Putting the Spotlight (of Attention) on Affect: Does the Valence of the Focus of Attention Modulate Affective State?

Abstract

Putting the Spotlight (of Attention) on Affect: Does the Valence of the Focus of Attention Modulate Affective State? Literature review: Background: To better treat anhedonia (reduced positive emotional experience) in depression, it is important to identify which psychological mechanisms drive anhedonia and whether simple manipulations can correct these mechanisms. One candidate mechanism is biases in attentional processing, including both the content of attention (the extent to which positive versus negative aspects of experience are focused on) and the quality of attention (the extent to which, that when attention is directed to positive aspects of experience, this is elaborated and savoured). Objectives: This systematic review will evaluate empirical evidence investigating whether manipulating the content and quality of attention alters positive emotion experience in adult (healthy and depressed) populations. Method: Experimental studies in adults manipulating the quality or content of positive attention and measuring its impact using a valid measurement of positive affect were identified, via a systematic search of Web of Knowledge and PsycInfo databases. 1,583 non-duplicate articles were found. A full text screen of 60 articles yielded 19 eligible articles (reporting 20 studies) for inclusion in the analysis (four manipulating the content of attention and 16 manipulating the quality of attention). Results: Nearly all studies were in healthy rather than dysphoric/depressed samples. Of four studies manipulating the content of attention (predominantly using valenced dot probe training paradigms), one showed robust changes in positive affect in the expected direction and three found no significant effects. Of 16 studies manipulating the quality of attention (including savouring, imagery and processing mode manipulations), 12 showed robust changes in positive affect in the expected direction and four found no significant effects. Conclusions: This review provides clear evidence that manipulating the quality of attention modifies positive affect. There was mixed evidence that changing the content of attention modifies positive affect. These null results may partly reflect limitations in the dot probe manipulation used and further research is warranted. It is premature to translate these findings into clinical application as a majority of studies have been conducted on healthy populations, but the results nevertheless suggest modifying positive attention remains a promising potential future treatment target to enhance psychological interventions for depression. Empirical Study: Background: The manner in which individuals focus their attention may modulate affective experience during positive activity scheduling. Focusing on the most positive elements of an activity may enhance positive affect (PA) and reduce negative affect (NA), whereas focusing on the most negative elements of an activity may reduce PA and elevate NA, but this possibility remains untested. Objectives: The study implements a novel manipulation of the valence of focus of attention deployed using a smartphone application, and evaluates the impact on PA and NA. Method: 68 unselected participants from the University of Exeter online recruitment portal completed all three conditions in a randomised control crossover study. Attention was manipulated during a pleasant walk to either the positive, negative, or no instruction control, using verbal prompts listened to via a smartphone application in an event contingent experience sampling protocol. Change in PA and NA from before to after the walk was recorded using an adapted Positive and Negative Affect Scale (PANAS). Results: Attending to the positive enhanced PA and reduced NA during positive activity scheduling, relative to a no instruction control condition. Attending to the negative increased NA and reduced PA during positive activity scheduling, compared to a no-instruction control condition. The benefit of the positive attention manipulation on increasing PA was more marked in individuals with a more marked negative attentional bias and in those with higher depression symptoms. Conclusions: This supports the view that reduced positive and enhanced negative attentional biases may be one mechanism driving anhedonia and suggests that the beneficial effects of positive activity scheduling during treatment for conditions characterised by anhedonia may be encouraging the cultivation of positive attentional bias when engaging with activities. This possibility now requires further testing in a clinical population.