Threat-related selective attention predicts treatment success in childhood anxiety disorders.
OBJECTIVE
The present study examined whether threat-related selective attention was predictive of treatment success in children with anxiety disorders and whether age moderated this association. Specific components of selective attention were examined in treatment responders and nonresponders.


METHODS
Participants consisted of 131 children with anxiety disorders (aged 8-16 years), who received standardized cognitive-behavioral therapy. At pretreatment, a pictorial dot-probe task was administered to assess selective attention. Both at pretreatment and posttreatment, diagnostic status of the children was evaluated with a semistructured clinical interview (the Anxiety Disorders Interview Schedule for Children).


RESULTS
Selective attention for severely threatening pictures at pretreatment assessment was predictive of treatment success. Examination of the specific components of selective attention revealed that nonresponders showed difficulties to disengage their attention away from severe threat. Treatment responders showed a tendency not to engage their attention toward severe threat. Age was not associated with selective attention and treatment success.


CONCLUSIONS
Threat-related selective attention is a significant predictor of treatment success in children with anxiety disorders. Clinically anxious children with difficulties disengaging their attention away from severe threat profit less from cognitive-behavioral therapy. For these children, additional training focused on learning to disengage attention away from anxiety-arousing stimuli may be beneficial.
Legerstee
Jeroen S
JS
Department of Child and Adolescent Psychiatry, Erasmus Medical Center Rotterdam/Sophia Children's Hospital, Dr. Molewaterplein 60, PO Box 2060, 3000 CB Rotterdam, The Netherlands.
Tulen
Joke H M
JH
Kallen
Victor L
VL
Dieleman
Gwen C
GC
Treffers
Philip D A
PD
Verhulst
Frank C
FC
Utens
Elisabeth M W J
EM
D000293:Adolescent; D000367:Age Factors; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D001288:Attention; D001362:Avoidance Learning; D002648:Child; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D016896:Treatment Outcome