# Development of a novel exercise threat attentional bias assay

> **NIH NIH R01** · RUTGERS, THE STATE UNIV OF N.J. · 2022 · $110,740

## Abstract

ABSTRACT
Age-related changes to the heart increase risk for cardiovascular disease as well as other health risks, such as
frailty, falls, and dementia. Exercise helps to slow the progression of aging-associated changes to the heart
and is an essential component cardiac rehabilitation (CR), which is a secondary prevention program used to
speed recovery from cardiac events or surgical procedures. However, the majority of patients who enroll in CR
only attend a portion of sessions and the majority that do attend fail to maintain sufficient levels of physical
activity after the CR program. Anxiety is among the earliest and most intense psychological reactions following
acute CVD. “Exercise anxiety”, i.e., fear and avoidance of physical activity – may be particularly relevant to
successful CR. From a cognitive-behavioral framework, the presence of heart-related symptoms or comorbid
conditions can heighten individuals’ awareness of bodily sensations, promote fear and worry about health and
safety, and lead to exercise avoidance. We developed a manualized, theoretically-informed, cognitive-behavioral
intervention called Behavioral Exposure For Interoceptive Tolerance (BE-FIT) designed to target exercise
anxiety in CR patients. The fully powered parent grant (R01AG070136-01A1) includes careful examination of
cognitive, behavioral and physiological mechanisms that contribute to exercise anxiety and serve as important
treatment targets. Missing from the parent grant is a careful examination of deficits in information processing that
reflect a bias toward threat, a core feature of anxiety pathology that can be assessed via attentional bias (AB)
tasks. The literature on AB to threat has documented that anxious, compared to non-anxious, individuals
exhibit threat related attentional biases across a range of anxiety disorders and there is evidence that these
biases are responsive to intervention. However, relatively no work has considered how AB to exercise-related
threat stimuli could influence physical activity behavior. We propose that AB towards exercise and medical-
related stimuli is contextually relevant to patients in CR, and can contribute to and maintain exercise anxiety,
which in turn, can undermine exercise and physical activity participation. Consistent with NOT-OD-22-140, we
plan to develop and validate a new assay in order to further assessment treatment mechanism in our current
RCT, and evaluate whether this mechanism is related to the intervention study’s main effect (efficacy) over the
course of behavior initiation and maintenance. Specifically, we propose to develop a modified Stroop task to
examine basal attentional bias to exercise threat in patients attending CR, examine its relations with validated
self-report measures of fear about exercise sensations and heart-focused anxiety, and test well as whether these
threat biases improve as a function of intervention. By developing and administering a novel modified Stroop task
to examine threa...

## Key facts

- **NIH application ID:** 10666968
- **Project number:** 3R01AG070136-02S1
- **Recipient organization:** RUTGERS, THE STATE UNIV OF N.J.
- **Principal Investigator:** Samantha Gwen Farris
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $110,740
- **Award type:** 3
- **Project period:** 2021-08-15 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10666968

## Citation

> US National Institutes of Health, RePORTER application 10666968, Development of a novel exercise threat attentional bias assay (3R01AG070136-02S1). Retrieved via AI Analytics 2026-06-08 from https://api.ai-analytics.org/grant/nih/10666968. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*