The influence of (social) anxiety and visual exploration on threat responding and generalization

Fear generalization has been identified as an important mechanism that might contribute to the etiology and maintenance of anxiety disorders. It is, however, yet unclear to what degree attentional processes contribute to overgeneralization of fear in clinical samples. To address this issue, we utilized a set of facial photographs that was meticulously created such that pairs of faces could either be distinguished by looking into the eyes or the region around mouth and nose, respectively. These pairs were then employed as CS+ and CS- in a differential fear conditioning paradigm followed by a generalization test with morphs in steps of 20 %, creating a continuum between CS+ and CS-. In a sample with diverse levels of social and general anxiety (N = 87), we demonstrated that the amount of fear generalization depends on attentional orienting towards diagnostic facial features. While social anxiety did not affect the shape of generalization gradients, we observed altered visual exploration patterns and a distinct multi-phasic heart rate modulation in participants with higher social anxiety. General anxiety symptomatology was also related to these characteristics of visual exploration and additionally predicted a broad elevation of threat ratings. In summary, fear generalization depends on attentional deployment. Future work should build on these findings to further explore these processes in clinical populations.