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Reaction time (RT) data are often pre-processed before analysis by rejecting outliers and errors and aggregating the data. In stimulus-response compatibility paradigms such as the approach-avoidance task (AAT), researchers often decide how to pre-process the data without an empirical basis, leading to the use of methods that may harm data quality. To provide this empirical basis, we investigated how different pre-processing methods affect the reliability and validity of the AAT. Our literature review revealed 108 unique pre-processing pipelines among 163 examined studies. Using empirical datasets, we found that validity and reliability were negatively affected by retaining error trials, by replacing error RTs with the mean RT plus a penalty, and by retaining outliers. In the relevant-feature AAT, bias scores were more reliable and valid if computed with D-scores; medians were less reliable and more unpredictable, while means were also less valid. Simulations revealed bias scores were likely to be less accurate if computed by contrasting a single aggregate of all compatible conditions with that of all incompatible conditions, rather than by contrasting separate averages per condition. We also found that multilevel model random effects were less reliable, valid, and stable, arguing against their use as bias scores. We call upon the field to drop these suboptimal practices to improve the psychometric properties of the AAT. We also call for similar investigations in related RT-based bias measures such as the implicit association task, as their commonly accepted pre-processing practices involve many of the aforementioned discouraged methods. HIGHLIGHTS: • Rejecting RTs deviating more than 2 or 3 SD from the mean gives more reliable and valid results than other outlier rejection methods in empirical data • Removing error trials gives more reliable and valid results than retaining them or replacing them with the block mean and an added penalty • Double-difference scores are more reliable than compatibility scores under most circumstances • More reliable and valid results are obtained both in simulated and real data by using double-difference D-scores, which are obtained by dividing a participant's double mean difference score by the SD of their RTs.

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People are better at approaching appetitive cues signaling reward and avoiding aversive cues signaling punishment than vice versa. This action bias has previously been shown in approach-avoidance tasks involving arm movements in response to appetitive or aversive cues. It is not known whether appetitive or aversive stimuli also bias more distal dexterous actions, such as gripping and slipping, in a similar manner. To test this hypothesis, we designed a novel task involving grip force control (gripping and slipping) to probe gripping-related approach and avoidance behavior. 32 male volunteers, aged 18-40 years, were instructed to either grip ("approach") or slip ("avoid") a grip-force device with their right thumb and index finger at the sight of positive or negative images. In one version of this pincer grip task, participants were responding to graspable objects and in another version of the task they were responding to happy or angry faces. Bayesian repeated measures Analysis of variance revealed extreme evidence for an interaction between response type and cue valence (Bayes factor = 296). Participants were faster to respond in affect-congruent conditions ("approach appetitive," "avoid aversive") than in affect-incongruent conditions ("approach aversive," "avoid appetitive"). This bias toward faster response times for affect-congruent conditions was present regardless of whether it was a graspable object or a face signaling valence. Since our results mirror the approach and avoidance effects previously observed for arm movements, we conclude that a tendency favoring affectively congruent cue-response mappings is an inherent feature of motor control and thus also includes precision grip.

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Interpersonal-motivational models posit that heightened avoidance of aversive social stimuli and diminished approach of appetitive social stimuli increases social withdrawal and reduces positive social interactions, thereby increasing risk for future social anxiety and depression. The current study examined if approach-avoidance biases toward angry and happy faces, measured during the Approach Avoidance Task (AAT), would be associated with the development of adolescent depressive and social anxiety symptoms. At baseline, participants included 129 never-depressed adolescent girls (ages 11-13), two-thirds of whom were at high-risk for internalizing problems due to shy/fearful temperament. Girls reported their depressive and social anxiety symptoms every 6 months for 24 months and completed the AAT at baseline and 24-mo follow-up. Heightened avoidance bias toward angry faces at baseline predicted increases in depressive symptoms across the follow-up, even after accounting for temperament and pubertal status. In contrast, girls with greater depression and social anxiety symptoms at 24-mo follow-up exhibited less avoidance bias for angry faces at the same time point. Findings suggest that avoidance behaviors (i.e., avoiding people or settings associated with angry faces, which are often perceived as hostile, critical, or rejecting) may be a risk factor for depression, above and beyond risk imparted by temperament or advances in puberty. However, with increasing internalizing symptoms, it may become more difficult for adolescents to maintain avoidance for aversive social stimuli, and without the introduction of more adaptive emotion regulation strategies, these biases may continue to increase and maintain risk for internalizing problems.

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Implicit ('unconscious') approach-avoidance tendencies towards stimuli can be measured using the Approach Avoidance Task (AAT). We recently expanded a toolbox for analyzing the raw data of a novel, mobile version of the AAT (mAAT), that asks participants to move their phone towards their face (pull) or away (push) in response to images presented on the phone. We here tested the mAAT reaction time and the mAAT distance in a study with 71 Dutch participants that were recruited online and performed an experiment without coming to the laboratory. The participants used both the mAAT and (explicit) rating scales to respond to photographic images of food. As hypothesized, the rated wanting, rated valence and mAAT reaction time indicated a preference for palatable over unpalatable food, and for Dutch over Asian food. Additionally, as expected, arousal was rated higher for unpalatable than for palatable food, and higher for Dutch than for Asian food. The mAAT distance indicated that the unpalatable food images were moved across larger distances, regardless of the movement direction (pull or push), compared to the palatable food images; and the Dutch food images were moved across larger distances than the Asian food images. We conclude that the mAAT can be used to implicitly probe approach-avoidance motivation for complex images in the food domain. The new measure of mAAT distance may be used as an implicit measure of arousal. The ratings and the mAAT measures do not reflect the exact same information and may complement each other. Implicit measures, such as mAAT variables, are particularly valuable when response biases that can occur when using explicit ratings are expected.

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Patients with binge eating disorder (BED) suffer from regular food binges with loss of control. This may be due to dysfunctional approach vs. avoidance tendencies towards food in BED. We applied an approach-avoidance task (AAT), in which n = 24 patients with obesity and active BED (OB-BED), n = 32 patients with obesity without current BED (OB), and n = 25 healthy controls (CO) either approached ("pulled") or avoided ("pushed") high (HC) vs. low calorie (LC) food pictures. We tested the hypothesis that OB-BED patients would show an approach bias (measured as different response times RT) towards HC food compared to the other groups. While there was no main effect for group or direction of movement, a significant main effect for calorie (p < 0.001; RT for HC significantly slower than for LC) was found. Repeated measures ANOVA (rm-ANOVA) for comparison of OB-BED vs. OB vs. CO revealed a significant three-fold interaction group × direction × calorie (p = 0.02). Against our hypothesis, the OB-BED group showed an avoidance bias for LC. In explicit ratings, OB-BED reported a significantly reduced urge to consume LC food compared to the OB group. Similar to OB-BED, CO also showed an avoidance bias for LC. The implications of our results are discussed and future directions in this field of research are presented.

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Patients with anorexia nervosa (AN) have a strong ability to limit food intake. Thus, dysfunctional approach vs. avoidance behaviors towards food are evident in AN. We applied an approach-avoidance task (AAT), in which n = 41 AN patients and n = 42 controls either approached ("pull") or avoided ("push") high (HC) vs. low calorie (LC) food pictures based solely on the presented picture format (landscape vs. portrait). We tested the hypothesis that -in opposition to controls displaying an approach bias towards HC food cues- AN patients would show an avoidance bias (measured as different response times) towards HC food. Explicit ratings of food cues were also performed. We found a significant interaction "group" x "direction" (p = 0.03). rm-ANOVAs performed for each of the two groups separately showed a main effect for "direction" of motion in controls (p = 0.02), but not in AN patients (p = 0.40). The two groups did not differ in their reaction times (RTs) with regard to "push" (p = 0.27). However, RTs with regard to "pull" were significantly different between the groups (p = 0.04). Controls show a clear approach bias, expressed by significantly faster RTs for "pull" compared to "push", independent of "calorie" content of the food stimuli. This approach bias is absent in the group of AN patients. This is indicative of a global loss of incentive value of food in AN. Implicit trainings as add-on to psychotherapy in AN patients are asked for.

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BACKGROUND: Avoidance of stimuli that are associated with the traumatic event is a key feature of posttraumatic stress disorder (PTSD). Thus far, studies on the role of avoidance in the development and maintenance of PTSD focused primarily on strategic or explicit avoidance. However, patients may also show implicit avoidance behavior, which may remain even when explicit avoidance is reduced. OBJECTIVES: The present pilot study was designed to test the hypothesis that PTSD patients show implicit avoidance of threatening, trauma-related stimuli. In addition, it was tested whether this avoidance behavior also occurs for other stimuli. METHODS: The Approach-Avoidance Task was used as an indirect measure of avoidance. Participants were 16 women suffering from PTSD who had experienced a sexual trauma, and 23 healthy non-traumatized women. Using a joystick, they pulled pictures closer to themselves or pushed them away. The pictures varied in content, being either high-threat sexual, non-threat sexual, high-threat accident, or positive. RESULTS: Compared to control participants, PTSD patients avoided high-threat sexual pictures, and the degree of avoidance was predicted by self-reported arousal level. Moreover, PTSD patients with high levels of self-reported explicit avoidance, depressive symptoms, and PTSD symptom severity also avoided high-threat accident pictures. CONCLUSIONS: These findings point to the possible importance of threat value instead of trauma-relatedness in explaining implicit avoidance. The results are discussed in light of cognitive-behavioral models of PTSD, and clinical implications are suggested.