Attention Deployment to the Eye Region of Emotional Faces among Adolescents with and without Social Anxiety Disorder

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ORIGINAL ARTICLE

Attention Deployment to the Eye Region of Emotional Faces among Adolescents with and without Social Anxiety Disorder Nicole N. Capriola‑Hall1 · Thomas H. Ollendick2 · Susan W. White1 Accepted: 15 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract Background  Avoidance of the eye region, especially of faces showing anger, may maintain social anxiety symptoms by negatively reinforcing expectations and fears associated with social situations. Eye-tracking research, however, has yet to explicitly examine differences in attention allocation to the eye region of emotional faces among adolescents with social anxiety disorder (SAD). Methods  Gaze patterns were explored in a sample of youth with and without SAD matched on age and sex. Results  Adolescents with SAD were quicker to fixate, and maintained their initial gaze longer, to the eye region, regardless of emotion, relative to teens without SAD. Group-level differences also emerged for initial fixation duration directed to the eye region of angry faces (when compared with happy faces). Conclusions  These findings suggest that vigilance to the eye region of faces, especially angry faces, (when compared with happy faces) is characteristic of adolescents with SAD. Adolescents with SAD seem drawn to the eye region, more so than teens without SAD. Keywords  Social anxiety disorder · Adolescents · Eye-tracking · Attention · Emotion Cognitive models of social anxiety suggest that symptoms are maintained by deficits in social information processing (Rapee and Heimberg 1997) and that social anxiety disorder (SAD) is characterized by abnormalities in visual processing of threat related stimuli (Armstrong and Olatunji 2012; Schmidtendorf et al. 2018). Specifically, eye tracking studies using emotional face pairs have found that compared with healthy controls, children and adolescents with SAD demonstrate an initial orienting bias towards angry faces relative to neutral faces (Capriola-Hall et al. 2019; Seefeldt et al. 2014). However, findings by Schmidtendorf et al. (2018) did not find evidence for hypervigilance using free-viewing eyetracking paradigms. These authors found that children (ages 9–13, M age = 11.4) with SAD initially fixated their gaze less often on angry faces relative to happy and neutral faces; however, the directionality of attention changed following * Nicole N. Capriola‑Hall [email protected] 1



Center for Youth Development and Intervention, University of Alabama, Tuscaloosa, AL 35487, USA



Department of Psychology, Virginia Tech; Child Study Center, Blacksburg, VA 24061, USA

2

schema activation (i.e., participants told they were going to give a speech task which prompted fears of social evaluation). Overall, these findings provide initial evidence for patterns of attention allocation associated with SAD in children and adolescents and suggest the importance of considering the temporal course of attention bias across stimulus presentation (i.e., both initial fixation and over the time