Attention bias to emotional information in children as a function of maternal emotional disorders and maternal attention biases
Introduction
Children of parents with emotional disorders have an increased risk for developing anxiety and depressive disorders (e.g. Micco et al., 2009, Weissman et al., 2006). Parental depression is associated with a threefold increase in an individual's risk for developing a depressive episode during adolescence (Williamson, Birmaher, Axelson, Ryan, & Dahl, 2004), and maternal depression is linked with an earlier onset and more severe course of depression in offspring (Lieb, Isensee, Hofler, Pfister, & Wittchen, 2002). Similarly, offspring of parents with anxiety disorders are at 3.5 (range 1.3–13.3) times greater risk for anxiety disorders than are offspring of non-anxious parents (e.g., Merikangas, Avenevoli, Dierker, & Grillon, 1999). However, the mechanisms underlying this risk to offspring are not well understood. Children's exposure to maternal cognitive biases might be one factor influencing offspring risk for emotional disorders (Goodman & Gotlib, 1999).
Cognitive theories propose that individuals with emotional disorders, and those at risk for their development, selectively attend to negative stimuli and/or fail to attend to positive stimuli (Beck, 1967, Eysenck, 1997; Mogg & Bradley, 1998; Teasdale, 1988; Williams, Watts, MacLeod, & Mathews, 1997). Empirically, it has been repeatedly demonstrated that emotional disorders are linked with attention biases. For example, increased attention bias to threat is associated with both high levels of anxiety symptoms and a range of anxiety disorders (e.g., see Bar-Haim, Lamy, Pergamin, Bakermans-Kraneburg, & van Ijzendoom, 2007 for a review) while increased attention bias to negative information, and a reduced bias for positive information has been repeatedly found in depression (e.g., Gotlib and Joormann, 2010, Joormann and Gotlib, 2007, Browning et al., 2012). Thus, if mothers have a lifetime history of an emotional disorder and dysfunctional attention biases (e.g. increased bias for negative information and/or reduced bias for positive information), their offspring may be more likely to develop attention biases favouring negative information and to develop emotional disorders later in life.
Previous studies of high-risk children suggest that attention biases may be cognitive markers of risk for emotional disorders. For example, children of mothers with a lifetime history of depression showed greater attention bias to negative faces, and a reduced bias for positive faces, compared with children of mothers with no history of emotional disorders (i.e., Joormann, Talbot, & Gotlib, 2007). Daughters of mothers with a lifetime history of depression have also showed greater attention to sad faces than children of never-depressed mothers, while no group differences were observed for positive faces (i.e., Kujawa et al., 2011). In both of these studies, attention bias was assessed following negative mood induction. In other studies (not using mood induction), children of mothers with a lifetime history of depression showed greater avoidance of sad faces than children of never-depressed mothers and no effect for angry or happy faces (i.e., Gibb, Benas, Grassia, & McGeary, 2009), while children of mothers with lifetime panic disorder showed increased bias towards threat stimuli (i.e., Mogg, Wilson, Hayward, Cunning, & Bradley, 2012). Attention bias for positive stimuli was not assessed.
Therefore, evidence to date regarding the direction of attention biases in high-risk children is mixed in terms of biases towards versus avoidance of negative information. One factor that could be contributing to these mixed findings is that attention biases of high-risk children are influenced by the attention biases exhibited by their mothers (Goodman & Gotlib, 1999). That is, high-risk children may exhibit an attention bias for negative information if their mothers also preferentially attend to negative information and/or ignore positive information.
Therefore, the aims of the present study were to examine (a) attention biases for emotional information in children as a function of mothers' lifetime history of emotional disorders, and (b) mothers' own attention biases for emotional information. It was hypothesised that (1) attention bias for negative information would be greater in high-risk children (i.e. offspring of mothers with a lifetime history of emotional disorders) compared to low-risk children; and (2) within high-risk children, attention bias to negative information would be greater in children whose mothers have an increased attention bias for negative stimuli, or lack of an attention bias for positive stimuli.
Section snippets
Participants
One hundred and six parent-child dyads were initially assessed to participate in this study which was approved by the Griffith University Human Research Ethics Committee. They were recruited through community advertisements, primary school and university notices and newsletters, local newspapers, GPs, and community mental health clinics as part of a larger study on risk factors for the development of emotional disorders in children (see Waters, Peters, Forrest, & Zimmer-Gembeck, 2014). Initial
Characteristics of high-and low-risk groups
High-risk (n = 38) and low-risk (n = 29) children did not differ significantly in age, t(65) = 0.31, p = .76, gender ratio, Χ2 = 0.14, p = .71, SCAS-C, t(65) = 0.31, p = .76, SCAS-P, t(65) = 0.57, p = .57, or CES-DC total scores, t(65) = 1.21, p = .23 (see Table 1). Compared to mothers without lifetime emotional disorders, mothers with lifetime emotional disorders had significantly higher STAI-trait anxiety, t(65) = 3.01, p = .004, and DASS-Depression scores, t(65) = 2.48, p = .016, and trends
Discussion
Despite a growing literature demonstrating that children of mothers with lifetime emotional disorders are at elevated risk for developing an emotional disorder, relatively little is known about the factors and mechanisms that underlie this elevated risk. The present study found no support for the first hypothesis that, as a group, offspring of mothers with a lifetime history of emotional disorders would display an attention bias for negative information. However, consistent with the second
Acknowledgements
This research was supported by Australian Research Council Grant DP1095536 awarded to Dr Allison Waters.
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