Attentional Bias in Children with Social Anxiety Disorder

Schmidtendorf, Steffen; Wiedau, Susanne; Asbrand, Julia; Tuschen‐Caffier, Brunna; Heinrichs, Nina

doi:10.1007/s10608-017-9880-7

Cited by 28 publications

(36 citation statements)

References 45 publications

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“…Our result could have been expected in a younger sample of children, as it has been suggested that attention bias to threat is a normal phenomenon in early childhood [53] but that youth with a typical development, through cognitive maturation, learn to inhibit automatic reactivity to threat, and only those on a trajectory towards an anxiety disorder may fail to develop this control [54]. However, our results are in line with previous research using eye tracking to compare children with SAD and non-anxious controls that found similar attention patterns in both groups [18, 20]. It may be that the choice of method for capturing attention processes is important for the outcome, and our current understanding of vigilance in anxious populations stem much from studies using reaction-time measures such as the dot-probe paradigm.…”

Section: Discussionsupporting

confidence: 91%

“…Children in the non-anxious control group did not show any attention bias in either direction, i.e., they were as likely to direct their gaze toward angry as well as to neutral faces when they were presented in pairs [19]. A third study compared children with SAD to a healthy control group, using eye tracking, and found that both groups tended to avoid angry faces, relative to neutral faces [20].…”

Section: Introductionmentioning

confidence: 99%

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Visual attention to emotional faces in adolescents with social anxiety disorder receiving cognitive behavioral therapy

et al. 2019

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Social anxiety disorder (SAD) is a psychiatric condition that often onsets in childhood. Cognitive models underline the role of attention in the maintenance of SAD, but studies on youth populations are few, particularly those using eye tracking to measure attention. Cognitive behavioral therapy (CBT) for SAD includes interventions targeting attention, like exposure to eye contact, but the link between CBT and attention bias is largely unexplored. This study investigated attention bias in youth with SAD and the association with outcome from CBT. Latency to attend to pictures of faces with different emotions (vigilance) and latency to disengage from social stimuli (avoidance) was examined in N = 25 adolescents (aged 13–17) with SAD in relation to treatment outcome. Vigilance was operationalized as the time it took to relocate the gaze from a central position to a peripherally appearing social stimulus. The latency to disengage from a centrally located social stimulus, when a non-social stimulus appeared in the periphery, was used as a proxy for avoidance. Attention characteristics in the SAD group were compared to non-anxious (NA) controls (N = 22). Visual attention was measured using eye tracking. Participants in both the SAD and NA groups were vigilant towards angry faces, compared to neutral and happy faces. Similarly, both groups disengaged attention faster from angry faces. Adolescents with SAD who disengaged faster from social stimuli had less social anxiety after CBT. The results indicate that anxious youth display a vigilant-avoidant attention pattern to threat. However, partly inconsistent with previous research, the same pattern was observed in the NA group.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Visual attention to emotional faces in adolescents with social anxiety disorder receiving cognitive behavioral therapy

et al. 2019

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“…So far, a small number of eye-tracking studies have been conducted in children and adolescents with SAD (36)(37)(38)(39)(40)(41)(42). These studies examined the relative distribution of attention between threat-related faces and other stimuli during free viewing tasks.…”

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confidence: 99%

Restricted Visual Scanpaths During Emotion Recognition in Childhood Social Anxiety Disorder

et al. 2021

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Background: Social anxiety disorder (SAD) has its typical onset in childhood and adolescence. Maladaptive processing of social information may contribute to the etiology and maintenance of SAD. During face perception, individuals execute a succession of visual fixations known as a scanpath which facilitates information processing. Atypically long scanpaths have been reported in adults with SAD, but no data exists from pediatric samples. SAD has also been linked to atypical arousal during face perception. Both metrics were examined in one of the largest eye-tracking studies of pediatric SAD to date.Methods: Participants were children and adolescents with SAD (n = 61) and healthy controls (n = 39) with a mean age of 14 years (range 10–17) who completed an emotion recognition task. The visual scanpath and pupil dilation (an indirect index of arousal) were examined using eye tracking.Results: Scanpaths of youth with SAD were shorter, less distributed, and consisted of a smaller number of fixations than those of healthy controls. These findings were supported by both frequentist and Bayesian statistics. Higher pupil dilation was also observed in the SAD group, but despite a statistically significant group difference, this result was not supported by the Bayesian analysis.Conclusions: The results were contrary to findings from adult studies, but similar to what has been reported in neurodevelopmental conditions associated with social interaction impairments. Restricted scanpaths may disrupt holistic representation of faces known to favor adaptive social understanding.

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“…Eye-tracking research on biased attention in anxious children is scarce and mostly focuses on initial hypervigilance or attentional avoidance (e.g., In-Albon et al, 2010;Seefeldt et al, 2014). We recently analyzed both components in a sample of 79 schoolaged children, 37 of them diagnosed with SAD (Schmidtendorf et al, 2018). A hypervigilance-avoidance pattern to angry faces emerged, when they were paired with a nonsocial stimulus.…”

mentioning

confidence: 99%

“…The present short report aims to consider initial maintenance of attention (component 3) in the same sample of children with SAD above and beyond the already analyzed first and second component of biased attention (Schmidtendorf et al, 2018; see above). Therefore, the present data are taken from a larger research project to investigate cognitive and psychophysiological reactions in children with SAD to emotional stimuli (data collection from 2011 to 2014).…”

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confidence: 99%

Initial Maintenance of Attention to Threat in Children with Social Anxiety Disorder? Findings from an Eye-Tracking Experiment

et al. 2021

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Background Attentional biases are assumed to be a core feature in the etiology and maintenance of clinical anxiety. The present study focuses on initial maintenance of attention to threat, one of three attentional components investigated the least, particularly in child anxiety. Methods Angry and neutral facial expressions were presented in a free-viewing task, while eye-movements were recorded. Participants were N = 96 school-aged children, with n = 50 children with a clinical social anxiety disorder (SAD) and n = 46 healthy control children (HC). Prior to the task, social stress was induced in half of participating children to investigate the impact of increased levels of distress on initial attention allocation. Results The length of first fixation to angry faces in children with SAD neither differed from the length of first fixation to neutral faces nor the length of first fixation to angry faces in HC children. Furthermore, this variable was not affected by a stress induction procedure. However, children with SAD initially fixated longer on faces than HC children. Conclusion Our findings provide evidence for difficulties disengaging attention from faces. This may indicate that attention allocation is determined by the social nature of the stimuli rather than by the specific emotional valence.

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Attentional Bias in Children with Social Anxiety Disorder

Cited by 28 publications

References 45 publications

Visual attention to emotional faces in adolescents with social anxiety disorder receiving cognitive behavioral therapy

Visual attention to emotional faces in adolescents with social anxiety disorder receiving cognitive behavioral therapy

Restricted Visual Scanpaths During Emotion Recognition in Childhood Social Anxiety Disorder

Initial Maintenance of Attention to Threat in Children with Social Anxiety Disorder? Findings from an Eye-Tracking Experiment

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