انعطاف پذیری خصلتی مشخص شده توسط الگوهای خاص تعصب توجه به محرک های عاطفی و کنترل توجه

Abstract Background and objectives Attentional processes have been suggested to play a crucial role in resilience defined as positive adaptation facing adversity. However, research is lacking on associations between attentional biases to positive and threat-related stimuli, attentional control and trait resilience. Methods Data stem from the follow-up assessment of a longitudinal study investigating mental health and related factors among German soldiers. Trait resilience was assessed with the Connor-Davidson Resilience Scale and attentional control with the Attentional Control Scale. A subset of n = 198 soldiers also completed a dot probe task with happy, neutral and threatening faces. Results Attentional control was positively related to trait resilience. Results revealed no associations between both attentional biases and trait resilience. However, there was a negative association between attentional bias to threat and trait resilience when attentional control was low and a positive association between attentional bias to threat and trait resilience when attentional control was high. No such associations were found for attentional bias to positive stimuli. Limitations Generalizability to other populations may be limited since we exclusively focused on male soldiers. Also, the cross-sectional design does not allow for causal conclusions. Conclusions Findings suggest that attentional processing may promote trait resilience. Future research on preventive interventions should consider these findings.

Introduction Trait resilience is defined as a stress coping ability, which enables individuals to successfully adapt facing adversity (Connor & Davidson, 2003). Empirical evidence has shown that lower levels of trait resilience are associated with an increased risk of developing mental disorders after stressful life events, e.g. PTSD (Lee, Ahn, Jeong, Chae, & Choi, 2014) as well as other anxiety (e.g. Scali et al., 2012), depressive (e.g. Edward, 2005 and Kukihara et al., 2014), and substance use disorders (Wingo, Ressler, & Bradley, 2014). Furthermore, trait resilience has been shown to predict treatment response in subjects with depression and PTSD (Davidson et al., 2012 and Min et al., 2012). Even though previous evidence suggests that trait resilience might protect from maladaptive outcomes and might help to recover from stressful life events little is known about cognitive characteristics and underlying mechanisms of trait resilience. This may be of pivotal importance regarding the development of empirical based interventions for promoting resilience. Theoretical accounts postulate that attentional processing may play a crucial role in trait resilience. Schwager and Rothermund (2013) proposed that attention is the core of cognition and affect, which is responsible for adaptation in stressful situations. Theories of attention postulate two systems (e.g. Corbetta & Shulman, 2002) which can be related to the concepts of attentional control and attentional bias. Accordingly, attentional bias can be seen as a bottom-up, stimulus-driven attentional process, responsible for the detection and attentional holding of relevant stimuli. Attentional control is described as a top-down process, supposed to be responsible for preparation, regulation and application of goal-directed selective attention. Even though theoretical accounts suggest that attentional biases to positive and negative stimuli may encourage trait resilience (e.g. Schwager & Rothermund, 2013), little effort has been made to directly investigate these associations. However, indirect evidence comes from research investigating associations with variations in the serotonin transporter gene. Serotonin is an important neurotransmitter involved in different psychological processes. The 5-HTTLPR polymorphism of serotonin transporter has been found to be associated with different mental disorders (e.g. Karg et al., 2011 and Kenna et al., 2012). Therefore, one might assume that it is also involved in trait resilience. Accordingly, Stein, Campbell-Sills, and Gelernter (2009) found a negative association between the number of s-alleles of 5-HTTLPR and trait resilience. Additionally, Perez-Edgar et al. (2010) and Fox, Ridgewell, and Ashwin (2009) found that attentional bias for angry faces was positively associated with the number of long alleles of 5-HTTLPR and the reverse pattern was evident for attentional bias to happy faces. These findings suggest that trait resilience might be positively associated with attentional bias toward positive stimuli and negatively associated with attentional bias toward negative stimuli. However, to our best knowledge no study so far directly examined associations of trait resilience with attentional biases. Moreover, a better ability to control attention may enable individuals to decide which internal and external stimuli they attend to and thus promote adaptive emotion regulation (Troy & Mauss, 2011). This may support coping with adverse situations. Consistent with this proposition Eisenberg et al. (2004) found that effortful control, a superordinate construct including AC, predicted trait resilience in a longitudinal study in children. Furthermore, Bardeen, Fergus, and Orcutt (2014) found that higher attentional control predicted lower symptoms of PTSD in traumatized individuals compared to non-traumatized individuals. However, to our knowledge research is lacking on examining the relations between attentional control and trait resilience directly. According to theories about attentional processing attentional control and attentional biases are distinct systems but supposed to interact with each other (e.g. Corbetta and Shulman, 2002 and Petersen and Posner, 2012). In line with this, Verwoerd, Wessel, de Jong and Nieuwenhuis (2009) found in a laboratory study that attentional bias and attentional control were related in the prediction of intrusions after watching a trauma film. Furthermore, Bardeen and Orcutt (2011) and Schoorl, Putman, Van Der Werff, and Van Der Does (2014) found that the interaction of attentional control and symptoms of PTSD was associated with attentional bias to threat. Results of the study of Bardeen and Orcutt (2011) using general threat stimuli (whereas Schoorl et al. (2014) used trauma-related stimuli) indicated that participants with strong AC and strong symptoms of PTSD showed attentional avoidance of threat whereas participants with poor AC and strong symptoms of PTSD showed an attentional bias towards threat. In summary, it can be proposed that attentional control may be associated with a differential association between attentional biases to threat and positive stimuli and trait resilience. Attentional control may allow individuals to cope with stress and regulate negative emotions by attending to positive stimuli and disengaging the attention from threat-related, negative information (e.g. Gross, 2002 and Troy and Mauss, 2011). 1.1. Present study This study aims at investigating the basic cognitive mechanisms of trait resilience, concentrating on attentional processing. We examined whether resilient individuals are characterized by attentional biases to emotional stimuli, i.e. avoiding threat and turning to positive stimuli relative to neutral stimuli, indicating that resilient individuals use emotional stimuli for adaptive emotional responses (e.g. Gross, 2002 and Troy and Mauss, 2011). This may be related to the ability to voluntarily control attention. Therefore, we examined the relationships between attentional biases, attentional control and trait resilience in German soldiers – a sample at increased risk of experiencing stressful life events. We expect a) a positive association between attentional bias to positive stimuli and trait resilience and a negative association between attentional bias to threat and trait resilience, b) a positive association between attentional control and trait resilience and c) that a higher attentional control is associated with heightened attentional bias to positive stimuli and more trait resilience and d) that a higher attentional control is associated with diminished attentional bias to threat and more trait resilience. Since attentional bias to threat, attentional control and trait resilience are associated with symptoms of anxiety disorders, respectively (Bar-Haim et al., 2007, Reinholdt-Dunne et al., 2013 and Scali et al., 2012), we tested these associations also by adjusting for these symptoms. Accordingly, since attentional bias to positive stimuli, attentional control and trait resilience are associated with symptoms of depression, respectively, (Armstrong and Olatunji, 2012, Edward, 2005 and Reinholdt-Dunne et al., 2013) we tested these associations also by adjusting for these symptoms. Thereby, we tested whether the associations are only due to these specific symptoms but not to trait resilience.

Funding This study was funded by the German Defense Ministry, respectively the Medical Office thereof (Bundesministerium der Verteidigung, represented by: Sanitätsamt der Bundeswehr: Project Funding number M/SAB X/9A004) and was further logistically supported by the staff of the Centre for Psychiatry and Posttraumatic Stress in Berlin and an internal army Steering and Advisory Board of the Bundeswehr. The German Defense Ministry had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication. The first author (Judith Schäfer) was funded by a doctoral stipend of the Technischen Universität Dresden (Stipendienprogramm zur Förderung von Nachwuchswissenschaftlerinnen).