Divergent attentional effects of nondeceptive placebo treatment and cognitive reappraisal during visually induced emotional distress: an eye-tracking study

Abstract

Background: Emotion regulation often involves shifting attentional focus. This eye-tracking study with a divided attention task compared nondeceptive placebo treatment and cognitive reappraisal for reducing emotional distress. It was investigated whether the two types of interventions would differ in attentional processes (directing attention toward the external environment vs. one’s body). Method: A total of 116 participants (mean age = 26.5 years; 50% female) were randomly allocated to one of three groups that were each exposed to images depicting body parts with or without injuries. One group received a placebo pill to reduce emotional distress, while another group engaged in cognitive reappraisal. The third group passively viewed the images. Half of the images were coupled with an electrocutaneous stimulus (at the perceptual threshold level) that was administered to participants’ forearms. The task was to view these images with eye-tracking glasses while also responding as quickly as possible to the tactile sensation evoked by the electrocutaneous stimulus (pressing a response button). Results: Cognitive reappraisal provoked a relative increase in total gaze time for injuries as predicted. The majority of participants in this group responded accurately to the electrocutaneous stimuli administered during injury images (no omissions). In contrast, the maximal number of omission errors was most prevalent in the placebo group. Limitations: Participants reported a low level of fear concerning injuries, which could indicate a self-selection bias. Conclusion: Both regulation strategies exerted a protective effect against emotional distress. However, cognitive reappraisal heightened attention, while a reverse pattern was found for placebo treatment. To assess the clinical implications of these findings, future studies should target patients with blood-injury phobia.

Keywords

• nondeceptive placebo
• cognitive reappraisal
• eye-tracking
• attention
• electrocutaneous stimulation
• clinical psychology.