Michael W. Vasey

Biased attention in childhood anxiety disorders : a preliminary study

This study provides preliminary tests of two hypotheses: (1) Anxiety-disordered children show an attentional bias toward emotionally threatening stimuli, and (2) normal controls show an attentional bias away from emotionally threatening stimuli. Twelve children, 9 to 14 years of age, with primary diagnoses of anxiety disorder were compared with 12 normal controls matched for age, gender, vocabulary level, and reading ability. Subjects completed a reaction time task that measured visual attention toward threatening versus neutral words. The anxious group showed the predicted attentional bias toward threat words. However, controls did not show the predicted bias away from threat words. These results are the first showing that biased attentional processing occurs among clinically anxious children. The potential role of such an attentional bias in childhood anxiety disorders and future direction for research are discussed.

Temperament, Anxiety, and the Processing of Threat-Relevant Stimuli.

This article discusses converging evidence from developmental, clinical, and cognitive psychology suggesting that there is significant overlap between research findings on affect, temperament, and attentional processes associated with pathological anxiety. We offer a proposal for the integration of these 3 areas aimed at developing a more clear understanding of the developmental sequence and operative mechanisms in the dysregulation of negative affect and the development of symptoms of anxiety pathology. We review evidence for a model indicating that reactive and effortful temperamental processes, possibly mediated by an attentional bias toward threat-relevant information, interact to produce problems of dysregulated negative affect and elevated levels of pathological anxiety. This model may assist in understanding the development of anxiety disorders, identifying children at risk for such disorders, and selecting points of entry for both preventative and curative interventions.

An information-processing perspective on childhood anxiety

In the past decade, cognitive theories of adult anxiety disorders have become increasingly complex, reflecting enhanced understanding of anxiety-related information-processing. This growth has fostered the development and enhancement of numerous assessment and treatment methods. Unfortunately, similar growth has been slower to occur in theories of childhood anxiety. This paper attempts to foster such growth by adopting an information-processing perspective. Doing so expands the extant cognitive perspective on childhood anxiety in four major ways. First, the division of cognitive processing into a sequence of steps provides a framework for organizing predictions regarding cognitive factors in childhood anxiety. Second, consideration of the cognitive operations active during each stage in the sequence facilitates elaboration of the types of cognitive deficits and distortions characteristic of anxious children. Third, it promotes development and application of performance-based assessment methodologies. Finally, an information-processing perspective highlights several targets for clinical intervention that may promote widespread change in an anxiety-supporting cognitive system.

Negative affectivity, effortful control, and attention to threat-relevant stimuli.

There is increasing recognition of temperamental influences on risk for psychopathology. Whereas the link between the broad temperament construct of negative affectivity (NA) and problems associated with anxiety and depression is now well-established, the mechanisms through which this link operate are not well understood. One possibility involves interactions between reactive and effortful components of temperament, as well as cognitive factors, like attentional biases to threat stimuli. This study tested a predicted relation between high levels of NA, low levels of effortful control (EC), and an attentional bias toward threat in children. A sample of 104 4th through 12th graders, selected from a larger screening sample because they reported high or low levels of trait NA and EC, completed a dot probe detection task. Results indicated that EC moderated the relation between NA and attentional bias; only children with low levels of EC and high levels of NA showed an attentional bias to threat stimuli. This pattern was not moderated by grade level or age.

Worry in childhood: A developmental perspective

Age-related and developmental differences in the content and process of worry were examined in children 5 to 6, 8 to 9, and 11 to 12 years of age. These ages were chosen to approximate three levels of cognitive development. A measure of self-concept development was also included. Results suggest that worrisome thoughts occur in childrens anxious experiences across the age range studied. However, such thoughts were found to be more prevalent among children age 8 and older. Furthermore, children in the two older groups generated a significantly greater variety of worries than 5- to 6-year-olds. These older children were also significantly more able to elaborate the potentially negative consequences of selected worrisome possiblities. These findings suggest that the worry process may become increasingly complex in middle childhood. Results also supported the view that the content of childrens worries is constrained by social-cognitive limitations reflected by their age and level of self-concept development. Worries related to physical well-being decreased significantly, while concerns about behavioral competence, social evaluation and psychological well-being became more prevalent with increasing age and self-concept complexity. Implications for a definition of worry in childhood and its role in childhood anxiety are discussed.

Attentional retraining: A randomized clinical trial for pathological worry ☆

OBJECTIVE Research has consistently shown that highly anxious individuals tend to show an attentional bias in favor of threat cues (i.e., a threat bias). Further, recent evidence suggests that it is possible to modify patterns of attention allocation for such stimuli and the resulting changes in attention allocation alter affective responses to stress. However, to date such changes in patterns of attention have been shown only over brief time intervals and only in non-anxious individuals who lack a pre-existing attentional bias. In contrast, the present study tested the efficacy of such attentional training in a sample of severe worriers over an extended period of time using psychometrically validated measures of anxiety and depression. METHOD Twenty-four adult participants reporting severe worry were randomly assigned to receive five sessions of either computer-delivered attentional retraining or sham training. The study was conducted from January to August 2001 and June to August 2002. RESULTS Significant Treatment Group X Time interactions were found for both threat bias (p=001) and a composite measure of anxious and depressive symptoms (p=.002). Compared to sham-training, the active retraining program produced significant reductions in both threat bias and symptoms. CONCLUSIONS These data support the view that an attentional bias in favor of threat cues is an important causal factor in generalized anxiety and suggest that a computer-based attentional retraining procedure may be an effective component of treatment.

Suppressed Attention to Rejection, Ridicule, and Failure Cues: A Unique Correlate of Reactive but Not Proactive Aggression in Youth

Tested the hypothesis that reactive aggression (RA) but not proactive aggression (PA) should be associated with heightened attention to rejection, ridicule, and failure cues. In addition to a reaction time measure of selective attention, participants also completed a vignette-based interview regarding their interpretation of ambiguous social situations, and children, parents, and teachers completed questionnaire measures of child aggression and related variables. Consistent with predictions, RA but not PA was related to biased attention for rejection, ridicule, and failure cues. However, contrary to expectation, heightened RA scores were associated with suppressed rather than enhanced attention to such cues. Despite the unexpected direction of this attentional bias, as predicted it was significantly related to the well-established tendency of aggressive children to interpret ambiguous social situations as threatening, which was also uniquely related to RA. Further, the correlation between suppressed attention and RA was fully mediated by interpretation bias.

Anxiety Enhances Threat Processing Without Competition Among Multiple Inputs: A Diffusion Model Analysis

Enhanced processing of threatening information is a well established phenomenon among high-anxious individuals. This effect is most reliably shown in situations where 2 or more items compete for processing resources, suggesting that input competition is a critical component of the effect. However, it could be that there are small effects in situations without input competition, but the dependent measures typically used are not sensitive enough to detect them. The present study analyzed data from a noncompetition task, single-string lexical decision, with the diffusion model, a decision process model that provides a more direct measure of performance differences than either response times or accuracy alone. The diffusion model analysis showed a consistent processing advantage for threatening words in high-anxious individuals, whereas traditional comparisons showed no significant differences. These results challenge the view that input competition is necessary for enhanced threat processing. Implications for theories of anxiety are discussed.

Research on Information-Processing Factors in Child and Adolescent Psychopathology: A Critical Commentary

Provides a critical commentary on the state-of-the-art of research on information-processing (I-P) factors in clinical child and adolescent psychology. The articles in this special section amply demonstrate the value of the I-P paradigm as a heuristic framework for conceptualizing and studying the role(s) of cognitive factors in the etiology and maintenance of child and adolescent psychopathology. However, the current status of such research also reflects a number of limitations that warrant consideration if the potential value of the I-P paradigm is to be fully realized. Specifically, understanding the role(s) played by such factors is impeded by a variety of insufficiently addressed methodological and psychometric issues, as well as by insufficiently articulated theories regarding such factors. These issues are particularly challenging for child and adolescent psychopathology researchers because of the complexities added by development. The value of I-P theories of childhood and adolescent psychopathology will be considerably enhanced if these issues are more fully considered in future research.

Specificity of worry and rumination in the development of anxiety and depressive symptoms in children

OBJECTIVES AND DESIGN. Rumination (specifically Brooding) is thought to be an important vulnerability factor for depressive symptoms whereas Worry is believed to be involved in anxiety. The present study sought to clarify the extent to which these two types of perseverative cognition show symptom specificity or generality in their associations with depression and anxiety. Additionally, reactive (negative affectivity, NA; positive affectivity, PA) and self-regulatory aspects of temperament (effortful control) were considered as vulnerability factors for depression and anxiety and were also studied in relation to rumination and worry. METHODS. Self-report questionnaires tapping Rumination, Worry, temperament, depression, and anxiety were administered to a community sample of 138 children aged 9-13. RESULTS. Brooding (but not Reflection) and Worry were significantly associated with anxiety and depressive symptoms on the one hand and with the temperamental construct of NA on the other hand. However, consistent with a model predicting symptom-specific relations, only Brooding significantly mediated the association between NA and depressive symptoms, whereas only Worry was a mediator of the relation between NA and anxiety symptoms. Finally, among self-regulatory aspects of temperament, activation control and inhibitory control were uniquely associated with depressive symptoms, whereas attentional control was only associated with anxiety symptoms. CONCLUSIONS. This study supports high NA as a vulnerability factor for the development of depressed and anxious symptoms in children, but these symptoms develop through differential paths.