Biased attention to threat in paediatric anxiety disorders (generalized anxiety disorder, social phobia, specific phobia, separation anxiety disorder) as a function of ‘distress’versus‘fear’ diagnostic categorization
Abstract
BACKGROUND: Structural models of emotional disorders propose that anxiety disorders can be classified into fear and distress disorders. Sources of evidence for this distinction come from genetic, self-report and neurophysiological data from adults. The present study examined whether this distinction relates to cognitive processes, indexed by attention bias towards threat, which is thought to cause and maintain anxiety disorders. METHOD: Diagnostic and attention bias data were analysed from 435 children between 5 and 13 years of age; 158 had principal fear disorder (specific phobia, social phobia or separation anxiety disorder), 75 had principal distress disorder (generalized anxiety disorder, GAD) and 202 had no psychiatric disorder. Anxious children were a clinic-based treatment-seeking sample. Attention bias was assessed on a visual-probe task with angry, neutral and happy faces. RESULTS: Compared to healthy controls, children with principal distress disorder (GAD) showed a significant bias towards threat relative to neutral faces whereas children with principal fear disorder showed an attention bias away from threat relative to neutral faces. Overall, children displayed an attention bias towards happy faces, irrespective of diagnostic group. CONCLUSIONS: Our findings support the distinction between fear and distress disorders, and extend empirically derived structural models of emotional disorders to threat processing in childhood, when many anxiety disorders begin and predict lifetime impairment.
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Threat-avoidance is sometimes found in anxiety disorders.
“and is sometimes found in anxiety disorders (e.g., Eldar et al., 2012;Salum et al., 2013;Waters et al., 2014).”
From Anxiety and attention to threat: cognitive mechanisms and treatment with attention bias modification (2016) · cites this paper as Waters et al., 2014
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Attentional Bias towards Threatening and Neutral Facial Expressions in High Trait Anxious Children
Kelly, L., Maratos, F. A., Lipka, S., & Croker, S. J. (2016) · Journal of Experimental Psychopathology · doi:10.5127/jep.052915 · Cited by 15 · see citing works
Early behavioral and physiological markers of social anxiety in infants with fragile X syndrome
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Testing a Cognitive Pathway Between Temperament and Childhood Anxiety
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Attentional Bias in Children with Asthma with and without Anxiety Disorders
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Evidence of attentional bias toward body stimuli in men
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Autistic Children Quickly Orient Away from Both Eyes and Mouths During Face Observation
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Attentional bias and math avoidance: insights from a developmental sample
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Anxiety Disorders in Children and Adolescents
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Pediatric Generalized Anxiety Disorder
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- Authors
- Waters, A. M., Bradley, B. P., & Mogg, K.
- Affiliations
- Griffith University (AU)
- University of Southampton (GB)
- Corresponding author
- Waters, A. M.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2013-04-17
- Volume
- 44
- Issue
- 3
- Pages
- 607-616
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2150804423
- Cited by
- 126
- References
- 44
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 7 · 2023: 3 · 2022: 9 · 2021: 9 · 2020: 10 · 2019: 12 · 2018: 11 · 2017: 16 · 2016: 20 · 2015: 15 · 2014: 8 · 2013: 1
- FWCI
- 19.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Griffith Research Online (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- generalized anxiety disorder, social anxiety disorder, specific phobia, separation anxiety disorder, threat processing, emotional face processing, children, visual probe task
- MeSH terms
- Adolescent, Adult, Analysis of Variance, Anxiety Disorders, Attention, Child, Child, Preschool, Facial Expression, Fear, Female, Humans, Interview, Psychological, Male, Photic Stimulation, Reaction Time, Severity of Illness Index, Stress, Psychological, Case-Control Studies, Diagnostic and Statistical Manual of Mental Disorders, Self Report
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