The role of attention bias to threat in anxiety: mechanisms, modulators and open questions

- Anxious individuals and those at risk show attention biases to irrelevant threats.
- These attention biases are related to imbalanced prefrontal-limbic-sensory circuits.
- The causality between attention, expectancy and perception biases is not clear.
- Open questions exist regarding the factors influencing attention training success.
- When successful, attention training changes prefrontal-limbic-sensory connectivity.

Individuals at risk of developing anxiety and those with (sub-) clinical anxiety have robust attention biases to irrelevant threats, among them facilitated engagement, difficulty in disengaging and later avoidance of threat. These attention biases are thought to be associated with abnormal activation and connectivity in prefrontal-limbic-sensory neural circuits. Attention biases were shown to be related to other processing biases, but more empirical data are needed to better understand the causal role of each processing bias and to develop effective treatments. These attention biases have further been suggested as playing a causal role in anxiety, although mixed findings from attention bias modification studies challenge this contention.