Investigation of Cognitive and Emotional Mechanisms Associated With Anxiety Using Structural Equation Modeling and Eye-tracking Analysis of Attentional Bias

Background This study investigated cognitive–emotional mechanisms underlying anxiety within the Self-Regulatory Executive Function (S-REF) framework. It tested whether sensory processing sensitivity (SPS) is associated with trait anxiety through metacognitive beliefs and emotion regulation difficulties, and assessed threat-related attentional bias using eye-tracking. Methods The study was conducted in two phases. In Phase 1, self-report data were collected from 395 university students, and structural equation modeling (SEM) tested the associations among SPS, metacognitions, emotion regulation difficulties, and trait anxiety. In Phase 2, participants were selected using an extreme-groups approach based on trait anxiety scores (high trait anxiety: n = 30; control: n = 37) and completed a free-viewing task presenting fearful, sad, happy, and neutral faces while eye movements were recorded with an EyeLink 1000 Plus system. Results SEM supported a full mediation model: SPS did not directly predict trait anxiety, but showed significant indirect effects via metacognitive beliefs, emotion regulation difficulties, and a serial pathway. Eye-tracking findings indicated that high trait anxiety was primarily characterized by sustained attention to threat and difficulty disengaging, reflected in longer dwell time, higher fixation counts, and increased re-visits to fearful faces, rather than group differences in initial orienting (first fixation location). Furthermore, negative metacognitive beliefs about uncontrollability and danger and limited access to emotion regulation strategies were positively associated with late-stage threat maintenance indices (e.g., dwell time and dwell-time percentage). Conclusion Integrating self-report and physiological measures, findings suggest that SPS confers vulnerability to anxiety primarily through threat-focused metacognitions and inflexible emotion regulation processes. These vulnerabilities are reflected behaviorally in sustained threat-monitoring and disengagement difficulty patterns.