The Influence of Anxiety and Attentional Focus on Visual Search During Adaptive Gait

Research demonstrates the multifaceted influence of fall-related anxiety on postural control. However, very little work has sought to identify psychological mechanisms through which anxiety influences movement planning and jeopardizes balance safety. Experiment 1 demonstrates evidence of a causal link between postural threat and altered visual search during adaptive gait, indicative of both increased online control of stepping movements (at the expense planning future stepping actions) and a gaze bias toward threats to balance. Participants also reported allocating greater attention toward both conscious movement processing and external threatening stimuli. Experiment 2 sought to further evaluate possible attentional factors underpinning changes observed in Experiment 1. Here, participants completed the same task under conditions of (a) internal focus of attention and (b) reduced resources available for movement planning. Similar to when anxious, participants displayed increased online control of stepping-at the expense of feedforward planning-when focusing attention "internally." However, no such changes were observed during conditions of reduced resources. We consequently interpret altered patterns of visual search observed during anxious gait to represent both a gaze bias toward threats to balance (i.e., increased reliance on the stimulus-driven attentional system) and the subsequent conscious processing of movement to prevent a fall. Public Significance Statement This research demonstrates evidence in healthy controls of a causal link between fall-related anxiety and maladaptive patterns of visual search previously observed in older adults at high risk of falling-specifically, reduced visual previewing of future stepping constraints. We interpret these changes to indicate that fall-related anxiety may reduce safety while walking by limiting an individual's ability to plan future stepping movements. As a consequence, aside from the theoretical implications of this work, these findings could contribute to the development of tools designed to both predict and prevent falls in older adults and also monitor their recovery during rehabilitation.