Comparative cognitive processing of safety, threat and neutral cues by individuals with panic disorder

Whereas research supports a hypersensitivity to threat cues by individuals with anxiety disorders, less is known about attention to safety cues. In this investigation a cognitive psychology paradigm was utilized to empirically test the attentional biases in individuals with panic disorder towards both safety and threat cues. With a perceptual recognition task, different simultaneous pairings of safety, neutral, and threat cues were presented to demonstrate attentional focus. Specifically, 15 individuals with panic disorder and 15 normal controls were asked to read 18 pairs of threat, safety, and neutral words presented one pair at a time on a computer screen. Pairings were shown in all possible combinations. Words rated high in threat and safety value were obtained from polling 16 individuals with and 16 individuals without panic disorder. A single tachistoscopic presentation of all previously presented (primed) words interspersed with an equal number of non-presented threat, safety and neutral words immediately followed. Following the perceptual recognition task, the Know-Remember Test was administered to measure explicit and implicit memory for the primed words. There was no significant difference between perceptual recognition of threat, safety, or neutral words by the panic disorder group as compared to the normal control group. Nor did word pairings significantly affect perceptual recognition rates. Attentional bias and selective attention to threat or safety were not demonstrated in this investigation. Furthermore, the interpretation of these findings did not support an emotionality hypothesis to explain differential cognitive processing in anxiety disorders. The panic group and the normal control group had comparable implicit memory of study words, and implicit memory of a word was not related to whether a word was neutral, safe, or threatening. However, the panic group had significantly more explicit memory than the normal control group for threat words as compared to neutral or safety words. This enhanced explicit memory for threat was not related to whether threat was paired with threat, safety or neutral words. An enhanced explicit memory for threat remained even when the effects of state and trait anxiety and depression were statistically controlled.