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Attentional threat avoidance and familial risk
Attentional threat avoidance and familial risk
are independently associated with childhood
anxiety disorders
Hannah M. Brown,1 Tom A. McAdams,1 Kathryn J. Lester,1 Robert Goodman,2
David M. Clark,3 and Thalia C. Eley1
1Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK;
2Child and Adolescent Psychiatry Department, Institute of Psychiatry, King’s College London, London, UK;
3Department of Psychology, Oxford University, Oxford, UK
Background: Twin studies in children reveal that familial aggregation of anxiety disorders is due to both
genetic and environmental factors. Cognitive biases for threat information are considered a robust
characteristic of childhood anxiety. However, little is known regarding the underlying aetiology of such
biases and their role in anxiety disorders. Method: A face version of the dot-probe task measuring
attentional biases for negative (anger, fear, sad, disgust) and positive (happy) facial expressions was
completed by 600, 8-year-old twins; the largest study of its kind. Twin correlations for attentional bias
scores were compared to estimate genetic and environmental effects. Parent-report diagnostic inter-
views identified children with an anxiety disorder. Indices of inferred genetic and familial risk for anxiety
disorders were created for each child. Data were analysed using a series of logistic regres-
sions. Results: Anxious children showed greater attentional avoidance of negative faces than non-
anxious children; t (548) = 2.55, p .05. Attentional avoidance was not under genetic or shared
environmental influence. Risk for anxiety disorders was predicted by familial factors. Both attentional
avoidance and inferred familial risk were significant but independent predictors of anxiety disorders
(ORs = .65 and 3.64, respectively). Conclusions: Anxiety-related attentional biases and familial risk
play important but independent roles in childhood anxiety disorders. If replicated
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