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Gepubliceerd in: Cognitive Therapy and Research 3/2018

27-11-2017 | Original Article

Attentional Bias in Children with Social Anxiety Disorder

Auteurs: Steffen Schmidtendorf, Susanne Wiedau, Julia Asbrand, Brunna Tuschen-Caffier, Nina Heinrichs

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 3/2018

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Abstract

Previous research stated a robust attentional bias to threat in adult anxiety. However, the number of studies analyzing attentional biases in clinically anxious children is limited and results are inconsistent. The present study aims to assess attentional biases in children with social anxiety disorder (n = 37) and healthy control children (n = 42) using a free-viewing eye-tracking paradigm. Children viewed different picture pairs consisting of social and non-social stimuli under two conditions (with/without a stressor to activate social threat perception). We found the direction of gaze regarding threatening stimuli to be context-dependent. Both groups showed a hypervigilance-avoidance pattern to angry faces when they were paired with houses. In face–face trials, angry faces were less often initially fixated than neutral or happy faces in both groups. However, schema activation differentially affected initial fixations in angry-neutral face pairs across groups. Children with social anxiety disorder more often initially directed their gaze to angry faces than did healthy control children, indicating a lack of inhibiting threat representations rather than a hypervigilance to threat.
Voetnoten
1
Apart from the eye-tracking task and the anxiety questionnaires described below, further tasks and questionnaire measures were performed and administered to reach goals of other project parts (Asbrand et al. 2016): Trier Social Stress Test for Children (TSST-C; Buske-Kirschbaum et al. 1997); Five Minute Speech Sample (FMSS; Magaña et al. 1986); Culture Fair Intelligence Test (CFT 20-R; Weiß 2006); Fear of Negative Child Evaluation (FNCE; Schreier and Heinrichs 2010); Child Behavior Checklist (CBCL; Achenbach 2000); Depression Inventory for Children (DIKJ; Stiensmeier-Pelster 2000); Mini Social Phobia Inventory (Mini-SPIN; Connor et al. 2001); Symptom Checklist K-9 (SCL-K-9, a short form of the SCL-90-R; Derogatis and Unger 2010). Within the frame of a randomized controlled treatment trial, a subset of those questionnaires was administered up to five times (pre, post, follow-ups). The diagnostic procedure and each of the experimental tasks were performed on separate days, with the eye-tracking experiment conducted prior to the intervention program.
 
2
Exclusion of invalid data in eye-tracking experiments is rarely reported in clinical studies. The investigation of attentional biases is often based on area of interest (AOI) analysis. According to Holmqvist et al. (2011, pp. 224–225), data offsets are major concerns for AOI analyses. The application of the algorithm described in our paper (level 3 in particular) refers to the suggestions made by Holmqvist et al., concerning how to deal with inaccurate data. As can be seen in Fig. 1, there were three levels of data exclusion. (1) We checked if data were recorded for the full 60 trials. (2) We checked the tracking ratio in the collected gaze data. Participants with a tracking ratio < 80% were excluded. (3) Scan path visualization of four stimulus pairs (balanced regarding position of stimuli, age and gender) was checked for data offset. Participants were excluded if two or more of these four stimulus pairs were rated as invalid (e.g. due to a miscalibration in one corner, drift in the eye-tracker). In this case, AOIs were not hit, although children might have looked at the stimulus.
 
3
Following a request from an anonymous reviewer to include reliability of eye movement data in the discussion, reliability estimates for bias scores to threat were calculated post-hoc and added to the manuscript.
 
4
The association between the self-reported anxiety level and the attentional bias scores and dwell time was analyzed following another request from an anonymous reviewer post-hoc.
 
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Metagegevens
Titel
Attentional Bias in Children with Social Anxiety Disorder
Auteurs
Steffen Schmidtendorf
Susanne Wiedau
Julia Asbrand
Brunna Tuschen-Caffier
Nina Heinrichs
Publicatiedatum
27-11-2017
Uitgeverij
Springer US
Gepubliceerd in
Cognitive Therapy and Research / Uitgave 3/2018
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI
https://doi.org/10.1007/s10608-017-9880-7