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Bocanegra ES, Chang SW, Rozenman M, Lee SS, Delgadillo D, Chavira DA. Attention Bias and Anxiety: The Moderating Effect of Sociocultural Variables in Rural Latinx Youth. Community Ment Health J 2023; 59:1465-1478. [PMID: 37148436 PMCID: PMC10598104 DOI: 10.1007/s10597-023-01132-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 04/24/2023] [Indexed: 05/08/2023]
Abstract
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.
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Affiliation(s)
- Elizabeth S Bocanegra
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Los Angeles, CA, 90095, USA.
| | - Susanna W Chang
- Division of Child and Adolescent Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | | | - Steve S Lee
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Desiree Delgadillo
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Denise A Chavira
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Los Angeles, CA, 90095, USA
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2
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Palumbo IM, Patrick CJ, Latzman RD. Psychopathology in children: The transdiagnostic contribution of affiliative capacity and inhibitory control. Dev Psychopathol 2023; 35:1627-1642. [PMID: 35678172 DOI: 10.1017/s0954579422000347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Recent initiatives have focused on integrating transdiagnostic biobehavioral processes or dispositions with dimensional models of psychopathology. Toward this goal, biobehavioral traits of affiliative capacity (AFF) and inhibitory control (INH) hold particular promise as they demonstrate transdiagnostic stability and predictive validity across developmental stages and differing measurement modalities. The current study employed data from different modes of measurement in a sample of 1830 children aged 5-10 years to test for associations of AFF and INH, individually and interactively, with broad dimensions of psychopathology. Low AFF, assessed via parent-report, evidenced predictive relations with distress- and externalizing-related problems. INH as assessed by cognitive-task performance did not relate itself to either psychopathology dimension, but it moderated the effects observed for low AFF, such that high INH protected against distress symptoms in low-AFF participants, whereas low INH amplified distress and externalizing symptoms in low-AFF participants. Results are discussed in the context of the interface of general trait transdiagnostic risk factors with quantitatively derived dimensional models of psychopathology.
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3
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Rapee RM, Creswell C, Kendall PC, Pine DS, Waters AM. Anxiety disorders in children and adolescents: A summary and overview of the literature. Behav Res Ther 2023; 168:104376. [PMID: 37499294 DOI: 10.1016/j.brat.2023.104376] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
Considerable work has advanced understanding of the nature, causes, management, and prevention of anxiety disorders in children and adolescents over the past 30 years. Prior to this time the primary focus was on school refusal and specific phobias. It is now recognised that children and adolescents experience the full gamut of anxiety disorders in very similar ways to adults and that anxiety disorders in the paediatric years can predict a lifelong mental-health struggle. Given the vast array of specific studies in this field, the current review summarises current knowledge about these high prevalence disorders, points to overarching limitations, and suggests potentially important future directions. Following a brief historical overview, the review summarises knowledge about demographic and epidemiological characteristics, distal and proximal risk factors, current treatment directions, and prevention. There is still a great deal to learn about the causes and treatments of child and adolescent anxiety disorders. By amalgamating our current knowledge, this review provides a window to the research directions that are likely to lead to future advances.
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Affiliation(s)
- Ronald M Rapee
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, Australia.
| | - Cathy Creswell
- Departments of Psychiatry and Experimental Psychology, University of Oxford, Oxford, UK
| | - Philip C Kendall
- Department of Psychology, Temple University, Child and Adolescent Anxiety Disorders Clinic, USA
| | - Daniel S Pine
- National Institute of Mental Health Intramural Research Program (NIMH-IRP), USA
| | - Allison M Waters
- School of Applied Psychology, Griffith University, Brisbane, Australia
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4
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Liu R, Bell MA. Fearful temperament in middle childhood predicts adolescent attention bias and anxiety symptoms: The moderating role of frontal EEG asymmetry. Dev Psychopathol 2023; 35:1335-1345. [PMID: 34895372 PMCID: PMC9189245 DOI: 10.1017/s0954579421001231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
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.
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Affiliation(s)
- Ran Liu
- The Division of Child and Adolescent Psychiatry, Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, USA
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5
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Dennis Tiwary TA, Cho H, Myruski S. Effects of attention bias modification for anxiety: Neurophysiological indices and moderation by symptom severity. Clin Neurophysiol 2023; 147:45-57. [PMID: 36642007 PMCID: PMC9974920 DOI: 10.1016/j.clinph.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 12/06/2022] [Accepted: 12/15/2022] [Indexed: 12/31/2022]
Abstract
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.
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Affiliation(s)
- Tracy A Dennis Tiwary
- Department of Psychology, Hunter College, City University of New York, USA; Department of Psychology, The Graduate Center, City University of New York, USA.
| | - Hyein Cho
- Department of Neurology, NYU Grossman School of Medicine, USA
| | - Sarah Myruski
- Department of Psychology, The Pennsylvania State University, USA
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6
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Jónsdóttir LK, Neufeld J, Falck-Ytter T, Kleberg JL. Autistic Children Quickly Orient Away from Both Eyes and Mouths During Face Observation. J Autism Dev Disord 2023; 53:495-502. [PMID: 35138557 PMCID: PMC9889486 DOI: 10.1007/s10803-021-05378-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 02/04/2023]
Abstract
Studies have supported two different hypotheses of reduced eye gaze in people with ASD; gaze avoidance and gaze indifference, while less is known about the role of anxiety. We tested these hypotheses using an eye-tracking paradigm that cued the eyes or mouth of emotional faces. Autistic children (n = 12, mean age 7 years) looked faster away from both eyes and mouths than controls (n = 22). This effect was not explained by anxiety symptoms. No difference was found in latency towards either area. These results indicate that attentional avoidance of autistic children is not specific to eyes, and that they do not show attentional indifference to eyes compared to controls. Atypicalities in visual scanning in ASD are possibly unrelated to specific facial areas.
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Affiliation(s)
- Lilja Kristín Jónsdóttir
- grid.8993.b0000 0004 1936 9457Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Box 1225, 751 42 Uppsala, Sweden
| | - Janina Neufeld
- grid.4714.60000 0004 1937 0626Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Centre for Psychiatry Research, Department of Women’s & Children’s Health, Karolinska Institutet & Region Stockholm, Stockholm, Sweden
| | - Terje Falck-Ytter
- grid.4714.60000 0004 1937 0626Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Centre for Psychiatry Research, Department of Women’s & Children’s Health, Karolinska Institutet & Region Stockholm, Stockholm, Sweden ,grid.8993.b0000 0004 1936 9457Development and Neurodiversity Lab, Department of Psychology, Uppsala University, Uppsala, Sweden ,grid.462826.c0000 0004 5373 8869Swedish Collegium for Advanced Study (SCAS), Uppsala, Sweden
| | - Johan Lundin Kleberg
- grid.4714.60000 0004 1937 0626Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Region Stockholm, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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7
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The Feasibility, Acceptability, and Efficacy of Positive Search Training for Irritable Youth: A Single-Case Experimental Design. BEHAVIOUR CHANGE 2022. [DOI: 10.1017/bec.2022.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Although irritability is common in youth, research on treatment is in its infancy. Threat biases are more pronounced in irritable compared to low irritable youth, similar to evidence found in anxious youth. Therefore, interventions targeting these biases may be promising for reducing irritability. This study utilised a multiple baseline case series design to determine the feasibility, acceptability, and efficacy of positive search training (PST) for irritable children. Three children were included who met criteria for a principal diagnosis of Disruptive Mood Dysregulation Disorder (DMDD), and a secondary diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) or Major Depressive Disorder (MDD). PST was feasible with two of the three participants; one child refused to continue after one session. For the two participants who completed PST, acceptability was stable with moderate-to-high ratings of engagement and enjoyment, and high and stable treatment-relevant verbalisations of the key strategies. Both cases showed declines in DMDD severity across treatment and no longer met criteria at post-treatment. Both participants met criteria for Oppositional Defiant Disorder (ODD) at post-treatment (considered less severe for irritability than DMDD). Declines in parent-reported irritability occurred for both cases, however some returns to baseline were observed. Overall, PST for irritable youth shows promise as an acceptable and feasible intervention. Further studies are needed combining PST with strategies for secondary diagnoses, given its high comorbidity with disruptive behaviour disorders.
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The Effects of Self-Perceived Parenting Attitudes on Visuo-Spatial Attention and Mental Rotation Abilities among Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148841. [PMID: 35886692 PMCID: PMC9316287 DOI: 10.3390/ijerph19148841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/13/2022] [Accepted: 07/19/2022] [Indexed: 11/30/2022]
Abstract
Highlights Abstract The present study aimed to investigate the effect of adolescents’ perceived negative evaluation of parenting on their visuo-spatial attention and mental rotation abilities. The useful field of view (UFOV) and mental rotation tasks were used to measure visuo-spatial attention and mental rotation abilities among adolescents. The experimental groups were divided into the negatively evaluating group (MAge = 18.44, SD = 0.87, 20.7% girls) and positively evaluating group (MAge = 18.40, SD = 0.81, 23.3% girls) based on their scores on the self-perceived parenting attitude scales. The UFOV task showed lesser accuracy of the negatively evaluating group when compared to the positively evaluating one in target perception presented in 20° visual angle, indicating a deteriorated visuo-spatial attention ability in the negatively evaluating group. In the mental rotation task, the negatively evaluating group exhibited a small trade-off effect between response times and rotation angles, which implied an impatient strategy was employed to perform the task, whereas such a trade-off was not observed in the positively evaluating group. Thus, both experimental groups differed in terms of their visual attention and mental spatial abilities. This study suggests that the reduced visuo-spatial attention and mental rotation abilities may act as precursors for serious psychological symptoms caused by the negative self-evaluation of their parents’ parenting attitudes.
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Abstract
Over the past 30 years, attentional bias for body shape and weight content has been implicated in the precipitation and maintenance of body dissatisfaction and eating disorders. Although the existence of this bias toward body stimuli is well-established in female populations, it is comparatively understudied in men. This review aimed to examine the nature of this visual attentional bias toward male bodies in male samples across a range of different attentional paradigms, including eye-tracking, dot-probe, and the visual search task. Results were heterogenous, finding some evidence that men with higher body dissatisfaction and eating disorder symptoms demonstrated an attentional bias toward desirable bodies of other men, and undesirable features of their own bodies. These results suggest that schematic cognitive models of body dissatisfaction and eating disorders body may also be applicable to men, however more research is needed.
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10
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Does irritability predict attention biases toward threat among clinically anxious youth? Eur Child Adolesc Psychiatry 2022:10.1007/s00787-022-01954-3. [PMID: 35138476 DOI: 10.1007/s00787-022-01954-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 01/27/2022] [Indexed: 11/03/2022]
Abstract
Aberrant threat processing is a known cognitive characteristic of anxiety disorders and irritability. Youth with more severe symptomatology show greater allocation of attention towards threat relative to neutral stimuli. Although irritability contributes to poorer outcomes among anxious youths, irritability has not been considered as a contributing factor to threat processing in anxiety disorders. Thus, the current study examined the role of irritability in predicting attention biases for threat among clinically anxious youth. Our study included 84 clinically anxious youth (M = 9.31 years old, SD = 2.44) who completed a dot-probe task to determine attention biases. Anxiety disorders were assessed using semi-structured diagnostic interviews. Well validated measures were used to assess the severity of anxiety and irritability symptoms via child- and parent-report, respectively. Findings indicated that more severe irritability predicted greater attention biases toward threat among clinically anxious youth, covarying for age, anxiety severity, and the number of comorbid diagnoses. At a trend-level, anxiety severity also predicted attention bias for threat. Among clinically anxious youth, irritability severity was the strongest predictor of attention bias toward threat. Findings point to the salience of irritability, and to some extent anxiety severity, in relation to threat processing among youth with clinical anxiety disorders.
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11
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Rowlands K, Grafton B, Cerea S, Simic M, Hirsch C, Cruwys T, Yellowlees R, Treasure J, Cardi V. A multifaceted study of interpersonal functioning and cognitive biases towards social stimuli in adolescents with eating disorders and healthy controls. J Affect Disord 2021; 295:397-404. [PMID: 34500369 DOI: 10.1016/j.jad.2021.07.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 07/02/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cognitive biases towards social stimuli have been identified as one of the putative modifiable mechanisms to remediate interpersonal difficulties in adolescents with mental disorders. However, evidence for these biases in adolescents with eating disorders is scarce. METHODS This study assessed interpersonal sensitivity, cognitive biases towards social stimuli, and quantity and quality of social group memberships in adolescents with eating disorders (n = 80), compared to healthy controls (n = 78), and examined whether a negative interpretation bias would mediate the relationship between interpersonal sensitivity, eating disorder symptoms and positive group memberships. RESULTS Adolescents with eating disorders displayed greater interpersonal awareness, negative interpretation biases of ambiguous social information and poorer quality relationships with their social groups compared to healthy controls. In a simple mediation model, interpersonal awareness predicted eating disorder symptoms, and this effect was partially mediated by a negative interpretation bias. CONCLUSIONS Psychological interventions which aim to reduce a negative interpretation bias might help to reduce the severity of eating disorder symptoms in adolescents with eating disorders.
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Affiliation(s)
- Katie Rowlands
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Ben Grafton
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Australia
| | - Silvia Cerea
- Department of General Psychology, University of Padova, Italy
| | - Mima Simic
- Child and Adolescent Eating Disorders Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Colette Hirsch
- Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Tegan Cruwys
- Research School of Psychology, The Australian National University, Canberra ACT 2601, Australia
| | - Robyn Yellowlees
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Valentina Cardi
- Department of General Psychology, University of Padova, Italy
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12
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Liu Y, Zhou D, Geng X. Can closed-off management in communities alleviate the psychological anxiety and stress caused by the COVID-19 pandemic? Int J Health Plann Manage 2021; 37:228-241. [PMID: 34525258 PMCID: PMC8652683 DOI: 10.1002/hpm.3330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 12/03/2022] Open
Abstract
Since the outbreak of the novel coronavirus (COVID‐19) pandemic, the number of individuals infected with the COVID‐19 has been increasing worldwide, posed a substantial threat to mental health. Therefore, discovering the means for blocking the transmission path of COVID‐19 and improving mental health is of great significance. Based on a survey on the life of urban and rural residents in China (in 2020), the study applied the least squares method to analyse the effect of closed‐off management on the psychological anxiety and psychological stress caused by the COVID‐19 pandemic. Furthermore, the bootstrap decomposition method was used to test for the mediating effects of satisfaction with and confidence in pandemic prevention. The study found that closed‐off management in communities exerted a negative effect on psychological anxiety and stress caused by the COVID‐19 pandemic. Additionally, satisfaction with and confidence in pandemic prevention played a mediating role on the psychological anxiety and stress caused by the COVID‐19 pandemic. Therefore, closed‐off management in communities will not only prevent the spread of the COVID‐19, but also improve satisfaction with and confidence in pandemic prevention and control. Furthermore, it will alleviate the psychological anxiety and stress caused by the COVID‐19 pandemic.
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Affiliation(s)
- Yiwei Liu
- School of Government, Central University of Finance and Economics, Beijing, China
| | - Deshui Zhou
- School of Finance and Public Management, Anhui University of Finance & Economics, Bengbu, China
| | - Ximei Geng
- School of Government, Central University of Finance and Economics, Beijing, China
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13
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Fearful Temperament and the Risk for Child and Adolescent Anxiety: The Role of Attention Biases and Effortful Control. Clin Child Fam Psychol Rev 2021; 23:205-228. [PMID: 31728796 DOI: 10.1007/s10567-019-00306-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
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.
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14
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Chan HL, Low I, Chen LF, Chen YS, Chu IT, Hsieh JC. A novel beamformer-based imaging of phase-amplitude coupling (BIPAC) unveiling the inter-regional connectivity of emotional prosody processing in women with primary dysmenorrhea. J Neural Eng 2021; 18. [PMID: 33691295 DOI: 10.1088/1741-2552/abed83] [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] [Received: 10/27/2020] [Accepted: 03/10/2021] [Indexed: 12/30/2022]
Abstract
Objective. Neural communication or the interactions of brain regions play a key role in the formation of functional neural networks. A type of neural communication can be measured in the form of phase-amplitude coupling (PAC), which is the coupling between the phase of low-frequency oscillations and the amplitude of high-frequency oscillations. This paper presents a beamformer-based imaging method, beamformer-based imaging of PAC (BIPAC), to quantify the strength of PAC between a seed region and other brain regions.Approach. A dipole is used to model the ensemble of neural activity within a group of nearby neurons and represents a mixture of multiple source components of cortical activity. From ensemble activity at each brain location, the source component with the strongest coupling to the seed activity is extracted, while unrelated components are suppressed to enhance the sensitivity of coupled-source estimation.Main results. In evaluations using simulation data sets, BIPAC proved advantageous with regard to estimation accuracy in source localization, orientation, and coupling strength. BIPAC was also applied to the analysis of magnetoencephalographic signals recorded from women with primary dysmenorrhea in an implicit emotional prosody experiment. In response to negative emotional prosody, auditory areas revealed strong PAC with the ventral auditory stream and occipitoparietal areas in the theta-gamma and alpha-gamma bands, which may respectively indicate the recruitment of auditory sensory memory and attention reorientation. Moreover, patients with more severe pain experience appeared to have stronger coupling between auditory areas and temporoparietal regions.Significance. Our findings indicate that the implicit processing of emotional prosody is altered by menstrual pain experience. The proposed BIPAC is feasible and applicable to imaging inter-regional connectivity based on cross-frequency coupling estimates. The experimental results also demonstrate that BIPAC is capable of revealing autonomous brain processing and neurodynamics, which are more subtle than active and attended task-driven processing.
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Affiliation(s)
- Hui-Ling Chan
- Department of Computer Science, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Intan Low
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Integrated Brain Research Unit, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Li-Fen Chen
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Integrated Brain Research Unit, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yong-Sheng Chen
- Department of Computer Science, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Ian-Ting Chu
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jen-Chuen Hsieh
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Integrated Brain Research Unit, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
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15
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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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Rutter LA, Norton DJ, Brown TA. Visual attention toward emotional stimuli: Anxiety symptoms correspond to distinct gaze patterns. PLoS One 2021; 16:e0250176. [PMID: 33983969 PMCID: PMC8118267 DOI: 10.1371/journal.pone.0250176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/31/2021] [Indexed: 11/24/2022] Open
Abstract
Decades of research have established a link between emotional disorders and attentional biases for emotional stimuli, but the relationship between symptom severity and visual attention is still not fully understood. Depression has been associated with increased attention towards dysphoric stimuli and decreased attention on positive stimuli (“negativity bias”), and some studies have also shown this trend in anxiety disorders. We examined eye fixation variables in 47 participants with emotional disorders completing an emotion recognition task. Results showed that depression severity was not associated with increased fixations on dysphoric stimuli, however, higher levels of generalized anxiety predicted increased fixations in the mouth region of sad and happy faces. Higher levels of social interaction anxiety predicted reduced fixations in the eye region of happy faces. While we did not replicate the negativity bias that has been shown in prior studies, our sample was highly comorbid, indicating the need to consider comorbidity, disorder severity, and the task itself when conducting research on visual attention in clinical samples. Additionally, more attention should be paid to the mouth region of emotional faces, as it may provide more specific information regarding the visual processing of emotions.
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Affiliation(s)
- Lauren A. Rutter
- Department of Psychological and Brain Sciences, Indiana University-Bloomington, Bloomington, Indiana, United States of America
- * E-mail:
| | - Daniel J. Norton
- Department of Psychology, Gordon College, Wenham, Massachusetts, United States of America
| | - Timothy A. Brown
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, United States of America
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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: 6] [Impact Index Per Article: 2.0] [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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Black CJ, Hogan AL, Smith KD, Roberts JE. Early behavioral and physiological markers of social anxiety in infants with fragile X syndrome. J Neurodev Disord 2021; 13:11. [PMID: 33743580 PMCID: PMC7980359 DOI: 10.1186/s11689-021-09356-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 02/16/2021] [Indexed: 12/16/2022] Open
Abstract
Background Social anxiety is highly prevalent in neurotypical children and children with fragile X syndrome (FXS). FXS is a genetic syndrome that is characterized by intellectual disability and an increased risk for autism spectrum disorder. If social anxiety is left untreated, negative outcomes are highly prevalent later in life. However, early detection of social anxiety is challenging as symptoms are often subtle or absent very early in life. Given the prevalence and impairment associated with childhood social anxiety, efforts have accelerated to identify risk markers of anxiety. A cluster of early features of anxiety have been identified including elevated behavioral inhibition, attentional biases, and physiological dysregulation that index early emerging markers of social anxiety. Infants with FXS provide a unique opportunity to study the earlier predictors of social anxiety. The current study utilized a multi-method approach to investigate early markers of social anxiety in 12-month-old infants with FXS. Method Participants included 32 infants with FXS and 41 low-risk controls, all approximately 12 months old. Parent-reported social behavioral inhibition was recorded from the Infant Behavior Questionnaire (IBQ-R). Direct observations of behavioral inhibition and attention were measured during a stranger approach task with respiratory sinus arrhythmia collected simultaneously. Results Parent-reported social behavioral inhibition was not significantly different between groups. In contrast, direct observations suggested that infants with FXS displayed elevated behavioral inhibition, increased attention towards the stranger, and a blunted respiratory sinus arrhythmia response. Conclusions Findings suggest that infants with FXS show both behavioral and physiological markers of social anxiety at 12 months old using a biobehavioral approach with multiple sources of input. Results highlight the importance of a multi-method approach to understanding the complex early emergent characteristics of anxiety in infants with FXS.
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Affiliation(s)
- Conner J Black
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Barnwell College, Suite #220, Columbia, SC, 29208, USA
| | - Abigail L Hogan
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Barnwell College, Suite #220, Columbia, SC, 29208, USA
| | - Kayla D Smith
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Barnwell College, Suite #220, Columbia, SC, 29208, USA
| | - Jane E Roberts
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Barnwell College, Suite #220, Columbia, SC, 29208, USA.
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Smith K, Hogan AL, Will E, Roberts JE. Attention Bias and Prodromal Anxiety Symptoms in Toddlers With Fragile X Syndrome and Down Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2021; 126:167-181. [PMID: 33651888 PMCID: PMC8108623 DOI: 10.1352/1944-7558-126.2.167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 11/10/2020] [Indexed: 06/12/2023]
Abstract
Early identification of behavioral risk markers for anxiety is essential to optimize long-term outcomes in children with neurodevelopmental disorders. This study analyzed attentional avoidance and its relation to anxiety and autism spectrum disorder (ASD) symptomatology during social and nonsocial fear conditions in toddlers with fragile X syndrome (FXS) and Down syndrome (DS). Toddlers with FXS and DS exhibited increased nonsocial attentional avoidance relative to typically developing (TD) toddlers. Attentional avoidance was not related to anxiety symptom severity in any group; however, higher ASD symptom severity was related to more social attentional avoidance in the FXS and TD groups. Findings suggest that there may be different underlying mechanisms driving attentional avoidance across neurodevelopmental disorders.
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Affiliation(s)
- Kayla Smith
- Kayla Smith, Abigail L. Hogan, Elizabeth Will, and Jane E. Roberts, University of South Carolina
| | - Abigail L Hogan
- Kayla Smith, Abigail L. Hogan, Elizabeth Will, and Jane E. Roberts, University of South Carolina
| | - Elizabeth Will
- Kayla Smith, Abigail L. Hogan, Elizabeth Will, and Jane E. Roberts, University of South Carolina
| | - Jane E Roberts
- Kayla Smith, Abigail L. Hogan, Elizabeth Will, and Jane E. Roberts, University of South Carolina
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20
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Thompson RJ, Borenstein JB, Kircanski K, Gotlib IH. Standards for Socially-and Achievement-Oriented Roles in Major Depressive Disorder and Generalized Anxiety Disorder. COGNITIVE THERAPY AND RESEARCH 2021; 44:1025-1033. [PMID: 33551520 DOI: 10.1007/s10608-020-10123-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background People with major depressive disorder (MDD) and generalized anxiety disorder (GAD) have elevated trait perfectionism. We tested whether they hold perfectionistic standards for specific life roles and examined the extent to which they met their own expectations for, gained satisfaction from, and expended effort in these roles. Methods Seventy-four women with MDD, GAD, both disorders, or no mental disorders (CTL) described their standards for a socially- and achievement-oriented roles, coded for perfectionism. Using ecological momentary assessment, participants reported the extent to which they met, how much satisfaction they gained from, and how much effort they expended in each role. Results Although the clinical groups endorsed elevated trait perfectionism, they did not differ from CTLs in their role-specific standards. Compared to CTLs, the clinical groups reported meeting their standards to a lesser extent and receiving less satisfaction from both roles. The two MDD groups reported expending less effort in achievement-oriented, but not socially-oriented, roles than the other two groups. Conclusion Despite similar standards for socially- and achievement-oriented roles, people with MDD and/or GAD are less likely to meet their standards and gain satisfaction from these roles. Having MDD, independent of GAD, is associated with putting less effort into achievement-oriented roles.
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21
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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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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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23
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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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24
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Low-frequency parietal repetitive transcranial magnetic stimulation reduces fear and anxiety. Transl Psychiatry 2020; 10:68. [PMID: 32066739 PMCID: PMC7026136 DOI: 10.1038/s41398-020-0751-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 01/02/2020] [Accepted: 01/10/2020] [Indexed: 12/23/2022] Open
Abstract
Anxiety disorders are the most prevalent mental disorders, with few effective neuropharmacological treatments, making treatments development critical. While noninvasive neuromodulation can successfully treat depression, few treatment targets have been identified specifically for anxiety disorders. Previously, we showed that shock threat increases excitability and connectivity of the intraparietal sulcus (IPS). Here we tested the hypothesis that inhibitory repetitive transcranial magnetic stimulation (rTMS) targeting this region would reduce induced anxiety. Subjects were exposed to neutral, predictable, and unpredictable shock threat, while receiving double-blinded, 1 Hz active or sham IPS rTMS. We used global brain connectivity and electric-field modelling to define the single-subject targets. We assessed subjective anxiety with online ratings and physiological arousal with the startle reflex. Startle stimuli (103 dB white noise) probed fear and anxiety during the predictable (fear-potentiated startle, FPS) and unpredictable (anxiety-potentiated startle, APS) conditions. Active rTMS reduced both FPS and APS relative to both the sham and no stimulation conditions. However, the online anxiety ratings showed no difference between the stimulation conditions. These results were not dependent on the laterality of the stimulation, or the subjects' perception of the stimulation (i.e. active vs. sham). Results suggest that reducing IPS excitability during shock threat is sufficient to reduce physiological arousal related to both fear and anxiety, and are consistent with our previous research showing hyperexcitability in this region during threat. By extension, these results suggest that 1 Hz parietal stimulation may be an effective treatment for clinical anxiety, warranting future work in anxiety patients.
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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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26
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Shifeng LI, Yiling WU, Fumin ZHANG, Qiongying XU, Aibao ZHOU. Self-affirmation buffering by the general public reduces anxiety levels during the COVID-19 epidemic. ACTA PSYCHOLOGICA SINICA 2020. [DOI: 10.3724/sp.j.1041.2020.00886] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- LI Shifeng
- School of Psychology, Northwest Normal University, Lanzhou 730070, China
| | - WU Yiling
- School of Psychology, Northwest Normal University, Lanzhou 730070, China
| | - ZHANG Fumin
- School of Psychology, Northwest Normal University, Lanzhou 730070, China
| | - XU Qiongying
- School of Psychology, Northwest Normal University, Lanzhou 730070, China
| | - ZHOU Aibao
- School of Psychology, Northwest Normal University, Lanzhou 730070, China
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27
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Klusek J, Moser C, Schmidt J, Abbeduto L, Roberts JE. A novel eye-tracking paradigm for indexing social avoidance-related behavior in fragile X syndrome. Am J Med Genet B Neuropsychiatr Genet 2020; 183:5-16. [PMID: 31418535 PMCID: PMC6898737 DOI: 10.1002/ajmg.b.32757] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 07/22/2019] [Accepted: 07/26/2019] [Indexed: 11/07/2022]
Abstract
Fragile X syndrome (FXS) is characterized by hallmark features of gaze avoidance, reduced social approach, and social anxiety. The development of therapeutics to manage these symptoms has been hindered, in part, by the lack of sensitive outcome measures. This study investigated the utility of a novel eye-tracking paradigm for indexing social avoidance-related phenotypes. Adolescent/young adult-aged males with FXS (n = 24) and typical development (n = 23) participated in the study. Participants viewed faces displaying direct or averted gaze and the first fixation duration on the eyes was recorded as an index of initial stimulus registration. Fixation durations did not differ across the direction of gaze conditions in either group, although the control group showed longer initial fixations on the eyes relative to the FXS group. Shorter initial fixation on averted gaze in males with FXS was a robust predictor of the severity of their social avoidance behavior exhibited during a social greeting context, whereas parent-reported social avoidance symptoms were not related to performance in the semi-naturalistic context. This eye-tracking paradigm may represent a promising outcome measure for FXS clinical trials because it provides a quantitative index that closely maps onto core social avoidance phenotypes of FXS, can be completed in less than 20 min, and is suitable for use with individuals with low IQ.
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Affiliation(s)
- Jessica Klusek
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, South Carolina
| | - Carly Moser
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, South Carolina
| | - Joseph Schmidt
- Department of Psychology, University of Central Florida, Orlando, Florida
| | - Leonard Abbeduto
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, California
| | - Jane E Roberts
- Department of Psychology, University of South Carolina, Columbia, South Carolina
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28
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Clarke T, Jamieson JD, Malone P, Rayhan RU, Washington S, VanMeter JW, Baraniuk JN. Connectivity differences between Gulf War Illness (GWI) phenotypes during a test of attention. PLoS One 2019; 14:e0226481. [PMID: 31891592 PMCID: PMC6938369 DOI: 10.1371/journal.pone.0226481] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 11/26/2019] [Indexed: 01/05/2023] Open
Abstract
One quarter of veterans returning from the 1990–1991 Persian Gulf War have developed Gulf War Illness (GWI) with chronic pain, fatigue, cognitive and gastrointestinal dysfunction. Exertion leads to characteristic, delayed onset exacerbations that are not relieved by sleep. We have modeled exertional exhaustion by comparing magnetic resonance images from before and after submaximal exercise. One third of the 27 GWI participants had brain stem atrophy and developed postural tachycardia after exercise (START: Stress Test Activated Reversible Tachycardia). The remainder activated basal ganglia and anterior insulae during a cognitive task (STOPP: Stress Test Originated Phantom Perception). Here, the role of attention in cognitive dysfunction was assessed by seed region correlations during a simple 0-back stimulus matching task (“see a letter, push a button”) performed before exercise. Analysis was analogous to resting state, but different from psychophysiological interactions (PPI). The patterns of correlations between nodes in task and default networks were significantly different for START (n = 9), STOPP (n = 18) and control (n = 8) subjects. Edges shared by the 3 groups may represent co-activation caused by the 0-back task. Controls had a task network of right dorsolateral and left ventrolateral prefrontal cortex, dorsal anterior cingulate cortex, posterior insulae and frontal eye fields (dorsal attention network). START had a large task module centered on the dorsal anterior cingulate cortex with direct links to basal ganglia, anterior insulae, and right dorsolateral prefrontal cortex nodes, and through dorsal attention network (intraparietal sulci and frontal eye fields) nodes to a default module. STOPP had 2 task submodules of basal ganglia–anterior insulae, and dorsolateral prefrontal executive control regions. Dorsal attention and posterior insulae nodes were embedded in the default module and were distant from the task networks. These three unique connectivity patterns during an attention task support the concept of Gulf War Disease with recognizable, objective patterns of cognitive dysfunction.
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Affiliation(s)
- Tomas Clarke
- Center for Functional and Molecular Imaging, Georgetown University, Washington, DC, United States of America
| | - Jessie D. Jamieson
- Department of Mathematics, University of Nebraska-Lincoln, Lincoln, Nebraska, United States of America
| | - Patrick Malone
- Center for Functional and Molecular Imaging, Georgetown University, Washington, DC, United States of America
| | - Rakib U. Rayhan
- Department of Physiology and Biophysics, Howard University College of Medicine, Washington, DC, United States of America
| | - Stuart Washington
- Division of Rheumatology, Immunology and Allergy, Georgetown University, Washington, DC, United States of America
| | - John W. VanMeter
- Center for Functional and Molecular Imaging, Georgetown University, Washington, DC, United States of America
| | - James N. Baraniuk
- Division of Rheumatology, Immunology and Allergy, Georgetown University, Washington, DC, United States of America
- * E-mail:
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Popa AM, Cruz JR, Wong LM, Harvey DJ, Angkustsiri K, Leckliter IN, Perez-Edgar K, Simon TJ. Seeing Eye to Eye With Threat: Atypical Threat Bias in Children With 22q11.2 Deletion Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2019; 124:549-567. [PMID: 31756146 PMCID: PMC6927396 DOI: 10.1352/1944-7558-124.6.549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Individuals with 22q11.2 deletion syndrome (22q11DS) show high rates of anxiety associated with their increased risk of developing schizophrenia. Biased attention is associated with anxiety and is important to investigate in those with 22q11DS given this association. We analyzed attention bias to emotional faces in 7- to 17-year olds with 22q11DS and typically developing controls (TD) using a dot probe threat bias paradigm. We measured response time, eye tracking, and pupilometry. Those with 22q11DS showed no significant changes in early versus late trials, whereas those who were TD showed differing patterns in both gaze and pupilometry over time. The patterns in those who are TD may indicate adaptation that is lacking or slower in individuals with 22q11DS.
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Affiliation(s)
- Abbie M Popa
- Abbie M. Popa, Joshua R. Cruz, Ling M. Wong, Danielle J. Harvey, Kathleen Angkustsiri, and Ingrid N. Leckliter, UC Davis, MIND Institute, Sacramento, CA; Koraly Perez-Edgar, Penn State University, University Park; and Tony J. Simon, UC Davis, MIND Institute, Sacramento, CA
| | - Joshua R Cruz
- Abbie M. Popa, Joshua R. Cruz, Ling M. Wong, Danielle J. Harvey, Kathleen Angkustsiri, and Ingrid N. Leckliter, UC Davis, MIND Institute, Sacramento, CA; Koraly Perez-Edgar, Penn State University, University Park; and Tony J. Simon, UC Davis, MIND Institute, Sacramento, CA
| | - Ling M Wong
- Abbie M. Popa, Joshua R. Cruz, Ling M. Wong, Danielle J. Harvey, Kathleen Angkustsiri, and Ingrid N. Leckliter, UC Davis, MIND Institute, Sacramento, CA; Koraly Perez-Edgar, Penn State University, University Park; and Tony J. Simon, UC Davis, MIND Institute, Sacramento, CA
| | - Danielle J Harvey
- Abbie M. Popa, Joshua R. Cruz, Ling M. Wong, Danielle J. Harvey, Kathleen Angkustsiri, and Ingrid N. Leckliter, UC Davis, MIND Institute, Sacramento, CA; Koraly Perez-Edgar, Penn State University, University Park; and Tony J. Simon, UC Davis, MIND Institute, Sacramento, CA
| | - Kathleen Angkustsiri
- Abbie M. Popa, Joshua R. Cruz, Ling M. Wong, Danielle J. Harvey, Kathleen Angkustsiri, and Ingrid N. Leckliter, UC Davis, MIND Institute, Sacramento, CA; Koraly Perez-Edgar, Penn State University, University Park; and Tony J. Simon, UC Davis, MIND Institute, Sacramento, CA
| | - Ingrid N Leckliter
- Abbie M. Popa, Joshua R. Cruz, Ling M. Wong, Danielle J. Harvey, Kathleen Angkustsiri, and Ingrid N. Leckliter, UC Davis, MIND Institute, Sacramento, CA; Koraly Perez-Edgar, Penn State University, University Park; and Tony J. Simon, UC Davis, MIND Institute, Sacramento, CA
| | - Koraly Perez-Edgar
- Abbie M. Popa, Joshua R. Cruz, Ling M. Wong, Danielle J. Harvey, Kathleen Angkustsiri, and Ingrid N. Leckliter, UC Davis, MIND Institute, Sacramento, CA; Koraly Perez-Edgar, Penn State University, University Park; and Tony J. Simon, UC Davis, MIND Institute, Sacramento, CA
| | - Tony J Simon
- Abbie M. Popa, Joshua R. Cruz, Ling M. Wong, Danielle J. Harvey, Kathleen Angkustsiri, and Ingrid N. Leckliter, UC Davis, MIND Institute, Sacramento, CA; Koraly Perez-Edgar, Penn State University, University Park; and Tony J. Simon, UC Davis, MIND Institute, Sacramento, CA
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Kleberg JL, Hanqvist C, Serlachius E, Högström J. Pupil dilation to emotional expressions in adolescent social anxiety disorder is related to treatment outcome. J Anxiety Disord 2019; 65:26-33. [PMID: 31136877 DOI: 10.1016/j.janxdis.2019.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 02/11/2019] [Accepted: 04/22/2019] [Indexed: 10/26/2022]
Abstract
Atypical attention to potential social threats, such as emotional faces, may be one of the core mechanisms underlying social anxiety disorder (SAD). Pupil dilation is an index of locus coreuleus-noradrenergic activity, and closely linked to attention. In the present study, pupil dilation was studied in adolescents with SAD (N = 26; 22 Female) before the onset of a 12-week cognitive behavioral treatment, and in healthy controls (N = 23). Stimuli were faces with angry or happy emotional expressions. Contrary to our hypothesis, the SAD group did not show hyper-responsiveness to angry compared to happy faces. Instead, an atypical time course of the pupil dilation response was found, resulting in an attenuated response during late time stages. Larger pupil dilation amplitude to happy faces before treatment was related to worse treatment response. These results contribute significantly to our understanding of the mechanisms underlying adolescent SAD.
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Affiliation(s)
- Johan Lundin Kleberg
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden; Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Sweden.
| | - Cornelia Hanqvist
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Eva Serlachius
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Jens Högström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
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Dennis-Tiwary TA, Roy AK, Denefrio S, Myruski S. Heterogeneity of the Anxiety-Related Attention Bias: A Review and Working Model for Future Research. Clin Psychol Sci 2019; 7:879-899. [PMID: 33758680 DOI: 10.1177/2167702619838474] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The anxiety-related attention bias (AB) has been studied for several decades as a clinically-relevant output of the dynamic and complex threat detection-response system. Despite research enthusiasm for the construct of AB, current theories and measurement approaches cannot adequately account for the growing body of mixed, contradictory, and null findings. Drawing on clinical, neuroscience, and animal models, we argue that the apparent complexity and contradictions in the empirical literature can be attributed to the field's failure to clearly conceptualize AB heterogeneity and the dearth of studies in AB that consider additional cognitive mechanisms in anxiety, particularly disruptions in threat-safety discrimination and cognitive control. We review existing research and propose a working model of AB heterogeneity positing that AB may be best conceptualized as multiple subtypes of dysregulated processing of and attention to threat anchored in individual differences in threat-safety discrimination and cognitive control. We review evidence for this working model and discuss how it can be used to advance knowledge of AB mechanisms and inform personalized prevention and intervention approaches.
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Affiliation(s)
- Tracy A Dennis-Tiwary
- Hunter College, The City University of New York, Department of Psychology, New York, NY.,The Graduate Center, The City University of New York, Department of Psychology, New York, NY
| | - Amy Krain Roy
- Fordham University, Department of Psychology, Bronx, NY.,New York University Langone School of Medicine, Department of Child and Adolescent Psychiatry, New York, NY
| | - Samantha Denefrio
- The Graduate Center, The City University of New York, Department of Psychology, New York, NY.,Hunter College, The City University of New York, Department of Psychology, New York, NY
| | - Sarah Myruski
- Hunter College, The City University of New York, Department of Psychology, New York, NY
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Maratos FA, Pessoa L. What drives prioritized visual processing? A motivational relevance account. PROGRESS IN BRAIN RESEARCH 2019; 247:111-148. [PMID: 31196431 DOI: 10.1016/bs.pbr.2019.03.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Emotion is fundamental to our being, and an essential aspect guiding behavior when rapid responding is required. This includes whether we approach or avoid a stimulus, and the accompanying physiological responses. A common tenet is that threat-related content drives stimulus processing and biases visual attention, so that rapid responding can be initiated. In this paper, it will be argued instead that prioritization of threatening stimuli should be encompassed within a motivational relevance framework. To more fully understand what is, or is not, prioritized for visual processing one must, however, additionally consider: (i) stimulus ambiguity and perceptual saliency; (ii) task demands, including both perceptual load and cognitive load; and (iii) endogenous/affective states of the individual. Combined with motivational relevance, this then leads to a multifactorial approach to understanding the drivers of prioritized visual processing. This accords with current recognition that the brain basis allowing for visual prioritization is also multifactorial, including transient, dynamic and overlapping networks. Taken together, the paper provides a reconceptualization of how "emotional" information prioritizes visual processing.
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Affiliation(s)
- Frances Anne Maratos
- Department of Psychology and Human Sciences Research Centre, University of Derby, Derby, United Kingdom.
| | - Luiz Pessoa
- Department of Psychology and Maryland Neuroimaging Center, University of Maryland, College Park, MD, United States
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Baker HM, Barry TJ, Kumari V, Pandey R, Shanta N, Lau JYF. Problematic attention processing and fear learning in adolescent anxiety: Testing a combined cognitive and learning processes model. J Behav Ther Exp Psychiatry 2019; 62:146-153. [PMID: 30412825 DOI: 10.1016/j.jbtep.2018.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 09/26/2018] [Accepted: 10/04/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Anxiety in adolescence is characterised by disturbances in attentional processes and the overgeneralisation of fear, however, little is known about the combined and reciprocal effects of and between these factors on youth anxiety. The present study investigated whether attention (attention allocation and control) and fear generalisation processes together predict more variance on adolescent anxiety symptoms than each factor in isolation, and explored their interrelations. METHODS 197 adolescents completed a novel conditioning task, which paired balloon cues with mildly aversive or neutral outcomes. A spatial cueing task, and self-report measures of emotional attentional control and anxiety, were also completed. RESULTS Threat-avoidant attention allocation biases, impaired attention control, and exaggerated fear generalisation together predicted greater variance in anxiety symptoms (55.3%), than each set of fear and attention processes in isolation. Results also provided evidence of an interplay between these factors. Individual differences in threat-avoidant attention allocation biases predicted variability in the generalisation of fear, whilst the association between heightened anxiety and the overgeneralization of fear was moderated by poor attention control. CONCLUSIONS This study provides unique evidence of the combined effects of attention and fear generalisation mechanisms in explaining youth anxiety, and interrelations between these factors. Importantly, results suggested that deficiencies in attention control may bring out anxiety-associated impairments in fear generalisation. LIMITATIONS We relied on self-reported ratings of fear during generalization and also of attention control. Thus demand effects cannot be discounted. Reaction-time measures of attention focus are also indirect assessments of attention that may lack precision.
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Affiliation(s)
- Helen M Baker
- The Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Tom J Barry
- The Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Department of Psychology, The University of Hong Kong, Hong Kong
| | - Veena Kumari
- The Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Centre for Cognitive Neuroscience, University of Brunel, London, United Kingdom
| | | | | | - Jennifer Y F Lau
- The Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
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Bose D, Vaclavik D, Buitron V, Rey Y, Silverman WK, Pettit JW. Attentional Control and Threat-Related Attention Bias Partially Explain the Association Between Maternal Psychological Control and Youth Anxiety Severity. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9982-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lebowitz ER, François B. Using Motion Tracking to Measure Avoidance in Children and Adults: Psychometric Properties, Associations With Clinical Characteristics, and Treatment-Related Change. Behav Ther 2018; 49:853-865. [PMID: 30316485 PMCID: PMC6394864 DOI: 10.1016/j.beth.2018.04.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 04/18/2018] [Accepted: 04/25/2018] [Indexed: 01/09/2023]
Abstract
Avoidance is implicated in many areas of psychopathology, particularly anxiety and its disorders. Accurate, reliable, valid, and objective measurement of avoidance behavior poses methodological challenges. Two key technological advances, increased computing power and the advent of motion-tracking technology, offer novel solutions to these challenges. We describe a series of three studies using a novel motion-tracking system to measure avoidance in children and adults. The first study examined behavioral avoidance of spider stimuli in large samples of children and adults (N = 200 each; the adults were the mothers of the children). Behavioral avoidance was associated with self-rated fear of spiders and increased state anxiety from before to after the task. The second study examined avoidance of threat faces in children and adults (N = 35 each; the adults were the mothers of the children) and test-retest reliability in the adults. Avoidance of threat faces was associated with broadband anxiety symptom severity. Test-retest correlations in behavioral avoidance measured 6 weeks apart was high and significant. The third study examined behavioral avoidance of spiders in clinically anxious children (N = 25) before and after cognitive-behavioral therapy for childhood anxiety disorders. Behavioral avoidance was significantly reduced following cognitive-behavioral therapy and reduction in behavioral avoidance correlated significantly with improvement in child-rated anxiety symptoms. Taken together, these studies provide strong support for the promise of motion-tracking technology to enable a new phase of behavioral avoidance research with sensitive, valid, reliable, and cost- and time-effective measurement of behavioral avoidance across the lifespan.
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Dudeney J, Sharpe L, Sicouri G, Lorimer S, Dear BF, Jaffe A, Selvadurai H, Hunt C. Attentional Bias in Children with Asthma with and without Anxiety Disorders. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 45:1635-1646. [PMID: 28066857 DOI: 10.1007/s10802-017-0261-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Children with asthma have a high prevalence of anxiety disorders, however, very little is known about the mechanisms that confer vulnerability for anxiety in this population. This study investigated whether children with asthma and anxiety disorders display attentional biases towards threatening stimuli, similar to what has been seen in children with anxiety disorders more generally. We also examined the relationships between attentional biases and anxiety symptomatology and asthma control for children with asthma. Ninety-three children, aged 8-13, took part in the study and were recruited into one of four conditions (asthma/anxiety, asthma, anxiety, control). Asthma was medically confirmed and anxiety was assessed through clinical interview. We used self- and parent-report questionnaires to measure child asthma (ATAQ) and anxiety (SCAS, CASI) variables. Participants completed a visual dot-probe task designed to measure attentional bias towards two types of stimuli: asthma related words and general threat words, as well as tasks to assess reading ability and attentional control. Results showed that attentional biases did not differ between the groups, although children with anxiety disorders displayed poorer attentional control. A significant correlation was found between poor asthma control and an attentional bias of asthma stimuli. While we found no evidence that anxiety disorders in children with asthma were associated with threat- or asthma-related attentional biases, preliminary evidence suggested that children with poor asthma control displayed biases towards asthma-specific stimuli. Future research is needed to explore whether these attentional biases are adaptive.
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Affiliation(s)
- Joanne Dudeney
- School of Psychology, University of Sydney, Sydney, NSW 2006, Australia.
| | - Louise Sharpe
- School of Psychology, University of Sydney, Sydney, NSW 2006, Australia
| | - Gemma Sicouri
- School of Psychology, University of Sydney, Sydney, NSW 2006, Australia
| | - Sarah Lorimer
- School of Psychology, University of Sydney, Sydney, NSW 2006, Australia
| | - Blake F Dear
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
| | - Adam Jaffe
- School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, Australia.,Department of Respiratory Medicine, Sydney Children's Hospital Randwick, Sydney, Australia
| | - Hiran Selvadurai
- The Children's Hospital at Westmead Clinical School, Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, Sydney, Australia.,Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, Australia
| | - Caroline Hunt
- School of Psychology, University of Sydney, Sydney, NSW 2006, Australia
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The dot-probe task to measure emotional attention: A suitable measure in comparative studies? Psychon Bull Rev 2018; 24:1686-1717. [PMID: 28092078 DOI: 10.3758/s13423-016-1224-1] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
For social animals, attending to and recognizing the emotional expressions of other individuals is of crucial importance for their survival and likely has a deep evolutionary origin. Gaining insight into how emotional expressions evolved as adaptations over the course of evolution can be achieved by making direct cross-species comparisons. To that extent, experimental paradigms that are suitable for investigating emotional processing across species need to be developed and evaluated. The emotional dot-probe task, which measures attention allocation toward emotional stimuli, has this potential. The task is implicit, and subjects need minimal training to perform the task successfully. Findings in nonhuman primates, although scarce, show that they, like humans, have an attentional bias toward emotional stimuli. However, the wide literature on human studies has shown that different factors can have important moderating effects on the results. Due to the large heterogeneity of this literature, these moderating effects often remain unnoticed. We here review this literature and show that subject characteristics and differences in experimental designs affect the results of the dot-probe task. We conclude with specific recommendations regarding these issues that are particularly relevant to take into consideration when applying this paradigm to study animals.
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38
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Pile V, Robinson S, Topor M, Hedderly T, Lau JYF. Attention bias for social threat in youth with tic disorders: Links with tic severity and social anxiety. Child Neuropsychol 2018; 25:394-409. [PMID: 29877753 DOI: 10.1080/09297049.2018.1480754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Many individuals with Tourette syndrome and chronic tic disorders (TS/CTDs) report poor social functioning and comorbid social anxiety. Yet limited research has investigated the role of cognitive factors that highlight social threats in youth with TS/CTD, and whether these biases underlie tic severity and co-occurring social anxiety. This study examined whether selective attention to social threat is enhanced young people with TS/CTDs compared to healthy controls, and whether attention biases are associated with tic severity and social anxiety. Twenty seven young people with TS/CTDs and 25 matched control participants completed an experimental measure of attention bias toward/away from threat stimuli. A clinician-rated interview measuring tic severity/impairment (YGTSS Total Score) and questionnaire measures of social anxiety were completed by participants and their parents. Young people with TS/CTD showed an attention bias to social threat words (relative to benign words) compared to controls but no such bias for social threat faces. Attention bias for social threat words was associated with increasing YGTSS Total Score and parent-reported social anxiety in the TS/CTDs group. Mediation analysis revealed a significant indirect path between YGTSS Total Score and social anxiety, via attention to social threat. Tentatively, these associations appeared to be driven by impairment rather than tic severity scores. Preliminary data suggests that youth with TS/CTD have enhanced attention to threat, compared to controls, and this is associated with impairment and social anxiety. Attention to threat could offer a cognitive mechanism connecting impairment and social anxiety, and so be a valuable trans-diagnostic treatment target.
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Affiliation(s)
- Victoria Pile
- a King's College London, Department of Psychology , Institute of Psychiatry Psychology & Neuroscience , London , UK
| | - Sally Robinson
- b Tic and Neurodevelopmental Movements Service (TANDeM), Children's Neurosciences Centre , Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, St Thomas' Hospital , London , UK
| | - Marta Topor
- b Tic and Neurodevelopmental Movements Service (TANDeM), Children's Neurosciences Centre , Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, St Thomas' Hospital , London , UK
| | - Tammy Hedderly
- b Tic and Neurodevelopmental Movements Service (TANDeM), Children's Neurosciences Centre , Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, St Thomas' Hospital , London , UK
| | - Jennifer Y F Lau
- a King's College London, Department of Psychology , Institute of Psychiatry Psychology & Neuroscience , London , UK
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Naim R, Kivity Y, Bar-Haim Y, Huppert JD. Attention and interpretation bias modification treatment for social anxiety disorder: A randomized clinical trial of efficacy and synergy. J Behav Ther Exp Psychiatry 2018; 59:19-30. [PMID: 29127945 DOI: 10.1016/j.jbtep.2017.10.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 09/11/2017] [Accepted: 10/23/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVES Attention bias modification treatment (ABMT) and cognitive bias modification of interpretation (CBM-I) both have demonstrated efficacy in alleviating social anxiety, but how they compare with each other, their combination, and with a combined control condition has not been studied. We examined their relative and combined efficacy compared to control conditions in a randomized controlled trial (RCT). METHODS Ninety-five adults diagnosed with social anxiety disorder (SAD), were randomly allocated to 4 groups: ABMT + CBM-I control (hereafter ABMT; n = 23), CBM-I + ABMT control (hereafter CBM-I; n = 24), combined ABMT + CBM-I (n = 23), and combined control (n = 25). Treatment included eight sessions over four weeks. Clinician-rated and self-reported measures of social anxiety symptoms, functional impairment, and threat-related attention and interpretive biases were evaluated at baseline, post-treatment, and 3-month follow-up. RESULTS ABMT yielded greater symptom reduction as measured by both clinician-ratings (Cohen's ds = 0.57-0.70) and self-reports (ds = 0.70-0.85) compared with the CBM-I, the combined ABMT + CBM-I, and the combined control conditions. Neither of the other conditions demonstrated superior symptom change compared to the control condition. No group differences were found for functioning or cognitive biases measures. LIMITATIONS Limitations mainly include the mix of active and control treatments applied across the different groups. Therefore, the net effect of each of the treatments by itself could not be clearly tested. CONCLUSIONS Results suggest superiority of ABMT compared to CBM-I and their combination in terms of symptom reduction. Possible interpretations and methodological issues underlying the observed findings are discussed.
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Affiliation(s)
- Reut Naim
- School of Psychological Sciences, Tel Aviv University, Israel.
| | - Yogev Kivity
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yair Bar-Haim
- School of Psychological Sciences, Tel Aviv University, Israel; The Sagol School of Neuroscience, Tel Aviv University, Israel
| | - Jonathan D Huppert
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
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Autistic Traits and Symptoms of Social Anxiety are Differentially Related to Attention to Others' Eyes in Social Anxiety Disorder. J Autism Dev Disord 2018; 47:3814-3821. [PMID: 28000078 PMCID: PMC5676829 DOI: 10.1007/s10803-016-2978-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Autism spectrum disorder (ASD) and social anxiety disorder (SAD) have partly overlapping symptoms. Gaze avoidance has been linked to both SAD and ASD, but little is known about differences in social attention between the two conditions. We studied eye movements in a group of treatment-seeking adolescents with SAD (N = 25), assessing SAD and ASD dimensionally. The results indicated a double dissociation between two measures of social attention and the two symptom dimensions. Controlling for social anxiety, elevated autistic traits were associated with delayed orienting to eyes presented among distractors. In contrast, elevated social anxiety levels were associated with faster orienting away from the eyes, when controlling for autistic traits. This distinction deepens our understanding of ASD and SAD.
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41
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O'Malley KR, Waters AM. Attention avoidance of the threat conditioned stimulus during extinction increases physiological arousal generalisation and retention. Behav Res Ther 2018; 104:51-61. [DOI: 10.1016/j.brat.2018.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 03/01/2018] [Accepted: 03/05/2018] [Indexed: 11/26/2022]
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Anxiety and Threat-Related Attention: Cognitive-Motivational Framework and Treatment. Trends Cogn Sci 2018; 22:225-240. [DOI: 10.1016/j.tics.2018.01.001] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 11/18/2017] [Accepted: 01/02/2018] [Indexed: 12/15/2022]
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Abend R, de Voogd L, Salemink E, Wiers RW, Pérez-Edgar K, Fitzgerald A, White LK, Salum GA, He J, Silverman WK, Pettit JW, Pine DS, Bar-Haim Y. Association between attention bias to threat and anxiety symptoms in children and adolescents. Depress Anxiety 2018; 35:229-238. [PMID: 29212134 PMCID: PMC6342553 DOI: 10.1002/da.22706] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 07/07/2017] [Accepted: 11/08/2017] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Considerable research links threat-related attention biases to anxiety symptoms in adults, whereas extant findings on threat biases in youth are limited and mixed. Inconsistent findings may arise due to substantial methodological variability and limited sample sizes, emphasizing the need for systematic research on large samples. The aim of this report is to examine the association between threat bias and pediatric anxiety symptoms using standardized measures in a large, international, multi-site youth sample. METHODS A total of 1,291 children and adolescents from seven research sites worldwide completed standardized attention bias assessment task (dot-probe task) and child anxiety symptoms measure (Screen for Child Anxiety Related Emotional Disorders). Using a dimensional approach to symptomatology, we conducted regression analyses predicting overall, and disorder-specific, anxiety symptoms severity, based on threat bias scores. RESULTS Threat bias correlated positively with overall anxiety symptoms severity (ß = 0.078, P = .004). Furthermore, threat bias was positively associated specifically with social anxiety (ß = 0.072, P = .008) and school phobia (ß = 0.076, P = .006) symptoms severity, but not with panic, generalized anxiety, or separation anxiety symptoms. These associations were not moderated by age or gender. CONCLUSIONS These findings indicate associations between threat bias and pediatric anxiety symptoms, and suggest that vigilance to external threats manifests more prominently in symptoms of social anxiety and school phobia, regardless of age and gender. These findings point to the role of attention bias to threat in anxiety, with implications for translational clinical research. The significance of applying standardized methods in multi-site collaborations for overcoming challenges inherent to clinical research is discussed.
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Affiliation(s)
- Rany Abend
- Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Leone de Voogd
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Elske Salemink
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Reinout W. Wiers
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Koraly Pérez-Edgar
- Department of Psychology, Pennsylvania State University, University Park, PA, USA
| | | | - Lauren K. White
- Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
- Childrens Hospital of Philadelphia, Philadelphia, PA, USA
| | - Giovanni A. Salum
- Departament of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jie He
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | | | - Jeremy W. Pettit
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Daniel S. Pine
- Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Yair Bar-Haim
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
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Abstract
As a form of therapy, cognitive behavioral therapy (CBT) is more than a mere “toolbox.” CBT allows us to better understand how the human mind is functioning because it is based on neuroscience and experimental and scientific psychology. At the beginning, the Diagnostic and Statistical Manual of Mental Disorders (DSM) was “nontheoretical,” but nowadays (the most recent version being DSM-5), it is increasingly based on CBT paradigms (with the insertion of important notions such as cognitions and behaviors). This Brief Report presents what we currently know about generalized anxiety disorder (GAD) and how we can treat this condition by nonpharmaceutical means. In the last few years, GAD theories have evolved, becoming more precise about the cognitive functioning of GAD sufferers. Here, we look at current theoretical models and the main techniques of therapeutic care, as well as the advances in research about the “transdiagnostic” process and GAD in childhood. CBT is an effective treatment for GAD, typically leading to reductions in worry, and a study has shown that such therapy is equal to pharmaceutical treatment and more effective 6 months after study completion.
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Affiliation(s)
- Lucas Borza
- Psychologist in private practice, Eschau, France; Institution La Doctrine Chrétienne, Strasbourg, France; Strasbourg University, Strasbourg, France
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46
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Cox JA, Christensen BK, Goodhew SC. Temporal dynamics of anxiety-related attentional bias: is affective context a missing piece of the puzzle? Cogn Emot 2017; 32:1329-1338. [PMID: 28984503 DOI: 10.1080/02699931.2017.1386619] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
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.
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Affiliation(s)
- Jolene A Cox
- a Research School of Psychology, The Australian National University , Canberra , Australia
| | - Bruce K Christensen
- a Research School of Psychology, The Australian National University , Canberra , Australia
| | - Stephanie C Goodhew
- a Research School of Psychology, The Australian National University , Canberra , Australia
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Capriola NN, Booker JA, Ollendick TH. Profiles of Temperament among Youth with Specific Phobias: Implications for CBT Outcomes. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2017; 45:1449-1459. [PMID: 28032271 PMCID: PMC5491379 DOI: 10.1007/s10802-016-0255-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Specific phobias (SPs) are characterized by excessive fear or anxiety regarding an object or situation. SPs often result in a host of negative outcomes in childhood and beyond. Children with SPs are broadly assumed to show dispositional over-regulation and fearfulness relative to children without SPs, but there are few attempts to distinguish dispositional patterns among children with SPs. In the present study, we examined trajectories of differing temperamental profiles for youth receiving a CBT-based treatment for their SP. Participants were 117 treatment seeking youth (M Age = 8.77 years, Age Range = 6-15 years; 54.7% girls) who met criteria for a SP and their mothers. Three temperament profiles emerged and were conceptually similar to previously supported profiles: well-adjusted; inhibited; and under-controlled. While all groups showed similarly robust reductions in SP severity following treatment, differences among the three groups emerged in terms of broader internalizing symptoms, externalizing symptoms, and global outlook. The well-adjusted group was higher in functioning initially than the other two groups. The inhibited group had initial disadvantages in initial internalizing symptoms. The under-controlled group showed greatest comorbidity risks and had initial disadvantages in both internalizing and externalizing symptoms. These distinct clusters represent considerable heterogeneity within a clinical sample of youth with SP who are often assumed to have homogenous behavior tendencies of inhibition and fearfulness. Findings suggest that considering patterns of temperament among children with phobias could assist treatment planning and inform ongoing refinements to improve treatment response.
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Affiliation(s)
| | - Jordan A Booker
- Department of Psychology, Emory University, Atlanta, GA, 30322, USA
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White LK, Degnan KA, Henderson HA, Pérez-Edgar K, Walker OL, Shechner T, Leibenluft E, Bar-Haim Y, Pine DS, Fox NA. Developmental Relations Among Behavioral Inhibition, Anxiety, and Attention Biases to Threat and Positive Information. Child Dev 2017; 88:141-155. [PMID: 28042902 DOI: 10.1111/cdev.12696] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
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.
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Morales S, Brown KM, Taber-Thomas BC, LoBue V, Buss KA, Pérez-Edgar KE. Maternal anxiety predicts attentional bias towards threat in infancy. Emotion 2017; 17:874-883. [PMID: 28206795 PMCID: PMC5519443 DOI: 10.1037/emo0000275] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
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
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Affiliation(s)
| | - Kayla M Brown
- Department of Psychology, The Pennsylvania State Universit
| | | | | | - Kristin A Buss
- Department of Psychology, The Pennsylvania State Universit
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Understanding comorbidity among internalizing problems: Integrating latent structural models of psychopathology and risk mechanisms. Dev Psychopathol 2017; 28:987-1012. [PMID: 27739389 DOI: 10.1017/s0954579416000663] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
It is well known that comorbidity is the rule, not the exception, for categorically defined psychiatric disorders, and this is also the case for internalizing disorders of depression and anxiety. This theoretical review paper addresses the ubiquity of comorbidity among internalizing disorders. Our central thesis is that progress in understanding this co-occurrence can be made by employing latent dimensional structural models that organize psychopathology as well as vulnerabilities and risk mechanisms and by connecting the multiple levels of risk and psychopathology outcomes together. Different vulnerabilities and risk mechanisms are hypothesized to predict different levels of the structural model of psychopathology. We review the present state of knowledge based on concurrent and developmental sequential comorbidity patterns among common discrete psychiatric disorders in youth, and then we advocate for the use of more recent bifactor dimensional models of psychopathology (e.g., p factor; Caspi et al., 2014) that can help to explain the co-occurrence among internalizing symptoms. In support of this relatively novel conceptual perspective, we review six exemplar vulnerabilities and risk mechanisms, including executive function, information processing biases, cognitive vulnerabilities, positive and negative affectivity aspects of temperament, and autonomic dysregulation, along with the developmental occurrence of stressors in different domains, to show how these vulnerabilities can predict the general latent psychopathology factor, a unique latent internalizing dimension, as well as specific symptom syndrome manifestations.
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