Attention allocation in posttraumatic stress disorder: An eye-tracking study

Amit Lazarov*, Benjamin Suarez-Jimenez, Xi Zhu, Daniel S. Pine, Yair Bar-Haim, Yuval Neria

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background Eye-tracking-based attentional research implicates sustained attention to threat in posttraumatic stress disorder (PTSD). However, most of this research employed small stimuli set-sizes, small samples that did not include both trauma-exposed healthy participants and non-trauma-exposed participants, and generally failed to report the reliability of used tasks and attention indices. Here, using an established eye-tracking paradigm, we explore attention processes to different negatively-valenced cues in PTSD while addressing these limitations. Methods PTSD patients (n = 37), trauma-exposed healthy controls (TEHC; n = 34), and healthy controls (HC; n = 30) freely viewed three blocks of 30 different matrices of faces, each presented for 6 s. Each block consisted of matrices depicting eight negatively-valenced faces (anger, fear, or sadness) and eight neutral faces. Gaze patterns on negative and neural areas of interest were compared. Internal consistency and test-retest reliability were evaluated for the entire sample and within groups. Results The two trauma-exposed groups dwelled longer on negatively-valenced faces over neutral faces, while HC participants showed the opposite pattern. This attentional bias was more prominent in the PTSD than the TEHC group. Similar results emerged for first-fixation dwell time, but with no differences between the two trauma-exposed groups. No group differences emerged for first-fixation latency or location. Internal consistency and 1-week test-retest reliability were adequate, across and within groups. Conclusions Sustained attention on negatively-valenced stimuli emerges as a potential target for therapeutic intervention in PTSD designed to divert attention away from negatively-valenced stimuli and toward neutral ones.

Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalPsychological Medicine
Issue number15
Early online date26 Feb 2021
StatePublished - 26 Nov 2022


  • Attention allocation
  • PTSD
  • eye-tracking
  • reliability
  • sustained attention
  • trauma-exposure


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