Association between attention bias to threat and anxiety symptoms in children and adolescents

Abend, Rany; Voogd, Leone de; Salemink, Elske; Pérez‐Edgar, Koraly; Fitzgerald, Amanda; White, Lauren K.; Salum, Giovanni Abrahão; He, Jun-Hua; Silverman, Wendy K.; Pettit, Jeremy W.; Pine, Daniel S.; Bar‐Haim, Yair

doi:10.1002/da.22706

Cited by 79 publications

(52 citation statements)

References 61 publications

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“…A more recent meta‐analysis from Dudeney, Sharpe, and Hunt () replicated Bar‐Haim et al. () by showing that an attentional bias towards threat is also present in high‐anxious children (for a recent large‐scale study, see Abend et al, ; for a more critical view, see Roy, Dennis, & Warner, ).…”

Section: Introductionmentioning

confidence: 77%

Intergenerational transmission of attentional bias and anxiety

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Bockstaele

Pérez‐Edgar

et al. 2019

Developmental Science

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Earlier evidence has revealed a bi‐directional causal relationship between anxiety and attention biases in adults and children. This study investigated the prospective and concurrent relations between anxiety and attentional bias in a sample of 89 families (mothers, fathers, and first‐born children). Parents’ and children's attentional bias was measured when children were 7.5 years old, using both a visual probe task and visual search task with angry versus happy facial expressions. Generalized and social anxiety symptoms in parents and children were measured when children were 4.5 and 7.5 years old. Anxiety in parents and children was prospectively (but not concurrently) related to their respective attentional biases to threat: All participants showed a larger attentional bias to threat in the visual search (but not in the visual probe) task if they were more anxious at the 4.5 (but not at the 7.5) year measurement. Moreover, parents’ anxiety levels were prospectively predictive of the visual search attentional bias of their children after controlling for child anxiety. More anxiety in mothers at 4.5 years was related to a faster detection of angry among happy faces, while more anxiety in fathers predicted a faster detection of happy among angry faces in children at 7.5 years. We found no direct association between parental and child attentional biases. Our study contributes to the recently emerging literature on attentional biases as a potential mechanism in the intergenerational transmission of anxiety by showing that parents’ anxiety rather than parents’ attentional bias contributes to the intergenerational transmission of risk for child anxiety.

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Section: Introductionmentioning

confidence: 77%

Intergenerational transmission of attentional bias and anxiety

Aktar

Bockstaele

Pérez‐Edgar

et al. 2019

Developmental Science

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“…These models propose that youth who exhibit heightened attention to threatening stimuli are at increased risk for developing anxiety. In support of these models, extensive evidence documents that youth with anxiety disorders display significantly higher levels of attention to threat compared to youth without anxiety disorders (e.g., Dudeney, Sharpe, & Hunt, 2015), and levels of attention to threat are significantly correlated with anxiety symptom severity in youth (Abend et al, 2017). The most commonly used paradigm for assessing attention to threatening stimuli is the visual dot probe task.…”

Section: Introductionmentioning

confidence: 95%

Can less be more? Open trial of a stepped care approach for child and adolescent anxiety disorders

Pettit

Rey

Bechor

et al. 2017

Journal of Anxiety Disorders

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This open trial presents a stepped care treatment approach for youths with anxiety disorders. In Step 1, 124 youths (65 girls; M age=9.7 years) participated in a low intensity computer administered attention bias modification (ABM) protocol. Statistically significant reductions in youth anxiety severity were found following Step 1. Youths and parents were then given the option to not continue with further treatment or step up to a higher intensity cognitive behavioral therapy (CBT) protocol (Step 2). Of 112 youths who completed Step 1, 67 (59.8%) discontinued treatment and 45 (40.2%) stepped up. Co-occurring ADHD and higher anxiety severity at baseline were significantly associated with the decision to step up. Of those youths who completed Step 2, additional statistically significant reductions in youth anxiety severity were found. Across the entire protocol, 68.6% of youths were rated as either very much improved or much improved on the Clinical Global Impressions-Improvement scale. In a hypothetical comparison in which all youths received CBT alone, the stepped care protocol resulted in approximately 50% less time in treatment sessions. These findings support the promise of initiating youth anxiety disorder treatment with low intensity treatment and then stepping up to higher intensity treatment as needed.

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“…Recently, Pergamin-Hight and colleagues (2015) demonstrated the content specificity of attentional biases and distorted beliefs associated with the various anxiety disorders, suggesting that it might be important for the threat stimuli used in these studies to be tailored to the specific disorders under study. In the usual dot-probe paradigm, the facial stimuli which depict anger and disgust might be more salient to SAD (Abend et al, 2018) and less so, for example, to specific phobia or separation anxiety disorder, thus potentially masking the effects of the potential bias in these studies.…”

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confidence: 99%

Attention Bias Modification Treatment for Adolescents With Social Anxiety Disorder

et al. 2019

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Social anxiety disorder (SAD) tends to emerge during the early teenage years and is particularly refractory to change even when standard evidence-based CBT treatments are delivered. Efforts have been made to develop novel, mechanistic-driven interventions for this disorder. In the present study, we examined Attention Bias Modification Treatment (ABMT) for youth with SAD. Participants were 58 adolescents (mean age = 14.29 years) who met diagnostic criteria for SAD and who were randomized to ABMT or a placebo control condition, Attention Control Training (ACT). We predicted that ABMT would result in greater changes in both threat biases and social anxiety symptoms. We also explored potential moderators of change including the severity of social anxiety symptoms, the level of threat bias at pre-treatment, and the degree of temperament-defined attention control. Contrary to our hypotheses, changes in attention bias were not observed in either condition, changes in social anxiety symptoms and diagnosis were small, and significant differences were not observed between the ABMT and ACT conditions. Little support for the proposed moderators was obtained. Reasons for our failure to find support for ABMT and its potential moderators are explored and recommendations for changes in the ABMT paradigm are suggested.

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Association between attention bias to threat and anxiety symptoms in children and adolescents

Cited by 79 publications

References 61 publications

Intergenerational transmission of attentional bias and anxiety

Intergenerational transmission of attentional bias and anxiety

Can less be more? Open trial of a stepped care approach for child and adolescent anxiety disorders

Attention Bias Modification Treatment for Adolescents With Social Anxiety Disorder

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