Comprehensive summary of ALL literature concerning Task 5 (Information processing), summarized per article. Written in English, with Dutch clarifications. All tasks of this course are also available as a bundle! GGZ2024 - Anxiety Disorders
Critcal Learning t eoryn – Voncken.
1. W at is t e informaton rocessing t eoryn and ow is it related to cognitie t eoryny e ring
2. W at is atentonal l ias and ow can it l e measuredy
3. W at is inter retatonal l ias and ow can it l e measuredy
4. W at are t e ot er/addiotonal l iases coiariaton/readingg and ow can it l e measuredy
5. W at is memoryn l ias and ow can it l e measuredy
6. Is t ere eiidence for resence of cognitie l iases in anxietyn disordersy
7. How do cognitie l iases sustain in anxietyn disordersy Does it reallyn cause t e anxietyn or is it a
side-efecty
8. W at is t e diference l etween l otom-u and to ing-down rocessingy
9. Diferent l iases and w at ordery W at a ened irsty
10. W at are treatment targets l ased on cognitie t eoryn and w at is t e diference wit l e aiioral
t era yny
Treatment focus on inter retaton l ias so not on atenton l iasg l ecause inter retaton l ias is
more conscious l ewustg ynou can’t talk al out atenton l ias.
de Jong, P. J. (2014) Informaton Processing, in The Wiley Handbook of Anxiety Disorders
Introducton
Cognitie models im lyn t at emotonal disorder critcallyn de end on t e existence of malada tie
cognitie structures or sc emas in memoryn. T ese sc emas are assumed to automatcallyn infuence
all stages of indiiiduals’ informaton rocessing.
T e l asic assum ton of t e informaton- rocessing models of anxietyn disorders ADsg is t at t ese
rocessing l iases are not merelyn synm toms l ut layn a iital role in t e maintenance and causaton of
ADs.
Transdiagnostc informaton- rocessing l iases
1) Attentional biaa ( nAB)
C aracteristcs – if t reatening and neutral stmuli occur toget er, t e atenton of indiiiduals wit
anxietyn disorders will likelyn l e l iased toward t reat. A salient feature of t reat-related AB concerns
its temporal unfoldang. T e earlyn stages of t reat rocessing are c aracterized l yn enhanced
attention versterkte aandachtg to t reat, w ereas later stages are c aracterized l yn attentional
avoadance of t reat.
Underlyning mec anisms – T e mec anisms underlyning t is atern of an a arentlyn refexiie AB
toward t reat t at is quicklyn followed l yn a l ias awayn from t reat is not l eynond dis ute and diferent
rocesses mayn l e iniolied in t e iarious com onents of AB. Atenton is not a unitaryn synstem, l ut
rat er a set of diferent com onents t at are functonallyn and structurallyn inde endent, l ut t eyn mayn
work coo eratielyn. Current iiews diferentate l etween t ree major com onents: alertng,
orientng, and executie control , eac of w ic mig t l e diferentallyn iniolied oier t e course of
informaton rocessing in t e face of t reatening stmuli:
Alertng – as l een ro osed to l e iniolied in maintaining an a ro riate sensitiityn leiel to
erceiie and rocess releiant stmuli ieryn earlyn in rocessing of stmuli
Orientng – would l e iniolied in selecton of informaton and mig t l e es eciallyn releiant for t e
facilitated engagement toward concern-releiant stmuli in AD atent ieryn earlyn in rocessing
of stmuli
Executie control – is ro osed to l e iniolied in confict resoluton and ioluntaryn acton control.
It mayn l e releiant wit res ect to t e confict l etween t e motiatonal releiance of concern-
releiant t reats and t e urge to aioid t em.
,Alertng 2 laatjes, je ziet eerder die met de s in dan de neutrale
Anxietyn atents s ow an enhanced (en (ativatt to perceave and proce ( ( threatenang (timula. T is
is s owed l yn researc on bianocular ravalrt nBR) BR occurs w en two ictures are rojected to
t e two eynes, and t e ol serier is onlyn aware of one image. T e erceiied duratons of eac of
t e images iaryn as a functon of ersonal releiance. Preiiouslyn neutral CS+ stmuli can acquire
dominance oier CS- stmuli following fear-conditoning. Concern related stmuli similarlyn s ow
dominance oier control stmuli in anxietyn atents.
Rapad (eraal va (ual pre (entation nRSVP) iniolies mult le slides including artcular targets t at
are resented ra idlyn. Partci ants are asked to identfyn t e targets following eac trial. T e
al ilityn to identfyn a artcular target T2g is im aired w en it is resented closelyn afer a receding
target T1g. T is deicit in identicaton of T2 is called t e attentional bilano a enomenon t at
refects t e tem oral costs in t e allocatng selectie atentong. It as l een s own t at in ig
fearful indiiiduals, ol ia-releiant stmuli are relatielyn frequentlyn detected eien w en
resented in t e atentonal l link.
T e en anced sensitiityn for t reat stmuli also comes wit a cost, as t e atentonal ca ture of
t reat stmuli interferes wit indiiiduals’ al ilityn to identfyn t e targets t eyn were looking for
distractng efectsg. T us, eo le mayn l e not onlyn alerted l yn t reat stmuli, l ut also s ow
deicits in detectng safe/ el ful/reassuring stmuli t at occur close afer t e t reat-stmuli.
Su ortng t e ro osed causal role of suc en anced atentonal ca ture for t e generaton of
PTSD synm toms, analogue researc using t e trauma-ilm aradigm s owed t at ex erimentallyn
reducing ilm-induced atentonal ca ture l yn means of a cognative biaa ( modafcation nCBM)
rocedure resulted in fewer ilm-related intrusion
Orientng – anxious indiiiduals are tyn icallyn faster in res onding to rol es t at re lace l riefyn
resented t reat t an neutral control stmuli dots test, angstge mensen zien eerder et angstge
woord dan et neutrale woord
Anxietyn seems to l e associated wit l ot enhanced engagement and a dafcultt to da (engage,
l ut t e releiance of t ese rocesses de ends on t e rocessing stage. Exogenou ( cueang ta (o
nECT) studies roiide more eiidence. In ECT, as iisual stmulus is resented eit er at t e rig t or
t e lef side of t e screen. At stmulus ofset a rol e a ears. Sometmes, rol es a ear on t e
same side as t e stmulus ialid trialsg, sometmes t eyn are resented at t e o osite locaton
inialid trialsg. Facalatated attention is refected in relatielyn fast res onses on ialid-t reat trials
com ared to ialid-neutral trials. Difcultyn to disengage is refected in relatielyn slow res onse on
inialid-t reat trials com ared to inialid-neutral trials.
o T e results suggest t at facilitated atenton would l e most releiant during t e earlyn
stages of rocessing, w ereas disengagement difcultes l ecome increasinglyn im ortant
during later stages of stmulus rocessing.
So, t e t reat l ias is not an al normal trait-like enomenon, l ut a common
c aracteristc.
Executie control – t e treat stmuli re resent task-irreleiant features, and artci ants’ erformance
would l eneit from ignoring t e content of t ese stmuli.
T e inding t at task erformance is synstematcallyn afected l yn t e content of t e task-irreleiant
t reatg stmuli seems to im lyn t at atentonal ca ture and old at least artlyn refect an inal ilityn
to in il it automatc t reat alerts from l eing furt er rocessed. T e capacatt to voluntaralt
regulate attention to t reat stmuli mayn iaryn as a functon of t e stmulus’ t reat ialue and t e
aiailal le cognitie resources.
Deicits in executie control will en ance indiiiduals’ sensitiityn to t reat stmuli. Indiiiduals wit
an efcient executie network are al le to reallocate t e atenton to releiant stmulus feature
and to aioid furt er rocessing of t e t reatening com onent of t e com ound stmulus.
,Prognostc ialue and causal status
If AB layns a critcal role in t e ersistence of synm toms, it s ould l e reduced following successful
treatment. Cognative Baa ( Modafcation nCBM) rimarilyn targeted t e later com onents of AB related
to engagement difcultes. It would l e im ortant to ex lore furt er w et er modifyning earlyn AB
mig t er a s l e eien more efectie as it mig t reient cascading efects. Furt ermore, it mig t l e
releiant to test t e synnergistc efect of coml ining CBM wit CBT. Recent researc as roiided
eiidence to suggest t at t e strengt as well as t e atern of retreatment atentonal l ias
aioidant is. iigilantg moderates t e efcacyn of CBT. Per a s, t en, re-CBT CBM mig t furt er
en ance t e efcacyn of CBT rocedures.
2) Interpretation biaa ( nIB)
Muc of t e informaton we receiie is ambiaguou ( and open to anterpretation. AD atents tend to
s ow t reatening inter retatons of aml iguous stmuli releiant to t eir concerns. Panic disorder
atents tend to ex lain t eir aml iguous ynsical sensatons as t reatening. Similarlyn, sociallyn
anxious indiiiduals tend to inter ret aml iguous facial ex ressions in a t reatening manner.
IB mayn occur as a consequence of ost-eient rocessing, l ut could also occur during t e actual
encounter wit artcular aml iguous informaton. Non-sociallyn anxious indiiiduals seem
c aracterized l yn a po (ative IB an ambiaguou ( (ocaal (atuation (, w ic is al sent in SAD. T e
al sence of a ositie is. t e resence of a negatie IB mayn well de end on t e otental t reat
ialue of t e aml iguous context.
o In t e resence of relatielyn, (trong negative anterpretation (, instead of t e al sence of
ositie IB, mayn l e more stronglyn iniolied in t e maintenance of fearful concerns.
Anot er im ortant issue of IB concerns its time cour (e. Studies suggest t at ig trait anxious
indiiiduals get stuck to a t reatening inter retaton during t e later stages of rocessing.
Estmaton of t reat judgmental l iasLL
3) Covaraation Baa ( nCB)
An im ortant feature of ADs is t eir ersistence in t e abi (ence of contingent aver (ave event (.
Alt oug eo le will usuallyn not l e ridiculed during a social eient, and eart al itatons are
commonlyn not followed l yn a eart atack, atents sufering from ADs tyn icallyn contnue to
l e aie as if t ese catastro ic outcomes will a en. To ex lain t is, it as l een ro osed t at
anxietyn-disordered indiiiduals tend to oierestmate t e contngencyn l etween concern-releiant
stmuli and aiersiie outcomes coiariaton l iasg.
CB mayn a lyn not onlyn to t e ex ectancyn ialue of the occurrence of an aver (ave UCS giien t e
resence of t e concern releiant stmuli, l ut also the laoelahood of encounterang t e concern-
releiant stmuli. A consequences-CB and an encounter-CB mig t diferentallyn afect t e fear
res onse.
Models of coiariaton erce ton suggest t at t e strengt of CB iaries as a functon of rior
ex ectancies and current situatonal informaton. It as l een suggested t at uncertaintyn layns a
critcal role in t e ersistence of t e t reat-conirming ex ectancies. T e strengt of t e CB is
found to l e ositielyn correlated wit actiaton of t e anterior cingulate cortex ACCg. ACC
activation as l een linked to t e antci aton of aiersiie in uts and t e regulaton of negatie
emoton and t e insula to interoce ton and re resentaton of emotonal states. T is suggests
t at CB mig t refect a “l eing alwayns re ared for t e worst” strategyn to co e wit situatons
inioliing an unknown risk for t reatening outcomes.
To conclude, studies suggest t at CB originates from acquired l eliefs al out t e
contngencyn l etween concern-related stmuli and aiersiie outcomes. Eien w en
eo le cannot aioid or esca e otentallyn correctng encounters, strong rior
ex ectancies al out t e negatie consequences are relatielyn immune to
correctie informaton.
, 4) Rea (onang biaa ( nRB)
Selectie atenton, inter retie l ias and coiariaton l ias contril ute to maintenance of
dynsfunctonal anxiogenic l eliefs. Correctng suc l eliefs requires t e al ilityn to accuratelyn deduce
t e logical im licatons of t e em irical eiidence and to actielyn searc for falsifyning informaton.
Indiiiduals tend to searc for bielaef-confrmang anformation, and t eir al itual reasoning atern
is l iased in a wayn t at confrm ( thear bielaef (. T us, t e refectie synstem seems, just as t e
refexiie synstem, inclined to sustain faultyn anxiogenic l eliefs.
Indiiiduals tend to searc for l elief-conirming informaton and t at t eir al itual reasoning
atern is l iased in a wayn t at conirms rat er t an falsiies rior l eliefs. T us, t e refectie and
refexiie synstem is inclined to sustain rat er t an to correct faultyn anxious coniictons. T ere are
t ree common reasoning fallacies t at mayn contril ute to t e maintenance of fearful
reoccu atons.
o 1) Htpothe (a ( te (ting – t e frig tening coniictons of ADs can l e tyn icallyn condensed
into ro ositons of t e tyn e ‘If A, then B’ If I l lus Ag, t en eo le will judge me
incom etent Bg.
In t reatening situatons, informaton t at mayn signifyn danger is of
relatielyn great ialue. Alt oug it mayn seem in efcient to fee for false
alarms, a single instance of ignoring a danger signal mayn l e fatal. In t e
case of safetyn signals, t e o osite is true. Informaton t at mayn signifyn
t at a certain safetyn signal is not relial le as greater suriiial ialue t an
informaton w ic mayn roie t e signal relial le.
o 2) Belaef biaa ( – eien if anxious indiiiduals are roiided wit informaton to draw
a ro riate conclusions, t is stll is no guarantee t at it will result in a correcton of
faultyn l eliefs, l ecause eo le generallyn tend to relyn on t e euristc w at is l elieial le is
true’. Belief-l iased reasoning is tyn icallyn iniestgated using synllogisms. Belief l ias is most
common in social anxietyn. Deiniton – if some kind of cognitie content is l elieial le, it
does not reallyn mater if it is logical or not. Exam les wit a (tlloga (m:
Sleeping is nicer than going to a lecture. Going to a lecture is nicer than studying
for an exam.
Su osing t at t ose two claims are correct, t an t e queston is, is t is
statement correct as well: Slee ing is nicer t an studyning for an exam’ – t is
is ialid and l elieial le.
Having an exam is nicer than going to lectures. Going to lectures is nicer than
going to the movies.
Su osing t at t ose two claims are correct, t an t e queston is, is t is
statement correct as well: Going to t e moiies is nicer t an aiing an
exam’ – t is is inialid and l elieial le.
- T e s eed of logical reasoning is disturl ed l yn t e leiel of
bielaevabialatt. Wit regard to social anxietyn ow do t eyn come
to t e l eliefs t eyn aie and ow do t eyn kee to t ese l eliefsy
Belief-l iased reasoning is tyn icallyn iniestgated using synllogisms – t e Net erlands is safer
t an t e US, t e US is safer t an Afg anistan, t us t e Net erlands is safer t an
Afg anistang.
o 3) Afrmation of the con (enuent – so-called emotonal reasoning if a stmulus is
t reatening, I will l ecome afraid. I feel afraid, t us t e stmulus must l e t reatening. A
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