Hypervigilance and avoidance in visual attention in children with social phobia.

BACKGROUND AND OBJECTIVES Attentional bias towards threat in socially anxious adults is well documented; however, research on this bias in children with social phobia is rather scarce. The present study investigates whether the hypervigilance-avoidance hypothesis also applies to children with social phobia. METHODS Thirty children (aged 8-12) with social phobia and 43 control children participated in an eye-tracking experiment while their attentional distribution was recorded. Social anxiety was induced in half of the children before the eye-tracking task. Stimuli were presented for 3000 ms, and bias scores for initial fixations and the time span of attention were assessed. RESULTS Results indicated initial vigilance towards angry faces for all children independent of anxiety induction, while hypervigilance (but not avoidance) was only established in children with social phobia for angry-neutral face pairs and with social fears induced. Self-report measures of anxiety correlated with bias towards threat with more pronounced associations occurring in the anxiety induction condition. LIMITATIONS We did not record reaction times simultaneously which limits the opportunity to compare our results to some previous studies which focused on this variable as an indicator of attention. CONCLUSIONS Cognitive biases in elementary school children (between 8 and 12 years) relate to hypervigilant rather than to avoidant information processing. Attentional distribution varies over time. Differences between clinical anxious and healthy children seem to be modified by anxiety induction, symptom severity and contextual stimuli, such as the emotional valence of a face and the context in which the threat stimulus appears.