Using eye movements in the dot-probe paradigm to investigate attention bias in illness anxiety disorder

Yan-Bo Zhang; Peng-Chong Wang; Yun Ma; Xiang-Yun Yang; Fan-Qiang Meng; Simon A Broadley; Jing Sun; Zhan-Jiang Li

doi:10.5498/wjp.v11.i3.73

Using eye movements in the dot-probe paradigm to investigate attention bias in illness anxiety disorder

World J Psychiatry. 2021 Mar 19;11(3):73-86. doi: 10.5498/wjp.v11.i3.73.

Authors

Yan-Bo Zhang¹, Peng-Chong Wang¹, Yun Ma¹, Xiang-Yun Yang¹, Fan-Qiang Meng¹, Simon A Broadley², Jing Sun¹, Zhan-Jiang Li¹

Affiliations

¹ The Department of Clinical Psychology and National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing An'Ding Hospital, Capital Medical University, and Center of Schizophrenia, Beijing Institute for Brain Disorders, Beijing 100089, China.
² Menzies Health Institute Queensland and School of Medicine, Griffith University, Gold Coast 4222, Queensland, Australia.

Abstract

Background: Illness anxiety disorder (IAD) is a common, distressing, and debilitating condition with the key feature being a persistent conviction of the possibility of having one or more serious or progressive physical disorders. Because eye movements are guided by visual-spatial attention, eye-tracking technology is a comparatively direct, continuous measure of attention direction and speed when stimuli are oriented. Researchers have tried to identify selective visual attention biases by tracking eye movements within dot-probe paradigms because dot-probe paradigm can distinguish these attentional biases more clearly.

Aim: To examine the association between IAD and biased processing of illness-related information.

Methods: A case-control study design was used to record eye movements of individuals with IAD and healthy controls while participants viewed a set of pictures from four categories (illness-related, socially threatening, positive, and neutral images). Biases in initial orienting were assessed from the location of the initial shift in gaze, and biases in the maintenance of attention were assessed from the duration of gaze that was initially fixated on the picture per image category.

Results: The eye movement of the participants in the IAD group was characterized by an avoidance bias in initial orienting to illness-related pictures. There was no evidence of individuals with IAD spending significantly more time viewing illness-related images compared with other images. Patients with IAD had an attention bias at the early stage and overall attentional avoidance. In addition, this study found that patients with significant anxiety symptoms showed attention bias in the late stages of attention processing.

Conclusion: Illness-related information processing biases appear to be a robust feature of IAD and may have an important role in explaining the etiology and maintenance of the disorder.

Keywords: Attention bias; Disengagement; Dot-probe; Eye tracking; Illness anxiety disorder; Selective attention.