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From Anxious Youth to Depressed Adolescents: Prospective Prediction of 2-Year Depression Symptoms via Attentional Bias Measures
Price RB, Rosen D, Siegle GJ, Ladouceur CD, Tang K, Allen KB, Ryan ND, Dahl RE, Forbes EE and Silk JS.
Journal of Abnormal Psychology, 2015, Published Online

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. 

In a study led by Dr. Rebecca Price, 67 anxious youth ages 9-14 years old 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 two years after the conclusion of a larger psychotherapy treatment trial. 

Dr. Price and her colleagues found that eye-tracking patterns indicating threat avoidance predicted greater two-year depression scores, over and above baseline and posttreatment symptoms. Sustained, post-threat 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 two 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.

Contributors:
Rebecca B. Price, PhD, Greg J. Siegle, PhD, Cecile D. Ladouceur, PhD, Neal D. Ryan, MD, Erika E. Forbes, PhD, Kevin Tang (Department of Psychiatry, University of Pittsburgh)

Jennifer S. Silk, PhD, Kristy Benoit Allen, PhD and Dana Rosen, BS (Department of Psychology, University of Pittsburgh)

Ronald E. Dahl, MD (School of Public Health, University of California, Berkeley) 

This article appears in the Journal of Abnormal Psychology.  Click here to view the abstract.