Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-24T17:57:40.278Z Has data issue: false hasContentIssue false
  • English
  • Français

Relationships between attention to emotion and anxiety among a community sample of adolescents

Published online by Cambridge University Press:  01 March 2021

Benjamin C. Mullin ,
Jacob B. W. Holzman ,
Laura Pyle ,
Emmaly L. Perks ,
Yaswanth Chintaluru ,
Lauren D. Gulley ,
Dustin A. Haraden  and
Benjamin L. Hankin
Benjamin C. Mullin*
Affiliation:
Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA Pediatric Mental Health Institute, Children's Hospital Colorado, Aurora, CO, USA
Jacob B. W. Holzman
Affiliation:
Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA Pediatric Mental Health Institute, Children's Hospital Colorado, Aurora, CO, USA
Laura Pyle
Affiliation:
Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA Department of Biostatistics and Informatics, University of Colorado School of Medicine, School of Public Health, Aurora, CO, USA
Emmaly L. Perks
Affiliation:
Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
Yaswanth Chintaluru
Affiliation:
University of Colorado, Denver, Denver, CO, USA
Lauren D. Gulley
Affiliation:
Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
Dustin A. Haraden
Affiliation:
Department of Psychology, University of Illinois, Urbana-Champaign, IL, USA
Benjamin L. Hankin
Affiliation:
Department of Psychology, University of Illinois, Urbana-Champaign, IL, USA
*
Author for correspondence: Benjamin C. Mullin, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Attentional bias to threat has been implicated as a cognitive mechanism in anxiety disorders for youth. Yet, prior studies documenting this bias have largely relied on a method with questionable reliability (i.e. dot-probe task) and small samples, few of which included adolescents. The current study sought to address such limitations by examining relations between anxiety – both clinically diagnosed and dimensionally rated – and attentional bias to threat.

Methods

The study included a community sample of adolescents and employed eye-tracking methodology intended to capture possible biases across the full range of both automatic (i.e. vigilance bias) and controlled attentional processes (i.e. avoidance bias, maintenance bias). We examined both dimensional anxiety (across the full sample; n = 215) and categorical anxiety in a subset case-control analysis (n = 100) as predictors of biases.

Results

Findings indicated that participants with an anxiety disorder oriented more slowly to angry faces than matched controls. Results did not suggest a greater likelihood of initial orienting to angry faces among our participants with anxiety disorders or those with higher dimensional ratings of anxiety. Greater anxiety severity was associated with greater dwell time to neutral faces.

Conclusions

This is the largest study to date examining eye-tracking metrics of attention to threat among healthy and anxious youth. Findings did not support the notion that anxiety is characterized by heightened vigilance or avoidance/maintenance of attention to threat. All effects detected were extremely small. Links between attention to threat and anxiety among adolescents may be subtle and highly dependent on experimental task dimensions.

Keywords

Adolescentanxietyattentioneye-tracking
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 8 , June 2022 , pp. 1548 - 1559
Check for updates
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Armstrong, T., & Olatunji, B. O. (2012). Eye tracking of attention in the affective disorders: A meta-analytic review and synthesis. Clinical Psychology Review, 32, 704–723.CrossRefGoogle ScholarPubMed
Baldwin, J. S., & Dadds, M. R. (2007). Reliability and validity of parent and child versions of the multidimensional anxiety scale for children in community samples. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 252–260.CrossRefGoogle ScholarPubMed
Bar-Haim, Y., Lamy, D., Pergamin, L., Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (2007). Threat-related attentional bias in anxious and nonanxious individuals: A meta-analytic study. Psychological Bulletin, 133, 1–24.CrossRefGoogle ScholarPubMed
Beevers, C. G., Ellis, A. J., Wells, T. T., & McGeary, J. E. (2010). Serotonin transporter gene promoter region polymorphism and selective processing of emotional images. Biological psychology, 83, 260–265.CrossRefGoogle ScholarPubMed
Brown, H. M., McAdams, T. A., Lester, K. J., Goodman, R., Clark, D. M., & Eley, T. C. (2013). Attentional threat avoidance and familial risk are independently associated with childhood anxiety disorders. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 54, 678–685.CrossRefGoogle ScholarPubMed
Chapman, A., Devue, C., & Grimshaw, G. M. (2019). Fleeting reliability in the dot-probe task. Psychological Research, 83, 308–320.CrossRefGoogle ScholarPubMed
Cisler, J. M., & Koster, E. H. W. (2010). Mechanisms of attentional biases towards threat in anxiety disorders: An integrative review. Clinical Psychology Review, 30, 203–216.CrossRefGoogle ScholarPubMed
Cooney, R. E., Atlas, L. Y., Joormann, J., Eugène, F., & Gotlib, I. H. (2006). Amygdala activation in the processing of neutral faces in social anxiety disorder: Is neutral really neutral? Psychiatry Research: Neuroimaging, 148, 55–59.CrossRefGoogle ScholarPubMed
Derakshan, N., & Koster, E. H. W. (2010). Processing efficiency in anxiety: Evidence from eye-movements during visual search. Behaviour Research and Therapy, 48, 1180–1185.CrossRefGoogle ScholarPubMed
Dudeney, J., Sharpe, L., & Hunt, C. (2015). Attentional bias towards threatening stimuli in children with anxiety: A meta-analysis. Clinical Psychology Review, 40, 66–75.CrossRefGoogle ScholarPubMed
Filkowski, M., & Haas, B. (2017). Rethinking the use of neutral faces as a baseline in fMRI neuroimaging studies of axis-I psychiatric disorders. Journal of Neuroimaging, 27, 281–291.CrossRefGoogle ScholarPubMed
Fox, E., Russo, R., Bowles, R., & Dutton, K. (2001). Do threatening stimuli draw or hold visual attention in subclinical anxiety? Journal of Experimental Psychology: General, 130, 681–700.CrossRefGoogle ScholarPubMed
Fu, X., & Pérez-Edgar, K. (2019). Threat-related attention bias in socioemotional development: A critical review and methodological considerations. Developmental Review, 51, 31–57.CrossRefGoogle ScholarPubMed
Gamble, A. L., & Rapee, R. M. (2009). The time-course of attentional bias in anxious children and adolescents. Journal of Anxiety Disorders, 23, 841–847.CrossRefGoogle ScholarPubMed
Gentili, C., Gobbini, M. I., Ricciardi, E., Vanello, N., Pietrini, P., Haxby, J. V., & Guazzelli, M. (2008). Differential modulation of neural activity throughout the distributed neural system for face perception in patients with Social Phobia and healthy subjects. Brain Research Bulletin, 77, 286–292.CrossRefGoogle ScholarPubMed
Hankin, B., Young, J., Abela, J., Smolen, A., Jenness, J., Gulley, L., … Oppenheimer, C. (2015). Depression from childhood into late adolescence: Influence of gender, development, genetic susceptibility, and peer stress. Journal of Abnormal Psychology, 124, 803–816.CrossRefGoogle ScholarPubMed
Holas, P., Krejtz, I., Cypryanska, M., & Nezlek, J. B. (2014). Orienting and maintenance of attention to threatening facial expressions in anxiety--an eye movement study. Psychiatry Research, 220, 362–369.CrossRefGoogle Scholar
In-Albon, T., Kossowsky, J., & Schneider, S. (2010). Vigilance and avoidance of threat in the eye movements of children with separation anxiety disorder. Journal of Abnormal Child Psychology, 38, 225–235.CrossRefGoogle ScholarPubMed
Kaufman, J., Birmaher, B., Brent, D. A., Rao, U., Flynn, C., & Moreci, P. (1999). Schedule for affective disorders and schizophrenia for school-age children – present and lifetime versions (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 1065–1069.Google Scholar
Kellough, J. L., Beevers, C. G., Ellis, A. J., & Wells, T. T. (2008). Time course of selective attention in clinically depressed young adults: An eye tracking study. Behaviour Research and Therapy, 46, 1238–1243.CrossRefGoogle Scholar
Klein, D. N., Dougherty, L. R., & Olino, T. M. (2005). Toward guidelines for evidence-based assessment of depression in children and adolescents. Journal of Clinical Child & Adolescent Psychology, 34, 412–432.CrossRefGoogle ScholarPubMed
Lazarov, A., Ben-Zion, Z., Shamai, D., Pine, D. S., & Bar-Haim, Y. (2018). Free viewing of sad and happy faces in depression: A potential target for attention bias modification. Journal of Affective Disorders, 238, 94–100.CrossRefGoogle ScholarPubMed
Macleod, C, Grafton, B, & Notebaert, L. (2019). Anxiety-Linked Attentional Bias: Is It Reliable? Annual Review of Clinical Psychology, 15, 529–554.CrossRefGoogle ScholarPubMed
March, J. (1997). Multidimensional anxiety scale for children. Tonawnda, NY: Multi-Health Systems.Google ScholarPubMed
March, J., Parker, J., Sullivan, K., Stallings, P., & Conners, C. (1997). The Multidimensional Anxiety Scale for Children (MASC): Factor structure, reliability, and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 554–565.CrossRefGoogle ScholarPubMed
Merikangas, K. R., He, J.-P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., … Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication – Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49, 980–989.CrossRefGoogle Scholar
Miller, G. A., & Chapman, J. P. (2001). Misunderstanding analysis of covariance. Journal of Abnormal Psychology, 110, 40–48.CrossRefGoogle ScholarPubMed
Mogg, K., & Bradley, B. P. (2018). Anxiety and threat-related attention: Cognitive-motivational framework and treatment. Trends in Cognitive Sciences, 22, 225–240.CrossRefGoogle ScholarPubMed
Monk, C. S., Nelson, E. E., McClure, E. B., Mogg, K., Bradley, B. P., Leibenluft, E., … Pine, D. S. (2006). Ventrolateral prefrontal cortex activation and attentional bias in response to angry faces in adolescents with generalized anxiety disorder. American Journal of Psychiatry, 163, 1091–1097.CrossRefGoogle ScholarPubMed
Moore, T., Armstrong, K., & Fallah, M. (2003). Visuomotor origins of covert spatial attention. Neuron, 40, 671–683.CrossRefGoogle ScholarPubMed
Peterson, C. A., Crockett, L., Richards, M., & Boxer, A. (1988). A self-report measure of pubertal status: Reliability, validity, and initial norms. Journal of Youth and Adolescence, 17, 117–133.CrossRefGoogle Scholar
Pettit, J. W., Bechor, M., Rey, Y., Vasey, M. W., Abend, R., Pine, D. S., … Silverman, W. K. (2019). A randomized controlled trial of attention bias modification treatment in youth with treatment-resistant anxiety disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 59, 157–165.CrossRefGoogle ScholarPubMed
Pillay, S. S., Rogowska, J., Gruber, S. A., Simpson, N., & Yurgelun-Todd, D. A. (2007). Recognition of happy facial affect in panic disorder: An fMRI study. Journal of Anxiety Disorders, 21, 381–393.CrossRefGoogle ScholarPubMed
Pine, D. S., Mogg, K., Bradley, B. P., Montgomery, L., Monk, C. S., McClure, E., … Kaufman, J. (2005). Attention bias to threat in maltreated children: Implications for vulnerability to stress-related psychopathology. The American Journal of Psychiatry, 162, 291–296.CrossRefGoogle ScholarPubMed
Price, R. B., Kuckertz, J. M., Siegle, G. J., Ladouceur, C. D., Silk, J. S., Ryan, N. D., … Amir, N. (2015). Empirical recommendations for improving the stability of the dot-probe task in clinical research. Psychological Assessment, 27, 365–376.CrossRefGoogle ScholarPubMed
Price, R. B., Rosen, D., Siegle, G. J., Ladouceur, C. D., Tang, K., Allen, K. B., … Silk, J. S. (2016). From anxious youth to depressed adolescents: Prospective prediction of 2-year depression symptoms via attentional bias measures. Journal of abnormal Psychology, 125, 267–278.CrossRefGoogle ScholarPubMed
Puliafico, A. C., & Kendall, P. C. (2006). Threat-related attentional bias in anxious youth: A review. Clinical Child and Family Psychology Review, 9, 162–180.CrossRefGoogle ScholarPubMed
Richards, H. J., Benson, V., Donnelly, N., & Hadwin, J. A. (2014). Exploring the function of selective attention and hypervigilance for threat in anxiety. Clinical Psychology Review, 34, 1–13.CrossRefGoogle ScholarPubMed
Rodebaugh, T. L., Scullin, R. B., Langer, J. K., Dixon, D. J., Huppert, J. D., Bernstein, A., … Lenze, E. J. (2016). Unreliability as a threat to understanding psychopathology: The cautionary tale of attentional bias. Journal of Abnormal Psychology, 125, 840–851.CrossRefGoogle ScholarPubMed
Sass, S. M., Heller, W., Stewart, J. L., Silton, R. L., Edgar, J. C., Fisher, J. E., & Miller, G. A. (2010). Time course of attentional bias in anxiety: Emotion and gender specificity. Psychophysiology, 47, 247–259.CrossRefGoogle ScholarPubMed
Schofield, C., Johnson, A., Inhoff, A., & Coles, M. (2012). Social anxiety and difficulty disengaging threat: Evidence from eye-tracking. Cognition & Emotion, 26, 300–311.CrossRefGoogle ScholarPubMed
Seefeldt, W. L., Krämer, M., Tuschen-Caffier, B., & Heinrichs, N. (2014). Hypervigilance and avoidance in visual attention in children with social phobia. Journal of Behavior Therapy and Experimental Psychiatry, 45, 105–112.CrossRefGoogle ScholarPubMed
Shechner, T., Britton, J. C., Perez-Edgar, K., Bar-Haim, Y., Ernst, M., Fox, N. A., … Pine, D. S. (2012). Attention biases, anxiety, and development: Toward or away from threats or rewards? Depression and Anxiety, 29, 282–294.CrossRefGoogle ScholarPubMed
Shechner, T., Jarcho, J. M., Britton, J. C., Leibenluft, E., Pine, D. S., & Nelson, E. E. (2013). Attention bias of anxious youth during extended exposure of emotional face pairs: An eye-tracking study. Depression and Anxiety, 30, 14–21.CrossRefGoogle Scholar
Shechner, T., Jarcho, J. M., Wong, S., Leibenluft, E., Pine, D. S., & Nelson, E. E. (2017). Threats, rewards, and attention deployment in anxious youth and adults: An eye tracking study. Biological Psychology, 122, 121–129.CrossRefGoogle Scholar
Silverman, W. K., & Albano, A. M. (1996). Anxiety disorders interview schedule (ADIS-IV) (child and parent versions). San Antonio, TX: Psychological Corporation.Google Scholar
Stirling, L. J., Eley, T. C., & Clark, D. M. (2006). Preliminary evidence for an association between social anxiety symptoms and avoidance of negative faces in school-age children. Journal of Clinical Child and Adolescent Psychology: The Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division, 53(35), 431–439.CrossRefGoogle Scholar
Wieckowski, A. T., Capriola-Hall, N. N., Elias, R., Ollendick, T. H., & White, S. W. (2019). Variability of attention bias in socially anxious adolescents: Differences in fixation duration toward adult and adolescent face stimuli. Cognition and Emotion, 33, 825–831.CrossRefGoogle ScholarPubMed
Wieser, M. J., Pauli, P., Weyers, P., Alpers, G. W., & Mühlberger, A. (2009). Fear of negative evaluation and the hypervigilance-avoidance hypothesis: An eye-tracking study. Journal of Neural Transmission, 116, 717–723.CrossRefGoogle ScholarPubMed