Abstract
Background: Cognitive biases have been acknowledged as key causal mechanisms in a wide range of psychiatric disorders. In particular, attentional biases have been noted as contributing to the cause and maintenance of several disorders. Whilst there has been two decades of research investigating attentional biases in affective disorders, research is notably lacking in investigations of attention to emotion in psychosis.
Objectives: The objectives of this study were to progress our understanding of biased attention in psychosis by assessing a) whether there are any psycho-pathologically congruent selective attentional biases associated with clinical paranoid psychosis, b) Whether these biases are for specific types of stimuli, thereby examining the content specificity of any observed attentional bias, and c) assess the specific selective attentional mechanisms involved in any observed attentional bias, specifically whether biases in engaging or disengaging attention are involved.
Method: Fifty-two individuals with Schizophrenia (30 paranoid and 22 non-paranoid) and thirty healthy controls were recruited for this study. Each participant undertook a clinical interview to assess symptomology, completed a battery of questionnaires and undertook 3 computer tasks. Tasks included an Attention Probe Task (with neutral-neutral baseline condition to assess spatial orienting hypothesis) a Central Cuing Task and an Emotional Stroop Task to allow for backwards comparability of our sample to previous studies.
Results: Overall the present study found a selective attentional avoidance bias for socially threatening stimuli and an engagement to physical threat bias within individuals with paranoid psychosis. Non-paranoid individuals however showed an attentional avoidance and slowed engagement bias for positive stimuli. Control participants showed no attentional biases to any of the stimuli across the three tasks. The findings thereby provide broad support for all three hypotheses.
Conclusions: The present data provides one of the first attempts to investigate attentional processes in paranoid psychosis with the specific aim of delineating the more specific components of selective attention implicated in biased processing. Overall, the current findings provided support for the study’s hypotheses and provide evidence for a qualitative difference in attentional biases between two types of psychosis. Limitations and clinical implications are discussed.