title: From anxious youth to depressed adolescents: Prospective prediction of 2-year depression symptoms via attentional bias measures.
abstract: Anxious youth are at heightened risk for subsequent development of depression; however, little is known regarding which anxious youth are at the highest prospective risk. Biased attentional patterns (e.g., vigilance and avoidance of negative cues) are implicated as key mechanisms in both anxiety and depression. Aberrant attentional patterns may disrupt opportunities to effectively engage with, and learn from, threatening aspects of the environment during development and/or treatment, compounding risk over time. Sixty-seven anxious youth (ages 9-14; 36 female) completed a dot-probe task to assess baseline attentional patterns provoked by fearful-neutral face pairs. The time course of attentional patterns both during and after threat was assessed via eye-tracking and pupilometry. Self-reported depressive and anxiety symptoms were assessed 2 years after the conclusion of a larger psychotherapy treatment trial. Eye-tracking patterns indicating threat avoidance predicted greater 2-year depression scores, over and above baseline and posttreatment symptoms. Sustained, postthreat pupillary avoidance (reflecting preferential neural engagement with the neutral relative to the previously threatening location) predicted additional variance in depression scores, suggesting sustained avoidance in the wake of threat further exacerbated risk. Identical eye-tracking and pupil indices were not predictive of anxiety at 2 years. These biobehavioral markers imply that avoidant attentional processing in the context of anxiety may be a gateway to depression across a key maturational window. Excessive avoidance of threat could interfere with acquisition of adaptive emotion regulation skills during development, culminating in the broad behavioral deactivation that typifies depression. Prevention efforts explicitly targeting avoidant attentional patterns may be warranted.
authors.affiliation: Department of Psychiatry, University of Pittsburgh.
authors.forename: Rebecca B
authors.initials: RB
authors.lastname: Price
authors.affiliation: Department of Psychology, University of Pittsburgh.
authors.forename: Dana
authors.initials: D
authors.lastname: Rosen
authors.affiliation: Department of Psychiatry, University of Pittsburgh.
authors.forename: Greg J
authors.initials: GJ
authors.lastname: Siegle
authors.affiliation: Department of Psychiatry, University of Pittsburgh.
authors.forename: Cecile D
authors.initials: CD
authors.lastname: Ladouceur
authors.affiliation: Department of Neuroscience, University of Pittsburgh.
authors.forename: Kevin
authors.initials: K
authors.lastname: Tang
authors.affiliation: Department of Psychiatry, University of Pittsburgh.
authors.forename: Kristy Benoit
authors.initials: KB
authors.lastname: Allen
authors.affiliation: Department of Psychiatry, University of Pittsburgh.
authors.forename: Neal D
authors.initials: ND
authors.lastname: Ryan
authors.affiliation: Department of Community Health and Human Development, Berkeley School of Public Health.
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Dahl
authors.affiliation: Department of Psychiatry, University of Pittsburgh.
authors.forename: Erika E
authors.initials: EE
authors.lastname: Forbes
authors.affiliation: Department of Psychiatry, University of Pittsburgh.
authors.forename: Jennifer S
authors.identifier: 0000-0002-8638-4337
authors.initials: JS
authors.lastname: Silk
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D000070379:Attentional Bias; D001362:Avoidance Learning; D015415:Biomarkers; D002648:Child; D003863:Depression / Q000150:complications* / Q000175:diagnosis*; D053483:Eye Movement Measurements; D005133:Eye Movements; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D011379:Prognosis; D011613:Psychotherapy; D012307:Risk Factors
chemical_list: D015415:Biomarkers