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. 2021 Feb 26:1-10.
doi: 10.1017/S0033291721000581. Online ahead of print.

Attention allocation in posttraumatic stress disorder: an eye-tracking study

Amit Lazarov  1   2 , Benjamin Suarez-Jimenez  3   4 , Xi Zhu  4 , Daniel S Pine  5 , Yair Bar-Haim  6 , Yuval Neria  4
Affiliations

Attention allocation in posttraumatic stress disorder: an eye-tracking study

Amit Lazarov et al. Psychol Med. .

Abstract

Background: Eye-tracking-based attentional research implicates sustained attention to threat in posttraumatic stress disorder (PTSD). However, most of this research employed small stimuli set-sizes, small samples that did not include both trauma-exposed healthy participants and non-trauma-exposed participants, and generally failed to report the reliability of used tasks and attention indices. Here, using an established eye-tracking paradigm, we explore attention processes to different negatively-valenced cues in PTSD while addressing these limitations.

Methods: PTSD patients (n = 37), trauma-exposed healthy controls (TEHC; n = 34), and healthy controls (HC; n = 30) freely viewed three blocks of 30 different matrices of faces, each presented for 6 s. Each block consisted of matrices depicting eight negatively-valenced faces (anger, fear, or sadness) and eight neutral faces. Gaze patterns on negative and neural areas of interest were compared. Internal consistency and test-retest reliability were evaluated for the entire sample and within groups.

Results: The two trauma-exposed groups dwelled longer on negatively-valenced faces over neutral faces, while HC participants showed the opposite pattern. This attentional bias was more prominent in the PTSD than the TEHC group. Similar results emerged for first-fixation dwell time, but with no differences between the two trauma-exposed groups. No group differences emerged for first-fixation latency or location. Internal consistency and 1-week test-retest reliability were adequate, across and within groups.

Conclusions: Sustained attention on negatively-valenced stimuli emerges as a potential target for therapeutic intervention in PTSD designed to divert attention away from negatively-valenced stimuli and toward neutral ones.

Keywords: Attention allocation; PTSD; eye-tracking; reliability; sustained attention; trauma-exposure.

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Figures

Fig. 1.
Fig. 1.
An example of a single matrix for (a) the angry-neutral block; (b) the fear-neutral block; and (c) the sad-neutral block. In each block, the eight emotional faces comprise the angry/fearful/sad area of interest (AOI) and the eight neutral faces comprise the neutral AOI.
Fig. 2.
Fig. 2.
Mean averaged total dwell time (in seconds) by area of interest (AOI) and group. Higher values indicate higher mean average dwell time. Error bars denote standard error of the mean. HC, healthy controls; PTSD, posttraumatic stress disorder; TEHC, trauma-exposed healthy control.
Fig. 3.
Fig. 3.
Averaged first-fixation dwell time (in milliseconds) by area of interest (AOI) and group. Higher values indicate higher average dwell time. Error bars denote standard error of the mean. HC, healthy controls; PTSD, posttraumatic stress disorder; TEHC, trauma-exposed healthy control.
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