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Bosmans G, Van Vlierberghe L, Bakermans-Kranenburg MJ, Kobak R, Hermans D, van IJzendoorn MH. A Learning Theory Approach to Attachment Theory: Exploring Clinical Applications. Clin Child Fam Psychol Rev 2022; 25:591-612. [PMID: 35098428 PMCID: PMC8801239 DOI: 10.1007/s10567-021-00377-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2021] [Indexed: 02/05/2023]
Abstract
Although clinicians typically acknowledge the importance of insecure attachment as one factor that can contribute to children's psychopathology, translating attachment theory into clinical practice has proved a challenge. By specifying some of the mechanisms through which the child's attachment develops and changes, learning theory can enhance attachment based approaches to therapy. Specifically, interventions building on operant (parent management training) and classical (exposure therapy) learning can be used to stimulate new learning that increases the child's security and confidence in the parent's availability and responsiveness. To explore the clinical application and utility of a Learning Theory of Attachment (LTA), we focus on two attachment-focused interventions: Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) and Middle Childhood Attachment-based Family Therapy (MCAT). VIPP-SD is an evidence-based parent management training designed to promote sensitive parenting and secure attachment in early childhood. MCAT is a recently developed intervention that uses exposure to stimulate secure attachment in middle childhood. LTA sheds light on the mechanisms set in train by VIPP-SD and MCAT facilitating the induction of professionals in clinical applications.
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Affiliation(s)
- Guy Bosmans
- Clinical Psychology, KU Leuven, Leuven, Belgium.
| | | | | | - Roger Kobak
- Department of Psychological and Brain Sciences, University of Delaware, Newark, USA
| | - Dirk Hermans
- Centre for Psychology of Learning and Experimental Psychopathology, KU Leuven, Leuven, Belgium
| | - Marinus H van IJzendoorn
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
- Research Department of Clinical, Education and Health Psychology, Faculty of Brain Sciences, UCL, London, UK
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52
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Keil V, Tuschen-Caffier B, Schmitz J. Effects of Cognitive Reappraisal on Subjective and Neural Reactivity to Angry Faces in Children with Social Anxiety Disorder, Clinical Controls with Mixed Anxiety Disorders and Healthy Children. Child Psychiatry Hum Dev 2022; 53:886-898. [PMID: 33895894 PMCID: PMC9470612 DOI: 10.1007/s10578-021-01173-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 11/24/2022]
Abstract
Cognitive models of social anxiety suggest that social anxiety disorder (SAD) is characterized by both enhanced emotional reactivity and deficits in emotion regulation. Emotional reactivity to socially threatening children's faces and their modulation through reappraisal were measured via subjective ratings and electrocortical responses in children (age 10-13) with SAD (n = 28), clinical controls with mixed anxiety disorders (n = 28), and healthy controls (n = 29). Children with SAD showed higher subjective reactivity to the images of angry children's faces while all children reported reduced reactivity in their subjective ratings following reappraisal. Reduced electrocortical reactivity after reappraisal was only evident in older children and boys and was unrelated to anxiety. The present study indicates that cognitive reappraisal may be beneficial in reducing subjective reactivity in children with anxiety disorders, while neural effects of reappraisal may emerge at older ages.
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Affiliation(s)
- Verena Keil
- Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany
| | - Brunna Tuschen-Caffier
- Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany
| | - Julian Schmitz
- Department of Clinical Child and Adolescent Psychology, Leipzig University, Leipzig, Germany. .,Leipzig Research Center for Early Child Development, Leipzig University, Leipzig, Germany.
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53
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Gong W, Yi B, Liu X, Luo F. The subsequent interruptive effects of pain on attention. Eur J Pain 2021; 26:786-795. [PMID: 34970813 DOI: 10.1002/ejp.1904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 12/26/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Pain is known to interrupt attentional performance selectively. In a previous study we showed that the interruptive effect of thermal pain on attention could persist up to 1500 ms after painful stimulus offset, but whether the pain modality affects this subsequent interruptive effect remains unclear. METHODS The present study was conducted to determine the time course of the interruptive effect of electrically induced pain on orienting and executive attention using various intervals between electric stimulation and attentional tasks (0, 250, 500, 750, 1000, 1250, and 1500 ms) and three study groups (pain, non-pain, and control). We performed two separate experiments in which participants performed a spatial cue task (experiment 1) and the Stroop task (experiment 2). Participants in the pain and non-pain groups received brief electric somatosensory stimulation, and those in the control group received no physical stimulus. We compared the performance of the three groups under the interstimulus interval (ISI) conditions. RESULTS The impairment of orienting attention prevailed under the first six ISI conditions in the pain and non-pain groups (F2, 63 = 5.72, P < 0.01); executive attention was not affected (F1,66 = 1.64, P = 0.20), confirming the persistence of the interruptive effect after stimulus offset. CONCLUSIONS This study demonstrated the interruptive effect of somatic stimulation on subsequent orienting attention performance, with no effect on executive attention. These findings suggest that pain has differential effects on the components of attention, depending on its modality and salience.
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Affiliation(s)
- Wenxiao Gong
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, P.R. China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, P.R. China
| | - Bing Yi
- Department of Psychology, Renmin University of China, Beijing, 100872, P.R. China
| | - Xiaoqian Liu
- School of Sociology, China University of Political Science and Law, Beijing, 100088, P.R. China
| | - Fei Luo
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, P.R. China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, P.R. China
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54
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The transdiagnostic origins of anxiety and depression during the pediatric period: Linking NIMH research domain criteria (RDoC) constructs to ecological systems. Dev Psychopathol 2021; 33:1599-1619. [DOI: 10.1017/s0954579421000559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractIn the last decade, an abundance of research has utilized the National Institute of Mental Health (NIMH) research domain criteria (RDoC) framework to examine mechanisms underlying anxiety and depression in youth. However, relatively little work has examined how these mechanistic intrapersonal processes intersect with context during childhood and adolescence. The current paper covers reviews and meta-analyses that have linked RDoC-relevant constructs to ecological systems in internalizing problems in youth. Specifically, cognitive, biological, and affective factors within the RDoC framework were examined. Based on these reviews and some of the original empirical research they cover, we highlight the integral role of ecological factors to the RDoC framework in predicting onset and maintenance of internalizing problems in youth. Specific recommendations are provided for researchers using the RDoC framework to inform future research integrating ecological systems and development. We advocate for future research and research funding to focus on better integration of the environment and development into the RDoC framework.
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55
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Sareen S, Doyle FL, Kemp LJ, Northam JC, Morgan BG, Kimonis ER, Richmond JL, Le Pelley ME, Eapen V, Frick PJ, Hawes DJ, Moul C, Mehta D, Dadds MR. Still connecting the dots: An investigation into infants' attentional bias to threat using an eye-tracking task. INFANCY 2021; 27:46-66. [PMID: 34846094 DOI: 10.1111/infa.12444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/03/2021] [Accepted: 11/10/2021] [Indexed: 12/01/2022]
Abstract
An attentional bias toward threat has been theorized to be a normative aspect of infants' threat and safety learning, and an indicator of risk for internalizing psychopathology in older populations. To date, only four studies have examined this bias using the dot-probe task in infancy and the findings are mixed. We extended the literature by examining patterns of attention to threat in a culturally and linguistically diverse sample of infants aged 5-11 months old (N = 151) using all measures previously employed in the infant dot-probe literature. Given that an attentional bias toward threat is associated with higher risk of developing anxiety disorders later in life, we also examined how negative affect-an early correlate of later anxiety disorders-is related to attentional bias toward threat in infancy. This study was the first to use a consistent measure of negative affect across the whole sample. An eye-tracking dot-probe task was used to examine attentional bias toward threat (i.e., angry faces) relative to positive (i.e., happy faces) stimuli. Results showed that an attention bias to threat was not characteristic of infants at this age, and negative affect did not moderate the putative relationship between attention and emotional faces (angry, happy). These findings therefore suggest that attention biases to socio-emotional threat may not have emerged by 11 months old.
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Affiliation(s)
- Sinia Sareen
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Frances L Doyle
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia.,The MARCS Institute for Brain, Behaviour and Development, School of Psychology, Western Sydney University, Penrith, NSW, Australia
| | - Lindsay J Kemp
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Jaimie C Northam
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Bronte G Morgan
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Eva R Kimonis
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Jenny L Richmond
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Mike E Le Pelley
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Valsamma Eapen
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Paul J Frick
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - David J Hawes
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Caroline Moul
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Divya Mehta
- Centre for Genomics and Personalised Health, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, Qld, Australia
| | - Mark R Dadds
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
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56
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Rayson H, Massera A, Belluardo M, Ben Hamed S, Ferrari PF. Early social adversity modulates the relation between attention biases and socioemotional behaviour in juvenile macaques. Sci Rep 2021; 11:21704. [PMID: 34737307 PMCID: PMC8569114 DOI: 10.1038/s41598-021-00620-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 10/11/2021] [Indexed: 01/06/2023] Open
Abstract
Affect-biased attention may play a fundamental role in early socioemotional development, but factors influencing its emergence and associations with typical versus pathological outcomes remain unclear. Here, we adopted a nonhuman primate model of early social adversity (ESA) to: (1) establish whether juvenile, pre-adolescent macaques demonstrate attention biases to both threatening and reward-related dynamic facial gestures; (2) examine the effects of early social experience on such biases; and (3) investigate how this relation may be linked to socioemotional behaviour. Two groups of juvenile macaques (ESA exposed and non-ESA exposed) were presented with pairs of dynamic facial gestures comprising two conditions: neutral-threat and neutral-lipsmacking. Attention biases to threat and lipsmacking were calculated as the proportion of gaze to the affective versus neutral gesture. Measures of anxiety and social engagement were also acquired from videos of the subjects in their everyday social environment. Results revealed that while both groups demonstrated an attention bias towards threatening facial gestures, a greater bias linked to anxiety was demonstrated by the ESA group only. Only the non-ESA group demonstrated a significant attention bias towards lipsmacking, and the degree of this positive bias was related to duration and frequency of social engagement in this group. These findings offer important insights into the effects of early social experience on affect-biased attention and related socioemotional behaviour in nonhuman primates, and demonstrate the utility of this model for future investigations into the neural and learning mechanisms underlying this relationship across development.
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Affiliation(s)
- Holly Rayson
- Institut des Sciences Cognitives Marc Jeannerod, Centre National de la Recherche Scientifique, Université Claude Bernard Lyon 1, Bron, France.
| | - Alice Massera
- Institut des Sciences Cognitives Marc Jeannerod, Centre National de la Recherche Scientifique, Université Claude Bernard Lyon 1, Bron, France
| | - Mauro Belluardo
- Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Suliann Ben Hamed
- Institut des Sciences Cognitives Marc Jeannerod, Centre National de la Recherche Scientifique, Université Claude Bernard Lyon 1, Bron, France
| | - Pier Francesco Ferrari
- Institut des Sciences Cognitives Marc Jeannerod, Centre National de la Recherche Scientifique, Université Claude Bernard Lyon 1, Bron, France
- Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, Parma, Italy
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57
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Walczak M, Austgulen E, Kirsten L, Breinholst S. Examining Changes in the Cognitive Attentional Syndrome and Attentional Control Following Metacognitive Therapy for Children with Generalized Anxiety Disorder. Int J Cogn Ther 2021. [DOI: 10.1007/s41811-021-00124-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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58
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Lau JYF, Watkins-Muleba R, Lee I, Pile V, Hirsch CR. Promoting helpful attention and interpretation patterns to reduce anxiety and depression in young people: weaving scientific data with young peoples' lived experiences. BMC Psychiatry 2021; 21:403. [PMID: 34429091 PMCID: PMC8386061 DOI: 10.1186/s12888-021-03320-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/19/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Anxiety and depression are common, disabling and frequently start in youth, underscoring the need for effective, accessible early interventions. Empirical data and consultations with lived experience youth representatives suggest that maladaptive cognitive patterns contribute to and maintain anxiety and depression in daily life. Promoting adaptive cognitive patterns could therefore reflect "active ingredients" in the treatment and/or prevention of youth anxiety and depression. Here, we described and compared different therapeutic techniques that equipped young people with a more flexible capacity to use attention and/or promoted a tendency to positive/benign (over threatening/negative) interpretations of uncertain situations. METHODS We searched electronic databases (PubMed, PsycINFO, EMBASE, and PsycARTICLES) for studies containing words relating to: intervention; youth; anxiety and/or depression and attention and/or interpretation, and selected studies which sought to reduce self-reported anxiety/depression in youth by explicitly altering attention and/or interpretation patterns. Ten young people with lived experiences of anxiety and depression and from diverse backgrounds were consulted on the relevance of these strategies in managing emotions in their daily lives and also whether there were additional strategies that could be targeted to promote adaptive thinking styles. RESULTS Two sets of techniques, each targeting different levels of responding with different strengths and weaknesses were identified. Cognitive bias modification training (CBM) tasks were largely able to alter attention and interpretation biases but the effects of training on clinical symptoms was more mixed. In contrast, guided instructions that teach young people to regulate their attention or to evaluate alternative explanations of personally-salient events, reduced symptoms but there was little experimental data establishing the intervention mechanism. Lived experience representatives suggested that strategies such as deliberately recalling positive past experiences or positive aspects of oneself to counteract negative thinking. DISCUSSION CBM techniques target clear hypothesised mechanisms but require further co-design with young people to make them more engaging and augment their clinical effects. Guided instructions benefit from being embedded in clinical interventions, but lack empirical data to support their intervention mechanism, underscoring the need for more experimental work. Feedback from young people suggest that combining complimentary techniques within multi-pronged "toolboxes" to develop resilient thinking patterns in youth is empowering.
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Affiliation(s)
- Jennifer Y. F. Lau
- grid.13097.3c0000 0001 2322 6764Psychology Department, IOPPN, King’s College London, Denmark Hill, London, SE5 8AF UK ,grid.4868.20000 0001 2171 1133Youth Resilience Research Unit, Queen Mary University of London, London, UK
| | - Rebecca Watkins-Muleba
- grid.13097.3c0000 0001 2322 6764Psychology Department, IOPPN, King’s College London, Denmark Hill, London, SE5 8AF UK
| | - Isabelle Lee
- grid.13097.3c0000 0001 2322 6764Psychology Department, IOPPN, King’s College London, Denmark Hill, London, SE5 8AF UK
| | - Victoria Pile
- grid.13097.3c0000 0001 2322 6764Psychology Department, IOPPN, King’s College London, Denmark Hill, London, SE5 8AF UK ,grid.4970.a0000 0001 2188 881XRoyal Holloway University of London, London, UK
| | - Colette R. Hirsch
- grid.13097.3c0000 0001 2322 6764Psychology Department, IOPPN, King’s College London, Denmark Hill, London, SE5 8AF UK
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59
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Kret ME, van Berlo E. Attentional Bias in Humans Toward Human and Bonobo Expressions of Emotion. EVOLUTIONARY PSYCHOLOGY 2021; 19:14747049211032816. [PMID: 34318723 PMCID: PMC10358346 DOI: 10.1177/14747049211032816] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 06/29/2021] [Indexed: 11/16/2022] Open
Abstract
Correctly recognizing and efficiently attending to emotional situations are highly valuable skills for social species such as humans and bonobos, humans' closest living relatives. In the current study, we investigated whether humans perceive a range of emotional situations differently when these involved other humans compared to bonobos. A large group of children and adults participated in an emotion perception task and rated scenes showing either bonobos or humans in situations depicting distressed or aggressive behavior, yawning, scratching, grooming, playing, sex scenes or neutral situations. A new group of people performed a dot-probe task to assess attentional biases toward these materials. The main finding is that humans perceive emotional scenes showing people similarly as emotional scenes of bonobos, a result reflecting a shared evolutionary origin of emotional expressions. Other results show that children interpreted bonobos' bared teeth displays as a positive signal. This signal is related to the human smile, but is frequently seen in distressed situations, as was the case in the current experiment. Children may still need to learn to use contextual cues when judging an ambiguous expression as positive or negative. Further, the sex scenes were rated very positively, especially by male participants. Even though they rated these more positively than women, their attention was captured similarly, surpassing all other emotion categories. Finally, humans' attention was captured more by human yawns than by bonobo yawns, which may be related to the highly contagious nature of yawns, especially when shown by close others. The current research adds to earlier work showing morphological, behavioral and genetic parallels between humans and bonobos by showing that their emotional expressions have a common origin too.
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Affiliation(s)
- Mariska E. Kret
- Leiden University, Institute of Psychology, Cognitive Psychology Unit, CoPAN lab, Wassenaarseweg, Leiden, Zuid-Holland, The Netherlands
| | - Evy van Berlo
- Leiden University, Institute of Psychology, Cognitive Psychology Unit, CoPAN lab, Wassenaarseweg, Leiden, Zuid-Holland, The Netherlands
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60
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Schmidtendorf S, Herwig A, Wiedau S, Asbrand J, Tuschen-Caffier B, Heinrichs N. Initial Maintenance of Attention to Threat in Children with Social Anxiety Disorder? Findings from an Eye-Tracking Experiment. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10244-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Abstract
Background
Attentional biases are assumed to be a core feature in the etiology and maintenance of clinical anxiety. The present study focuses on initial maintenance of attention to threat, one of three attentional components investigated the least, particularly in child anxiety.
Methods
Angry and neutral facial expressions were presented in a free-viewing task, while eye-movements were recorded. Participants were N = 96 school-aged children, with n = 50 children with a clinical social anxiety disorder (SAD) and n = 46 healthy control children (HC). Prior to the task, social stress was induced in half of participating children to investigate the impact of increased levels of distress on initial attention allocation.
Results
The length of first fixation to angry faces in children with SAD neither differed from the length of first fixation to neutral faces nor the length of first fixation to angry faces in HC children. Furthermore, this variable was not affected by a stress induction procedure. However, children with SAD initially fixated longer on faces than HC children.
Conclusion
Our findings provide evidence for difficulties disengaging attention from faces. This may indicate that attention allocation is determined by the social nature of the stimuli rather than by the specific emotional valence.
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61
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Jenness JL, Lambert HK, Bitrán D, Blossom JB, Nook EC, Sasse SF, Somerville LH, McLaughlin KA. Developmental Variation in the Associations of Attention Bias to Emotion with Internalizing and Externalizing Psychopathology. Res Child Adolesc Psychopathol 2021; 49:711-726. [PMID: 33534093 PMCID: PMC8102336 DOI: 10.1007/s10802-020-00751-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2020] [Indexed: 11/30/2022]
Abstract
Attention biases to emotion are associated with symptoms of internalizing and externalizing psychopathology in children and adolescents. It is unknown whether attention biases to emotion and their associations with different symptoms of psychopathology vary across development from early childhood through young adulthood. We examine this age-related variation in the current study. Participants (N = 190; ages: 4-25) completed survey-based psychopathology symptom measures and a dot-probe task to assess attention bias to happy, sad, and angry relative to neutral faces. We tested whether linear or non-linear (e.g., spline-based models) associations best characterized age-related variation in attention to emotion. We additionally examined whether attention biases were associated with depression, anxiety, and externalizing symptoms and whether these associations varied by age. No age-related differences in attention biases were found for any of the emotional faces. Attention biases were associated with psychopathology symptoms, but only when examining moderation by age. Biased attention to angry faces was associated with greater symptoms of anxiety and depression in adolescents and young adults, but not children. Similarly, biased attention to happy faces was associated with externalizing symptoms in adolescents and young adults, but not in children. In contrast, biased attention to happy faces was associated with greater anxiety symptoms in children, but not in adolescents or young adults. Biased attention toward social threat and reward becomes more strongly coupled with internalizing and externalizing symptoms, respectively, during the transition to adolescence. These findings could inform when interventions such as attention bias modification training may be most effective.
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Affiliation(s)
- Jessica L Jenness
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, US.
| | - Hilary K Lambert
- Department of Psychology, University of Washington, Seattle, WA, US
| | - Debbie Bitrán
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, US
| | - Jennifer B Blossom
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, US
- Department of Psychology, University of Maine at Farmington, Farmington, ME, US
| | - Erik C Nook
- Department of Psychology, Harvard University, Cambridge, MA, US
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62
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Capriola-Hall NN, Ollendick TH, White SW. Attention Deployment to the Eye Region of Emotional Faces among Adolescents with and without Social Anxiety Disorder. COGNITIVE THERAPY AND RESEARCH 2021; 45:456-467. [PMID: 34305207 PMCID: PMC8297822 DOI: 10.1007/s10608-020-10169-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Avoidance of the eye region, especially of faces showing anger, may maintain social anxiety symptoms by negatively reinforcing expectations and fears associated with social situations. Eye-tracking research, however, has yet to explicitly examine differences in attention allocation to the eye region of emotional faces among adolescents with social anxiety disorder (SAD). METHODS Gaze patterns were explored in a sample of youth with and without SAD matched on age and sex. RESULTS Adolescents with SAD were quicker to fixate, and maintained their initial gaze longer, to the eye region, regardless of emotion, relative to teens without SAD. Group-level differences also emerged for initial fixation duration directed to the eye region of angry faces (when compared with happy faces). CONCLUSIONS These findings suggest that vigilance to the eye region of faces, especially angry faces, (when compared with happy faces) is characteristic of adolescents with SAD. Adolescents with SAD seem drawn to the eye region, more so than teens without SAD.
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Affiliation(s)
- Nicole N Capriola-Hall
- Center for Youth Development and Intervention, University of Alabama; Tuscaloosa, AL 35487
| | - Thomas H Ollendick
- Virginia Tech; Child Study Center, Department of Psychology, Blacksburg, VA 24061
| | - Susan W White
- Center for Youth Development and Intervention, University of Alabama; Tuscaloosa, AL 35487
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63
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Harrewijn A, Abend R, Naim R, Haller SP, Stavish CM, Bajaj MA, Matsumoto C, Dombek K, Cardinale EM, Kircanski K, Brotman MA. Attention bias to negative versus non-negative faces is related to negative affectivity in a transdiagnostic youth sample. J Psychiatr Res 2021; 138:514-518. [PMID: 33975068 PMCID: PMC8192477 DOI: 10.1016/j.jpsychires.2021.04.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/09/2021] [Accepted: 04/25/2021] [Indexed: 10/21/2022]
Abstract
This study identified a shared pathophysiological mechanism of pediatric anxiety and irritability. Clinically, anxiety and irritability are common, co-occurring problems, both characterized by high-arousal negative affective states. Behaviorally, anxiety and irritability are associated with aberrant threat processing. To build on these findings, we examined eye-tracking measures of attention bias in relation to the unique and shared features of anxiety and irritability in a transdiagnostic sample of youth (n = 97, 58% female, Mage = 13.03, SDage = 2.82). We measured attention bias to negative versus non-negative emotional faces during a passive viewing task. We employed bifactor analysis to parse the unique and shared variance of anxiety and irritability symptoms from self- and parent-report questionnaires. Negative affectivity is the derived latent factor reflecting shared variance of anxiety and irritability. We found that higher negative affectivity was associated with looking longer at negative versus non-negative faces, reflecting a shared mechanism of anxiety and irritability. This finding suggests that modification of elevated attention to negative emotional faces may represent a common potential treatment target of anxiety and irritability.
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Affiliation(s)
- Anita Harrewijn
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA.
| | - Rany Abend
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Reut Naim
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Simone P. Haller
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Caitlin M. Stavish
- Department of Psychology, University of Washington, Roosevelt Way NE, Seattle, WA 98115, USA
| | - Mira A. Bajaj
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Chika Matsumoto
- University of California San Diego, School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Kelly Dombek
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Elise M. Cardinale
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Melissa A. Brotman
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
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Attention bias modification for anxiety disorders in children and adolescents: A systematic review and meta-analysis. Psychiatry Res 2021; 300:113896. [PMID: 33799199 DOI: 10.1016/j.psychres.2021.113896] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 03/19/2021] [Indexed: 11/20/2022]
Abstract
Despite accumulating evidence suggesting the effectiveness of Attention Bias Modification (ABM) in adults, little is known about its efficacy in children and adolescents. As anxiety has been the chief target in most studies and research in this area has grown rapidly in recent years, we conducted the first meta-analysis to establish the effects of ABM alone for anxiety disorders in children and adolescents. Studies were identified through a systematic search in three main databases: PubMed, EMBASE and PsycInfo, resulting in 17 randomized studies. The quality of these studies, possible publication bias and moderators were then examined. ABM had small but significant effects on clinician-rated anxiety symptoms and attention bias towards threat, while the effect on self or parent-reported anxiety measures was non-significant. Evidence quality ranged from moderate to very low. ABM was more effective when conducted as a stand-alone treatment than as an adjunct to other treatments. In addition, younger age and larger number of training sessions were associated with a greater reduction in clinician-rated anxiety symptoms. Results indicate that ABM may have significant effects on anxiety and attention bias in children and adolescents. Overall, the effects of ABM are mainly evident when clinical outcome is assessed by a clinician.
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Sequeira SL, Rosen DK, Silk JS, Hutchinson E, Allen KB, Jones NP, Price RB, Ladouceur CD. "Don't judge me!": Links between in vivo attention bias toward a potentially critical judge and fronto-amygdala functional connectivity during rejection in adolescent girls. Dev Cogn Neurosci 2021; 49:100960. [PMID: 33975229 PMCID: PMC8120940 DOI: 10.1016/j.dcn.2021.100960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 04/06/2021] [Accepted: 04/22/2021] [Indexed: 11/17/2022] Open
Abstract
We used innovative, ecologically valid eye-tracking and fMRI measures to examine social threat sensitivity in adolescent girls. Findings support the reliability of a novel in vivo attention bias task. Real-world attentional biases toward social threat correlated with amygdala-anterior PFC functional connectivity during social evaluation. Greater positive amygdala-anterior PFC connectivity during social evaluation could suggest disrupted prefrontal regulation of the amygdala. Disrupted prefrontal regulation of the amygdala could contribute to deployment of attention to social evaluative threat in daily life.
During adolescence, increases in social sensitivity, such as heightened attentional processing of social feedback, may be supported by developmental changes in neural circuitry involved in emotion regulation and cognitive control, including fronto-amygdala circuitry. Less negative fronto-amygdala circuitry during social threat processing may contribute to heightened attention to social threat in the environment. However, “real-world” implications of altered fronto-amygdala circuitry remain largely unknown. In this study, we used multiple novel methods, including an in vivo attention bias task implemented using mobile eye-tracking glasses and socially interactive fMRI task, to examine how functional connectivity between the amygdala and prefrontal cortex (PFC) during rejection and acceptance feedback from peers is associated with heightened attention towards potentially critical social evaluation in a real-world environment. Participants were 77 early adolescent girls (ages 11–13) oversampled for shy/fearful temperament. Results support the reliability of this in vivo attention task. Further, girls with more positive functional connectivity between the right amygdala and anterior PFC during both rejection and acceptance feedback attended more to potentially critical social evaluation during the attention task. Findings could suggest that dysfunction in prefrontal regulation of the amygdala’s response to salient social feedback supports heightened sensitivity to socially evaluative threat during adolescence.
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Affiliation(s)
| | - Dana K Rosen
- University of Pittsburgh, Department of Psychology, United States
| | - Jennifer S Silk
- University of Pittsburgh, Department of Psychology, United States
| | - Emily Hutchinson
- University of Pittsburgh, Department of Psychology, United States
| | | | - Neil P Jones
- University of Pittsburgh, Department of Psychiatry, United States
| | - Rebecca B Price
- University of Pittsburgh, Department of Psychiatry, United States
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66
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Ho SM, Zhang Q, Lai Y, Dai DWT. Cognitive vulnerabilities to anxiety symptoms among Chinese adolescents: A 3-year longitudinal study. J Clin Psychol 2021; 77:1700-1714. [PMID: 33951200 DOI: 10.1002/jclp.23161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 03/26/2021] [Accepted: 04/12/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study established cognitive vulnerability of anxiety symptoms among high school students. METHOD A total of 72 grade 9-11 students completed measures on levels of anxiety sensitivity (AS), selective attentional processing, and anxiety symptoms annually between 2016 and 2018. RESULTS Latent class growth analysis (unconditional model) showed a four-class model: High (stable) (6.94%), low (stable) (11.11%), medium (decreasing) (61.11%), and medium (increasing) (20.83%). The conditioned model controlling for the physical-concerns dimension of AS and negative attentional bias demonstrated that a two-class model consisted of a low anxiety class (n = 59, 81.9%) and a high anxiety class (n = 13, 18.1%) provided the best fit for the data. Negative attentional bias is a significant factor related to the development of anxiety trajectories. CONCLUSION Attentional bias modification to disengage from negative stimuli may serve as a potential target of intervention to reduce chronic anxiety among high school students.
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Affiliation(s)
- Samuel My Ho
- Psychology Laboratory, Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong, China
| | - Qiaochu Zhang
- Psychology Laboratory, Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong, China
| | - Yihuan Lai
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Darren W T Dai
- Department of Educational Psychology, Tsung Tsin Mission of Hong Kong, Hong Kong, China
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67
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Brain and Behavior Correlates of Risk Taking in Pediatric Anxiety Disorders. Biol Psychiatry 2021; 89:707-715. [PMID: 33451676 PMCID: PMC9037066 DOI: 10.1016/j.biopsych.2020.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/28/2020] [Accepted: 11/03/2020] [Indexed: 12/16/2022]
Abstract
Avoidant behavior is a defining feature of pediatric anxiety disorders. Although prior research has examined it from the perspective of early information processing events, there has been relatively less consideration of the processes by which anxious youth make avoidant decisions and how these choices are reinforced over time. Studies of risk taking are valuable in this regard because they consider how individuals identify the pros and cons of their choices, how they weigh potential gains and losses and estimate their respective probabilities, and how they tolerate the uncertainty intrinsic to any decision. In this review, we place risk taking within existing models of information processing in pediatric anxiety disorders and highlight the particular value of this construct for informing models of developmental psychopathology and individual differences in outcome over time. We review existing behavioral and neurobiological studies of risk taking in anxious youth and conclude by identifying directions for future research.
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68
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Emerging Domain-Based Treatments for Pediatric Anxiety Disorders. Biol Psychiatry 2021; 89:716-725. [PMID: 33451677 DOI: 10.1016/j.biopsych.2020.08.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/19/2020] [Accepted: 08/19/2020] [Indexed: 12/25/2022]
Abstract
Domain-specific cognitive training treatments for pediatric anxiety disorders rely on accurate and reliable identification of specific underlying deficits and biases in neurocognitive functions. Once identified, such biases can serve as specific targets for therapeutic intervention. Clinical translations typically reflect mechanized training protocols designed to rectify the identified biases. Here, we review and synthesize research on key neurocognitive processes that emerge as potential targets for specialized cognitive training interventions in pediatric anxiety disorders in the domains of attention, interpretation, error monitoring, working memory, and fear learning. For each domain, we describe the current status of target establishment (i.e., an association between pediatric anxiety and a specific neurocognitive process), and then review extant translational efforts regarding these targets and the evidence supporting their clinical utility in youths. We then localize each of the domains within the path leading to efficacious, evidence-supported treatments for pediatric anxiety, providing a roadmap for future research. The review indicates that specific cognitive targets in pediatric anxiety have been established in all the reviewed domains except for fear learning, where a clear target is yet to be elucidated. In contrast, evidence for clinical efficacy emerged only in the threat-related attention domain, with some preliminary findings in the domains of interpretation and working memory. The path to clinical translation in the domain of error monitoring is yet unclear. Implications and potential avenues for future research and translation are discussed.
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69
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Frasier K, Burker E, Chan DV. Tablet therapy as an assistive technology-based treatment for anxiety in pediatric oncology. Assist Technol 2021; 34:533-542. [PMID: 33544063 DOI: 10.1080/10400435.2021.1884919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
The painful interventions and invasive procedures associated with pediatric cancer treatment can result in anxiety. Anxiety can be reduced or better controlled through distraction and thought retraining. Although art therapy, non-electronic play therapy, music therapy, and traditional counseling are often used to alleviate stress and anxiety, new technology innovations are proving to be additional options to decrease stress and anxiety through distraction and attention shifting. Tablet-based interventions are emerging as an easily available and effective means of reducing stress and fear prior to operations, and have potential applications to reduce anxiety for patients before receiving chemotherapy, during time spent in hospital rooms, and while experiencing distressing physiological symptoms. This paper reviews the research on tablet therapy and discusses the application of assistive technologies in clinical oncology settings to reduce pediatric anxiety throughout the treatment process.
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Affiliation(s)
- Kelly Frasier
- Division of Clinical Rehabilitation and Mental Health Counseling, Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Eileen Burker
- Division of Clinical Rehabilitation and Mental Health Counseling, Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Dara V Chan
- Division of Clinical Rehabilitation and Mental Health Counseling, Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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70
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Vervoort L, Braun M, De Schryver M, Naets T, Koster EHW, Braet C. A Pictorial Dot Probe Task to Assess Food-Related Attentional Bias in Youth With and Without Obesity: Overview of Indices and Evaluation of Their Reliability. Front Psychol 2021; 12:644512. [PMID: 33746859 PMCID: PMC7965983 DOI: 10.3389/fpsyg.2021.644512] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/09/2021] [Indexed: 11/29/2022] Open
Abstract
Several versions of the dot probe detection task are frequently used to assess maladaptive attentional processes associated with a broad range of psychopathology and health behavior, including eating behavior and weight. However, there are serious concerns about the reliability of the indices derived from the paradigm as measurement of attentional bias toward or away from salient stimuli. The present paper gives an overview of different attentional bias indices used in psychopathology research and scrutinizes three types of indices (the traditional attentional bias score, the dynamic trial-level base scores, and the probability index) calculated from a pictorial version of the dot probe task to assess food-related attentional biases in children and youngsters with and without obesity. Correlational analyses reveal that dynamic scores (but not the traditional and probability indices) are dependent on general response speed. Reliability estimates are low for the traditional and probability indices. The higher reliability for the dynamic indices is at least partially explained by general response speed. No significant group differences between youth with and without obesity are found, and correlations with weight are also non-significant. Taken together, results cast doubt on the applicability of this specific task for both experimental and individual differences research on food-related attentional biases in youth. However, researchers are encouraged to make and test adaptations to the procedure or computational algorithm in an effort to increase psychometric quality of the task and to report psychometric characteristics of their version of the task for their specific sample.
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Affiliation(s)
- Leentje Vervoort
- Department of Developmental Psychology, Radboud University, Nijmegen, Netherlands
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Maya Braun
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Maarten De Schryver
- Faculty of Psychology and Educational Sciences, Faculty Research Support Office, Ghent University, Ghent, Belgium
| | - Tiffany Naets
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
- Department Health Care (Dietetics), Odisee University College, Ghent, Belgium
| | - Ernst H. W. Koster
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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Hechler T. Altered interoception and its role for the co-occurrence of chronic primary pain and mental health problems in children. Pain 2021; 162:665-671. [PMID: 33021565 DOI: 10.1097/j.pain.0000000000002099] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 09/23/2020] [Indexed: 01/09/2023]
Affiliation(s)
- Tanja Hechler
- Department of Clinical Psychology and Psychotherapy in Children and Adolescents, University of Trier, Trier, Germany
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72
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Gober CD, Lazarov A, Bar-Haim Y. From cognitive targets to symptom reduction: overview of attention and interpretation bias modification research. EVIDENCE-BASED MENTAL HEALTH 2021; 24:42-46. [PMID: 33246935 PMCID: PMC10231632 DOI: 10.1136/ebmental-2020-300216] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/14/2020] [Accepted: 11/18/2020] [Indexed: 12/15/2022]
Abstract
Cognitive bias modification (CBM) is a class of mechanised psychological interventions designed to target specific aberrant cognitive processes considered key in the aetiology and/or maintenance of specific psychiatric disorders. In this review, we outline a multistage translational process that allows tracking progress in CBM research. This process involves four steps: (1) the identification of reliable cognitive targets and establishing their association with specific disorders; (2) clinical translations designed to rectify the identified cognitive targets; (3) verification of effective target engagement and (4) testing of clinical utility in randomised controlled trials. Through the prism of this multistage process, we review progress in clinical CBM research in two cognitive domains: attention and interpretation; in six psychiatric conditions: anxiety disorders, major depressive disorder, post-traumatic stress disorder, addictive disorders, eating disorders and obsessive-compulsive disorder. The review highlights achievement as well as shortcomings of the CBM approach en route to becoming a recognised evidence-supported therapy for these disorders.
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Affiliation(s)
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Yair Bar-Haim
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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73
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Kleberg JL, Högström J, Sundström K, Frick A, Serlachius E. Delayed gaze shifts away from others' eyes in children and adolescents with social anxiety disorder. J Affect Disord 2021; 278:280-287. [PMID: 32977266 DOI: 10.1016/j.jad.2020.09.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Social anxiety disorder (SAD) is linked to atypical attention to other's eyes. Empirical literature about this phenomenon in childhood and adolescence is scarce. Previous studies in adults have suggested that SAD may be characterized by either rapid avoidance of eye contact, or by impaired shifting of attention away from eyes once eye contact has been established. SAD has also been linked to quick orienting towards eyes, indicating vigilant monitoring of perceived threat. METHODS In the largest eye-tracking study of youth with SAD to date, 10 to 17 year-olds with SAD (n = 88) and healthy controls (n = 62) were primed to look at either the eyes or the mouth of human faces. The latency and likelihood of a first gaze shift from, or to the eyes, was measured. RESULTS Individuals with SAD were slower to shift their gaze away from the eye region of faces than controls, but did not differ in orienting toward eyes. LIMITATIONS Participants were assessed once after the onset of SAD symptoms, meaning that the longitudinal predictive value of delayed gaze shifts from others' eyes could not be examined. CONCLUSIONS Youth with SAD may be impaired in shifting attention from other's eyes. This could contribute to the experience of eye contact as aversive, and may be a maintaining factor of childhood SAD.
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Affiliation(s)
- Johan Lundin Kleberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, CAP Research Centre, Gävlegatan 22, SE-113 30 Stockholm, Sweden.
| | - Jens Högström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, CAP Research Centre, Gävlegatan 22, SE-113 30 Stockholm, Sweden
| | - Karin Sundström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, CAP Research Centre, Gävlegatan 22, SE-113 30 Stockholm, Sweden
| | - Andreas Frick
- The Beijer Laboratory, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Eva Serlachius
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, CAP Research Centre, Gävlegatan 22, SE-113 30 Stockholm, Sweden
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Ramdhonee-Dowlot K, Balloo K, Essau CA. Effectiveness of the Super Skills for Life programme in enhancing the emotional wellbeing of children and adolescents in residential care institutions in a low- and middle-income country: A randomised waitlist-controlled trial. J Affect Disord 2021; 278:327-338. [PMID: 32980656 DOI: 10.1016/j.jad.2020.09.053] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 06/07/2020] [Accepted: 09/11/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND The present study examined the effectiveness of a transdiagnostic prevention programme, Super Skills for Life (SSL), among children and adolescents with emotional problems in residential care institutions (RCIs) in the low- and middle-income country of Mauritius using a randomised waitlist-controlled trial (RCT). SSL is based on the principles of cognitive behavioural therapy, behavioural activation, social skills training, and uses video-feedback and cognitive preparation as part of the treatment. METHODS The RCT involved 100 children and adolescents aged 9 to 14 years, from six RCIs, randomly allocated to either an SSL intervention group (IG) or a waitlist-control (WLC) group. A set of questionnaires measuring internalising and externalising problems, emotion regulation and self-esteem, and experimental tasks measuring attentional bias and inhibitory control, were completed at baseline, post-intervention and 3-month follow-up. Participants also completed a 2-min video speech task during the first and final sessions of the SSL intervention. RESULTS Children and adolescents in the IG showed significant improvements in internalising symptoms (e.g. anxiety and depression), externalising symptoms (e.g. conduct problems and hyperactivity), and inhibitory control, and an increase in adaptive (except putting into perspective strategy) and decrease in maladaptive emotion regulation strategies, at both post-intervention and follow-up. These findings were not replicated among children in the WLC. LIMITATIONS The small sample size and lack of an active control group were the major limitations of this study. CONCLUSIONS This study provides evidence for the effectiveness of a transdiagnostic prevention programme for emotional problems in RCIs in a low- and middle-income country.
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75
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Stuijfzand S, Stuijfzand B, Reynolds S, Dodd H. Anxiety-Related Attention Bias in Four- to Eight-Year-Olds: An Eye-Tracking Study. Behav Sci (Basel) 2020; 10:bs10120194. [PMID: 33348888 PMCID: PMC7766356 DOI: 10.3390/bs10120194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 11/25/2022] Open
Abstract
(1) Background: There is evidence of an attention bias–anxiety relationship in children, but lack of appropriate methods has limited the number of studies with children younger than eight years old. This study used eye tracking as a measure of overt attention in young children. The aim of this study was to assess anxiety-related attention bias in children aged four to eight years. Age was considered a moderator, and the influence of effortful control was investigated. (2) Method: A community sample of 104 children was shown pairs of happy–neutral and angry–neutral faces. Growth curve analyses were used to examine patterns of gaze over time. (3) Results: Analyses revealed moderation by age and anxiety, with distinct patterns of anxiety-related biases seen in different age groups in the angry–neutral face trials. Effortful control did not account for age-related effects. (4) Conclusions: The results support a moderation model of the development of anxiety in children.
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Affiliation(s)
- Suzannah Stuijfzand
- School of Psychology and Clinical Language Sciences, University of Reading, Berkshire RG6 6AH, UK; (S.S.); (S.R.)
| | | | - Shirley Reynolds
- School of Psychology and Clinical Language Sciences, University of Reading, Berkshire RG6 6AH, UK; (S.S.); (S.R.)
| | - Helen Dodd
- School of Psychology and Clinical Language Sciences, University of Reading, Berkshire RG6 6AH, UK; (S.S.); (S.R.)
- Correspondence:
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76
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The Co-occurrence of Pediatric Chronic Pain and Anxiety: A Theoretical Review of a Developmentally Informed Shared Vulnerability Model. Clin J Pain 2020; 35:989-1002. [PMID: 31513056 DOI: 10.1097/ajp.0000000000000763] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The development and maintenance of pediatric chronic pain and anxiety are complex, underscoring the need to better understand the interactive forces contributing to their co-occurrence. The shared vulnerability model (SVM) was developed to explain the co-occurrence of chronic pain and posttraumatic stress disorder in adults. Although many core tenets have been well supported by pediatric research, the SVM has yet to be extended to pediatric pain populations. We propose a developmentally informed pediatric SVM for advancing our understanding of the co-occurrence of pediatric chronic pain and anxiety disorders. The proposed SVM postulates that youth at increased risk for the development of chronic pain and/or anxiety share predisposing vulnerabilities, including anxiety sensitivity, and that these shared vulnerabilities give rise to negative emotional responses (child and parent) in the context of stressful events. Consequences of fear and anxiety, including avoidance behavior, further contribute to the development of chronic pain, anxiety, and their co-occurrence. The parental, school, and peer contexts in which these problems develop and are maintained in youth are pertinent to integrate into a SVM, as pediatric chronic pain and anxiety disorders share several social-contextual risk and maintenance factors. We also highlight new areas of inquiry.
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77
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Chong LJ, Meyer A. Psychometric properties of threat-related attentional bias in young children using eye-tracking. Dev Psychobiol 2020; 63:1120-1131. [PMID: 33146915 DOI: 10.1002/dev.22053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 12/14/2022]
Abstract
Anxiety is one of the most common forms of child psychopathology associated with persistent impairment across the lifespan. Therefore, investigating mechanisms that underlie anxiety in early childhood may improve prevention and intervention efforts. Researchers have linked selective attention toward threat (i.e., attentional bias to threat) with the development of anxiety. However, previous work on attentional bias has used less reliable, reaction time (RT)-based measures of attention. Additionally, few studies have used eye-tracking to measure attentional bias in young children. In the present study, we investigated the psychometric properties of an eye-tracking measure of attentional bias in a sample of young children between 6- and 9-years-old and explored if trait and clinical anxiety were related to attentional biases to threat. Results showed good psychometric properties for threat and neutral attentional biases, comparable to those found in adult eye-tracking studies. Temperamental and clinical anxiety did not significantly relate to threat/neutral dwell time and attentional biases. The significance of these null findings was discussed in relation to existing developmental theories of attentional biases. Future studies should explore if temperamental or clinical anxiety prospectively predict threat attentional bias and the onset of anxiety in older children using a longitudinal design.
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Affiliation(s)
- Lyndsey J Chong
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Alexandria Meyer
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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78
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Golombek K, Lidle L, Tuschen-Caffier B, Schmitz J, Vierrath V. The role of emotion regulation in socially anxious children and adolescents: a systematic review. Eur Child Adolesc Psychiatry 2020; 29:1479-1501. [PMID: 31201527 DOI: 10.1007/s00787-019-01359-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/27/2019] [Indexed: 01/04/2023]
Abstract
While numerous studies suggest that emotion dysregulation is important in maintaining social anxiety among adults, the role of emotion regulation in children and adolescents with social anxiety is not yet well understood. In this systematic review, we use the process model of emotion regulation as a framework for understanding emotion regulation in children and adolescents with social anxiety. We performed a systematic literature search in the electronic data bases Medline and PsycINFO. Additional studies were identified by hand search. We identified 683 studies, screened their titles and abstracts, viewed 142 studies, and included 55 of these. Study results indicate that children and adolescents with social anxiety disorder or high social anxiety show emotion dysregulation across all five domains of emotion regulation, such as enhanced social avoidance, more safety behaviors, repetitive negative thinking, biased attention and interpretation of social information, and reduced emotional expression. While enhanced social avoidance seems to be specific to childhood social anxiety, other maladaptive emotion regulation strategies, such as repetitive negative thinking, seem to occur transdiagnostically across different childhood anxiety disorders. Implications for current theory, interventions and future research are discussed.
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Affiliation(s)
- Kristin Golombek
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr 41, Freiburg, 79106, Germany
| | - Leonie Lidle
- Department of Psychology, Clinical Child and Adolescent Psychology, Leipzig University, Leipzig, Germany.,Leipzig Research Center for Early Child Development, Leipzig University, Leipzig, Germany
| | - Brunna Tuschen-Caffier
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr 41, Freiburg, 79106, Germany
| | - Julian Schmitz
- Department of Psychology, Clinical Child and Adolescent Psychology, Leipzig University, Leipzig, Germany.,Leipzig Research Center for Early Child Development, Leipzig University, Leipzig, Germany
| | - Verena Vierrath
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr 41, Freiburg, 79106, Germany.
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79
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Thompson A, Steinbeis N. Computational modelling of attentional bias towards threat in paediatric anxiety. Dev Sci 2020; 24:e13055. [PMID: 33098719 PMCID: PMC8244064 DOI: 10.1111/desc.13055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 09/18/2020] [Accepted: 10/04/2020] [Indexed: 12/04/2022]
Abstract
Computational modelling can be used to precisely characterize the cognitive processes involved in attentional biases towards threat, yet so far has only been applied in the context of adult anxiety. Furthermore, studies investigating attentional biases in childhood anxiety have largely used tasks that conflate automatic and controlled attentional processes. By using a perceptual load paradigm, we separately investigate contributions from automatic and controlled processes to attentional biases towards negative stimuli and their association with paediatric anxiety. We also use computational modelling to investigate these mechanisms in children for the first time. In a sample of 60 children (aged 5‐11 years) we used a perceptual load task specifically adapted for children, in order to investigate attentional biases towards fearful (compared with happy and neutral) faces. Outcome measures were reaction time and percentage accuracy. We applied a drift diffusion model to investigate the precise cognitive mechanisms involved. The load effect was associated with significant differences in response time, accuracy and the diffusion modelling parameters drift rate and extra‐decisional time. Greater anxiety was associated with greater accuracy and the diffusion modelling parameter ‘drift rate’ on the fearful face trials. This was specific to the high load condition. These findings suggest that attentional biases towards fearful faces in childhood anxiety are driven by increased perceptual sensitivity towards fear in automatic attentional systems. Our findings from computational modelling suggest that current attention bias modification treatments should target perceptual encoding directly rather than processes occurring afterwards.
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Affiliation(s)
- Abigail Thompson
- Department of Clinical, Educational and Health Psychology, UCL, London, UK
| | - Nikolaus Steinbeis
- Department of Clinical, Educational and Health Psychology, UCL, London, UK
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80
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Anxiety and Attentional Bias in Children with Specific Learning Disorders. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:487-497. [PMID: 30043123 DOI: 10.1007/s10802-018-0458-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Children with specific learning disorders (SLDs) face a unique set of socio-emotional challenges as a result of their academic difficulties. Although a higher prevalence of anxiety in children with SLD is often reported, there is currently no research on cognitive mechanisms underlying this anxiety. One way to elucidate these mechanisms is to investigate attentional bias to threatening stimuli using a dot-probe paradigm. Our study compared children ages 9-16 with SLD (n = 48) to typically-developing (TD) controls (n = 33) on their attentional biases to stimuli related to general threats, reading, and stereotypes of SLD. We found a significant threat bias away from reading-related stimuli in the SLD, but not TD group. This attentional bias was not observed with the general threat and stereotype stimuli. Further, children with SLD reported greater anxiety compared to TD children. These results suggest that children with SLD experience greater anxiety, which may partially stem from reading specifically. The finding of avoidance rather than vigilance to reading stimuli indicates the use of more top-down attentional control. This work has important implications for therapeutic approaches to anxiety in children with SLD and highlights the need for attention to socio-emotional difficulties in this population. Future research is needed to further investigate the cognitive aspects of socio-emotional difficulties in children with SLD, as well as how this may impact academic outcomes.
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81
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Attentional threat biases and their role in anxiety: A neurophysiological perspective. Int J Psychophysiol 2020; 153:148-158. [DOI: 10.1016/j.ijpsycho.2020.05.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 02/06/2023]
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82
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Deveney CM, Grasso D, Hsu A, Pine DS, Estabrook CR, Zobel E, Burns JL, Wakschlag LS, Briggs-Gowan MJ. Multi-method assessment of irritability and differential linkages to neurophysiological indicators of attention allocation to emotional faces in young children. Dev Psychobiol 2020; 62:600-616. [PMID: 31631345 PMCID: PMC7328764 DOI: 10.1002/dev.21930] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 08/25/2019] [Accepted: 09/09/2019] [Indexed: 01/31/2023]
Abstract
Facilitated attention toward angry stimuli (attention bias) may contribute to anger proneness and temper outbursts exhibited by children with high irritability. However, most studies linking attention bias and irritability rely on behavioral measures with limited precision and no studies have explored these associations in young children. The present study explores irritability-related attention biases toward anger in young children (N = 128; ages 4-7 years) engaged in a dot-probe task with emotional faces, as assessed with event-related brain potential (ERP) indices of early selective attention and multi-method assessment of irritability. Irritability assessed via semi-structured clinical interview predicted larger anterior N1 amplitudes to all faces. In contrast, irritability assessed via a laboratory observation paradigm predicted reduced P1 amplitudes to angry relative to neutral faces. These findings suggest that altered early attentional processing occurs in young children with high irritability; however, the nature of these patterns may vary with methodological features of the irritability assessments. Future investigations using different assessment tools may provide greater clarity regarding the underlying neurocognitive correlates of irritability. Such studies may also contribute to the ongoing debates about how to best define and measure irritability across the developmental spectrum in a manner that is most informative for linkage to neural processes.
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Affiliation(s)
| | - Damion Grasso
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Amy Hsu
- Department of Psychology, Wellesley College, Wellesley, MA, USA
| | - Daniel S. Pine
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Christopher R. Estabrook
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Elvira Zobel
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - James L. Burns
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Lauren S. Wakschlag
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
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83
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Biased perception of physiological arousal in child social anxiety disorder before and after cognitive behavioral treatment. CLINICAL PSYCHOLOGY IN EUROPE 2020; 2:e2691. [PMID: 36397826 PMCID: PMC9645492 DOI: 10.32872/cpe.v2i2.2691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/11/2020] [Indexed: 11/27/2022] Open
Abstract
Background A biased perception of physiological hyperreactivity to social-evaluative situations is crucial for the maintenance of social anxiety disorder (SAD). Alterations in interoceptive accuracy (IAc) when confronted with social stressors may play a role for SAD in children. We expected a biased perception of hyperarousal in children with SAD before treatment and, consequently, a reduced bias after successful cognitive behavioral therapy (CBT). Method In two centers, 64 children with the diagnosis of SAD and 55 healthy control (HC) children (both 9 to 13 years) participated in the Trier Social Stress Test for Children (TSST-C), which was repeated after children with SAD were assigned to either a 12-week group CBT (n = 31) or a waitlist condition (n = 33). Perception of and worry about physiological arousal and autonomic variables (heart rate, skin conductance) were assessed. After each TSST-C, all children further completed a heartbeat perception task to assess IAc. Results Before treatment, children with SAD reported both a stronger perception of and more worry about their heart rate and skin conductance than HC children, while the objective reactivity of heart rate did not differ. Additionally, children with SAD reported heightened perception of and increased worry about trembling throughout the TSST-C compared to HC children, but reported increased worry about blushing only after the stress phase of the TSST-C compared to HC children. Children with and without SAD did not differ in IAc. Contrary to our hypothesis, after treatment, children in the CBT group reported heightened perception of physiological arousal and increased worry on some parameters after the baseline phase of the TSST-C, whereas actual IAc remained unaffected. IAc before and after treatment were significantly related. Conclusions Increased self-reported perception of physiological arousal may play a role in childhood SAD and could be an important target in CBT. However, further studies should examine if this is an epiphenomenon, a temporarily occurring and necessary condition for change, or indeed an unwanted adverse intervention effect. Biased perception of physiological arousal may play a role in child social anxiety disorder (SAD). Faced with standardized social stress, biased perception of heart rate but not skin conductance. No change in biased perception due to cognitive-behavioral treatment. Further research regarding the nature of biased perception (e.g. epiphenomenon) necessary.
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84
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Crochiere RJ, Hughes Lansing A, Carracher A, Vaid E, Stanger C. Attentional bias to diabetes cues mediates disease management improvements in a pilot randomized controlled trial for adolescents with type 1 diabetes. J Health Psychol 2020; 26:2699-2710. [PMID: 32508201 DOI: 10.1177/1359105320926535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
For type 1 diabetes management, the role of attentional bias remains unclear. This secondary analysis examined type 1 diabetes attentional bias and adolescent type 1 diabetes management prior to and during a cognitive and behavioral intervention. Youth with type 1 diabetes and above target glycemic control were assigned to intervention or usual care control. Participants completed baseline and follow-up type 1 diabetes Stroop tasks, HbA1c tests, and blood glucose meter downloads. Intervention was associated with greater reductions in type 1 diabetes attentional bias than control, and these reductions partially mediated the effect of treatment on diabetes management behaviors. Type 1 diabetes attentional bias is a potential target to improve type 1 diabetes management.
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85
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Mao Y, Zuo XN, Ding C, Qiu J. OFC and its connectivity with amygdala as predictors for future social anxiety in adolescents. Dev Cogn Neurosci 2020; 44:100804. [PMID: 32716853 PMCID: PMC7301179 DOI: 10.1016/j.dcn.2020.100804] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/01/2020] [Accepted: 06/05/2020] [Indexed: 01/22/2023] Open
Abstract
Social anxiety is a common problem that usually emerges at puberty, during which great developmental changes occur both in the brain and mental state. However, little is known about the influence of social anxiety on adolescents’ brain and behavior. The present study investigated the neural basis of social anxiety using voxel-based morphometry (VBM) and functional connectivity analysis. Then we investigated whether social anxiety is associated with attention bias. Furthermore, we investigated the neural basis of this association. Finally, longitudinal data was used to test if these biomarkers could predict social anxiety. The results indicated that social anxiety is positively associated with the grey matter volume (GMV) of orbital-frontal cortex (OFC), and the functional connectivity (FC) of OFC-amygdala. Mediation analysis revealed that the relationship between social anxiety and attention avoidance is partly mediated by the FC of OFC-amygdala. Finally, the present study demonstrated a close relationship between FC of the OFC-amygdala, the GMV of the OFC and the individual’s social anxiety one year later. The present study suggested the aberrant structure of OFC and its connectivity with amygdala as the neural underpinning of social anxiety, which might serve as a compensatory mechanism to decrease attention avoidance and promote effective emotion regulation.
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Affiliation(s)
- Yu Mao
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715, China; Department of Psychology, Southwest University, Chongqing, 400715, China
| | - Xi-Nian Zuo
- Institute of Psychology, CAS, Beijing, China.
| | - Cody Ding
- Department of Psychology, Southwest University, Chongqing, 400715, China; Educational Psychology, University of Missouri-St. Louis, United States.
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715, China; Department of Psychology, Southwest University, Chongqing, 400715, China.
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86
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Attentional Bias in specific symmetry and cleaning dimensions of obsessive-compulsive disorder. J Anxiety Disord 2020; 73:102238. [PMID: 32447225 DOI: 10.1016/j.janxdis.2020.102238] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 03/12/2020] [Accepted: 05/08/2020] [Indexed: 11/23/2022]
Abstract
Attentional bias (AB) refers to increased allocation of attention on threat stimuli when compared to neutral stimuli. It is not clear if AB occurs in subjects with obsessive-compulsive disorder (OCD). We tested AB for symmetry and cleaning symptoms of OCD. Sixty-two patients with OCD and 40 healthy controls matched by gender, age and IQ, completed a computerized dot-probe task where two pictures (with symmetry or cleaning related content) were shown. The probe appeared in the location previously occupied by one of the pictures. Within-subjects linear mixed-effect models were used to investigate the effects of the factors: group (patients vs controls), OCD dimension (cleaning vs symmetry), task condition (neutral, congruent and incongruent), and the interaction among them. We also correlated AB scores with the clinical and demographic variables. No positive interaction resulted among the factors, but positive results were observed in group and condition, separately. Patients were significantly slower than controls (p-value = 0.014) (an effect that was accounted for by depression and anxiety symptoms and comorbidity) and the neutral condition was significantly faster when compared the other two conditions (congruent and incongruent, p-value = 0.013). No association was found between AB scores and clinical symptoms. There was no AB toward specific, content-related, stimuli in this sample of OCD patients.
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87
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Kreuze LJ, Jonker NC, Hartman CA, Nauta MH, de Jong PJ. Attentional Bias for Cues Signaling Punishment and Reward in Adolescents: Cross-Sectional and Prognostic Associations with Symptoms of Anxiety and Behavioral Disorders. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1007-1021. [PMID: 32445103 PMCID: PMC7351843 DOI: 10.1007/s10802-020-00654-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Heightened reward sensitivity has been proposed as a risk factor for developing behavioral disorders whereas heightened punishment sensitivity has been related to the development of anxiety disorders in youth. Combining a cross-sectional (n = 696, mean age = 16.14) and prospective (n = 598, mean age = 20.20) approach, this study tested the hypotheses that an attentional bias for punishing cues is involved in the development of anxiety disorders and an attentional bias for rewarding cues in the development of behavioral disorders. A spatial orientation task was used to examine the relation between an attentional bias for punishing cues and an attentional bias for rewarding cues with anxiety and behavioral problems in a subsample of a large prospective population cohort study. Our study indicates that attentional biases to general cues of punishment and reward do not seem to be important risk factors for the development of anxiety or behavioral problems respectively. It might be that attentional biases play a role in the maintenance of psychological problems. This remains open for future research.
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Affiliation(s)
- L J Kreuze
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
| | - N C Jonker
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - C A Hartman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M H Nauta
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - P J de Jong
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
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88
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A systematic review with subset meta-analysis of studies exploring memory recall biases for pain-related information in adults with chronic pain. Pain Rep 2020; 5:e816. [PMID: 32440609 PMCID: PMC7209823 DOI: 10.1097/pr9.0000000000000816] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/23/2020] [Accepted: 01/23/2020] [Indexed: 01/08/2023] Open
Abstract
Supplemental Digital Content is Available in the Text. Pain-related memory biases have been frequently explored in individuals with chronic pain, and along with attentional and interpretation biases are hypothesised to contribute to the onset and/or maintenance of chronic pain. The aim of this review is to provide a systematic review and synthesis of studies exploring memory recall biases for pain-related information in individuals with chronic pain relative to healthy controls and the recall of neutral information. Studies were identified through a search of Medline, PsychINFO, Web of Science, CINAHL, Cochrane Library, and Open Grey databases. Search terms were memory, recall, recognition, and bias*, intersected with pain. Eighteen studies meeting the inclusion criteria were included. Subset meta-analyses are also reported from 12 studies with relevant between-groups data (comparing recall in chronic pain vs healthy control groups) and 12 studies with relevant within-groups data (eg, comparing recall of pain-related/emotional vs neutral words). Between-groups analysis revealed significantly weaker recall bias for affective-pain words in individuals with chronic pain relative to healthy controls, but only when nondepressed chronic pain individuals were included. No significant differences were found between groups in the recall of sensory-pain, illness-related, or depression-related words. Within-groups analysis revealed individuals with chronic pain show a significant recall bias favouring sensory-pain words relative to neutral and affective-pain words, and a bias for illness-related words relative to depression-related words. A recall bias favouring neutral words was found in healthy individuals. Evidence for the presence of pain-related memory biases in patients with chronic pain is inconclusive. Further methodologically rigorous research is required.
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89
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Kelleher BL, Hogan AL, Ezell J, Caravella K, Schmidt J, Wang Q, Roberts JE. Anxiety and threat-related attentional biases in adolescents with fragile X syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:296-302. [PMID: 32020687 PMCID: PMC7087430 DOI: 10.1111/jir.12715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Fragile X syndrome (FXS) is a single-gene disorder highly associated with anxiety; however, measuring anxiety symptoms in FXS and other neurogenetic syndromes is challenged by common limitations in language, self-awareness and cognitive skills required for many traditional assessment tasks. Prior studies have documented group-level differences in threat-related attentional biases, assessed via eye tracking, in FXS and non-FXS groups. The present study built on this work to test whether attentional biases correspond to clinical features of anxiety among adolescents and young adults with FXS. METHODS Participants included 21 male adolescents with FXS ages 15-20 years who completed an adapted eye-tracking task that measured attentional bias towards fearful faces of varied emotional intensity. RESULTS Among participants without anxiety disorders, attentional bias towards fear increased across age, similar to non-FXS paediatric anxiety samples. In contrast, participants with anxiety disorders exhibited greater stability in fear-related attentional biases across age. Across analyses, subtle fear stimuli were more sensitive to within-group anxiety variability than full-intensity stimuli. CONCLUSIONS Our results provide novel evidence that although threat-related attentional biases may correspond with anxiety outcomes in FXS, these associations are complex and vary across developmental and task factors. Future studies are needed to characterise these associations in more robust longitudinal samples, informing whether and how eye-tracking tasks might be optimised to reliably predict and track anxiety in FXS.
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Affiliation(s)
- B L Kelleher
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - A L Hogan
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - J Ezell
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - K Caravella
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - J Schmidt
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Q Wang
- Yale Child Study Center, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - J E Roberts
- Department of Psychology, University of South Carolina, Columbia, SC, USA
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90
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McLaughlin KA, Colich NL, Rodman AM, Weissman DG. Mechanisms linking childhood trauma exposure and psychopathology: a transdiagnostic model of risk and resilience. BMC Med 2020; 18:96. [PMID: 32238167 PMCID: PMC7110745 DOI: 10.1186/s12916-020-01561-6] [Citation(s) in RCA: 205] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 03/17/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Transdiagnostic processes confer risk for multiple types of psychopathology and explain the co-occurrence of different disorders. For this reason, transdiagnostic processes provide ideal targets for early intervention and treatment. Childhood trauma exposure is associated with elevated risk for virtually all commonly occurring forms of psychopathology. We articulate a transdiagnostic model of the developmental mechanisms that explain the strong links between childhood trauma and psychopathology as well as protective factors that promote resilience against multiple forms of psychopathology. MAIN BODY We present a model of transdiagnostic mechanisms spanning three broad domains: social information processing, emotional processing, and accelerated biological aging. Changes in social information processing that prioritize threat-related information-such as heightened perceptual sensitivity to threat, misclassification of negative and neutral emotions as anger, and attention biases towards threat-related cues-have been consistently observed in children who have experienced trauma. Patterns of emotional processing common in children exposed to trauma include elevated emotional reactivity to threat-related stimuli, low emotional awareness, and difficulties with emotional learning and emotion regulation. More recently, a pattern of accelerated aging across multiple biological metrics, including pubertal development and cellular aging, has been found in trauma-exposed children. Although these changes in social information processing, emotional responding, and the pace of biological aging reflect developmental adaptations that may promote safety and provide other benefits for children raised in dangerous environments, they have been consistently associated with the emergence of multiple forms of internalizing and externalizing psychopathology and explain the link between childhood trauma exposure and transdiagnostic psychopathology. Children with higher levels of social support, particularly from caregivers, are less likely to develop psychopathology following trauma exposure. Caregiver buffering of threat-related processing may be one mechanism explaining this protective effect. CONCLUSION Childhood trauma exposure is a powerful transdiagnostic risk factor associated with elevated risk for multiple forms of psychopathology across development. Changes in threat-related social and emotional processing and accelerated biological aging serve as transdiagnostic mechanisms linking childhood trauma with psychopathology. These transdiagnostic mechanisms represent critical targets for early interventions aimed at preventing the emergence of psychopathology in children who have experienced trauma.
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Affiliation(s)
- Katie A McLaughlin
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02138, USA.
| | - Natalie L Colich
- Department of Psychology, University of Washington, Box 351525, Seattle, WA, 98195, USA
| | - Alexandra M Rodman
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02138, USA
| | - David G Weissman
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02138, USA
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Neural Correlates of Attentional Processing of Threat in Youth with and without Anxiety Disorders. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:119-129. [PMID: 29607460 DOI: 10.1007/s10802-018-0424-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Late-stage attentional processing of threatening stimuli, quantified through event-related potentials (ERPs), differentiates youth with and without anxiety disorders. It is unknown whether early-stage attentional processing of threatening stimuli differentiates these groups. Examining both early and late stage attentional processes in youth may advance knowledge and enhance efforts to identify biomarkers for translational prevention and treatment research. Twenty-one youth with primary DSM-IV-TR anxiety disorders (10 males, ages 8-15 years) and 21 typically developing Controls (15 males, ages 8-16 years) completed a dot probe task while electroencephalography (EEG) was recorded, and ERPs were examined. Youth with anxiety disorders showed significantly larger (more positive) P1 amplitudes for threatening stimuli than for neutral stimuli, and Controls showed the opposite pattern. Youth with anxiety showed larger (more negative) N170 amplitudes compared with Controls. Controls showed significantly larger (more positive) P2 and P3 amplitudes, regardless of stimuli valence, compared with youth with anxiety disorders. ERPs observed during the dot probe task indicate youth with anxiety disorders display distinct neural processing during early stage attentional orienting and processing of faces; this was not the case for Controls. Such results suggest these ERP components may have potential as biomarkers of anxiety disorders in youth.
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92
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Biagianti B, Conelea C, Brambilla P, Bernstein G. A systematic review of treatments targeting cognitive biases in socially anxious adolescents: Special Section on "Translational and Neuroscience Studies in Affective Disorders" Section Editor, Maria Nobile MD, PhD. J Affect Disord 2020; 264:543-551. [PMID: 32056778 PMCID: PMC7024067 DOI: 10.1016/j.jad.2019.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/13/2019] [Accepted: 12/02/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Adolescence is a period of brain plasticity that is affected by social and affective stimuli. Adaptive neurodevelopmental changes in the context of complex social situations may precipitate or exacerbate cognitive biases (i.e., attention and/or interpretation biases) and predispose at-risk individuals to symptoms of social anxiety. METHODS This systematic review followed the PRISMA guidelines. Nine adolescent studies were examined including 3 studies using Cognitive Bias Modification Training (CBMT) to target attention biases (CBMT-A), 3 studies using CBMT to target interpretation biases (CBMT-I), and 3 aimed at reducing both attention and interpretation biases. RESULTS The studies of CBMT-A alone did not find significant effects on cognitive and clinical outcomes. However, studies of CBMT-I alone showed some improvement in interpretation bias. The combination of CBMT-A and CBMT-I appeared promising in reducing both attentionl and interpretation biases. LIMITATIONS The paucity of studies and the heterogeneity across studies (e.g., format of CBMT, assessment measures) limit the calculation of overall effect sizes and the examination of predictors, moderators, and mediators of outcome. CONCLUSIONS Technology-driven interventions such as CBMT have the potential to extend treatments outside the clinic setting and to augment current therapies for social anxiety. Further research is needed to develop CBMT procedures that optimize learning in group and real-world settings and to identify predictors of treatment response. Understanding the neural correlates of response to CBMT may help identify future targets for intervention.
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Affiliation(s)
- Bruno Biagianti
- Department of R&D, Posit Science Corporation, San Francisco, CA, USA; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Christine Conelea
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gail Bernstein
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
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Willner CJ, Jetha MK, Segalowitz SJ, Gatzke-Kopp LM. Neurophysiological evidence for distinct biases in emotional face processing associated with internalizing and externalizing symptoms in children. Biol Psychol 2020; 150:107829. [PMID: 31790713 PMCID: PMC7007849 DOI: 10.1016/j.biopsycho.2019.107829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 11/24/2019] [Accepted: 11/27/2019] [Indexed: 01/24/2023]
Abstract
Attentional bias to threat has been implicated in both internalizing and externalizing disorders. This study utilizes event-related potentials to examine early stages of perceptual attention to threatening (angry or fearful) versus neutral faces among a sample of 200 children ages 6-8 years from a low-income, urban community. Although both internalizing and externalizing symptoms were associated with processing biases, the nature of the bias differed between these two symptom domains. Internalizing symptoms were associated with heightened early attentional selection (P1) and later perceptual processing (P2) of fearful faces. In contrast, externalizing symptoms were associated with reduced early attentional selection (P1) of fearful faces and enhanced perceptual processing (P2) of neutral faces, possibly indicative of a hostile interpretation bias for ambiguous social cues. These results provide insight into the distinct cognitive-affective processes that may contribute to the etiology and maintenance of internalizing and externalizing psychopathology.
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Affiliation(s)
- Cynthia J Willner
- The Pennsylvania State University, Department of Human Development and Family Studies, 228 Health and Human Development Building, University Park, PA, 16802, United States.
| | - Michelle K Jetha
- Cape Breton University, Department of Psychology, 1250 Grand Lake Road, Sydney, Nova Scotia, B1P 6L2, Canada.
| | - Sidney J Segalowitz
- Brock University, Department of Psychology, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada.
| | - Lisa M Gatzke-Kopp
- The Pennsylvania State University, Department of Human Development and Family Studies, 228 Health and Human Development Building, University Park, PA, 16802, United States.
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94
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Abstract
Worry is common in children and adolescents, yet some youth experience excessive worries that persist over time and cause significant distress. Whilst the literature on worry and generalised anxiety disorder (GAD) in adults is well established, relatively less is known about the cognitive mechanisms underlying child and adolescent worry. An influential cognitive model of adult pathological worry (Hirsch and Matthews in Behav Res Therapy 50:636–646, 10.1016/j.brat.2012.06.007, 2012) proposes that negative information-processing biases, reduced executive functions, and verbal worry are critical in the aetiology of GAD in adults. The current systematic review investigated whether this cognitive model of worry could be extended to understand child and adolescent worry. Following a systematic search of the literature and screening for eligibility, 30 studies were identified. Evidence indicates that negative information-processing biases and reduced executive functions play an important role in worry and GAD in children and adolescents. However, evidence that children and adolescents experience verbal worry is inconclusive. Building upon Hirsch and Matthews' cognitive model (Behav Res Therapy 50:636–646, 10.1016/j.brat.2012.06.007, 2012), we propose a model of child and adolescent worry to provide a guiding framework for future research. We conclude that cognitive models of worry should incorporate a developmental framework in order to provide greater insight into the mechanisms uniquely associated with worry in children and adolescents and help to identify the cognitive processes to target for early interventions and treatments.
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95
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Pettit JW, Bechor M, Rey Y, Vasey MW, Abend R, Pine DS, Bar-Haim Y, Jaccard J, Silverman WK. A Randomized Controlled Trial of Attention Bias Modification Treatment in Youth With Treatment-Resistant Anxiety Disorders. J Am Acad Child Adolesc Psychiatry 2020; 59:157-165. [PMID: 30877049 PMCID: PMC6744353 DOI: 10.1016/j.jaac.2019.02.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 02/20/2019] [Accepted: 03/01/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Randomized clinical trials of augmentation strategies for youth with treatment-resistant anxiety disorders do not exist. This report presents findings from an efficacy trial of attention bias modification treatment (ABMT) as an augment for this population compared with attention control training (ACT). METHOD Sixty-four youths (34 boys; mean age 11.7 years) who continued to meet for anxiety diagnoses after completing cognitive-behavioral therapy were randomized to ABMT or ACT. ABMT and ACT consisted of dot-probe attention training trials presenting angry and neutral faces; probes appeared in the location of neutral faces on 100% of trials in ABMT and 50% of trials in ACT. Independent evaluators, youths, and parents completed ratings of youth anxiety severity, and youths completed measures of attention bias to threat and attention control at pretreatment, post-treatment, and 2-month follow-up. RESULTS The 2 arms showed significant decreases in anxiety severity, with no differences between arms. Specifically, across informants, anxiety severity was significantly decreased at post-treatment and decreases were maintained at follow-up. Primary anxiety disorder diagnostic recovery combined across arms was 50% at post-treatment and 58% at follow-up. Attention control, but not attention bias to threat, was significantly improved at post-treatment in the 2 arms. CONCLUSION This is the first study to show anxiety can be decreased in youth who did not respond to cognitive-behaviorial therapy, and that the anxiety-decreasing effect is found using these 2 attention training contingency schedules. These findings and increases in attention control in the 2 arms raise intriguing questions about mechanisms of decreasing anxiety in treatment-resistant youth with attention training that require further research. CLINICAL TRIAL REGISTRATION INFORMATION Attention Bias Modification Training for Child Anxiety CBT Nonresponders; https://clinicaltrials.gov/; NCT01819311.
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96
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Neural correlates of emotion-attention interactions: From perception, learning, and memory to social cognition, individual differences, and training interventions. Neurosci Biobehav Rev 2020; 108:559-601. [DOI: 10.1016/j.neubiorev.2019.08.017] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 07/02/2019] [Accepted: 08/21/2019] [Indexed: 12/12/2022]
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97
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Pettit JW, Silverman WK. Editorial: Attention to Threat in Child Anxiety: Gazing Into the Future While Keeping Sight of the Past. J Am Acad Child Adolesc Psychiatry 2020; 59:33-35. [PMID: 31585158 DOI: 10.1016/j.jaac.2019.09.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
Abstract
Since the 1960s, cognitive theories of anxiety have prioritized attention to threat in the etiology and maintenance of anxiety and its disorders.1 The development of computer-administered tasks in the 1980s, displaying threatening stimuli on the screen and relying on participants' clicking of keys or mouse buttons to measure reaction time, permitted experimental testing of the hypothesis that individuals with anxiety disorders show biased attention to threat.2 Considerable data have since accumulated supporting this hypothesis, including in children and adolescents.1,3 However, reaction times measured by mouse button clicks are indirect and imprecise measurements of attention.4 With the availability of eye-tracking in the last decade, researchers have been able to directly and precisely measure attention. Lisk et al.,5 in this issue of the Journal, provide a systematic review and meta-analysis of studies that used eye-tracking to measure attention to threat in children and adolescents.
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98
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Lisk S, Vaswani A, Linetzky M, Bar-Haim Y, Lau JYF. Systematic Review and Meta-Analysis: Eye-Tracking of Attention to Threat in Child and Adolescent Anxiety. J Am Acad Child Adolesc Psychiatry 2020; 59:88-99.e1. [PMID: 31265874 DOI: 10.1016/j.jaac.2019.06.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 05/24/2019] [Accepted: 06/26/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Attention biases for threat may reflect an early risk marker for anxiety disorders. Yet questions remain regarding the direction and time-course of anxiety-linked biased attention patterns in youth. A meta-analysis of eye-tracking studies of biased attention for threat was used to compare the presence of an initial vigilance toward threat and a subsequent avoidance in anxious and nonanxious youths. METHOD PubMed, PsycARTICLES, Medline, PsychINFO, and Embase were searched using anxiety, children and adolescent, and eye-tracking-related key terms. Study inclusion criteria were as follows: studies including participants ≤18 years of age; reported anxiety using standardized measures; measured attention bias using eye tracking with a free-viewing task; comparison of attention toward threatening and neutral stimuli; and available data to allow effect size computation for at least one relevant measure. A random effects model estimated between- and within-group effects of first fixations toward threat and overall dwell time on threat. RESULTS Thirteen eligible studies involving 798 participants showed that neither youths with or without anxiety showed significant bias in first fixation to threat versus neutral stimuli. However anxious youths showed significantly less overall dwell time on threat versus neutral stimuli than nonanxious controls (g = -0.26). CONCLUSION Contrasting with adult eye-tracking data and child and adolescent data from reaction time indices of attention biases to threat, there was no vigilance bias toward threat in anxious youths. Instead, anxious youths were more avoidant of threat across the time course of stimulus viewing. Developmental differences in brain circuits contributing to attention deployment to emotional stimuli and their relationship with anxiety are discussed.
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Affiliation(s)
- Stephen Lisk
- Institute of Psychiatry, Psychology and Neuroscience, King's College London
| | - Ayesha Vaswani
- Institute of Psychiatry, Psychology and Neuroscience, King's College London
| | - Marian Linetzky
- School of Psychological Sciences, Tel Aviv University, Israel
| | - Yair Bar-Haim
- School of Psychological Sciences, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Israel
| | - Jennifer Y F Lau
- Institute of Psychiatry, Psychology and Neuroscience, King's College London.
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99
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Rosen D, Price RB, Ladouceur CD, Siegle GJ, Hutchinson E, Nelson EE, Stroud LR, Forbes EE, Ryan ND, Dahl RE, Silk JS. Attention to Peer Feedback Through the Eyes of Adolescents with a History of Anxiety and Healthy Adolescents. Child Psychiatry Hum Dev 2019; 50:894-906. [PMID: 31028507 PMCID: PMC6790282 DOI: 10.1007/s10578-019-00891-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
During adolescence, youth may experience heightened attention bias to socially relevant stimuli; however, it is unclear if attention bias toward social threat may be exacerbated for adolescents with a history of anxiety. This study evaluated attentional bias during the Chatroom-Interact task with 25 adolescents with a history of anxiety (18F, Mage = 13.6) and 22 healthy adolescents (13F, Mage = 13.8). In this task, participants received feedback from fictional, virtual peers who either chose them (acceptance) or rejected them (rejection). Overall, participants were faster to orient toward and spent longer time dwelling on their own picture after both rejection and acceptance compared to non-feedback cues. Social feedback was associated with greater pupillary reactivity, an index of cognitive and emotional neural processing, compared to non-feedback cues. During acceptance feedback (but not during rejection feedback), anxious youth displayed greater pupil response compared to healthy youth, suggesting that positive feedback from peers may differentially influence youth with a history of an anxiety disorder.
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Affiliation(s)
- Dana Rosen
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
| | - Rebecca B Price
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
| | | | - Greg J Siegle
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
| | - Emily Hutchinson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Eric E Nelson
- Department of Pediatrics, Center for Biobehavioral Health, Nationwide Children's Hospital & Ohio State University, Columbus, USA
| | - Laura R Stroud
- Department of Psychiatry, University of Brown, Providence, USA
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
| | - Neal D Ryan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
| | - Ronald E Dahl
- School of Public Health, University of California at Berkeley, Berkeley, USA
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, 15213, USA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
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100
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White SW, Capriola-Hall NN, Wieckowski AT, Ollendick TH. Change in gaze-based attention bias in adolescents with Social Anxiety Disorder. Cogn Emot 2019; 33:1736-1744. [PMID: 30929578 PMCID: PMC11097143 DOI: 10.1080/02699931.2019.1598938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 03/18/2019] [Accepted: 03/19/2019] [Indexed: 01/30/2023]
Abstract
Although attention bias (AB) toward threat has been associated with Social Anxiety Disorder (SAD), concerns regarding the ability of current measures to detect change in AB following treatment exist. We sought to examine change in bias, as measured via eye-tracking, in adolescents with SAD receiving either attention-bias modification training (ABMT) or attention-control training (ACT). Gaze-based AB was associated (r = -0.361) with symptoms of social anxiety prior to treatment, whereas there was no association between bias as measured via dot probe and social anxiety. Moreover, gaze-based bias to same-age face stimuli showed change following treatment. Large effects are seen for condition (ABMT or ACT) and for time, independent of treatment condition, in gaze-based AB to same-age stimuli. Findings suggest that further research on gaze-based bias, to assess stability over time outside of treatment and sensitivity to change following intervention, is warranted.
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