Attentional Control Brain-Behavioral Relationships In Anxiety And Depression

On a daily basis, many of us are bombarded by emotionally-charged information such as news headlines, social media posts, and the various facial expressions we encounter that convey potent cues about our surroundings. Negative information is especially attention-grabbing and, therefore, difficult to ignore even when carrying out an unrelated activity, for example, trying to read on a bus while an argument ensues in the background.

This difficulty is due to a limited capacity system — it is not possible to simultaneously process all information that is available, thus, attending to a stimulus (or feature of a stimulus) comes at the cost of neglecting other information. Consequently, when a stimulus is inconsistent with a current goal, there is “competition” for processing resources.

Critical to maintaining on-going activities without undue interference from negative and other salient distractors is attentional control. Effective attentional control is when attention is directed to the task at hand thereby inhibiting the processing of task-irrelevant information (Corbetta and Shulman, 2002). Notably, the easier the goal, the more attentional control is required as more task-relevant resources are “left-over” to process distractors (Lavie et al., 2004).

A common self-report measure of attentional control is the Attentional Control Scale (“ACS”). The ACS assesses one’s ability to focus attention (e.g., “My concentration is good even if there is music in the room around me”) and shift attention (e.g., “I can quickly switch from one task to another”) (Derryberry and Reed, 2002). The higher the score, the better the attentional control.  Due to the stability of responses, attentional control is considered a trait characteristic (Derryberry and Reed, 2002).

Overall, people with higher ACS total scores have less anxiety or depression (Derryberry and Reed, 2002; Judah et al., 2014; Ólafsson et al., 2011). The inverse relationship between trait attentional control and negative mood is in keeping with influential cognitive models of psychopathology that propose excessive attention to negative stimuli contributes to the development and maintenance of mental health difficulties (Williams et al., 1997).

Yet, despite general support for the model, anxious or depressed people vary considerably in attentional control (Bar-Haim et al., 2007) suggesting mechanisms that underlie attentional control may help explain individual differences. As a step towards identifying mechanisms, we conducted a recent study, “Trait Attentional Control Modulates Neurofunctional Response to Threat Distractors in Anxiety and Depression,” published in the Journal of Psychiatric Research. In the study, 138 individuals with or without anxiety or depression completed the trait attentional control questionnaire (ACS) and an attentional control task during functional magnetic resonance imaging (fMRI).

The goal in the fMRI task was to identify a target letter (X or N) in a string of letters. All letter strings were superimposed on threating or neutral face distractors and the composite image was rapidly presented. To test the influence of task difficulty, there was an easy condition (i.e., low perceptual load) in which the letter string comprised target letters only (e.g., NNNNN) and a difficult condition (i.e., high perceptual load) where the letter string consisted of a single target letter and five non-target letters (H, K, M, W, Z). Thus, the task-irrelevant faces were more distracting in the low relative to high perceptual load condition thereby necessitating greater attention control.

With regard to group characteristics, 104 participants diagnosed with an anxiety or depressive disorder were more symptomatic and had less trait attentional control on average, as indexed by the ACS total score, compared to 34 participants without a psychiatric illness. Moreover, among those in the clinical group, higher ACS scores were associated with less negative mood. Interestingly, relationships between brain responses to threat (vs. neutral) face distractors and ACS scores were only observed in the clinical group. Results suggest participants in the smaller non-psychiatric group did not vary substantively in terms of self-reported trait attentional control and/or brain response during attentional control.

Among anxious or depressed participants, higher ACS scores corresponded with greater activity to negative (vs. neutral) face distractors in the ventral portion of the anterior cingulate cortex when perceptual load was low. Under high perceptual load, higher ACS scores corresponded with less neurofunctional activity to negative (vs. neutral) face distractors in the inferior frontal gyrus. In both cases findings were observed when controlling for illness severity suggesting trait attentional control, not anxiety or depression symptoms, tracked individual differences in attentional control mechanisms.

The anterior cingulate cortex and inferior frontal gyrus are involved in executive functions such as conflict monitoring, decision-making, and inhibition Cromheeke and Mueller, 2012). The difference in brain region and direction of brain-trait attentional control relationships signifies task difficulty as manipulated with perceptual load may represent distinct phenotypes. In other words, better attentional control by means of greater anterior cingulate cortex activity in the context of threat distractors and/or compensatory activity in the inferior frontal gyrus may characterize a subgroup of individuals.

These findings have important inferences for improving our understanding of psychiatric illness, as it suggests that for certain anxious or depressed individuals, exposure to negative information is lessened due to better attentional control. According to cognitive theory, this would mitigate reactivity to stressors and the development of negative thoughts or feelings. While it remains to be tested, the implication is attentional control phenotypes may predict the trajectory of illness severity over time, response to treatment, and/or risk of relapse in those who respond to treatment.

These findings are described in the article entitled Trait Attentional Control Modulates Neurofunctional Response to Threat Distractors in Anxiety and Depression, recently published in the Journal of Psychiatric ResearchThis work was conducted by Heide Klumpp, Kerry L. Kinney, Amy E. Kennedy, Stewart A. Shankman, Scott A. Langenecker, Anand Kumar, and K. Luan Phan from the University of Illinois at Chicago.


  1. Bar-Haim, Y., Lamy, D., Pergamin, L., Bakermans-Kranenburg, M J Van Ijzendoorn, M.H., 2007. Threat-related attentional bias in anxious and nonanxious individuals: a meta-analytic study. Psychological Bulletin 133, 1-24.
  2. Corbetta, M., Shulman, G.L. 2002. Control of goal-directed and stimulus-driven attention in the brain. Nature Reviews Neuroscience 3, 201-215.
  3. Cromheeke, S., Mueller, S.C. 2014. Probing emotional influences on cognitive control: an ALE meta-analysis of cognition emotion interactions.  Brain Structure and Function 219, 995-1008.
  4. Derryberry, D., Reed, M.A., 2002. Anxiety-related attentional biases and their regulation by attentional control. Journal of Abnormal Psychology 111, 225–236.
  5. Judah, M.R., Grant, D.M., Mills, A.C., Lechner, W.V., 2014. Factor structure and validation of the attentional control scale. Cognition and Emotion 28, 433–451.
  6. Lavie, N., Hirst, A., De Fockert, J.W., Viding, E., 2004. Load theory of selective attention and cognitive control. Journal of Experimental Psychology: General 133, 339-354.
  7. Ólafsson, R.P., Smári, J., Guðmundsdóttir, F., Ólafsdóttir, G., Harðardóttir, H.L., Einarsson, S.M., 2011. Self reported attentional control with the Attentional Control Scale: factor structure and relationship with symptoms of anxiety and depression. Journal of Anxiety Disorders 25, 777–782.
  8. Williams, J. M., Watts, F. N., MacLeod, C., & Mathews, A. (1997). Cognitive psychology and emotional disorder. Chichester, England: Wiley.