The effect of heart focused anxiety on attentional bias in cardiac and non-cardiac patients

Many patients in health settings, either with or without a medically verified cardiovascular disease (CVD) experience a specific Heart Focused Anxiety (HFA), characterised by cardiorespiratory pain, psychological distress and a belief that the heart is faulty. In accordance with general models of anxiety and Eifert's (1992) HFA model, this study aimed to examine whether HFA participants with or without CVD displayed a content-specific attentional bias towards threatening cardiac stimuli and to clarify if a number of commonly cited factors know to influence bias patterns are also active in HFA. One hundred and seventy-eight participants were allocated to five experimental groups (NoCVD-HighHFA, NoCVD-LowHFA, CVD-HighHFA, CVD LowHFA and NoCVD-LowHFA-High Trait Anxiety). The groups completed a visual probe task at two presentation levels, subliminal (<100ms) and supraliminal (1000ms), and responded to seven types of stimulus words (Heart-High Threat, Heart-Moderate Threat, Heart-High Positive, Social-High Threat, Social-High Positive, Disaster-High Threat and Neutral). Overall, the results support the presence of a content-specific attentional bias towards threatening cardiac material relative to other word types in high HFA individuals with or without CVD at both levels of processing. A similar bias pattern was documented in CVD participants with low HFA. This can be contrasted with the healthy control (NoCVD-LowHFA) and the Hight Trait Anxious (NoCVD LowHFA-HTA) groups who did not display this pattern. Unexpectedly, a bias towards positive information consistent with a protective attentional strategy to manage negative affect previously documented in the elderly was also displayed. The study's results provide evidence to support the HFA model (Eifert et al., 2000b) and the application of a Cognitive Behavioural approach in the treatment of HFA.