Effects of naturalistic benzodiazepine use on selective attention to threat cues among anxiety disorder patients

The present study examined the effects of naturalistic benzodiazepine (BZ) use on selective attention to threat cues in 50 patients diagnosed with anx iety disorders, according to DSM-IV (APA, 1994) criteria. Patients provided information on their BZ use histories, demographics, and severity of anxie ty symptomatology, and completed a computerized Stroop task involving color naming of social threat, physical threat, and matched no-threat control wo rds. Patients were selected to fill two age-, gender-, and diagnosis-matche d groups based on self-reported BZ use histories: 25 current BZ users versu s 25 medication nonusing controls. Planned comparisons were conducted to de termine whether BZ use groups differed in degree of selective attention to either the physical and/or social threat stimuli, or overall. Even with BZ use group differences in anxiety severity covaried out, the BZ risers demon strated significantly greater selective attention to threat than the medica tion nonusers, particularly in the case of physical threat stimuli. These f indings are consistent with Westra and Stewart's (1998) suggestion that si use may increase preferential attention to physical threat cues, since BZs are often taken on an "as needed" (prn) basis. This "prn enhancement" inter pretation was further supported through the finding of a significant positi ve correlation between frequency of pm use of BZs and degree of physical th reat-related interference on the Stroop among the BZ users group. Theoretic al explanations and clinical implications of these findings are discussed.