Some individuals may be more vulnerable to acute or chronic stress due to past experiences (trauma, early adversity), current environment (poverty, stigmatization), and/or personality/dispositions. Individual moderators of stress may illuminate who is more or less likely to experience physical or mental health problems. There are a variety of measures that attempt to capture individual vulnerability. Here we review a class of measures that fall under the larger category of “Threat Sensitivity Measures.” All of these measures offer a non-self-report approach to measuring threat sensitivity, which reduces concerns related to social desirability and dispositional positive/negative responding. Below we review seven of the most commonly used threat sensitivity measures.
Dot Probe Task
The Dot Probe Task for assessment of attentional bias for threat displays two stimuli (e.g., words/images) on a screen with one at the top and the other at the bottom (or one on the left and one on the right). Following a brief presentation of the stimuli (e.g., 500ms), both stimuli disappear and a probe appears in the place of one of the stimuli. The participant must either identify the probe or indicate where it appeared as quickly as possible. Outcomes are based on response times to probes replacing threatening versus neutral stimuli (MacLeod, Mathews, & Tata, 1986; Mather & Carstensen, 2005; Wald et al., 2011).
Reliability: Both the test-retest reliability and internal consistency are “very low” for dot probe difference scores (i.e., bias scores). However, the test-retest reliability of individual emotional and neutral response times may be higher.
State or trait: Attentional bias for threat using dot probe associated with trait anxiety in a meta-analysis. Older adults with high trait anxiety scores show a “vigilant-avoidant” reaction to sad faces (i.e., initially orient towards sad faces and then away from threat) and an “avoidant-vigilant” reaction to negative words (i.e., initially orient away from negative words but then towards them) (Lee & Knight, 2009).
Associations with chronic stress and depression: In a meta-analysis of 29 studies, there was a moderate and significant difference in attentional bias between groups, with depressed subjects showing significantly greater bias towards negative stimuli than healthy individuals (Peckham et al., 2010).
The Modified Stroop Task for assessment of cognitive interference by threat includes different types of words (either neutral or threatening) in varying colors. The participant is asked to report the color of the text while ignoring the semantic content of the word. One variation includes emotional and neutral pictures tinted a certain color. Longer response times to report the color of threat words indicate greater cognitive interference by threatening information (MacLeod, 1991; Michael et al., 2002).
Reliability: Test-retest reliability and internal consistency appear low for difference scores between neutral and threatening conditions, but higher for scores for either neutral or threatening conditions considered separately (Cisler et al., 2009; Kindt, Bierman, & Brosschot, 1996; Schmukle, 2005; Siegrist, 1997; Strauss et al., 2005).
State or trait. Researchers found a significant relationship between state anxiety and emotional Stroop reaction times (Dresler et al., 2009). The combination of low trait anxiety and high social desirability was associated with less interference in naming threat compared to neutral words, whereas the combination of high trait anxiety and low social desirability was associated with increased interference due to threat words (Mogg et al., 2000).
Associations with chronic stress and depression: In a meta-analysis of 29 studies, there was a marginally significant difference in Stroop scores between depressed and non-depression groups (Peckham et al., 2010). Lim and Kim reported depressed patients showed slower response times to negative words on the Stroop compared to healthy controls (Lim & Kim, 2005). A study by Broomfield et al reported a similar finding in elderly depressed patients (Broomfield et al., 2007). Conversely, Hill and Knowles reported that depressed subjects did not show selective attention to threat and instead displayed slower responses to all verbal stimuli, including threatening, negative and positive nouns (Hill & Knowles, 1991). Kerr et al reported similar findings, with MDD patients demonstrating slower response times on neutral, positive and negative conditions compared to healthy subjects (Kerr, Scott, & Phillips, 2005).
Posner Cueing Task/Posner Paradigm
Participants are asked to focus on a fixation point between two rectangles. A cue is presented in one of the rectangles (e.g. a threatening stimulus), which is followed by an asterisk appearing in one of the two rectangles. The participants press a key to indicate which rectangle the asterisk is in. The paradigm consists of “valid cues” (i.e. the cue brings attention to the rectangle the asterisk then appears in), “invalid cues” (i.e. the cue brings attention to the opposite rectangle that the asterisk then appears in), and “uncued” trials (no cue is presented). If a participant can detect the probe faster on validity cued trails with a threatening cue, it suggests “facilitated attention to threatening cues” as the threatening stimulus brings attention to the probe faster than a neutral cue. If a participant is slower in detecting the probe during invalid cues with a threatening cue, it suggests “difficulty in disengaging” from the threatening cue (Cisler et al., 2009).
Reliability: Attention bias scores from the Posner task have low reliability (Enock, Hofmann, & McNally, 2014).
State or trait: Differences in attentional engagement and disengagement between high and low trait anxious individuals (Sagliano et al., 2014). High compared to low trait anxious individuals showed slower reaction times on trials with invalid threat cues than invalid neutral cues, indicating difficulty in disengagement from threat cues. However, threat cues led to the slowing of reaction times in high but not low anxious individuals. When adjusting for this threat cue-related slowing, high anxious individuals showed greater engagement with threat cues, but no evidence of bias in disengagement processes (Mogg et al., 2008).
Associations with chronic stress and depression: Unknown
Fear Potentiated Startle
Startle responses to an acoustic stimulus are examined in varying threat conditions. Threat can be manipulated using dark/light, threat of shock and threat of airpuff etc. Outcomes can include changes in electromyography (EMG; eye blink, heart rate, skin conductance etc.). One startle paradigm consists of a visual threat cue (a monitor displaying the condition) as well as devices to deliver audio and shock and three threat conditions: low threat (participants perform the procedure without a finger shock device and are told they would not be shocked); ambiguous threat (participants wear a finger electrode during the procedure but are indicated by the monitor that they would not be shocked); and high shock (participants wear the finger shock device and the monitor indicated that shocks are possible). During the high threat condition, all shocks are delivered after the auditory cues (Pole et al., 2007).
Reliability: Multiple studies have claimed that the fear-potentiated startle response is a reliable measure that produces a reliable startle response in non-humans. However, reliability is less clear in humans (Campeau, Liang, & Davis 1990; Davis, 1993; Falls, Miserendino, & Davis, 1992).
State or trait: The measure has been correlated more with state anxiety (as measured by the STAI). Grillon, C., et al. found that high-fear subjected (based on state anxiety score) had larger startle amplitudes at time of shock expectation compared to low-fear. Further, the high fear subjects showed no difference in startle amplitude during the transition between No-Threat and Treat conditions. Trait anxiety was not associated with fear-potentiated startle (Grillon et al., 1993; Morgan et al., 1995).
Associations with chronic stress and depression: In a study of individuals with MDD, a lifetime history of suicide attempt was associated with an increased fear-potentiated startle to predictable shock. Further, the retrospective subjective anxiety ratings were higher for subjects with a suicide attempt history during the unpredictable condition than for subjects without a history (Ballard et al., 2014). Another study investigated whether children and grandchildren of individuals with MDD would exhibit increased startle reactivity. Results of the fear-potentiated startle task revealed a significantly greater overall magnitude of startle for the high-risk group compared to the low-risk group (Grillon et al., 2005). Finally, another study showed that childhood trauma was associated with greater skin conductance responses to startle across all threat conditions (Pole et al., 2007).
Dichotic Listening Task
This task is used to study selective attention. In this task, the participant is presented with two different stimuli simultaneously, each on one side of the headphones. The participant is directed to repeat aloud the words they heard in one ear while a different message is presented in the other year. As a result of focusing to repeat the words, participants do not notice the message in the other year, suggesting a selective consciousness to specific information. Attention bias in this task can be measured through 4 ways: 1) Asking the participants questions about the two different auditory stimuli, 2) Questions about the patterns of the words they were told to attend to, 3) both parts 1) and 2), or 4) Detect target words in the list of words (Arciuli & Slowiaczek, 2006; Drachman et al., 1980; Moray, 1959).
State or trait: Anxious subjects complaining of generalized anxiety were slower in performing a simultaneous reaction time task when unattended words were threatening in content, although neither anxious nor non-anxious subjects could report on or recognize the words to which they had been exposed (Mathews, Andrew, & MacLeod, 1986).
Associations with chronic stress and depression: Researchers found that patients with anxious depression have a greater propensity to activate right than left-hemisphere regions during auditory tasks. Those with a non-anxious depression have the opposite hemispheric asymmetry. There was no group difference in the sensitivity to emotional words (Bruder et al., 1999). In another study, researchers did not find a significant difference in cognitive functioning between depressed patients and the control group. Both groups showed a right ear advantage during the not-forced and forced-right conditions and a left ear advantage during the forced left condition (Hugdahl et al., 2003).
Facial Recognition Task
In relation to threat sensitivity, this task is also known as the Fearful Face Detection Task. This task asks participants to focus on a central point on a screen to orient themselves to the task, which is then followed by a blank screen. Next, a pair of faces appear on the screen consecutively. The first of the two faces, the target, is either fearful, happy, or neutral. The second face is neutral. Participants are asked to press a button to denote when they perceive fear, and press another button when they do not perceive fear. Threat sensitivity is measured by response time to each pair of faces, contrasting a pairing of neutral-neutral faces and fearful-neutral faces (Doty et al., 2013; Pessoa et al., 2006).
State or trait: Higher trait anxiety scores correlate with detection sensitivity for fearful faces. Subjects who were faster to correctly identify faces as fearful also had higher levels of state anxiety (Doty et al., 2013).
Associations with chronic stress and depression: Unknown
This summary was prepared by Aoife O'Donovan, PhD and reviewed by Stress Measurement Network leadership. If you have any comments on these measures, email firstname.lastname@example.org. Version date: February 2018.
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