Attentional Bias in Children with Asthma with and without Anxiety Disorders

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.

Evidence for mood-dependent attentional processing in asthma: attentional bias towards health-threat in depressive mood and attentional avoidance in neutral mood

“…Importantly, and in line with theories with regard to the impact of symptom perception processes in asthma, Dudeney et al ( 2017 ) did find a significant relationship between poorer asthma control (parent reported asthma control problems) and increased attentional bias in children with asthma. The researchers consequently discussed whether the relationship between poorly controlled asthma and attentional bias is adaptive or maladaptive.…”

“…In contrast, Dudeney et al ( 2017 ) did not observe an attentional bias towards asthma words in children with asthma despite replicating the method used by Lowther et al ( 2015 ). The study compared an asthma group, with a group with comorbid asthma and anxiety, a group with anxiety alone, and healthy controls.…”

Anxiety and Attentional Bias in Children with Specific Learning Disorders

“…After the word pairs, an arrow remained on the screen until participant response, and a 500 ms inter-trial interval preceded the next fixation cross. These parameters were chosen to be consistent with stimulus durations in previous literature using dot-probe tasks with children (Dudeney et al 2017;Vasey et al 1995).…”

“…The dot probe compares response times to probes in spatial proximity to threatening or neutral stimuli to quantify a threat-related attentional bias (MacLeod et al 1986). This task has been used to ascertain attentional bias in a variety of child populations, including those with depression (Joormann et al 2007;Neshat-Doost et al 2000;Taghavi et al 1999), post-traumatic stress disorder (Bertó et al 2017;Briggs-Gowan et al 2015;Dalgleish et al 2001), autism spectrum disorder (Hollocks et al 2013;May et al 2015;Moore et al 2012;Zhao et al 2016), Williams syndrome (Dodd and Porter 2010;McGrath et al 2016), asthma (Dudeney et al 2017;Lowther et al 2016), and a range of anxiety disorders (Hunt et al 2007;Salum et al 2013;Sylvester et al 2016;Vasey et al 1995;Waters et al 2010).…”

“…For example, dot-probe studies with children with asthma have included asthma-related words (e.g. dust, cough, allergic; Dudeney et al 2017), and studies with depressed children include depression-related words (e.g. crying, bully, lonely; Neshat-Doost et al 2000).…”