Biased attentional behavior in childhood anxiety: A review of theory and current empirical investigation
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.
Section snippets
An information processing framework
Crick and Dodge (1994), in an extension of work by McFall (1982) and McFall and Dodge (1982) regarding the roles of verbal capacity and intention cue detection in children's social behavior (Dodge, Murphy, & Buchabaum, 1984), proposed an information processing framework through which they suggested that one could understand both cognition and emotion as wholly intertwined in a “single symbolic scheme.” Within this framework, emotions are conceptualized as a driving energy, observed through
Recent investigations of anxiety-related attentional bias and cognitive deficits in children
From the perspective of Crick and Dodge's framework, it appears logical to say that anxious children's skillful selection of threatening stimuli may be the beginning link in a sequential chain of dysregulatory information processing behaviors. However, empirical observation of this behavior in childhood has been minimal. While compelling evidence points to the existence of such an attentional bias to threat cues in adults, systematic investigations of this process in children have only recently
Clinical implications
In terms of cognitive–behavioral models associated with childhood anxiety treatment, research on attentional bias to threat cues in a child's environment has clear importance to the conceptualization of this form of psychopathology. Reference is made to modifying constructs such as attention and memory biases in the treatment literature of Beck (1986) and Meichenbaum and Goodman (1971), as it is in most every major cognitive model of anxiety. Moreover, investigations such as McNally et al.
Conclusions and future directions for research
This review has examined the state of current research regarding facilitated encoding of threatening stimuli by anxious children, from both the perspective of a childhood psychopathology-based information processing theory and the various methodologies that have attempted to measure this phenomenon. It does appear that, under certain circumstances, such as high levels of clinical anxiety or under the combined influences of depression and anxiety symptomatology, attentional biases, which promote
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