Can attentional biases predict outcome of CBT in children with social anxiety disorder?

Background

Many studies have investigated differences in attention allocation to threat between socially anxious individuals and healthy controls in adult and child samples. The extent to which differences exist within the group of socially anxious individuals and whether these have a predictive value for the extent of symptom reduction after cognitive-behavioral therapy (CBT) has been studied less until to date and yielded inconsistent findings, particularly in child samples.

Methods

The present study investigated whether three different indices of biased attention, measured at pretreatment by eye-tracking, were associated with differences in response to a 12-session exposure-based group CBT in a sample of 41 children with social anxiety disorder (SAD).

Results

In linear regression analyses neither initial vigilance nor initial maintenance nor attentional avoidance predicted symptom reductions after CBT. Children who no longer met diagnostic criteria after treatment did not differ from those who did not fully remit in terms of initial vigilance and attentional avoidance (d < .36). With regard to initial maintenance of attention to threat, the analysis revealed a large but statistically non-significant effect between both groups (d = .81).

Conclusion

Initial maintenance of attention to threat may be beneficial for the treatment of social anxiety. However, the evidence in our study is only weak and further research is needed before clear implications can be drawn.