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Does irritability predict attention biases toward threat among clinically anxious youth?

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Abstract

Aberrant threat processing is a known cognitive characteristic of anxiety disorders and irritability. Youth with more severe symptomatology show greater allocation of attention towards threat relative to neutral stimuli. Although irritability contributes to poorer outcomes among anxious youths, irritability has not been considered as a contributing factor to threat processing in anxiety disorders. Thus, the current study examined the role of irritability in predicting attention biases for threat among clinically anxious youth. Our study included 84 clinically anxious youth (M = 9.31 years old, SD = 2.44) who completed a dot-probe task to determine attention biases. Anxiety disorders were assessed using semi-structured diagnostic interviews. Well validated measures were used to assess the severity of anxiety and irritability symptoms via child- and parent-report, respectively. Findings indicated that more severe irritability predicted greater attention biases toward threat among clinically anxious youth, covarying for age, anxiety severity, and the number of comorbid diagnoses. At a trend-level, anxiety severity also predicted attention bias for threat. Among clinically anxious youth, irritability severity was the strongest predictor of attention bias toward threat. Findings point to the salience of irritability, and to some extent anxiety severity, in relation to threat processing among youth with clinical anxiety disorders.

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Data availability

Due to the sensitive nature of the data, survey respondents were assured raw data would remain confidential.

Notes

  1. Recent CFA research indicates that irritability loads onto three items in the CBCL [45], however, in the current study, we followed previous attention bias research using the five item scale [14], which also had higher internal consistency in the sample.

Abbreviations

DMDD:

Disruptive mood dysregulation disorder

ADHD:

Attention deficit hyperactivity disorder

GAD:

Generalised anxiety disorder

ODD:

Oppositional defiant disorder

OCD:

Obsessive compulsive disorder

ADIS-P:

Anxiety disorders interview schedule: parent version

ADIS-C:

Anxiety disorders interview schedule: child version

SCAS-C:

Spence child anxiety scale-child report

CBCL:

Child behaviour checklist

RT:

Reaction time

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Funding

This research was supported by funding awarded to Professor Allison Waters by Griffith University and the Australian Research Council (DP120101678 and FT130101330).

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Authors and Affiliations

  1. School of Applied Psychology, Griffith University, Brisbane, Australia

    Olivia M. Elvin & Allison M. Waters

  2. School of Applied Psychology, Menzies Health Institute Queensland, Southport, Australia

    Kathryn L. Modecki

Authors
  1. Olivia M. Elvin
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  2. Allison M. Waters
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  3. Kathryn L. Modecki
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Corresponding authors

Correspondence to Olivia M. Elvin or Allison M. Waters.

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The authors have no conflicts of interest to declare.

Ethical approval

The study was approved by the University Human Research Ethics Committee (PSY/03/09/HREC; PSY/C4/11/HREC). Informed consent/assent was provided by both parents and children.

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Elvin, O.M., Waters, A.M. & Modecki, K.L. Does irritability predict attention biases toward threat among clinically anxious youth?. Eur Child Adolesc Psychiatry 32, 1435–1442 (2023). https://doi.org/10.1007/s00787-022-01954-3

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