Attentional capture by emotional scenes across episodes in bipolar disorder: Evidence from a free-viewing task

We examined whether the initial orienting, subsequent engagement, and overall allocation of attention are determined exogenously (i.e. by the affective valence of the stimulus) or endogenously (i.e. by the participant's mood) in the manic, depressive and euthymic episodes of bipolar disorder (BD). Participants were asked to compare the affective valence of two pictures (happy/threatening/neutral [emotional] vs. neutral [control]) while their eye movements were recorded in a free-viewing task. Results revealed that the initial orienting was exogenously captured by emotional images relative to control images. Importantly, engagement and overall allocation were endogenously captured by threatening images relative to neutral images in BD patients, regardless of their episode--this effect did not occur in a group of healthy controls. The threat-related bias in BD, which occurs even at the early stages of information processing (i.e. attentional engagement), may reflect a vulnerability marker.