Attention Biases Towards and Away from Threat Mark the Relation between Early Dysregulated Fear and the Later Emergence of Social Withdrawal

The Moderating Role of Emotion Regulation on Shyness and Internalizing Behavior of Turkish Preschool Children

The present study examined the moderating effect of children's emotion regulation on the relations between shyness and internalizing behavior in Turkish preschool children. Participants were N = 222 children (M = 58.20 months, SD = 11.24, 116 girls, 106 boys) attending five public kindergartens in Turkey. Mothers provided ratings of children's shyness and emotion regulation; teachers assessed children's internalizing behavior. Results indicated that shyness was positively associated with internalizing behavior and negatively associated with emotion regulation among Turkish preschool children. Moreover, children's emotion regulation significantly moderated the relationship between shyness and internalizing behavior. Specifically, among children with lower levels of emotion regulation, shyness was significantly and positively associated with internalizing behaviors while among children with higher levels of emotion regulation, shyness was not associated with internalizing behaviors. The current findings inform that the importance of improving children's emotional regulation to buffer the internalizing behaviors among Turkish shyness young children. The findings also highlight the importance of considering the meaning and implication of shyness for preschool children.

Attention Bias and Anxiety: The Moderating Effect of Sociocultural Variables in Rural Latinx Youth

Attention bias confers risk for anxiety development, however, the influence of sociodemographic variables on the relationship between attention bias and anxiety remains unclear. We examined the association between attention bias and anxiety among rural Latinx youth and investigated potential moderators of this relationship. Clinical symptoms, demographic characteristics, and a performance-based measure of attention bias were collected from 66 rural Latinx youth with clinical levels of anxiety (33.3% female; Mage = 11.74; 92.4% Latinx, 7.6% Mixed Latinx). No moderating effects for age or gender were found. Youth below the poverty line displayed an attention bias away from threat in comparison to youth above the poverty line, who displayed an attention bias towards threat. Among youth below the poverty line, this bias away from threat was associated with increased anxiety. Findings highlight the importance of economic adversity in understanding the relationship between attention bias and anxiety.

Variability in caregiver attention bias to threat: A Goldilocks effect in infant emotional development?

Attention biases to threat are considered part of the etiology of anxiety disorders. Attention bias variability (ABV) quantifies intraindividual fluctuations in attention biases and may better capture the relation between attention biases and psychopathology risk versus mean levels of attention bias. ABV to threat has been associated with attentional control and emotion regulation, which may impact how caregivers interact with their child. In a relatively diverse sample of infants (50% White, 50.7% female), we asked how caregiver ABV to threat related to trajectories of infant negative affect across the first 2 years of life. Families were part of a multi-site longitudinal study, and data were collected from 4 to 24 months of age. Multilevel modeling examined the effect of average caregiver attention biases on changes in negative affect. We found a significant interaction between infant age and caregiver ABV to threat. Probing this interaction revealed that infants of caregivers with high ABV showed decreases in negative affect over time, while infants of caregivers with low-to-average ABV showed potentiated increases in negative affect. We discuss how both high and extreme patterns of ABV may relate to deviations in developmental trajectories.

Fearful temperament in middle childhood predicts adolescent attention bias and anxiety symptoms: The moderating role of frontal EEG asymmetry

The current study provided first analyses of the moderating effect of baseline-to-task frontal EEG asymmetry on the associations between 9-year fearful temperament and adolescent attention bias to threat as well as anxiety symptoms. Participants include a community sample of 122 children (60 boys, 62 girls; Mage = 14.66 years; Range = 11.82-18.13 years). Baseline-to-task frontal EEG asymmetry at age 9 moderated the relation between fearful temperament at age 9 and adolescent anxiety symptoms. Specifically, fearful temperament predicted adolescent anxiety symptoms when children showed greater right activation from baseline to an executive function task, but not greater left activation. Baseline-to-task frontal EEG asymmetry moderated the association between fearful temperament and sustained (i.e., stimulus onset asynchrony is 1250 ms) but not automatic attention bias (i.e., stimulus onset asynchrony is 500 ms). Children with greater left frontal activation from baseline to task more efficiently direct attention away from threat. Adolescent automatic attention bias to threat was related to concurrent anxiety symptoms. These findings illustrate the importance of considering frontal EEG asymmetry to shape how fearful children process threat and to influence their behavioral problems.

(A lack of) effects of acute social stress on attentional bias to threat

Attentional biases toward or away from emotionally evocative stimuli have been well documented and are known to be clinically relevant, making it important to understand how various factors contribute to them. Some work has suggested that acute stress modulates attentional biases, but this work has produced inconsistent results. For example, many studies have found that stress enhances attentional bias, others that stress decreases attentional bias, and others still that there is no effect of stress at all. Methodological differences may explain these inconsistencies. For example, discrepancies exist between studies in participant sex (e.g., mixed sample vs. all men) and in the type of attentional bias paradigm. We addressed these gaps by examining the effects of an acute social stressor (vs. control) on attentional bias assessed via facial dot probe, focusing on potential sex differences in these effects (N = 141). We found that, overall, participants were significantly biased towards threat, but biases did not differ by stress condition or sex. These findings help to clarify the existing discrepancy in the literature, as we found that stress exerts little if any effect on attentional bias assessed via a facial dot probe.

Cross-cultural applicability of eye-tracking in assessing attention to emotional faces in preschool-aged children

Humans show an attention bias toward emotional versus neutral information, which is considered an adaptive pattern of information processing. Deviations from this pattern have been observed in children with socially withdrawn behaviors, with most research being conducted in controlled settings among children from urban areas. The goal of the current study was to examine the cross-cultural applicability of two eye-tracking-based measures in assessing attention biases and their relations to children's symptoms of socially withdrawn behaviors in two independent and diverse samples of preschool children. The cross-cultural comparison was conducted between the Navajo Birth Cohort study (NBCS), an indigenous cohort with relatively low socioeconomic status (SES), and the Illinois Kids Development study (IKIDS), a primarily Non-Hispanic White and high SES cohort. Children in both cohorts completed eye-tracking tasks with pictures of emotional faces, and mothers reported on children's symptoms of socially withdrawn behaviors. Results showed that general patterns of attention biases were mostly the same across samples, reflecting heightened attention toward emotional versus neutral faces. The differences across two samples mostly involved the magnitude of attention biases. NBCS children were slower to disengage from happy faces when these emotional faces were paired with neutral faces. Additionally, socially withdrawn children in the NBCS sample showed a pattern of attentional avoidance for emotional faces. The comparability of overall patterns of attention biases provides initial support for the cross-cultural applicability of the eye-tracking measures and demonstrates the robustness of these methods across clinical and community settings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Higher attention bias for fear at 8 months of age is associated with better socioemotional competencies during toddlerhood

BACKGROUND

In previous studies, an attention bias for signals of fear and threat has been related to socioemotional problems, such as anxiety symptoms, and socioemotional competencies, such as altruistic behaviors in children, adolescents and adults. However, previous studies lack evidence about these relations among infants and toddlers.

AIMS

Our aim was to study the association between the individual variance in attention bias for faces and, specifically, fearful faces during infancy and socioemotional problems and competencies during toddlerhood.

STUDY DESIGN AND SUBJECTS

The study sample was comprised of 245 children (112 girls). We explored attentional face and fear biases at the age of 8 months using eye tracking and the face-distractor paradigm with neutral, happy and fearful faces and a scrambled-face control stimulus. Socioemotional problems and competencies were reported by parents with the Brief Infant and Toddler Social Emotional Assessment (BITSEA) when children were 24 months old.

OUTCOME MEASURES AND RESULTS

A higher attentional fear bias at 8 months of age was related to higher levels of socioemotional competence at 24 months of age (β = .18, p = .008), when infants' sex and temperamental affectivity, maternal age, education and depressive symptoms were controlled. We found no significant association between attentional face or fear bias and socioemotional problems.

CONCLUSIONS

We found that the heightened attention bias for fearful faces was related to positive outcomes in early socioemotional development. Longitudinal study designs are needed to explore the changes in the relation between the attention bias for fear or threat and socioemotional development during early childhood.

Annual Research Review: Developmental pathways linking early behavioral inhibition to later anxiety

Behavioral Inhibition is a temperament identified in the first years of life that enhances the risk for development of anxiety during late childhood and adolescence. Amongst children characterized with this temperament, only around 40 percent go on to develop anxiety disorders, meaning that more than half of these children do not. Over the past 20 years, research has documented within-child and socio-contextual factors that support differing developmental pathways. This review provides a historical perspective on the research documenting the origins of this temperament, its biological correlates, and the factors that enhance or mitigate risk for development of anxiety. We review as well, research findings from two longitudinal cohorts that have identified moderators of behavioral inhibition in understanding pathways to anxiety. Research on these moderators has led us to develop the Detection and Dual Control (DDC) framework to understand differing developmental trajectories among behaviorally inhibited children. In this review, we use this framework to explain why and how specific cognitive and socio-contextual factors influence differential pathways to anxiety versus resilience.

Effects of attention bias modification for anxiety: Neurophysiological indices and moderation by symptom severity

OBJECTIVE

Attention bias modification (ABM) aims to decrease anxiety symptom severity through the reduction of threat-related attention bias (AB). Individual differences in treatment response and poor measurement reliability of AB have called its clinical promise into question. The current study examined whether individual differences in anxiety severity at baseline moderated treatment response, and employed both behavioral and neurophysiological metrics of AB.

METHODS

Participants (N = 99) were randomly assigned to four weeks of ABM or placebo control training (PT). Self-reported anxiety symptom severity, and AB metrics and ERPs generated during the dot probe task were collected at baseline (Time 1), one-week post-intervention (Time 5), and at a three-month follow-up (Time 6).

RESULTS

ABM, relative to PT, reduced ERPs indexing attention discrimination (N170) and increased ERPs indexing salience tracking (P3). Increases in P3 were associated with ABM-related reductions in anxiety. Anxiety severity was reduced following ABM, but only among those with higher baseline anxiety symptom severity.

CONCLUSIONS

ABM effectively reduced symptom severity among those with higher levels of anxiety, and modulated neurophysiological indices of AB.

SIGNIFICANCE

Results provide evidence for attention-relevant ERPs as outcomes of ABM treatment responsivity and suggest that ABM may be most beneficial for those with more severe anxiety symptoms.

Attentional biases in human anxiety

Across clinical and subclinical samples, anxiety has been associated with increased attentional capture by cues signaling danger. Various cognitive models attribute the onset and maintenance of anxiety symptoms to maladaptive selective information processing. In this brief review, we 1) describe the evidence for the relations between anxiety and attention bias toward threat, 2) discuss the neurobiology of anxiety-related differences in threat bias, 3) summarize work investigating the developmental origins of attention bias toward threat, and 4) examine efforts to translate threat bias research into clinical intervention. Future directions in each area are discussed, including the use of novel analytic approaches improving characterization of threat-processing-related brain networks, clarifying the role of cognitive control in the development of attention bias toward threat, and the need for larger, well-controlled randomized clinical trials examining moderators and mediators of treatment response. Ultimately, this work has important implications for understanding the etiology of and for intervening on anxiety difficulties among children and adults.

Relations between social attention, expressed positive affect and behavioral inhibition during play

Flexible social attention, including visually attending to social interaction partners, coupled with positive affect may facilitate adaptive social functioning. However, most research assessing social attention relies on static computer-based paradigms, overlooking the dynamics of social interactions and limiting understanding of individual differences in the deployment of naturalistic attention. The current study used mobile eye-tracking to examine relations between social attention, expressed affect, and behavioral inhibition during naturalistic play in young children. Children (N = 28, Mage = 6.12, 46.4% girls, 92.9% White) participated in a 5-min free play with a novel age- and sex-matched peer while mobile eye-tracking data were collected. Interactions were coded for social attention and expressed affect and modeled second-by-second, generating 4,399 observations. Children spent more time dwelling on toys than on peers or anywhere else in the room. Further analyses demonstrated children were almost twice as likely to gaze at their peer when simultaneously self-expressing positive affect. Additionally, children were more than twice as likely and more than three times as likely to self-express positive affect when dwelling on peer or in the presence of peer-expressed positive affect, respectively. Behavioral inhibition was not significantly related to social attention. However, children higher in behavioral inhibition were less likely to self-express positive affect in the presence of peer-expressed positive affect. The current results provide a snapshot of relations between social attention, expressed affect and individual differences during play and provide guidance for future work assessing the roles of social attention and positive affect in facilitating positive social interactions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Bi-directional relations between attention and social fear across the first two years of life

This study examined longitudinal relations between attention and social fear across the first two years of life. Our sample consisted of 357 infants and their caregivers across three sites. Data was collected at 4, 8, 12, 18, and 24 months of age. At all 5 assessments, the infants participated in 2 eye-tracking tasks (Vigilance and Overlap) which measured different components of attention bias (orientation, engagement, and disengagement), and parents completed questionnaires assessing infant temperament. For the first three assessments, social fear was measured using the Infant Behavioral Questionnaire-Revised (IBQ-R; Gartstein & Rothbart, 2003) focused on interactions with strangers, and for the final two time points, we used the social fearfulness subscale on the Toddler Behavior Assessment Questionnaire (TBAQ; Goldsmith, 1996). The results of a random intercept cross-lagged panel model showed intermittent evidence of uni-directional and reciprocal relations between attention to both threatening and positive emotion facial configurations and social fear. Our findings suggest that characteristics of behaviorally inhibited temperament-in this case, social fear-begin to interact with attention biases to emotion in the very first year of life, which carries implications for the timing of future interventions designed to mitigate the early development of maladaptive patterns of attention.

Parent-to-Child Anxiety Transmission Through Dyadic Social Dynamics: A Dynamic Developmental Model

The intergenerational transmission of psychopathology is one of the strongest known risk factors for childhood disorder and may be a malleable target for prevention and intervention. Anxious parents have distinct parenting profiles that impact socioemotional development, and these parenting effects may result in broad alterations to the biological and cognitive functioning of their children. Better understanding the functional mechanisms by which parental risk is passed on to children can provide (1) novel markers of risk for socioemotional difficulties, (2) specific targets for intervention, and (3) behavioral and biological indices of treatment response. We propose a developmental model in which dyadic social dynamics serve as a key conduit in parent-to-child transmission of anxiety. Dyadic social dynamics capture the moment-to-moment interactions between parent and child that occur on a daily basis. In shaping the developmental trajectory from familial risk to actual symptoms, dyadic processes act on mechanisms of risk that are evident prior to, and in the absence of, any eventual disorder onset. First, we discuss dyadic synchrony or the moment-to-moment coordination between parent and child within different levels of analysis, including neural, autonomic, behavioral, and emotional processes. Second, we discuss how overt emotion modeling of distress is observed and internalized by children and later reflected in their own behavior. Thus, unlike synchrony, this is a more sequential process that cuts across levels of analysis. We also discuss maladaptive cognitive and affective processing that is often evident with increases in child anxiety symptoms. Finally, we discuss additional moderators (e.g., parent sex, child fearful temperament) that may impact dyadic processes. Our model is proposed as a conceptual framework for testing hypotheses regarding dynamic processes that may ultimately guide novel treatment approaches aimed at intervening on dyadically linked biobehavioral mechanisms before symptom onset.

Expressions of positive and negative shyness in preschool-age children: Temperamental correlates and visual attention to emotions

Recent empirical evidence shows heterogeneity in the expression of shyness in children. Some children tend to express their shyness displaying positive affect along with gaze aversions (positive shyness), whereas others display more negative emotional reactions accompanied by gaze aversions (negative shyness). Temperamental differences in approach-avoidance tendencies are likely to explain these differences in shyness expression in children and influence their visual attention to social stimuli, yet little empirical attention has been devoted to these associations. Our study examined the temperamental profile (approach, fear, and inhibitory control) associated with positive and negative shyness and the relation between expression of shyness and attention to social stimuli in 47 children aged 3-6 years. Children's positive and negative expressions of shyness were assessed using a performance task. Visual attention to facial emotional expressions was measured with the dot - probe task, and temperament was measured with maternal reports. Positive shyness was found to be positively associated with temperamental dimensions of approach, inhibitory control, and fear. Positive shyness was significantly associated with attentional orientation to positive facial expressions and with less attentional avoidance of threatening facial expressions. Negative shyness was positively associated only with temperamental fear, and no associations were found with attention to social stimuli. Our study provides empirical support for the association between temperament and the multidimensional character of the expression of positive shyness and adds relevant evidence regarding the connection between the expression of shyness and attention to social stimuli.

Attention Biases to Threat in Infants and Parents: Links to Parental and Infant Anxiety Dispositions

Parent-to-child transmission of information processing biases to threat is a potential causal mechanism in the family aggregation of anxiety symptoms and traits. This study is the first to investigate the link between infants’ and parents’ attention bias to dynamic threat-relevant (versus happy) emotional expressions. Moreover, the associations between infant attention and anxiety dispositions in infants and parents were explored. Using a cross-sectional design, we tested 211 infants in three age groups: 5-to-7-month-olds (n = 71), 11-to-13-month-olds (n = 73), and 17-to-19-month-olds (n = 67), and 216 parents (153 mothers). Infant and parental dwell times to angry and fearful versus happy facial expressions were measured via eye-tracking. The parents also reported on their anxiety and stress. Ratings of infant temperamental fear and distress were averaged across both parents. Parents and infants tended to show an attention bias for fearful faces with marginally longer dwell times to fearful versus happy faces. Parents dwelled longer on angry versus happy faces, whereas infants showed an avoidant pattern with longer dwell times to happy versus angry expressions. There was a significant positive association between infant and parent attention to emotional expressions. Parental anxiety dispositions were not related to their own or their infant’s attention bias. No significant link emerged between infants’ temperament and attention bias. We conclude that an association between parental and infant attention may already be evident in the early years of life, whereas a link between anxiety dispositions and attention biases may not hold in community samples.

Fearful Temperament and the Risk for Child and Adolescent Anxiety: The Role of Attention Biases and Effortful Control

Fearful temperament represents one of the most robust predictors of child and adolescent anxiety; however, not all children with fearful temperament unvaryingly develop anxiety. Diverse processes resulting from the interplay between automatic processing (i.e., attention bias) and controlled processing (i.e., effortful control) drive the trajectories toward more adaptive or maladaptive directions. In this review, we examine the associations between fearful temperament, attention bias, and anxiety, as well as the moderating effect of effortful control. Based on the reviewed literature, we propose a two-mechanism developmental model of attention bias that underlies the association between fearful temperament and anxiety. We propose that the sub-components of effortful control (i.e., attentional control and inhibitory control) play different roles depending on individuals' temperaments, initial automatic biases, and goal priorities. Our model may help resolve some of the mixed findings and conflicts in the current literature. It may also advance our knowledge regarding the cognitive mechanisms linking fearful temperament and anxiety, as well as facilitate the continuing efforts in identifying and intervening with children who are at risk. Finally, we conclude the review with a discussion on the existing limitations and then propose questions for future research.

Children's shyness and neural responses to social exclusion: Patterns of midfrontal theta power usually not observed until adolescence

Adverse peer experiences, such as social exclusion, are known risks for socioemotional problems among shy youth. Yet, little is known about how shy children and adolescents process social exclusion in the brain and whether these responses are amplified in adolescence. Using the Cyberball task, we examined mediofrontal theta (4-7 Hz) event-related EEG spectral power during conditions of fair play and social exclusion in 122 participants (58 children, ages 10-12 years, and 64 adolescents, ages 14-17 years). Age effects of the task showed that adolescents displayed heightened theta power to both outright rejection and baseline "not my turn" events, whereas children showed higher theta power to rejection compared with "not my turn" events. Further results on individual differences showed that children with relatively higher levels of shyness displayed enhanced theta power to both rejection and "not my turn" events-a pattern that also was observed in adolescents. These findings suggest that a pattern of heightened neural sensitivity to both outright social exclusion and threats of exclusion, which is the norm by adolescence, also is observed in children with higher levels of shyness. The similar neural response pattern might be driven by salient social motivations that similarly modify the social cognition and behaviors of these groups and might reflect neural antecedents of rejection sensitivity.

Vigilant or avoidant? Children's temperamental shyness, patterns of gaze, and physiology during social threat

Temperamental shyness is characterized by fear, wariness, and the perception of threat in response to social novelty. Previous work has been inconsistent regarding attentional patterns to social threat among shy children, with evidence for both avoidance and vigilance. We examined relations between children's shyness and gaze aversion during the approach of a stranger (i.e., a context of social novelty), and tested whether these patterns of gaze moderated relations between shyness and autonomic reactivity and recovery. Participants included 152 typically-developing children (M_age  = 7.82 years, SD = 0.44 years) who had their respiratory sinus arrhythmia (RSA) recorded during baseline, social novelty, and recovery. Children's shyness correlated with increases in self-reported nervousness from baseline to social novelty, providing support for perceived threat. Results revealed that children's proportion of gaze aversion from social novelty was related to shyness in a U-shape pattern such that both low levels of gaze aversion (i.e., attentional vigilance) and high levels of gaze aversion (i.e., attentional avoidance) were related to higher levels of shyness. Further, we found that children's shyness was directly related to decreases in RSA from baseline to social novelty, whereas quadratic gaze to social novelty moderated the relation between shyness and RSA recovery. Specifically, shyness was related to greater RSA recovery among children who exhibited attentional vigilance during the novel social interaction. Our findings provide support for both avoidance of, and vigilance to, social threat among different shy children, and these gaze strategies may be differentially related to physiological regulation during novel social encounters.

Toddler dysregulated fear predicts continued risk for social anxiety symptoms in early adolescence

Identifying early risk factors for the development of social anxiety symptoms has important translational implications. Accurately identifying which children are at the highest risk is of critical importance, especially if we can identify risk early in development. We examined continued risk for social anxiety symptoms at the transition to adolescence in a community sample of children (n = 112) that had been observed for high fearfulness at age 2 and tracked for social anxiety symptoms from preschool through age 6. In our previous studies, we found that a pattern of dysregulated fear (DF), characterized by high fear in low threat contexts, predicted social anxiety symptoms at ages 3, 4, 5, and 6 years across two samples. In the current study, we re-evaluated these children at 11-13 years of age by using parent and child reports of social anxiety symptoms, parental monitoring, and peer relationship quality. The scores for DF uniquely predicted adolescents' social anxiety symptoms beyond the prediction that was made by more proximal measures of behavioral (e.g., kindergarten social withdrawal) and concurrent environmental risk factors (e.g., parental monitoring, peer relationships). Implications for early detection, prevention, and intervention are discussed.

Understanding the Emergence of Social Anxiety in Children With Behavioral Inhibition

Behavioral inhibition (BI) is a temperament characterized in early childhood by distress to novelty and avoidance of unfamiliar people, and it is one of the best-known risk factors for the development of social anxiety. However, nearly 60% of children with BI do not go on to meet criteria for social anxiety disorder. In this review we present an approach to understanding differential developmental trajectories among children with BI. We review research using laboratory-based tasks that isolate specific attention processes that enhance versus mitigate risk for social anxiety among behaviorally inhibited children and studies that suggest that BI is associated with heightened detection of novelty or threat. Moreover, stimulus-driven control processes, which we term "automatic control," increase the probability that behaviorally inhibited children display socially reticent behavior and develop social anxiety. In contrast, goal-driven control processes, which we term "planful control," decrease risk for anxiety. We suggest that these three categories of processes (detection, automatic control, and planful control) function together to determine whether behaviorally inhibited children are able to flexibly regulate their initial reactions to novelty, and in turn, decrease risk for social anxiety. Although laboratory-based tasks have identified these processes underlying risk and resilience, the challenge is linking them to the emotions, thoughts, and behaviors of behaviorally inhibited children in real-world contexts.

Emerging Evidence for Putative Neural Networks and Antecedents of Pediatric Anxiety in the Fetal, Neonatal, and Infant Periods

Anxiety disorders are the most prevalent psychiatric disorders in youth and are associated with profound individual impairment and public health costs. Research shows that clinically significant anxiety symptoms manifest in preschool-aged children, and correlates of anxiety symptoms are observable in infancy. Yet, predicting who is at risk for developing anxiety remains an enduring challenge. Predictive biomarkers of anxiety are needed before school age when anxiety symptoms typically consolidate into diagnostic profiles. Increasing evidence indicates that early neural measures implicated in anxiety and anxious temperament may be incorporated with traditional measures of behavioral risk (i.e., behavioral inhibition) to provide more robust classification of pediatric anxiety problems. This review examines the phenomenology of anxiety disorders in early life, highlighting developmental research that interrogates the putative neurocircuitry of pediatric anxiety. First, we discuss enduring challenges in identifying and predicting risk for pediatric anxiety. Second, we summarize emerging evidence for putative neural antecedents and networks underlying risk for pediatric anxiety in the fetal, neonatal, and infant periods that represent novel potential avenues for risk identification and prediction. We focus on evidence examining the importance of early amygdala and extended amygdala circuitry development to the emergence of anxiety. Finally, we discuss the utility of integrating developmental psychopathology and neuroscience to facilitate future research and clinical work.

Children's sleepiness facilitates the effect of vicarious learning on the development of fear

A substantial body of research demonstrates the importance of sleep for emotional processing and learning as well as the association between sleep problems and heightened anxiety. However, there is currently no research exploring the impact of sleepiness on vicariously learned fear responses. Experiment 1 (N = 38) first demonstrated no effect of trait or state sleepiness on children's (7-11 years of age) subjective ratings of fear. Experiment 2 (N = 42) and Experiment 3 (N = 46) used an established vicarious learning paradigm to demonstrate that trait sleepiness facilitated vicariously acquired avoidance preferences for animals paired with fearful faces (fear-paired animals), whereas state sleepiness facilitated children's fear cognitions and attentional bias toward fear-paired animals. This study is the first to demonstrate the role of state and trait sleepiness in moderating vicarious fear learning in children.

PCIT engagement and persistence among child welfare-involved families: Associations with harsh parenting, physiological reactivity, and social cognitive processes at intake

Parent-Child interaction therapy (PCIT) has been shown to improve positive, responsive parenting and lower risk for child maltreatment (CM), including among families who are already involved in the child welfare system. However, higher risk families show higher rates of treatment attrition, limiting effectiveness. In N = 120 child welfare families randomized to PCIT, we tested behavioral and physiological markers of parent self-regulation and socio-cognitive processes assessed at pre-intervention as predictors of retention in PCIT. Results of multinomial logistic regressions indicate that parents who declined treatment displayed more negative parenting, greater perceptions of child responsibility and control in adult-child transactions, respiratory sinus arrhythmia (RSA) increases to a positive dyadic interaction task, and RSA withdrawal to a challenging, dyadic toy clean-up task. Increased odds of dropout during PCIT's child-directed interaction phase were associated with greater parent attentional bias to angry facial cues on an emotional go/no-go task. Hostile attributions about one's child predicted risk for dropout during the parent-directed interaction phase, and readiness for change scores predicted higher odds of treatment completion. Implications for intervening with child welfare-involved families are discussed along with study limitations.

Behavioral Inhibition in Childhood: European Portuguese Adaptation of an Observational Measure (Lab-TAB)

The assessment of behaviorally inhibited children is typically based on parent or teacher reports, but this approach has received criticisms, mainly for being prone to bias. Several researchers proposed the additional use of observational methods because they provide a direct and more objective description of the child's functioning in different contexts. The lack of a laboratory assessment of temperament for Portuguese children justifies the adaptation of some episodes of the Laboratory Temperament Assessment Battery (Lab-TAB) as an observational measure for behavioral inhibition. Method: In our study, we included 124 children aged between 3 and 9 years and their parents. The evaluation of child behavioral inhibition was made by parent report (Behavioral Inhibition Questionnaire) and through Lab-TAB episodes. Parental variables with potential influence on parents’ reports were also collected using the Social Interaction and Performance Anxiety and Avoidance Scale (SIPAAS) and the Parental Overprotection Measure (POM). Results and Discussion: The psychometric analyses provided evidence that Lab-TAB is a reliable instrument and can be incorporated in a multi-method approach to assess behavioral inhibition in studies involving Portuguese-speaking children. Moderate convergence between observational and parent report measures of behavioral inhibition was obtained. Mothers’ characteristics, as well as child age, seem to significantly affect differences between measures, being potential sources of bias in the assessment of child temperament.

Behavioral Regulatory Problems Are Associated With a Lower Attentional Bias to Fearful Faces During Infancy

To investigate the role of early regulatory problems (RP), such as problems in feeding, sleeping, and calming down during later development, the association between parent-reported RP at 3 months (no-RP, n = 110; RP, n = 66) and attention to emotional faces at 8 months was studied. Eight-month-old infants had a strong tendency to look at faces and to specifically fearful faces, and the individual variance in this tendency was assessed with eye tracking using a face-distractor paradigm. The early RPs were related to a lower attention bias to fearful faces compared to happy and neutral faces after controlling for temperamental negative affectivity. This suggests that early RPs are related to the processing of emotional information later during infancy.

Variable- and person-centered approaches to affect-biased attention in infancy reveal unique relations with infant negative affect and maternal anxiety

Affect-biased attention is an automatic process that prioritizes emotionally or motivationally salient stimuli. Several models of affect-biased attention and its development suggest that it comprises an individual's ability to both engage with and disengage from emotional stimuli. Researchers typically rely on singular tasks to measure affect-biased attention, which may lead to inconsistent results across studies. Here we examined affect-biased attention across three tasks in a unique sample of 193 infants, using both variable-centered (factor analysis; FA) and person-centered (latent profile analysis; LPA) approaches. Using exploratory FA, we found evidence for two factors of affect-biased attention: an Engagement factor and a Disengagement factor, where greater maternal anxiety was related to less engagement with faces. Using LPA, we found two groups of infants with different patterns of affect-biased attention: a Vigilant group and an Avoidant group. A significant interaction noted that infants higher in negative affect who also had more anxious mothers were most likely to be in the Vigilant group. Overall, these results suggest that both FA and LPA are viable approaches for studying distinct questions related to the development of affect-biased attention, and set the stage for future longitudinal work examining the role of infant negative affect and maternal anxiety in the emergence of affect-biased attention.

Psychometric properties of threat-related attentional bias in young children using eye-tracking

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.

Capturing temporal dynamics of fear behaviors on a moment-to-moment basis

Identifying patterns of fearful behaviors early and accurately is essential to identify children who may be at increased risk for psychopathology. Previous work focused on the total amount of fear by using composites across time. However, considering the temporal dynamics of fear expression might offer novel insights into the identification of children at risk. One hundred and twenty-five toddlers participated in high- and low-fear tasks. Data were modeled using a novel two-step approach. First, a hidden Markov model estimated latent fear states and transitions across states over time. Results revealed children's behavior was best represented by six behavioral states. Next, these states were analyzed using sequence clustering to identify groups of children with similar dynamic trajectories through the states. A four-cluster solution found groups of children varied in fear response and regulation process: "external regulators" (using the caregiver as a regulation tool), "low reactive" (low reaction to stimulus), "fearful explorers" (managing their own internal state with minimal assistance from the caregiver), and "high fear" (fearful/at-caregiver state regardless of task). The combination of analytic tools enabled fine-grained examination of the processes of fearful temperament. These insights may help prevention programs target behaviors that perpetuate anxious behavior in the moment.

Attention bias to reward predicts behavioral problems and moderates early risk to externalizing and attention problems

The current study had three goals. First, we replicated recent evidence that suggests a concurrent relation between attention bias to reward and externalizing and attention problems at age 7. Second, we extended these findings by examining the relations between attention and behavioral measures of early exuberance (3 years), early effortful control (4 years), and concurrent effortful control (7 years), as well as later behavioral problems (9 years). Third, we evaluated the role of attention to reward in the longitudinal pathways between early exuberance and early effortful control to predict externalizing and attention problems. Results revealed that attention bias to reward was associated concurrently and longitudinally with behavioral problems. Moreover, greater reward bias was concurrently associated with lower levels of parent-reported effortful control. Finally, attention bias to reward moderated the longitudinal relations between early risk factors for behavioral problems (gender, exuberance, and effortful control) and later externalizing and attention problems, such that these early risk factors were most predictive of behavioral problems for males with a large attention bias to reward. These findings suggest that attention bias to reward may act as a moderator of early risk, aiding the identification of children at the highest risk for later behavioral problems.

Fearful Inhibition, Inhibitory Control, and Maternal Negative Behaviors During Toddlerhood Predict Internalizing Problems at Age 6

Many, but not all, young children with high levels of fearful inhibition will develop internalizing problems. Individual studies have examined either child regulatory or environmental factors that might influence the level of risk. We focused on the interaction of regulation and environment by assessing how early fearful inhibition at age 2, along with inhibitory control and maternal negative behaviors at age 3, interactively predicted internalizing problems at age 6. A total of 218 children (105 boys, 113 girls) and their mothers participated in the study. Results indicated a three-way interaction among fearful inhibition, inhibitory control, and maternal negative behaviors. The correlation between fearful inhibition and internalizing was significant only when children had low inhibitory control and experienced high levels of maternal negative behaviors. Either having high inhibitory control or experiencing low maternal negative behaviors buffered against the adverse effect caused by the absence of the other. These findings highlight the importance of considering associations among both within-child factors and environmental factors in studying children's socioemotional outcomes.

Stationary and ambulatory attention patterns are differentially associated with early temperamental risk for socioemotional problems: Preliminary evidence from a multimodal eye-tracking investigation

Behavioral Inhibition (BI) is a temperament type that predicts social withdrawal in childhood and anxiety disorders later in life. However, not all BI children develop anxiety. Attention bias (AB) may enhance the vulnerability for anxiety in BI children, and interfere with their development of effective emotion regulation. In order to fully probe attention patterns, we used traditional measures of reaction time (RT), stationary eye-tracking, and recently emerging mobile eye-tracking measures of attention in a sample of 5- to 7-year-olds characterized as BI (N = 23) or non-BI (N = 58) using parent reports. There were no BI-related differences in RT or stationary eye-tracking indices of AB in a dot-probe task. However, findings in a subsample from whom eye-tracking data were collected during a live social interaction indicated that BI children (N = 12) directed fewer gaze shifts to the stranger than non-BI children (N = 25). Moreover, the frequency of gazes toward the stranger was positively associated with stationary AB only in BI, but not in non-BI, children. Hence, BI was characterized by a consistent pattern of attention across stationary and ambulatory measures. We demonstrate the utility of mobile eye-tracking as an effective tool to extend the assessment of attention and regulation to social interactive contexts.

Effects of early maternal care on adolescent attention bias to threat in nonhuman primates

Attention bias towards threat using dot-probe tasks has mainly been reported in adults with stress-related disorders such as PTSD and other anxiety disorders, in some cases associated with early life stress or traumatic experiences. Studies during adolescence are scarce and inconsistent, which highlights the need to increase our understanding of the developmental processes that predict attentional biases, given that this is a time of emergence of psychopathology. Here, we use a translational nonhuman primate model of early life stress in the form of infant maltreatment to examine its long-term impact on attentional biases during adolescence using the dot-probe task and identify interactions with early life risk factors, such as prenatal exposure to stress hormones and emotional/stress reactivity during infancy. Maltreated animals showed higher reaction times to social threat than animals that experienced competent maternal care, suggesting interference of negative valence stimuli on attentional control and cognitive processes. Higher emotional reactivity during infancy in Maltreated animals predicted attention bias towards threat, whereas higher levels of prenatal cortisol exposure was associated with bias away (avoidance of) threat in maltreated and control groups. Our findings suggest that different postnatal experiences and early biobehavioral mechanisms regulate the development of emotional attention biases during adolescence.

Associations Between Attentional Bias and Interpretation Bias and Change in School Concerns and Anxiety Symptoms During the Transition from Primary to Secondary School

The transition from primary to secondary school is often associated with a period of heightened anxiety and worry. For most children, any feelings of anxiety subside relatively quickly but for a small minority, emotional difficulties can continue into the first year of secondary school and beyond. This study recruited 109 children and measured their anxiety symptoms and school concerns toward the end of primary school and again at the end of their first term of secondary school. We investigated for the first time whether pre-transition measures of attentional and interpretation bias, and the magnitude of change in attentional bias toward and away from threat stimuli were associated with pre- and post-transition measures of anxiety and school concerns, and the change in these measures over time. Over 50% of the current sample exceeded clinical levels of anxiety at pre-transition. However, anxiety symptoms and school concerns had significantly reduced by post-transition. Higher levels of pre-transition anxiety or school concerns, and a greater magnitude of change in attentional bias towards threat stimuli predicted a larger reduction in anxiety symptoms and school concerns across the transition period. A greater interpretation bias toward threat was associated with higher pre-transition anxiety symptoms and school concerns but not post-transition scores, or the change in these scores. While many children experience heightened anxiety prior to school transition, this appears to be largely temporary and self-resolves. Nonetheless, the current findings highlight the importance of monitoring children's anxiety and concerns, and related cognitive processes during this important transition period.

Maternal comforting behavior, toddlers' dysregulated fear, and toddlers' emotion regulatory behaviors

Developmental theories of emotion regulation suggest that influences from both extrinsic (e.g., from caregivers) and intrinsic (i.e., temperament) sources contribute to children's displays of emotion regulatory behaviors. Very few studies have examined specific caregiver behaviors in relation to specific regulatory behaviors. Further, few empirical investigations have tested theoretical notions that temperament may be an important context in which to understand the nature of the relation between caregiver behavior and toddlers' regulatory behaviors. The current study examined the specific maternal behavior of physical comfort in relation to three regulatory strategies exhibited by toddlers (attention-shifting, caregiver-focused behavior, and self-focused behavior) in 117 pairs of mothers and their 24-month-old toddlers. Further, we tested the temperament dimension of dysregulated fear, a more recent derivation of behavioral inhibition, both in relation to regulatory efforts and as a moderator of relations between maternal comforting and toddler regulatory behaviors. Dysregulated fear related directly and positively to attention-shifting, and it moderated the relation between maternal comforting and both caregiver-focused and self-focused behaviors. This study provides new evidence of the importance of both extrinsic and intrinsic correlates of emotion regulation in early childhood. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Threat-related Attention Bias in Socioemotional Development: A Critical Review and Methodological Considerations

Cross-sectional evidence suggests that attention bias to threat is linked to anxiety disorders and anxiety vulnerability in both children and adults. However, there is a lack of developmental evidence regarding the causal mechanisms through which attention bias to threat might convey risks for socioemotional problems, such as anxiety. Gaining insights into this question demands longitudinal research to track the complex interplay between threat-related attention and socioemotional functioning. Developing and implementing reliable and valid assessments tools is essential to this line of work. This review presents theoretical accounts and empirical evidence from behavioral, eye-tracking, and neural assessments of attention to discuss our current understanding of the development of normative threat-related attention in infancy, as well as maladaptive threat-related attention patterns that may be associated with the development of anxiety. This review highlights the importance of measuring threat-related attention using multiple attention paradigms at multiple levels of analysis. In order to understand if and how threat-related attention bias in real-life, social interactive contexts can predict socioemotional development outcomes, this review proposes that future research cannot solely rely on screen-based paradigms but needs to extend the assessment of threat-related attention to naturalistic settings. Mobile eye-tracking technology provides an effective tool for capturing threat-related attention processes in vivo as children navigate fear-eliciting environments and may help us uncover more proximal bio-psycho-behavioral markers of anxiety.

Relations of emotion-related temperamental characteristics to attentional biases and social functioning

The current study examined whether an important temperamental characteristic, effortful control (EC), moderates the associations between dispositional anger and sadness, attention biases, and social functioning in a group of preschool-aged children (N = 77). Preschoolers' attentional biases toward angry and sad facial expressions were assessed using eye-tracking, and we obtained teachers' reports of children's temperament and social functioning. Associations of dispositional anger and sadness with time looking at relevant negative emotional stimuli were moderated by children's EC, but relations between time looking at emotional faces and indicators of social functioning, for the most part, were direct and not moderated by EC. In particular, time looking at angry faces (and low EC) predicted high levels of aggressive behaviors, whereas longer time looking at sad faces (and high EC) predicted higher social competence. Finally, latency to detect angry faces predicted aggressive behavior under conditions of average and low levels of EC. Findings are discussed in terms of the importance of differentiating between components of attention biases toward distinct negative emotions, and implications for attention training. (PsycINFO Database Record

Neural correlates of attention bias to masked facial threat cues: Examining children at-risk for social anxiety disorder

Background

Behavioral inhibition (BI) is an early-appearing temperament trait and a robust predictor of social anxiety disorder (SAD). Both BI and anxiety may have distinct patterns of emotion processing marked by heightened neural responses to threat cues. BI and anxious children display similar frontolimbic patterns when completing an emotion-face attention bias task with supraliminal presentation. Anxious children also show a distinct neural response to the same task with subliminal face presentations, probing stimulus-driven attention networks. We do not have parallel data available for BI children, limiting our understanding of underlying affective mechanisms potentially linking early BI to the later emergence of anxiety.

Method

We examined the neural response to subliminal threat presentation during an emotion-face masked dot-probe task in children oversampled for BI (N = 67; 30 BI, 9–12 yrs).

Results

Non-BI children displayed greater activation versus BI children in several regions in response to threat faces versus neutral faces, including striatum, prefrontal and temporal lobes. When comparing congruent and incongruent trials, which require attention disengagement, BI children showed greater activation than non-BI children in the cerebellum, which is implicated in rapidly coordinating information processing, aversive conditioning, and learning the precise timing of anticipatory responses.

Conclusions

Non-BI children may more readily engage rapid coordinated frontolimbic circuitry to salient stimuli, whereas BI children may preferentially engage subcortical circuitry, in response to limbic “alarms” triggered by subliminal threat cues. These data help reveal the extent to which temperamental risk shares similar neurocircuitry previously documented in anxious adolescents and young adults in response to masked threat.

•

All children displayed amygdala activation in response to brief threat cues.

•

Non-BI children displayed activation in striatum, PFC and temporal lobes.

•

BI children showed greater activation in the cerebellum.

Temporal dynamics of anxiety-related attentional bias: is affective context a missing piece of the puzzle?

Previous research has demonstrated that anxious individuals attend to negative emotional information at the expense of other information. This is commonly referred to as attentional bias. The field has historically conceived of this process as relatively static; however, research by [Zvielli, A., Bernstein, A., & Koster, E. H. W. (2014). Dynamics of attentional bias to threat in anxious adults: Bias towards and/or away? PLoS ONE, 9(8), e104025; Zvielli, A., Bernstein, A., & Koster, E. H. W. (2015). Temporal dynamics of attentional bias. Clinical Psychological Science, 3(5), 772-788.], and others, challenges this assumption by demonstrating considerable temporal variability in attentional bias amongst anxious individuals. Still, the mechanisms driving these temporal dynamics are less well known. Using a modified dot-probe task, the present study examined the impact of two relevant contextual variables- affective valence and trial repetition. Affective context was instantiated by the presentation of negative versus neutral pictures before each trial, while repetition context was achieved via the presentation of the valenced pictures in either a blocked- or mixed-trial design. Results indicate that individuals with higher trait-anxiety levels were significantly more influenced by blocked presentations of negative affective information, leading to greater temporal fluctuations in attentional bias. Furthermore, our findings provide additional evidence that attentional bias is best conceptualised as dynamic and variable, and that an individual's affective experience is one factor that regulates attentional bias dynamics. Implications relating to theoretical and methodological factors are discussed.

Developmental Relations Among Behavioral Inhibition, Anxiety, and Attention Biases to Threat and Positive Information

This study examined relations between behavioral inhibition (BI) assessed in toddlerhood (n = 268) and attention biases (AB) to threat and positive faces and maternal-reported anxiety assessed when children were 5- and 7-year-old. Results revealed that BI predicted anxiety at age 7 in children with AB toward threat, away from positive, or with no bias, at age 7; BI did not predict anxiety for children displaying AB away from threat or toward positive. Five-year AB did not moderate the link between BI and 7-year anxiety. No direct association between AB and BI or anxiety was detected; moreover, children did not show stable AB across development. These findings extend our understanding of the developmental links among BI, AB, and anxiety.

Maternal anxiety predicts attentional bias towards threat in infancy

Although cognitive theories of psychopathology suggest that attention bias toward threat plays a role in the etiology and maintenance of anxiety, there is relatively little evidence regarding individual differences in the earliest development of attention bias toward threat. The current study examines attention bias toward threat during its potential first emergence by evaluating the relations between attention bias and known risk factors of anxiety (i.e., temperamental negative affect and maternal anxiety). We measured attention bias to emotional faces in infants (N = 98; 57 male) ages 4 to 24 months during an attention disengagement eye-tracking paradigm. We hypothesized that (a) there would be an attentional bias toward threat in the full sample of infants, replicating previous studies; (b) attentional bias toward threat would be positively related to maternal anxiety; and (c) attention bias toward threat would be positively related to temperamental negative affect. Finally, (d) we explored the potential interaction between temperament and maternal anxiety in predicting attention bias toward threat. We found that attention bias to the affective faces did not change with age, and that bias was not related to temperament. However, attention bias to threat, but not attention bias to happy faces, was positively related to maternal anxiety, such that higher maternal anxiety predicted a larger attention bias for all infants. These findings provide support for attention bias as a putative early mechanism by which early markers of risk are associated with socioemotional development. (PsycINFO Database Record

Attention bias to threat in mothers with emotional disorders predicts increased offspring anxiety symptoms: a joint cross-sectional and longitudinal analysis

There is convincing evidence of the transmission of anxiety and depression from parents to children; however, mechanisms by which this vulnerability is passed on are unclear. Cognitive models and a small body of cross-sectional research suggest that parental attention biases (ABs) may be one mechanism involved in transmission. Longitudinal associations of maternal and offspring ABs with offspring symptoms have been scarcely studied. Forty-three mothers-child dyads were included. All children (7-12 years old) were diagnosis-free while 24 mothers had a lifetime emotional disorder (anxiety or depression) (high risk, HR) and 19 mothers had no psychiatric diagnoses (low risk, LR). This study examined cross-sectional and longitudinal associations of maternal and child AB and child anxiety symptomology at initial and 12-month assessments. ABs were assessed using a visual-probe task with emotional faces. There was a significant cross-sectional but not longitudinal association of increased child anxiety symptoms with increased maternal threat AB for HR but not LR dyads. At the cross-sectional level, increases in HR but not LR offspring anxiety symptomology were associated with maternal threat AB. Larger longitudinal studies are required that examine the interplay between parent-child variables and include multiple time-points of assessment and measures of AB.

Attention to Threat as a Predictor of Shyness in the Context of Internalizing and Externalizing Problems

The duration of children's attention to putative threat has been documented as a consistent predictor of later anxiety in inhibited children across childhood (Fox, 2010; Perez-Edgar & Fox, 2005). However, attention to threat has not been broadly examined within existing behavioral contexts, and has seldom been studied in very early childhood. Whereas toddlers with high levels of internalizing behavior may view fear-inducing stimuli as a threat, toddlers with high levels of externalizing behavior may demonstrate attention out of interest or sensation seeking. Thus, attention to threat was expected to predict increased toddler shyness in the context of either high internalizing problems or low externalizing behavior. We examined 117 24-month-old toddlers to determine whether attention to threat interacted with internalizing and externalizing behavior at 24 months of age to predict toddler shyness one year later. Results indicated that attention to threat predicted toddlers' lower shyness at 36 months when toddlers' externalizing behavior at age 24 months were high, but there was no significant interaction between toddlers' internalizing behavior and their attention to threat in predicting later shyness. These results expand our understanding of the contexts in which attention to threat in early childhood is a viable predictor of later shyness.

A developmental neuroscience perspective on affect-biased attention

There is growing interest regarding the impact of affect-biased attention on psychopathology. However, most of the research to date lacks a developmental approach. In the present review, we examine the role affect-biased attention plays in shaping socioemotional trajectories within a developmental neuroscience framework. We propose that affect-biased attention, particularly if stable and entrenched, acts as a developmental tether that helps sustain early socioemotional and behavioral profiles over time, placing some individuals on maladaptive developmental trajectories. Although most of the evidence is found in the anxiety literature, we suggest that these relations may operate across multiple domains of interest, including positive affect, externalizing behaviors, drug use, and eating behaviors. We also review the general mechanisms and neural correlates of affect-biased attention, as well as the current evidence for the co-development of attention and affect. Based on the reviewed literature, we propose a model that may help us better understand the nuances of affect-biased attention across development. The model may serve as a strong foundation for ongoing attempts to identify neurocognitive mechanisms and intervene with individuals at risk. Finally, we discuss open issues for future research that may help bridge existing gaps in the literature.

Napping reduces emotional attention bias during early childhood

Sleep loss alters processing of emotional stimuli in preschool-aged children. However, the mechanism by which sleep modifies emotional processing in early childhood is unknown. We tested the hypothesis that a nap, compared to an equivalent time spent awake, reduces biases in attention allocation to affective information. Children (n = 43; M = 55.40 months, SD = 8.05 months) completed a Dot Probe task, which provides a measure of attention biases to emotional stimuli, following a mid-day nap and an equivalent interval spent awake. No emotional attention biases emerged when children napped. However, when nap-deprived, children exhibited biases towards negative and positive stimuli. This emotional bias after wake was greater in children who napped habitually. Gender differences also emerged such that females were more attentive to positive emotional stimuli whereas males showed heightened attention to negative emotional stimuli, regardless of having napped or not. Moreover, greater slow wave activity (SWA) during the nap was associated with faster responding, which suggests that SWA may promote efficiency of attention allocation. A video abstract of this article can be viewed at: https://www.youtube.com/watch?v=JIoZ8mzxQgg.

Neural correlates of attention biases, behavioral inhibition, and social anxiety in children: An ERP study

Behavioral inhibition (BI) is a biologically-based temperament characterized by vigilance toward threat. Over time, many children with BI increasingly fear social circumstances and display maladaptive social behavior. BI is also one of the strongest individual risk factors for developing social anxiety disorder. Although research has established a link between BI and anxiety, its causal mechanism remains unclear. Attention biases may underlie this relation. The current study examined neural markers of the BI-attention-anxiety link in children ages 9-12 years (N=99, Mean=9.97, SD=0.97). ERP measures were collected as children completed an attention-bias (dot-probe) task with neutral and angry faces. P2 and N2 amplitudes were associated with social anxiety and attention bias, respectively. Specifically, augmented P2 was related to decreased symptoms of social anxiety and moderated the relation between BI and social anxiety, suggesting that increasing attention mobilization may serve as a compensatory mechanism that attenuates social anxiety in individuals with high BI. The BI by N2 interaction found that larger N2 related to threat avoidance with increasing levels of BI, consistent with over-controlled socio-emotional functioning. Lastly, children without BI (BN) showed an augmented P1 to probes replacing angry faces, suggesting maintenance of attentional resources in threat-related contexts.

Improving the Prediction of Risk for Anxiety Development in Temperamentally Fearful Children

Pediatric anxiety disorders are among the most common disorders in children and adolescence resulting in both short-term and long-term negative consequences across a variety of domains including social and academic. Early fearful temperament has emerged as a strong predictor of anxiety development in childhood; however, not all fearful children become anxious. The current article summarizes theory and evidence for heterogeneity in the identification of temperamentally fearful children and trajectories of risk for anxiety. The findings presented in this article reveal that identification of subgroups of fearful temperament improves prediction of who is at risk for developing anxiety problems.

Patterns of attention to threat across tasks in behaviorally inhibited children at risk for anxiety

Although attention bias towards threat has been causally implicated in the development and maintenance of fear and anxiety, the expected associations do not appear consistently. Reliance on a single task to capture attention bias, in this case overwhelmingly the dot-probe task, may contribute to this inconsistency. Comparing across attentional bias measures could help capture patterns of behavior that have implications for anxiety. This study examines the patterns of attentional bias across two related measures in a sample of children at temperamental risk for anxiety. Children (Mean_age = 10.19 ± 0.96) characterized as behaviorally inhibited (N = 50) or non-inhibited (N = 64) via parent-report completed the dot-probe and affective Posner tasks to measure attentional bias to threat. Parent-report diagnostic interviews assessed children's social anxiety. Behavioral inhibition was not associated with performance in the dot-probe task, but was associated with increased attentional bias to threat in the affective Posner task. Cross-task convergence was dependent on temperament, such that attention bias across the two tasks was only related in behaviorally inhibited children. Finally, children who were consistently biased across tasks (showing high or low attentional bias scores in both tasks, rather than high in one but low in the other) had higher levels of anxiety. Convergence across attention bias measures may be dependent on individuals' predispositions (e.g. temperament). Moreover, convergence of attention bias across measures may be a stronger marker of information processing patterns that shape socioemotional outcomes than performance in a single task.