Child Anxiety and the Processing of Ambiguity

The Development of Ambiguity Processing Is Explained by an Inverted U-Shaped Curve

Understanding the developmental trajectories for recognizing facial expressions is important for a better understanding of development of psychiatric disorders. In this study, we examined the recognition of emotional and neutral facial expressions in 93 typically developing adolescents and adults. The Emotion Intensity Rating task required participants to rate the intensity of emotional expression in happy, neutral, and sad faces on a scale from 1 to 9. A score of '5' had to be assigned to neutral faces, scores between '6' (slightly happy) and '9' (very happy) to happy faces, and scores between '4' (slightly sad) and '1' (very sad) to sad faces. Mixed effects models were used to examine the effects of age and emotion on recognition accuracy, reaction time (RT), and emotional intensity. Participants tended to misjudge neutral faces as sad. Adolescents were less accurate than adults for neutral face recognition. There were significant quadratic effects of age on accuracy (negative quadratic effect) and RT (positive quadratic effect). The most accurate and fastest performance was observed in 25- to 35-year-old subjects. This trajectory may be associated with prefrontal cortex maturation, which provides top-down control over the heightened amygdala response to ambiguity that may be misinterpreted as emotional content.

An Integrative Model of Youth Anxiety: Cognitive-Affective Processes and Parenting in Developmental Context

Multiple theoretical frameworks have been proposed to provide a more comprehensive picture of the risk factors that influence anxiety-related developmental trajectories. Nonetheless, there remains a need for an integrative model that outlines: (1) which risk factors may be most pertinent at different points in development, and (2) how parenting may maintain, exacerbate, or attenuate an affective style that is characterized by high negative emotional reactivity to unfamiliar, uncertain, and threatening situations. A developmentally informed, integrative model has the potential to guide treatment development and delivery, which is critical to reducing the public health burden associated with these disorders. This paper outlines a model integrating research on many well-established risk mechanisms for anxiety disorders, focusing on (1) the developmental progression from emotional reactivity constructs early in life to those involving higher-level cognitive processes later in youth, and (2) potential pathways by which parenting may impact the stability of youth's cognitive-affective responses to threat-relevant information across development.

Interpretation Bias and Anticipated Distress in the Face of Ambiguity: Predictors of Change in Cognitive Behavioral Therapy for Youth Anxiety

This study examined associations among children's anxiety, interpretation bias, and anticipated distress before and after cognitive behavioral therapy (CBT) and investigated baseline levels of interpretation bias and anticipated distress as well as changes in these cognitive biases following treatment as predictors of treatment outcome. Clinically anxious youth (N = 39) were treated with brief CBT augmented with a smartphone app. Children completed measures assessing their anxiety, interpretation bias, and anticipated distress at baseline, post-treatment, and 2-month follow-up. Children's anxiety, interpretation bias, and anticipated distress significantly decreased following treatment. Anticipated distress was associated with higher anxiety at all time points; however, interpretation bias was not significantly associated with anxiety before or after treatment. Reductions in anticipated distress following treatment predicted concurrent and prospective reductions in anxiety. Reduced anticipated distress following treatment may contribute to enhanced treatment outcomes and may be more strongly related to the maintenance of youth anxiety than interpretation bias.

Adventurous Play as a Mechanism for Reducing Risk for Childhood Anxiety: A Conceptual Model

In this conceptual article, we draw upon the literature regarding cognitive and behavioural factors that underpin childhood anxiety to outline how a range of these risk markers might be targeted through adventurous play. When children play in an adventurous way, climbing trees, riding their bikes fast downhill and jumping from rocks, they experience feelings of fear and excitement, thrill and adrenaline. We propose that the positive, thrilling and playful emotions associated with this type of child-led play facilitate exposure to fear-provoking situations and, in doing so, provide opportunities for children to learn about physiological arousal, uncertainty and coping. We hypothesise that these learning opportunities will, over time, reduce children's risk for elevated anxiety by increasing children's expectations and ability to cope with anxiety, decreasing intolerance of uncertainty and preventing catastrophic misinterpretations of physiological arousal. If our conceptual model is correct, then ensuring that children have the physical and psychological space required to play in an adventurous way may help to decrease their risk for elevated or clinical anxiety.

Validating a mobile eye tracking measure of integrated attention bias and interpretation bias in youth

Introduction

This study sought to validate a real-world speech task designed to assess attention and interpretation bias in an integrated and ecologically valid manner.

Methods

Thirty adolescent girls gave a speech in front of an emotionally ambiguous judge and a positive judge while wearing mobile eye tracking glasses to assess how long they looked at each judge (i.e., attention bias). They also reported their interpretations of the ambiguous judge and distress associated with the task (i.e., interpretation bias).

Results

These task-based measures correlated with self-report of interpretation bias and mother-report of attentional control, demonstrating convergent validity. They did not correlate with frustration or high intensity pleasure, indicating discriminant validity. Task-based measures of interpretation bias also showed predictive and incremental validity in relation to child distress during the speech.

Discussion

This proof-of-concept study demonstrates the initial validity of a novel task designed to assess attention and interpretation bias as they manifest in real-world social interactions.