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Individuals with social anxiety often exhibit atypical processing of facial expressions. Previous research in social anxiety has primarily emphasized cognitive bias associated with face processing and the corresponding abnormalities in cortico-limbic circuitry, yet whether social anxiety influences early perceptual processing of emotional faces remains largely unknown. We used a psychophysical method to investigate the monocular advantage for face perception (i.e., face stimuli are better recognized when presented to the same eye compared to different eyes), an effect that is indicative of early, subcortical processing of face stimuli. We compared the monocular advantage for different emotional expressions (neutral, angry and sad) in three groups (N = 24 per group): individuals clinically diagnosed with social anxiety disorder (SAD), individuals with high social anxiety in subclinical populations (SSA), and a healthy control (HC) group of individuals matched for age and gender. Compared to SSA and HC groups, we found that individuals with SAD exhibited a greater monocular advantage when processing neutral and sad faces. While the magnitudes of monocular advantages were similar across three groups when processing angry faces, individuals with SAD performed better in this condition when the faces were presented to different eye. The former findings suggest that social anxiety leads to an enhanced role of subcortical structures in processing nonthreatening expressions. The latter findings, on the other hand, likely reflect an enhanced cortical processing of threatening expressions in SAD group. These distinct patterns of monocular advantage indicate that social anxiety altered representation of emotional faces at various stages of information processing, starting at an early stage of the visual system. • Individuals with social anxiety disorder showed increased monocular advantage for neutral and sad expressions. • Social anxiety did not affect the magnitude of monocular advantage for angry expression. • Distinct patterns of monocular advantage indicate altered facial emotion processing at an early stage of the visual system. [ABSTRACT FROM AUTHOR]

• Observed social support from one's partner is associated with lower PTSD symptom severity. • Informational support may be particularly important, perhaps because it helps individuals better appraise traumatic situations. • Social support from one's partner is associated with lower PTSD severity only among those making weak negative attributions about support. Lack of perceived social support is one of the strongest correlates of the development and maintenance of posttraumatic stress disorder (PTSD). However, little is known about observed social support and PTSD. The stress buffering effect of social support may be partly determined by the subjective experience of support, which is created by attributions regarding support behaviors. We examined negative attributions about partner-provided support as a moderator of the expected relation between observed support during couple discussions and PTSD symptom severity. Participants included 128 individuals from 64 heterosexual married or cohabitating couples. Per clinician-administered interview, 72 (56%) participants met subthreshold or diagnostic criteria for PTSD. Receipt of relatively more partner support was modestly associated with lower PTSD symptom severity. Negative causal attributions about partner support were not associated with the amount of support received, but were associated with higher PTSD severity. Additionally, the frequency and quality of received partner support was associated with lower PTSD symptom severity only among those who did not make strong negative causal attributions about partner support. Thus, negative causal attributions may dampen the positive effects of social support on PTSD symptoms. PTSD treatments may more effectively facilitate recovery from trauma by decreasing negative support attributions. [ABSTRACT FROM AUTHOR]

Fear of childbirth (FOC) is a phobic-like response concerning the prospect of giving birth. FOC can have negative implications for women during pregnancy and can impact their birthing experience. Cognitive processing biases (e.g., difficulty disengaging from threatening information, interpreting ambiguous information as threatening, and preferentially recalling threatening content) have previously been found to maintain general anxiety and low mood. To date, there has been no research assessing these attention, interpretation, and memory biases and their relationship with FOC in pregnant women. Accordingly, in this cross-sectional study, participants who were at least 12 weeks pregnant (n = 116), recruited through a local hospital trust, completed tasks assessing attention (emotional Stroop task), interpretation (scrambled sentences test), and explicit memory (recognition task) biases with materials including FOC-related content. They also completed three separate measures of FOC and measures of low mood, general anxiety, worry, and rumination. We found that a negative interpretation bias (but not attention or explicit memory biases) was associated with higher levels of FOC. These findings indicate that women presenting with higher FOC are more likely to demonstrate negative interpretation biases for ambiguous information relating to childbirth, which may inform research developing interventions to support women presenting with FOC. • Fear of childbirth (FOC) concerns anxiety regarding the process of giving birth. • General anxiety is maintained by cognitive processing biases. • We examined associations between cognitive biases and FOC in pregnant women. • Women completed attention, interpretation, and memory bias tasks, and FOC measures. • Greater negative interpretation bias was associated with higher levels of FOC. [ABSTRACT FROM AUTHOR]

Dysfunctional appraisals are a key factor suggested to be involved in the development and maintenance of PTSD. Research has shown that experimental induction of a positive or negative appraisal style following a laboratory stressor affects analogue posttraumatic stress symptoms. This supports a causal role of appraisal in the development of traumatic stress symptoms and the therapeutic promise of modifying appraisals to reduce PTSD symptoms. The present study aimed to extend previous findings by investigating the effects of experimentally induced appraisals on reactions to a naturally occurring analogue trauma and by examining effects on both explicit and implicit appraisals. Participants who had experienced a distressing life event were asked to imagine themselves in the most distressing moment of that event and then received either a positive or negative Cognitive Bias Modification training targeting appraisals (CBM-App). The CBM-App training induced training-congruent appraisals, but group differences in changes in appraisal over training were only seen for explicit and not implicit appraisals. However, participants trained positively reported less intrusion distress over the subsequent week than those trained negatively, and lower levels of overall posttraumatic stress symptoms. These data support the causal relationship between appraisals and trauma distress, and further illuminate the mechanisms linking the two. [ABSTRACT FROM AUTHOR]

Negative (or a lack of positive) interpretation of ambiguous social situations has been hypothesised to maintain social anxiety disorder in children, yet there is currently limited evidence to support this. Cognitive Bias Modification of Interpretation (CBM-I) provides a means to explore the causal influence of interpretation bias on social anxiety disorder, and has been associated with a reduction in social anxiety symptoms in adults. Seven to twelve year old children with a diagnosis of social anxiety disorder completed CBM-I training, adapted from materials designed for socially anxious children in the community, or no training. Effects on interpretation bias and social anxiety were assessed. The adapted CBM-I training was not associated with significant changes in benign or negative interpretation. Unsurprisingly given the lack of successful interpretation training, there were no significant changes in child or parent reported social anxiety symptoms, clinician-rated severity or diagnoses and change in interpretation was not significantly associated with change in social anxiety. These findings contrast with some studies with community populations although it is possible that more intensive CBM-I training is required to fully test this hypothesis among clinical groups. [ABSTRACT FROM AUTHOR]

Worry is characterized by a predominance of verbal thinking and relatively little mental imagery. This cognitive bias of verbal and abstract processing has been found to impair emotional processing of worry topics so that worrisome thoughts are maintained. On the other hand, engaging in mental imagery during the worry process fosters emotional processing of worry themes. In the present study, we examined whether training high worriers ( n = 71) to use more mental imagery in their everyday lives is an effective intervention to reduce pathological worry. Results indicated that our novel training in mental imagery (TMI) led to a significant reduction of worry and impairment, assessed both one and five weeks after the training. Furthermore, in highly anxious participants TMI had beneficial effects on controllability of worry, state anxiety, and positive mood. Theoretical and clinical implications of our findings and methodological limitations of this proof-of-principle study are discussed. [ABSTRACT FROM AUTHOR]

Cognitive bias and physiological arousal are two putative markers that may underlie youth anxiety. However, data on relationships between cognitive bias and arousal are limited, and typically do not include behavioral measurement of these constructs in order to tap real-time processes. We aimed to examine the relationship between performance-based cognitive bias and sympathetic arousal during stress in clinically anxious and typically-developing youth. The sample included children and adolescents ages 9 to 17 (Mean age = 13.18, SD = 2.60) who either met diagnostic criteria for primary generalized anxiety, social phobia, or separation anxiety (N = 24) or healthy controls who had no history of psychopathology (N = 22). Youth completed performance-based measures of attention and interpretation bias. Electrodermal activity was assessed while youth participated in the Trier Social Stress Test for Children (TSST-C; Buske-Kirschbaum, Jobst, & Wustmans, 1997). A mixed models analysis indicated significant linear and non-linear changes in skin conductance, with similar slopes for both groups. Interpretation bias, but not attention bias, moderated the relationship between group status and sympathetic arousal during the TSST-C. Arousal trajectories did not differ for anxious and healthy control youth who exhibited high levels of threat interpretation bias. However, for youth who exhibited moderate and low levels of interpretation bias, the anxious group demonstrated greater arousal slopes than healthy control youth. Results provide initial evidence that the relationship between anxiety status and physiological arousal during stress may be moderated by level of interpretation bias for threat. These findings may implicate interpretation bias as a marker of sympathetic reactivity in youth. Implications for future research and limitations are discussed. [ABSTRACT FROM AUTHOR]

Cyberchondria is characterized by excessive health-related online search behavior associated with an unfounded escalation of concerns about common symptomatology. It often co-occurs with health anxiety. We investigated whether base-rate neglect–the cognitive bias to ignore a priori probabilities (e.g., of serious diseases)–plays a significant role in cyberchondria and health anxiety. 368 participants were randomly assigned to eight experimental conditions, manipulating the base-rate (30 % vs. 70 %), the judgment domain (health-neutral versus health-related), and the salience of base-rate information (low vs. high) in a 2×2×2 between-subjects design when asking them for probability judgments with versus without disease relevance. We found that high salience decreased base-rate neglect in participants with low, but not in those with elevated levels of either cyberchondria or health anxiety. Under low salience conditions, however, both cyberchondria and health anxiety severity were uncorrelated with base-rate neglect. These effects were independent of whether health-related or health-neutral problems were evaluated. Our findings suggest a domain-general probabilistic reasoning style that may play a causal role in the pathogenesis of cyberchondria and health anxiety. • Investigated the role of base-rate neglect in cyberchondria and health-anxiety (HA). • No relation between base-rate neglect and cyberchondria/HA under low salience. • High salience decreased base-rate neglect in participants with low cyberchondria/HA. • Suggests a domain-general probabilistic reasoning style in cyberchondria and HA. [ABSTRACT FROM AUTHOR]

People with anxiety disorders often exhibit an attentional bias for threat. Attention bias modification (ABM) procedure may reduce this bias, thereby diminishing anxiety symptoms. In ABM, participants respond to probes that reliably follow non-threatening stimuli (e.g., neutral faces) such that their attention is directed away from concurrently presented threatening stimuli (e.g., disgust faces). Early studies showed that ABM reduced anxiety more than control procedures lacking any contingency between valenced stimuli and probes. However, recent work suggests that no-contingency training and training toward threat cues can be as effective as ABM in reducing anxiety, implying that any training may increase executive control over attention, thereby helping people inhibit their anxious thoughts. Extending this work, we randomly assigned participants with DSM-IV diagnosed social anxiety disorder to either training toward non-threat (ABM), training toward threat, or no-contingency condition, and we used the attention network task (ANT) to assess all three components of attention. After two training sessions, subjects in all three conditions exhibited indistinguishably significant declines from baseline to post-training in self-report and behavioral measures of anxiety on an impromptu speech task. Moreover, all groups exhibited similarly significant improvements on the alerting and executive (but not orienting) components of attention. Implications for ABM research are discussed. [ABSTRACT FROM AUTHOR]

Cognitive theories have postulated the relational nature of different cognitive biases in the development and maintenance of anxiety disorders. To test this combined cognitive bias hypothesis, this review addressed the following questions: (i) whether different cognitive biases are associated with each other and (ii) whether one bias influences another bias. We identified 36 articles that studied the relationship between cognitive biases (attention, interpretation and memory bias). Of these, 31 studies were entered into two meta-analyses. Sixteen studies were included in the first meta-analysis of the correlation between cognitive bias indices. A further 15 studies were included in another meta-analysis to examine the transfer effects of cognitive bias modification (CBM) to another bias. Both meta-analyses yielded small but significant overall pooled effect sizes after the removal of outliers (r = 0.11 and g = 0.19 respectively). Moderator analyses revealed that the relationship between interpretation and memory bias was significantly stronger than other types of cognitive bias correlations and CBM is more potent in modifying biases when it was delivered in the laboratory compared with online. Our review quantifies the strength of the relationships between biases and transfer effects following CBM, which serves as a basis to further understand the mechanisms underlying biased information processing. • We meta-analysed the relationship between cognitive biases (CB) in anxiety. • CB were correlated and could modify each other by training but effects were small. • Correlation between interpretation and memory bias was stronger than the others. • CB training in laboratory was stronger in modifying another CB than online delivery. • The results supported the Combined Cognitive Bias Hypothesis in anxiety. [ABSTRACT FROM AUTHOR]

Cognitive theories of hypochondriasis (HYP) suggest that catastrophic misinterpretations of benign body sensations are a core feature for the maintenance of the disorder. There is tentative support from an analog sample that the interpretation of illness-related information also involves an implicit affective component. This is the first study to examine this negative affective evaluation bias implicitly in patients with HYP. An adapted version of the Affect Misattribution Procedure (AMP) with illness, symptom and neutral primes was used in 80 patients with HYP, and compared to 83 patients with an anxiety disorder (AD), as well as 90 healthy controls (CG). The HYP group showed significantly more negative affective reactions in illness prime trials, compared to both control groups, as well as more negative implicit evaluations on symptom prime trials, compared to the CG. Significant inverse relationships were observed only between the implicit evaluations of illness words and health anxiety questionnaires. Thus, an implicit negative affective evaluation bias of serious illnesses rather than symptoms is a unique feature of HYP. [ABSTRACT FROM AUTHOR]

Intolerance of uncertainty (IU) is a cognitive bias associated with anxiety disorders that has only been reliably measured using self-report instruments. The current study investigated relationships between a probabilistic inference task - the Beads Task - and self-report IU. Individuals with anxiety disorders (ANX) and non-anxious controls (NAC) completed self-report measures as well as the Beads Task at three levels of difficulty. The Beads Task successfully induced task-related uncertainty as the decision became more difficult. While the two groups did not differ on the observable performance related measures, the ANX group was significantly more distressed during the task than were the NACs. Moreover, among the ANX group, self-reported IU was correlated with draws to decision and distress during the task. The Beads Task appears to provoke distress associated with uncertainty for anxious individuals, rather than altering their behavioral responses; thus, clinical implications and avenues for future research are discussed. [ABSTRACT FROM AUTHOR]

Abstract: A number of factors are believed to confer risk for anxiety development in children; however, cultural variation of purported risk factors remains unclear. We examined relations between controlling and rejecting parenting styles, parental modeling of anxious behaviors, child interpretive biases, and child anxiety in a mixed clinically anxious (n =27) and non-clinical (n =20) sample of Latino children and at least one of their parents. Families completed discussion-based tasks and questionnaires in a lab setting. Results indicated that child anxiety was: linked with parental control and child interpretative biases, associated with parental modeling of anxious behaviors at a trend level, and not associated with low parental acceptance. Findings that controlling parenting and child interpretive biases were associated with anxiety extend current theories of anxiety development to the Latino population. We speculate that strong family ties may buffer Latino children from detrimental effects of perceived low parental acceptance. [Copyright &y& Elsevier]

Abstract: People are typically faster and more accurate to detect angry compared to happy faces, which is known as the anger superiority effect. Many cognitive models of anxiety suggest anxiety disorders involve attentional biases towards threat, although the nature of these biases remains unclear. The present study used a Face-in-the-Crowd task to investigate the anger superiority effect in a control group and patients diagnosed with either generalized anxiety disorder (GAD) or panic disorder (PD). The main finding was that both anxiety groups showed an enhanced anger superiority effect compared to controls, which is consistent with key theories of anxiety. Furthermore, both anxiety groups showed a differential pattern of enhanced bias towards threat depending on the crowd in the displays. The different attentional bias patterns between the GAD and PD groups may be related to the diverse symptoms in these disorders. These findings have implications for the diagnosis and treatment of anxiety. [Copyright &y& Elsevier]

Abstract: Cognitive theories of anxiety postulate that negative processing biases play a causal role in the pathogenesis of a disorder, while a normalisation of bias drives recovery. To test these assumptions it is essential to investigate whether biases seen in anxiety are treatment-sensitive, or whether they instead represent enduring vulnerability factors. Twenty-nine spider fearfuls were tested before and after brief cognitive-behaviour therapy (CBT), with half of them additionally being tested before a waiting period to control for retest effects. Using three cognitive bias tasks, we measured implicit threat evaluation (Extrinsic Affective Simon Task), avoidance tendency (Approach-Avoidance Task), and working memory for threat. CBT significantly enhanced negative implicit evaluation and avoidance. This indicates that these cognitive biases are no stable risk factors and provides further evidence for their potential key role in the development and remission of anxiety. [Copyright &y& Elsevier]

Abstract: The current study tested the association between fear and perception in spider phobic individuals (n =57) within the context of a treatment outcome study. Participants completed 5 post-treatment Behavioral Approach Tasks (BATs) in which they encountered a live spider and were asked to provide spider size estimates. Consistent with predictions, results indicated that high levels of fear were associated with magnified perception of phobic stimuli. Specifically, we found a significant positive correlation between size estimates and self-reported fear while encountering spiders. Together with previous findings, these results further support the notion that fear is involved in the encoding and processing of perceptual information. [Copyright &y& Elsevier]

Abstract: Posttraumatic stress disorder (PTSD) may produce internal “threats to the self,” which generate shame. Shame is theoretically and empirically linked to intimate partner violence (IPV) perpetration. We examined relations among PTSD, cognitive processing of shame-relevant information, and IPV perpetration. Forty-seven community participants completed an emotional Stroop task with shame-relevant and neutral words. Stimuli were presented supraliminally (i.e., until vocal response) and subliminally (i.e., below an individualized threshold of conscious awareness). Facilitated color-naming of shame-relevant words (thought to reflect congruence between shame and self-schemas) mediated the relation between PTSD severity and IPV perpetration frequency. Mediation results for subliminal stimuli suggest that biased processing of shame cues may occur preconsciously and potentially catalyze processes (i.e., expectations of rejection in ambiguous situations with one''s partner; avoidance that minimizes discomfort and protects self-image) that lead to IPV perpetration. Psychotherapeutic approaches to PTSD and IPV should consider the role of facilitated processing of shame cues. [Copyright &y& Elsevier]

Abstract: Cognitive-behavioral models of social phobia emphasize the combined effects of cognitive biases in the maintenance of the condition, and recent findings in adults implicate self-focused attention as one such bias. However, research examining self-focus in youth is limited. This investigation examined the causal role of self-focused attention on threat interpretation biases in a community sample of 175 socially anxious children. Self-focused attention was experimentally induced via a mirror manipulation procedure and self-focused attention was assessed before and after mirror exposure. Social interpretation biases were examined via an ambiguous stories task with half of the children completing the task in front of a mirror and the other half without a mirror. Social anxiety predicted self-focus and threat interpretation bias. The mirror manipulation did not have an effect on focus of attention or on threat interpretation bias, nor did it interact with social anxiety. Implications and future research directions are discussed. [Copyright &y& Elsevier]

Attentional bias towards threat reliably correlates with clinical anxiety status as well as elevated trait anxiety. Although such findings have led many to posit a potential causative or predictive role of threat-biased attentional processes on anxiety problems, little informative research exists. The present investigation was designed to address the role of threat-biased attentional processes on emotional/fearful responding. Eighty-seven participants provided baseline measures of anxiety vulnerability (i.e., anxiety sensitivity; unmasked/masked emotional Stroop task indices) and then underwent biological challenge procedures (inhalations of 20% carbon dioxide (CO2)-enriched air). Following challenge, participants completed measures of emotional response. Regression analyses indicated that both unmasked and masked attentional bias indices significantly predicted emotional responding above and beyond anxiety sensitivity. Exploratory analyses also revealed a gender effect, with prediction of emotional response largely attributable to females. These findings support attentional bias towards threat as a relatively independent factor predictive of emotional responding. [Copyright &y& Elsevier]

Individuals with Social Phobia (SP) (n=23) and Panic Disorder (n=22), and a non-anxious comparison (NAC) group (n=62) rated the probability and cost of negative outcomes in the physical and the social domains. Overall, participants rated physical events as less probable but more costly than social events. Compared to the non-anxious group, participants with Social Phobia made significantly higher probability and cost estimates for social events, but not for physical events. Multiple regression analyses demonstrated that perceived cost of negative social events was the strongest unique predictor of scores on the Fear of Negative Evaluation Scale (FNE). Participants with Panic Disorder made significantly higher probability and cost estimates for both physical and social outcomes, compared to non-anxious participants. Both physical probability and social cost estimates predicted scores on the Body Sensations Questionnaire (BSQ). Findings support the disorder-specificity of cognitive biases in Social Phobia, but suggest that individuals with Panic Disorder have a wider range of judgment biases than previously thought. [Copyright &y& Elsevier]

This study investigated associations between anxious and depressive symptoms in 7- and 9-year-olds and their judgements of intention. It asked children to judge how a protagonist (other judgement) and they themselves (self-judgement) would interpret the intention of a second character, where this intention was ambiguously negative or benign. The results showed that levels of self-report depressive symptoms predicted an increase in the number of negative interpretations for self (but not for other) judgements. In comparison, increased levels of parent-report anxiety symptoms predicted an increase in number of negative interpretations for other (but not for self) judgements. [Copyright &y& Elsevier]

The modified or “emotional” Stroop paradigm has been frequently employed in previous evaluations of information processing models of Posttraumatic Stress Disorder (PTSD) and other anxiety disorders. These studies have frequently documented an attentional bias to trauma-specific threatening stimuli in PTSD patients. However, the response of the Stroop color-naming interference effect to psychological treatment has yet to be tested in a trauma population. The present study evaluated the effects of three treatment conditions on the Stroop interference effect in motor vehicle accident (MVA) survivors with PTSD. Following treatment, participants were classified as either treatment responders or nonresponders. Participants named the color of three types of stimuli: MVA trauma-specific words, neutral words, and nonwords. Results showed that change in selective color-naming interference for trauma cues was unrelated to treatment response or modality at either posttreatment or follow-up. Findings cast doubt on the clinical utility of the modified Stroop test as a measure of treatment outcome in this population. [Copyright &y& Elsevier]

Body dysmorphic disorder (BDD) is a syndrome characterized by distress about imagined defects in one’s appearance. Though categorized as a somatoform disorder, BDD is marked by many characteristics associated with social phobia (e.g., fear of negative evaluation) and obsessive-compulsive disorder (e.g., intrusive thoughts about one’s ugliness, checking). In the present experiment, we tested whether BDD patients exhibit selective processing of threat in the emotional Stroop paradigm as do anxiety-disordered patients. Relative to healthy control participants, BDD patients exhibited greater Stroop interference for positive and negative words, regardless of disorder-relevance, than for neutral words. Further analyses suggested that interference tended to be greatest for positive words related to BDD. These data suggest that BDD patients are vulnerable to distraction by emotional cues in general, and by words related to their current concerns in particular. Results suggest that BDD may indeed be related to anxiety disorders such as social phobia. [Copyright &y& Elsevier]

• Negative interpretation bias is a potential risk factor for emotional disorders. • A new clinically-based online Cognitive Bias Modification program was administered. • Self-report and experimental tasks were used to disentangle mechanisms of change. • The program directly reduced interpretation and memory biases. • Changes in interpretation bias mediated improvement in depression symptoms. Negative interpretation bias is a potential risk factor for emotional disorders. In this study, we tested a clinically inspired 4-session online Cognitive Bias Modification-Interpretation (CBM-I Clin) program to modify negative interpretation biases. We randomized one hundred and twenty-one volunteer young adults (Mean age = 21.6 years, SD = 3.5; 85 % women) with varying levels of emotional distress to either an experimental or waitlist control group. Mediation analyses were used to disentangle the associations between the intervention, changes in interpretation biases (assessed by both a self-report and an experimental task), and changes in measures of cognitive vulnerability and symptoms of depression and anxiety. The results showed that the CBM-I Clin could change negative interpretation biases. Also, it had a direct effect on the change in negative memory bias, an indirect effect on the change in depression symptoms via the change in interpretation bias, and both direct and indirect effects on the change in self-reported dysfunctional attitudes. The study included a non-clinical sample of participants and it did not control for some potential confounding factors (e.g., attentional disorders). Furthermore, participants' engagement during the sessions at home was not supervised. The CBM-I Clin is a potential tool to prevent and intervene in emotional disorders in young adults and could complement other traditional CBM procedures or clinical interventions. [ABSTRACT FROM AUTHOR]

Abstract: An inflated sense of responsibility often characterizes patients with obsessive-compulsive disorder (OCD). In this study, we asked OCD patients (n =20) and control participants (n =18) to resolve a series of moral dilemmas embedded in hypothetical scenarios. Each scenario required participants to choose one of two undesirable courses of action, both involving loss of life. The utilitarian option required them to act, thereby causing the death of one person, but indirectly saving the lives of others whose death would otherwise have occurred. The other option involved no action on their part, but their failure to act resulted in the deaths of people. The groups did not differ significantly in the options chosen, or in their latencies to resolve moral dilemmas. However, within the OCD group, the higher patients’ scores on the Responsibility Attitude Scale, the less likely they were to act to kill one person to save the lives of others. In summary, these data imply a stronger association between moral reasoning patterns and responsibility attitudes than to OCD per se. [Copyright &y& Elsevier]