Isolating delayed attentional disengagement from biased orienting to signals of threat in anxiety - not there yet.

It is often argued that increased "attentional bias to threat" in anxiety is due to delayed attentional disengagement from threat stimuli, rather than increased attentional orienting towards such signals. In 2013, [Clarke, P. J. F., Macleod, C., & Guastella, A. J. (2013). Assessing the role of spatial engagement and disengagement of attention in anxiety-linked attentional bias: A critique of current paradigms and suggestions for future research directions. Anxiety, Stress and Coping: An International Journal, 26(1), 1-19. https://doi.org/10.1080/10615806.2011.638054] critiqued this literature, pointing out that most studies used paradigms that could not isolate attentional disengagement from attentional orienting. Since this critique, over fifty studies claiming to measure attentional disengagement from threat in anxiety have been published, many using suboptimal methods. In this (preregistered) systematic review and meta-analysis, we outline why many of these paradigms fail to provide a valid measure of attentional disengagement from stimuli with different emotional content. We also highlight studies where the paradigms and task parameters allowed for the valid measurement of attentional disengagement and include a meta-analysis (759 participants) of this subset. Some evidence was observed for slowed disengagement from threat images (relative to neutral) in high-anxious individuals, but heterogeneity across studies was high, and the effect disappeared when restricting the analysis to paradigms that could rule out behavioural freezing as an alternative explanation. Overall, these findings highlight the need for better-quality research in this area and suggest best practices for the field moving forward.