Life-Threatening Danger and Suppression of Attention Bias to Threat

Objective: Life-threatening danger is assumed to produce, in tandem, increases in both vigilance toward threat and stress-related symptoms, but no data test the validity of this assumption. The authors examined associations, in real time, among imminent life-threatening danger, stress-related symptoms, and vigilance. Method: Symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety were measured in a civilian population (N=131) as a function of war-related stress, operationalized as the time available for seeking cover from rocket attack. A computerized measure of threatrelated vigilance using a classic dot-probe attention task was also collected. Results: PTSD symptoms, depression, and anxiety increased as a function of war-related threat. Acute proximal threat was associated with avoidance of, rather than vigilance toward, negative valence information. For participants within rocket range, the magnitude of threat bias varied with the magnitude of distress symptoms, such that as bias away from threat increased, distress symptoms increased. Conclusions: These data challenge current thinking about the role of attention in stress responding. Attentional threat avoidance may reduce the acute impact of imminent threat, but this may come at a price in terms of an elevated risk for psychopathology. (Am J Psychiatry 2010; 167:694-698)