Information processing biases in adults who stutter: Behavioral and eye-tracking indices of threat-related attention allocation

摘要 口吃是一种神经发育障碍与深刻的心理社会后果。个人 口吃的人通常会经历同伴的排斥，社会孤立，以及对他们的口吃的情绪反应。 口吃口吃的这些隐藏特征在个体之间差异很大，治疗起来很有挑战性， 根本的因果机制还不清楚。拟议项目通过以下方式解决这一关键差距： 专注于注意力过程，这可能会驱动对口吃的心理反应。该项目借鉴了 关于威胁相关注意力偏差（AB）的大量文献，研究了这种注意力偏差的程度。 与口吃有关。与威胁相关的AB指的是优先分配注意力， 威胁性刺激，并且在患有临床和亚临床焦虑的成人和儿童中是一个公认的发现。 认知模型将AB归因于发现威胁的早期过程或发现威胁的晚期过程的不平衡， 调节对威胁的反应，表现为更快地发现威胁（警惕），难以脱离威胁， 威胁（维护），威胁回避，或这些倾向的组合。AB可能通过促进 对威胁的高度敏感性和对环境刺激的高度警惕性扫描。口吃者 表现出与说话相关的类似的预期行为，这表明类似的AB模式可能是 口吃拟议的项目调查威胁相关的AB在成年人谁做和不口吃使用多- 范式方法，结合AB的行为和眼动跟踪指数。主要目的是建立 分组AB差异，并根据三个广泛的- 使用与信息处理的不同阶段和AB倾向相关的任务（目标1）。目标二是 确定口吃成年人中与威胁相关的AB的普遍程度（与焦虑一致）或 疾病特异性（反映口吃的个人生活经历），通过比较三种威胁 代表内容特异性增加的刺激（一般的、与口吃相关的和个人害怕的威胁 话）。目的3应用中介分析来检验AB作为一个关键的中介因素之间的作用 受试者水平的风险因素（与气质和注意力控制有关）和口吃的个体差异 结果（影响和预期）。该项目是创新的，因为它采用了新的概念和实验 AB研究的方法，使用眼动追踪方法来揭示动态注意力模式， 包括中介分析，以澄清AB和相关因素对口吃结果的贡献。结果将 增加我们对口吃反应的运作机制的理解， 以确定最容易受到口吃不利影响的个人。该项目的长期目标是 为未来的干预研究生成关键数据，旨在通过AB修饰范式逆转AB， 让注意力远离威胁。因此，拟议的研究支持NIDCD的使命， 了解口吃，并为评估和治疗口吃的新方法提供基础。

ABSTRACT Stuttering is a neurodevelopmental disorder associated with profound psychosocial consequences. Individuals who stutter commonly experience peer rejection, social isolation, and debilitating emotional responses to their stuttering. These hidden features of stuttering vary widely across individuals and are challenging to treat, but underlying causal mechanisms are not well-understood. The proposed project addresses this critical gap by focusing on attentional processes that may drive psychological responses to stuttering. The project draws upon the extensive literature on threat-related attention bias (AB), examining the extent to which such attentional patterns are associated with stuttering. Threat-related AB refers to preferential allocation of attention toward threatening stimuli and is a well-established finding in adults and children with clinical and subclinical anxiety. Cognitive models attribute AB to imbalances in early processes that detect threat, or late processes that modulate reactivity to threat, which manifest as faster detection of threat (vigilance), difficulty disengaging from threat (maintenance), threat avoidance, or combinations of these tendencies. AB may feed anxiety by promoting heightened sensitivity toward threat and hypervigilant scanning of environmental stimuli. Individuals who stutter show analogous anticipatory behaviors related to speaking, suggesting that similar AB patterns may underlie stuttering. The proposed project investigates threat-related AB in adults who do and do not stutter using a multi- paradigm approach that combines behavioral and eye-tracking indices of AB. The primary aim is to establish group differences in AB and identify the stage of processing at which differences emerge based on three widely- used tasks associated with different stages of information processing and AB tendencies (Aim 1). Aim 2 is to determine the extent to which threat-related AB in adults who stutter is general (consistent with anxiety) or disorder-specific (reflecting personal lived experiences of stuttering) by comparing three categories of threat stimuli representing increasing content specificity (general, stuttering-related, and personally-feared threat words). Aim 3 applies mediation analyses to examine the role of AB as a critical mediating factor between subject-level risk factors (related to temperament and attention control) and individual differences in stuttering outcomes (impact and anticipation). The project is innovative in that it applies novel conceptual and experimental approaches from AB research, uses eye-tracking methodologies that reveal dynamic attention patterns, and includes mediation analyses to clarify contributions of AB and related factors to stuttering outcomes. Results will increase our understanding of operative mechanisms shaping responses to stuttering and can provide a means to identify individuals most vulnerable to adverse stuttering impacts. The long-term goal of the project is to generate key data for future intervention studies designed to reverse AB through AB modification paradigms that train attention away from threat. The proposed research thus supports the mission of NIDCD by advancing our understanding of stuttering and providing a foundation for new approaches to its assessment and treatment.