(PS3-C68) Strategic Attention Control Moderates the Association Between Rapidly Deployed Attention to Threat and Social Anxiety in Youth: A Multimodal Approach

Objective: Attention processes play a critical role in the development and maintenance of social anxiety in youth. Theoretical models propose that heightened, rapidly deployed (i.e., automatic) attention to threat is associated with social anxiety, and that strategic attention control (AC) processes can attenuate or exacerbate this association. We used a multi-modal, multi-informant assessment approach to examine youth AC and its components, attention focusing and attention shifting, as moderators of the association between attention to threat and social anxiety symptom severity in peri-pubertal youth. We expected that attention to threat would be positively related to youth social anxiety, and that AC would moderate this relationship such that attention to threat would be positively related to social anxiety at low but not high levels of AC. We tentatively expected similar moderation effects for the components of AC, attention focusing and attention shifting.

Method: Participants were 100 youth (ages 9-14 years, M = 11.64 years, SD = 1.75; 81.4% White, 60.8% Hispanic or Latino; 58.0% females assigned at birth) referred to an anxiety disorders specialty research clinic. We used a multi-modal approach to examine social anxiety, AC, and attention to threat. We measured social anxiety using the Social Phobia and Anxiety Inventory for Children (SPAIC; youth self-report and parent-report). We measured AC, including attention focusing and attention shifting components, using the Attentional Control Scale (ACS; youth self-report). We measured attention to threat using eye-tracking during a free viewing task of emotional faces. Specifically, we quantified attention to threat as first fixation to threat stimuli (i.e., if youth’s first fixation was on a threatening face or a neutral face) and mean total first fixation dwell time on threat (i.e., how long youths maintained their first fixation on a threatening face).

Results: First fixation dwell time on threat was significantly associated with social anxiety, r = .35, p = .007. AC significantly moderated the association between social anxiety and attention to threat, such that attention was significantly and positively associated with social anxiety when AC scores were low but not high. A significant moderation effect was also found for attention focusing, but not attention shifting.

Conclusion: Rapidly deployed attention to threat was related to social anxiety symptom severity in peri-pubertal youth. Further, strategic AC and its component, attention focusing, moderated the association between attention to threat and youth social anxiety. These findings advance theory by demonstrating the interplay between distinct attentional processes – automatic and strategic – in social anxiety using a multi-modal approach. They also suggest distinct modifiable targets for interventions to reduce social anxiety.