The interplay between trait anxiety, cognitive biases and attentional control in healthy individuals with psychotic-like experiences

- The link between anxiety, attention bias (ATB), attention control and PLEs was tested.
- External attribution bias (EAB) predicted PLEs among high-anxious subjects.
- ATB, EAB and belief inflexibility predicted PLEs in the low-anxious (LA) group.
- In the LA group ATB increased PLEs if accompanied by good ability to focus attention.

Although both anxiety and cognitive biases contribute to psychosis, it is still unclear whether these factors interact in their influence on psychotic symptoms. The aim of the study was to examine the interactions between trait anxiety, cognitive biases and delusion-like experiences (PLEs) in a non-clinical sample; the moderational role of attentional control on this relationship was also considered in the study. Two subgroups of participants, 92 individuals (M=24.76; SD=6.33) with heightened (HA) trait anxiety and 78 individuals (M=23.09; SD=5.66) with lowered (LA) trait anxiety took part in the study. Anxiety, cognitive biases and attentional control were measured using self-report questionnaires. Regression analyses and moderation analyses were performed. External attribution bias predicted psychotic-like experiences in both groups, whereas attention to threat bias and belief inflexibility predicted PLEs within LA group. Further moderation analyses revealed that in LA group attention to threat bias increases PLEs only among individuals with a high and moderate ability to focus attention. The results indicated that trait anxiety is an important factor influencing the relationship between cognitive biases and PLEs, and that the ability to voluntarily focus attention is a significant moderator of the linkage between attention to threat bias and delusion-like experiences among low-anxious healthy individuals.