Cited by 127Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional DevelopmentPsychoanalysis and Psychopathology Research

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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

Waters, A. M., Bradley, B. P., Mogg, K.·2014·Psychological Medicine

DOI 10.1017/s0033291713000779

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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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Authors: Waters, A. M., Bradley, B. P., & Mogg, K.
Affiliations: Griffith University (AU)
University of Southampton (GB)
Corresponding author: Waters, A. M.
ORCID: Waters, A. M.
Bradley, B. P.
Mogg, K.
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
DOI: 10.1017/s0033291713000779
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
Licence: www.cambridge.org/core/terms (unspecified)
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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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

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