A study found that anxious and nonanxious children had similar patterns of attention to threat cues. These findings were published in Behaviour Research and Therapy.

Children aged 10-12 years meeting the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria for anxiety (n=92) and not meeting the criteria (n=371) were recruited in Sydney, Australia via advertisements. The gaze of participants was evaluated by eye-tracking software while they viewed adolescent faces depicting angry or happy expressions coupled with a face with a neutral expression. Face pairs were shown to the children for 5000 ms.

Participants were aged mean 11.19 (SD, 0.55) years, 46.9% were boys, 81.9% were White, and 89.2% were from a household that earned >$80,000 AUD. The anxious children had a specific phobia (51%), generalized anxiety disorder (43.5%), social phobia (40.2%), attention-deficit/hyperactivity disorder (10.8%), separation anxiety disorder (4.3%), oppositional defiant disorder (4.3%), major depressive disorder (1.1%), or persistent depressive disorder (1.1%).

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During the angry trials, girls tended to fixate significantly longer than boys on neutral faces (t[487], -3.92; P <.001) and shorter on the angry face (t[483], 3.91; P <.001). Asian participants fixated less on angry faces than White or other ethnicity participants (F[3,488], 4.47; P =.004).

All children had a faster latency to first fixate on angry faces (mean, 0.68) than on neutral faces (mean, 0.76). There was a significant main effect (F[1,446], 23.78; P <.001) and an effect for Spence Children’s Anxiety Scale (SCAS)-child scores (F[1,445], 15.31; P <.001).

At earlier times, the children dwelled longer on angry faces than on neutral faces (F[9,4059], 20.55; P <.001), and at later times, the children dwelled longer on neutral faces.

Stratified by age, preadolescents fixated more rapidly on angry faces (mean, 0.68) than on neutral faces (mean, 0.76).

During happy trials, all children fixated more rapidly on happy faces (mean, 0.66) than on neutral faces (mean, 0.77). There was a significant main effect (F[1,444], 30.46; P <.001) and effects for SCAS-child (F[1,443], 10.46; P =.001) and SCAS-parent (F[1,443], 29.48; P <.001) scores.

Stratified by age, preadolescents had longer dwell times on happy faces than on neutral faces (F[9,4032], 11.18; P <.001).

This study may have been biased by using faces of similar aged persons and angry faces of peers which may not convey the same type of anger as from an adult.

The study authors concluded, “In the largest study using eye-tracking methodology in young people to date, there was little evidence of anxiety-related differences in visual attention allocation to peer-related angry and happy faces relative to neutral faces in preadolescents between 10 and 12 years of age. Anxious and nonanxious youth showed faster initial attention allocation towards threat, followed by a later broadening of attention away from threat, while youth continued to preferentially dwell on happy relative to neutral faces overall.”


Oar EL, Johnco CJ, Waters AM, et al. Eye-tracking to assess anxiety-related attentional biases among a large sample of preadolescent children. Behav Res Ther. 2022;153:104079. doi:10.1016/j.brat.2022.104079