The free-viewing matrix task: A reliable measure of attention allocation in psychopathology.

Aberrant attention allocation has been implicated in the etiology and maintenance of a range of psychopathologies. However, three decades of research, relying primarily on manual response-time tasks, have been challenged on the grounds of poor reliability of its attention bias indices. Here, in a large, multisite, international study we provide reliability information for a new eye-tracking-based measure of attention allocation and its relation to psychopathology and age. Data from 1567 participants, across a wide range of psychiatric diagnoses and ages, were aggregated from nine sites around the world. Of these, 213 participants also provided retest data. Acceptable overall internal consistency and test-retest reliability were observed among adult participants (Cronbach's alpha = 0.86 and r(213) = 0.89, respectively), as well as across all examined psychopathologies. Youth demonstrated lower internal consistency scores (Cronbach's alpha = 0.65). Finally, the percent dwell time index derived from the task statistically differentiated between healthy participants and participants diagnosed with social anxiety disorder, major depression, and post-traumatic stress disorder. These results potentially address a long-standing reliability crisis in this research field. Aberrant attention allocation patterns in a variety of psychiatric disorders may be targeted with the hope of affecting symptoms. The attention allocation index derived from the matrix task offers reliable means to measure such cognitive target engagement in clinical contexts.

An Experimental Therapeutics Approach to the Development of a Novel Computerized Treatment Targeting Error-Related Brain Activity in Young Children.

In the current study, we utilize an experimental medicine approach to examine the extent to which a single-session, computerized intervention impacts a transdiagnostic neural marker of risk (i.e., the error-related negativity [ERN]) in 70 children between the ages of 6 and 9 years. The ERN is a deflection in the event-related potential occurring after an individual makes a mistake on a lab-based task and has been shown to be transdiagnostically associated with a variety of anxiety disorders (e.g., social anxiety, generalized anxiety), obsessive-compulsive disorder, and depressive disorders in over 60 studies to date. Building on these findings, work has been done to link an increased ERN to negative reactions to, and avoidance of, making mistakes (i.e., error sensitivity). In the current study, we capitalize on this previous work by examining the extent to which a single-session, computerized intervention may engage the target of "error sensitivity" (measured by the ERN, as well as self-report of error sensitivity). We examine the convergence of multiple measures of the construct of "error sensitivity" (i.e., child self-report, parent report on child, and child electroencephalogram [EEG]). We also examine relationships between these three measures of "error sensitivity" and child anxiety symptoms. Overall, results suggested that treatment condition predicted changes in self-reported error sensitivity but not changes in ERN. Based on the lack of previous work in this area, we view this study as a novel, preliminary, first step toward using an experimental medicine approach to examine our ability to engage the target of the ERN (i.e., error sensitivity) early in development.

Psychometric properties of threat-related attentional bias in young children using eye-tracking.

Anxiety is one of the most common forms of child psychopathology associated with persistent impairment across the lifespan. Therefore, investigating mechanisms that underlie anxiety in early childhood may improve prevention and intervention efforts. Researchers have linked selective attention toward threat (i.e., attentional bias to threat) with the development of anxiety. However, previous work on attentional bias has used less reliable, reaction time (RT)-based measures of attention. Additionally, few studies have used eye-tracking to measure attentional bias in young children. In the present study, we investigated the psychometric properties of an eye-tracking measure of attentional bias in a sample of young children between 6- and 9-years-old and explored if trait and clinical anxiety were related to attentional biases to threat. Results showed good psychometric properties for threat and neutral attentional biases, comparable to those found in adult eye-tracking studies. Temperamental and clinical anxiety did not significantly relate to threat/neutral dwell time and attentional biases. The significance of these null findings was discussed in relation to existing developmental theories of attentional biases. Future studies should explore if temperamental or clinical anxiety prospectively predict threat attentional bias and the onset of anxiety in older children using a longitudinal design.

The association between parenting and the error-related negativity across childhood and adolescence.

Anxiety is the most common form of psychopathology, and it is often characterized by chronic impairment across the lifespan. Researchers have identified core neural markers that confer risk for anxious outcomes. An increased error-related negativity (ERN) in anxious individuals has been shown to prospectively predict onset of anxiety disorders across development. Hence, it is critical to examine environmental factors that may shape the ERN. In the current study, we use a large sample of 170 female adolescents aged 10-17 to investigate whether the ERN mediates the relationship between parenting style and anxiety diagnostic status. This study replicates previous findings, and it extends previous work by suggesting that this relationship is more robust in young children as compared to adolescents. Interventions targeting the ERN via parenting may be most effective during childhood.

Parental Presence Impacts a Neural Correlate of Anxiety (the Late Positive Potential) in 5-7 Year Old Children: Interactions with Parental Sensitivity to Child Anxiety.

Anxiety disorders tend to onset early in development and often result in chronic impairment across the lifespan. Thus, there is substantial interest in identifying early neural markers of anxiety and leveraging these markers to better understand processes leading to anxiety. The late positive potential (i.e., LPP) indexes sustained attention to motivationally relevant stimuli; and the LPP to negative images is increased in individuals with anxiety. In the current study, we examined how parental presence impacts the LPP to threatening images in children (52.6% male) between 5 and 7 years-old (N = 78). Moreover, we explored interactions with parental sensitivity to child anxiety symptoms. Results suggest that when children are in the presence of their parent (compared to the presence of an experimenter), they displayed a larger LPP to threatening images. LPP activity was modulated by parental response to their child's anxiety symptoms, such that children with parents who were overly reactive to their children's anxiety symptoms had the greatest LPP response when viewing threatening stimuli in their parent's presence. Additionally, exploratory analyses indicated that children with clinical and subclinical anxiety were characterized by an increased LPP to negative images, but only when the LPP was measured with parents in the room. Findings are novel and extend previous work by suggesting that parents who react strongly when observing their children's anxiety symptoms in turn increase their child's engagement with threatening stimuli, thereby placing them at greater risk for anxiety.

The Presence of a Controlling Parent Is Related to an Increase in the Error-Related Negativity in 5-7 Year-Old Children.

Anxiety disorders often begin early in life and there is substantial interest in identifying neural markers that characterize developmental trajectories that result in anxiety. The error-related negativity (ERN) is elicited when people make errors on lab-based reaction-time tasks, is increased in anxious children, and can predict the onset of anxiety across development. In light of this, there is an increasing interest in identifying environmental factors that may shape the ERN in children. Previous work suggests that controlling parenting styles may relate to the ERN in offspring. However, no study had yet examined the specific mechanism whereby parenting style may impact the ERN in children. We propose that it may be children's repeated exposure to making mistakes in the context of their parents' reactions (i.e., verbal or non-verbal reactions, displays of parental control, etc.) that may lead to an increased ERN. We test this novel hypothesis by measuring the ERN in 94 children between the ages of 5-7 years old, while their parent observes them and then while an experimenter observes them complete a Go-No/Go task. Results suggest that the presence of parents characterized by high control potentiates the ERN in their children. Moreover, the relationship between controlling parenting styles and child anxiety disorder status was mediated by the parent presence potentiation of the ERN. These findings are important and novel insofar as they highlight the impact of an environmental factor (i.e., parenting) in shaping a neural marker of risk for anxiety in children (i.e., the ERN).

Understanding the Link between Anxiety and a Neural Marker of Anxiety (The Error-Related Negativity) in 5 to 7 Year-Old Children.

Despite growing evidence that an elevated error-related negativity (ERN) is a risk marker for anxiety, it is unclear what psychological construct underlies this association. To address this gap, we devised a 9-item self-report scale for assessing error sensitivity (i.e. the fear of making mistakes) in children. The Child Error Sensitivity Index was administered to 97 children ages 5-7 years old and demonstrated good internal reliability and convergent validity. The Child Error Sensitivity Index related to the ERN, and the relationship between the ERN and child anxiety symptoms was mediated by scores on the Child Error Sensitivity Index.