Information processing bias was evaluated in a sample of 25 older adults with generalized anxiety disorder (GAD) over the course of 12 weeks of escitalopram pharmacotherapy. Using the CANTAB Affective Go/No Go test, treatment response (as measured by the Hamilton Anxiety Rating Scale, Penn State Worry Questionnaire, and Generalized Anxiety Disorder Severity Scale) was predicted from a bias score (i.e., difference score between response latencies for negative and positive words) using mixed-models regression. A more positive bias score across time predicted better response to treatment. Faster responses to positive words relative to negative words were associated with greater symptomatic improvement over time as reflected by scores on the GADSS. There was a trend toward significance for PSWQ scores and no significant effects related to HAMA outcomes. These preliminary findings offer further insights into the role of biased cognitive processing of emotional material in the manifestation of late-life anxiety symptoms.
Information processing biases have been implicated as both causal and maintenance factors in cognitive models of anxiety (e.g., Beck and Clark, 1997 and Mogg and Bradley, 2005). For example, among younger and middle-aged adults, attention bias for threat-related stimuli has been linked to anxiety symptomatology, including symptoms of generalized anxiety disorder (GAD; Becker et al., 2001, Bradley et al., 1995, Bradley et al., 1999 and Mogg et al., 1993). In fact, it has been demonstrated that measures of attention bias can predict treatment outcome among persons with GAD (Mogg, Bradley, Millar, & White, 1995). There is also some evidence that information-processing biases can be altered with pharmacotherapy (Mogg, Baldwin, Brodrick, & Bradley, 2004). Preliminary research on attention training programs suggests that reductions in the magnitude of an attention bias toward threatening information can lead to reductions in anxiety symptoms, further suggesting that information processing biases play a role in the development or maintenance of GAD (e.g., Amir et al., 2009 and Hazen et al., 2009). Although progress has been made in this area, we know very little about whether these relationships between affective biases and anxiety are observed in older populations.
Among older adults without anxiety disorders, there is evidence for a bias toward positive material. Research on healthy aging suggests that older adults tend to attend to and remember positive information relative to neutral or negative information, a phenomenon that has been dubbed “the positivity effect” (cf. Mather & Carstensen, 2005). According to Socioemotional Selectivity Theory, this bias for positive information is not accidental; rather, it is theorized to reflect a shift of motivational goals with age from a focus on the acquisition of knowledge and information to the maintenance of emotional well-being ( Carstensen et al., 1999 and Charles and Carstensen, 2007). It is thought that this change occurs due to age-related shifts in time perspective, such that individuals become more acutely aware of the limited nature of time as they grow older.
