Association between attention bias to threat and anxiety symptoms in children and adolescents

Rany Abend*, Leone de Voogd, Elske Salemink, Reinout W. Wiers, Koraly Pérez-Edgar, Amanda Fitzgerald, Lauren K. White, Giovanni A. Salum, Jie He, Wendy K. Silverman, Jeremy W. Pettit, Daniel S. Pine, Yair Bar-Haim

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Considerable research links threat-related attention biases to anxiety symptoms in adults, whereas extant findings on threat biases in youth are limited and mixed. Inconsistent findings may arise due to substantial methodological variability and limited sample sizes, emphasizing the need for systematic research on large samples. The aim of this report is to examine the association between threat bias and pediatric anxiety symptoms using standardized measures in a large, international, multi-site youth sample. Methods: A total of 1,291 children and adolescents from seven research sites worldwide completed standardized attention bias assessment task (dot-probe task) and child anxiety symptoms measure (Screen for Child Anxiety Related Emotional Disorders). Using a dimensional approach to symptomatology, we conducted regression analyses predicting overall, and disorder-specific, anxiety symptoms severity, based on threat bias scores. Results: Threat bias correlated positively with overall anxiety symptoms severity (ß = 0.078, P =.004). Furthermore, threat bias was positively associated specifically with social anxiety (ß = 0.072, P =.008) and school phobia (ß = 0.076, P =.006) symptoms severity, but not with panic, generalized anxiety, or separation anxiety symptoms. These associations were not moderated by age or gender. Conclusions: These findings indicate associations between threat bias and pediatric anxiety symptoms, and suggest that vigilance to external threats manifests more prominently in symptoms of social anxiety and school phobia, regardless of age and gender. These findings point to the role of attention bias to threat in anxiety, with implications for translational clinical research. The significance of applying standardized methods in multi-site collaborations for overcoming challenges inherent to clinical research is discussed.

Original languageEnglish
Pages (from-to)229-238
Number of pages10
JournalDepression and Anxiety
Issue number3
StatePublished - Mar 2018


FundersFunder number
United States – Israel Binational Science Foundation2013349
National Institutes of HealthR34 MH097931, R01 MH094633
National Institute of Mental HealthZIAMH002781-15, UH2MH101470, NCT00018057
United States - Israel Binational Agricultural Research and Development Fund
Irish Research Council


    • GAD/generalized anxiety disorder
    • SAD/social anxiety disorder/social phobia
    • anxiety/anxiety disorders
    • biological markers
    • child/adolescent
    • computer/internet technology
    • international
    • phobia/phobic disorders
    • separation anxiety


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