Predicting anxiety symptoms through gaze-directed attention: A mobile eye-tracking study of adolescents during a real-world speech task

Adolescence is a key period in which anxiety symptoms dramatically increase, particularly among adolescent girls. Identifying potentially-modifiable risk factors that contribute to anxiety symptoms may be critical to mitigate anxiety symptoms and disorders among youth. Attention biases are one set of cognitive risk factors implicated in the development and maintenance of anxiety disorders. Yet previous research remains mixed as to what pattern of attention bias characterizes adolescents at-risk for developing anxiety. Further, prior literature has largely relied on indirect measures of attention (e.g., reaction time) and tasks with low ecological validity. The present study investigated how attention to social evaluative feedback contributed to concurrent and prospective anxiety symptoms in adolescent girls (n = 90, baseline M_age = 12.31, SD =.83). The present study used a novel speech task and mobile eye-tracking technology to assess gaze-directed attention in an ecologically valid context that adolescents encounter daily. We hypothesized that adolescents who engage in vigilance, avoidance, and the combination of vigilance-avoidance of potentially critical social evaluative feedback would report greater concurrent and prospective anxiety symptoms. We also explored the association between gaze-directed attention to positive social feedback. Contrary to our hypotheses, adolescents who exhibited both initial and sustained avoidance of potentially critical social feedback reported the greatest anxiety three-years later, controlling for baseline anxiety symptoms. Findings highlight the importance of avoidance in real-world socially threatening scenarios in contributing to and maintaining anxiety. Findings also highlight the value of studying attention biases that contribute to anxiety symptoms among adolescents using reliable methods and in real-world contexts.