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

Abstract

Fearful temperament, mostly studied as behavioral inhibition (BI), has been extensively associated with social withdrawal in childhood and the later emergence of anxiety disorders, especially social anxiety disorder (SAD). Recent studies have characterized a distinct type of fearful temperament marked by high levels of fear in low threat situations – labeled dysregulated fear. Dysregulated fear has been related to SAD over and above risks associated with BI. However, the mechanism by which dysregulated fear is related to SAD has not been studied. Cognitive mechanisms, such as attentional bias towards threat, may be a possible conduit. We examined differences in attentional bias towards threat in six-year-olds who displayed a pattern of dysregulated fear at age two (N = 23) compared with children who did not display dysregulated fear (N = 33). Moreover, we examined the concurrent relation between attentional bias and social withdrawal. Results indicated that children characterized by dysregulated fear showed a significant bias away from threat, and that this bias was significantly different from the children without dysregulated fear, who showed no significant bias. Moreover, attentional bias towards threat was positively related to social withdrawal only for the dysregulated fear group. These results are discussed in consideration of the existing knowledge of attentional bias to threat in the developmental and pediatric anxiety literatures, as well as recent studies that find important heterogeneity in attentional bias.

Impact of attention biases to threat and effortful control on individual variations in negative affect and social withdrawal in very young children

“…Additionally, it adds to our current understanding of the relations between components of temperament, cognitive control, attention bias, and social behaviors, extending these relations to a normative young sample. The current study replicated previous findings (Morales et al, in press-a; Pérez-Edgar, Bar-Haim et al, 2010; Pérez-Edgar et al, 2011; White et al, in press) indicating that attention bias to threat moderates the relation between negative reactivity and social withdrawal. These findings suggest that the relation between negative components of temperament, attention bias, and social behavior emerges early in childhood.…”

“…Consistent with previous findings (Morales et al, in press-a; Pérez-Edgar et al, 2011; White et al, in press), attention bias to threat moderated the relation between negative affect and social withdrawal, in that a significant link was only evident at increased levels of attention bias to threat. In contrast, effortful control did not interact with negative affect to impact social withdrawal.…”

“…However, others have found that attention bias away from happy increases risk for anxiety (White et al, in press) and training attention towards happy decreases risk (Britton et al, 2013; Waters, Pittaway, Mogg, Bradley, & Pine, 2013). Previous work has found stronger connections between attention bias to happy faces and temperamental exuberance (Frewen, Dozois, Joanisse, & Neufeld, 2008; Morales et al, in press-b; Shechner et al, 2012). In the current study, separate bias scores were created for happy and threatening faces to probe for affective specificity.…”

“…Direction may reflect diagnostic boundaries, as distress disorders have shown a significant bias towards threat, whereas children with fear disorders show an attention bias away from threat (Waters, Bradley, & Mogg, 2014). Patterns of anxiety-linked vigilance and avoidance are also evident in the temperament literature, as 5-year-old children characterized for Dysregulated Fear as toddlers displayed attentional avoidance of emotion faces (Morales, Pérez-Edgar, & Buss, in press-a). However, bias scores were still positively associated with anxiety.…”

“…Studies including happy or positive faces often do so in order to have a comparison condition. Among children, many studies have found that the relation between attention bias to happy and temperamental negative affect is fairly weak, with generally non-significant relations pointing both towards and away (Morales et al, in press-a; Pérez-Edgar et al, 2011). However, others have found that attention bias away from happy increases risk for anxiety (White et al, in press) and training attention towards happy decreases risk (Britton et al, 2013; Waters, Pittaway, Mogg, Bradley, & Pine, 2013).…”