 79:533-541. [CrossRef]
  • Price M, Tone EB, Anderson PL. Vigilant and avoidant attention biases as pre- dictors of response to cognitive behavioral therapy for social phobia. Depress Anxiety 2011; 28:349-353. [CrossRef]
  • Amir N, Weber G, Beard C, Bomyea J, Taylor CT. The effect of a single session attention modification program on response to a public speaking challenge in socially anxious individuals. J Abnorm Psychol 2008; 117:860-868. [CrossRef]
  • Klumpp H, Amir N. Preliminary study of attention training to threat and neu- tral faces on anxious reactivity to a social stressor in social anxiety. Cognit Ther Res 2010; 34:263-271. [CrossRef]
  • Li S, Tan J, Qian M, Liu X. Continual training of attentional bias in social anxiety. Behav Res Ther 2008; 46:905-912. [CrossRef]
  • Schmidt NB, Richey JA, Buckner JD, Timpano KR. Attention training for general- ized social anxiety disorder. J Abnorm Psychol 2009; 118:5-14. [CrossRef]
  • Enock PM, Hofmann SG, McNally RJ. Attention bias modification training via smartphone to reduce social anxiety: a randomized, controlled multi-session experiment. Cognit Ther Res 2014; 38:200-216. [CrossRef]
  • Neubauer K, von Auer M, Murray E, Petermann F, Helbig-Lang S, Gerlach AL. Internet-delivered attention modification training as a treatment for so- cial phobia: a randomized controlled trial. Behav Res Ther 2013; 51:87-97. [CrossRef]
  • Boettcher J, Berger T, Renneberg B. Internet-based attention training for so- cial anxiety: a randomized controlled trial. Cognit Ther Res 2012; 36:522-36. [CrossRef]
  • Mueller EM, Hofmann SG, Santesso DL, Meuret AE, Bitran S, Pizzagalli DA. Electrophysiological evidence of attentional biases in social anxiety disorder. Psychol Med 2009; 39:1141-1152. [CrossRef]
  • Eldar S, Bar-Haim Y. Neural plasticity in response to attention training in anx- iety. Psychol Med 2010; 40:667-677. [CrossRef] 7
APA FISTIKÇI N, SAATÇİOĞLU Ö, KEYVAN A, TOPÇUOĞLU V (2015). Attentional Bias and Training in Social Anxiety Disorder. , 4 - 7.
Chicago FISTIKÇI Nurhan,SAATÇİOĞLU Ömer,KEYVAN Ali,TOPÇUOĞLU Volkan Attentional Bias and Training in Social Anxiety Disorder. (2015): 4 - 7.
MLA FISTIKÇI Nurhan,SAATÇİOĞLU Ömer,KEYVAN Ali,TOPÇUOĞLU Volkan Attentional Bias and Training in Social Anxiety Disorder. , 2015, ss.4 - 7.
AMA FISTIKÇI N,SAATÇİOĞLU Ö,KEYVAN A,TOPÇUOĞLU V Attentional Bias and Training in Social Anxiety Disorder. . 2015; 4 - 7.
Vancouver FISTIKÇI N,SAATÇİOĞLU Ö,KEYVAN A,TOPÇUOĞLU V Attentional Bias and Training in Social Anxiety Disorder. . 2015; 4 - 7.
IEEE FISTIKÇI N,SAATÇİOĞLU Ö,KEYVAN A,TOPÇUOĞLU V "Attentional Bias and Training in Social Anxiety Disorder." , ss.4 - 7, 2015.
ISNAD FISTIKÇI, Nurhan vd. "Attentional Bias and Training in Social Anxiety Disorder". (2015), 4-7.
APA FISTIKÇI N, SAATÇİOĞLU Ö, KEYVAN A, TOPÇUOĞLU V (2015). Attentional Bias and Training in Social Anxiety Disorder. Nöropsikiyatri Arşivi, 52(1), 4 - 7.
Chicago FISTIKÇI Nurhan,SAATÇİOĞLU Ömer,KEYVAN Ali,TOPÇUOĞLU Volkan Attentional Bias and Training in Social Anxiety Disorder. Nöropsikiyatri Arşivi 52, no.1 (2015): 4 - 7.
MLA FISTIKÇI Nurhan,SAATÇİOĞLU Ömer,KEYVAN Ali,TOPÇUOĞLU Volkan Attentional Bias and Training in Social Anxiety Disorder. Nöropsikiyatri Arşivi, vol.52, no.1, 2015, ss.4 - 7.
AMA FISTIKÇI N,SAATÇİOĞLU Ö,KEYVAN A,TOPÇUOĞLU V Attentional Bias and Training in Social Anxiety Disorder. Nöropsikiyatri Arşivi. 2015; 52(1): 4 - 7.
Vancouver FISTIKÇI N,SAATÇİOĞLU Ö,KEYVAN A,TOPÇUOĞLU V Attentional Bias and Training in Social Anxiety Disorder. Nöropsikiyatri Arşivi. 2015; 52(1): 4 - 7.
IEEE FISTIKÇI N,SAATÇİOĞLU Ö,KEYVAN A,TOPÇUOĞLU V "Attentional Bias and Training in Social Anxiety Disorder." Nöropsikiyatri Arşivi, 52, ss.4 - 7, 2015.
ISNAD FISTIKÇI, Nurhan vd. "Attentional Bias and Training in Social Anxiety Disorder". Nöropsikiyatri Arşivi 52/1 (2015), 4-7.