Biased attentional behavior in childhood anxiety

Abstract

This review examines the state of current theory and research regarding a relatively new area of study in childhood anxiety: the examination of attentional biases associated with the processing of threatening environmental stimuli. In particular, this paper focuses upon current attempts to extend an information processing framework traditionally associated with childhood psychopathology (i.e., Crick & Dodge [Psychol Bull 115 (1994) 74]) and anxiety-related attentional bias research previously conducted only with adults, to populations of anxious children. First, a thorough discussion of Crick and Dodge's model and its applicability to current theories of anxiety is presented. Although each stage of Crick and Dodge's model is shown to possess correlates with current conceptualizations of anxiety, the research investigations reviewed here focus upon the multiple approaches that have been undertaken to better comprehend anxious children's attentional biases in encoding and subsequent task performance decrements. Specifically, recent investigations of anxious children's attentional performance utilizing Stroop tasks, probe detection tasks, and the relatively new probe localization task are reviewed. A discussion of the disparate findings associated with recent studies of each of these tasks is given, with an eye toward the need to specify the developmental, theoretical, demographic, and clinically relevant characteristics associated with the biased attentional behavior observed among highly anxious children.

Introduction

As demonstrated most acutely by the rapid rise and usage of the Internet, our world has become increasingly crowded with sensory stimuli demanding our scarce attentional resources. It has become a well-established notion that adults with significant levels of anxiety symptomatology wade their way through this mass of information with an attentional preference for those stimuli that possess some personal threat value. Anxious adults have empirically demonstrated faster reaction times to threatening stimuli when they are presented in simultaneous array with neutral stimuli, leading some researchers to conclude that anxious adults maintain a state of selective attentional vigilance for such cues (Mathews, 1990). Further, significant deficits in subsequent task performance of anxious persons, such as the impaired ability to select an appropriate response or enact such a response immediately after exposure to threatening stimuli, are often viewed as the direct result of a general reduction in the attentional processes available for such task performance (Sarason, 1988). In many ways, attentional biases to threat cues and associated cognitive interference effects are somewhat analogous to Easterbrook's (1959) findings suggesting that higher levels of arousal allow for facilitated performance on a primary task, but only at the expense of performance to a secondary task. Thus, prioritized attentional response to threat among anxious persons may initiate a chain of information processing events, which may act reciprocally to maintain and occasionally magnify anxiety states (Vasey & Daleiden, 1996).

However, understanding of how and when these biased cognitive mechanisms are triggered remains a mystery, since only a handful of studies have investigated the specific role of attentional vigilance to threat in the development and maintenance of childhood anxiety (e.g., Ehrenreich, 1999, Martin et al., 1992, Vasey et al., 1995, Vasey et al., 1996, Vasey et al., 1998). This lack of research remains mysterious, given that an understanding of childhood pathways to anxiety development can provide a unique perspective from which to understand the initial structure and function of anxiety-related information processing and associated cognitive schemata. In the existing literature on attentional biases among anxious children, the variety of methodologies employed, age groups investigated, and confusion with attentional behavior associated with comorbid disorders all suggest the need for both clarification of the variables associated with the childhood anxiety-related attentional biases and a broad framework from which to interpret such results. Moreover, the current understanding of attentional biases to threat has stemmed almost entirely from investigations with adults, possibly allowing the false assumption that the attentional mechanisms and cognitions of anxious children map perfectly with those experienced by adults.

As a context for understanding this phenomenon in children, this review will first present a single information processing framework, developed in conjunction with research on a range of developmental psychopathology, from which to understand the seemingly disparate attentional processes and related cognitive interference effects associated with childhood anxiety. The evolution and current status of the methodologies from which researchers have investigated attentional vigilance to threat cues in childhood anxiety will be introduced, with specific attention given to the most current and relevant attentional bias investigations with anxious children and the disparity of their findings. In this discussion, attention will be paid to the potential impact of variables such as age, gender, form of anxiety investigated, symptom severity, and comorbidity issues on the saliency and relevance of current childhood anxiety-related attentional vigilance and cognitive task interference investigations. The clinical relevance of this research will also be discussed. Finally, many of these same issues, along with the importance of specifying the developmental path of cognitive biases in childhood anxiety, regardless of whether such biases are primarily state or trait relevant, will be emphasized among the goals for future investigation of these information processing behaviors.