Anxiety and threat‐related attentional biases in adolescents with fragile X syndrome

• Published in: Journal of intellectual disability research Vol. 64; no. 4; pp. 296 - 302
• Main Authors: Kelleher, B. L., Hogan, A. L., Ezell, J., Caravella, K., Schmidt, J., Wang, Q., Roberts, J. E.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.04.2020
• Subjects: Adolescent; Adolescent boys; Adolescents; Adult; Age differences; anxiety; Anxiety disorders; Anxiety Disorders - epidemiology; Anxiety Disorders - physiopathology; Anxiety Disorders - psychology; attention; Attentional bias; Attentional Bias - physiology; Bias; Cognition & reasoning; Cognitive skills; Comorbidity; development; Emotional regulation; Eye tracking; Facial expressions; Fear & phobias; Fragile X syndrome; Fragile X Syndrome - epidemiology; Fragile X Syndrome - physiopathology; Fragile X Syndrome - psychology; Humans; Male; Teenagers; Thinking Skills; threat; Tracking; Variability; Young Adult; Young adults; anxiety; attention; development; threat; eye tracking; fragile X syndrome
• ISSN: 0964-2633; 1365-2788
• DOI: 10.1111/jir.12715

Background Fragile X syndrome (FXS) is a single‐gene disorder highly associated with anxiety; however, measuring anxiety symptoms in FXS and other neurogenetic syndromes is challenged by common limitations in language, self‐awareness and cognitive skills required for many traditional assessment tasks. Prior studies have documented group‐level differences in threat‐related attentional biases, assessed via eye tracking, in FXS and non‐FXS groups. The present study built on this work to test whether attentional biases correspond to clinical features of anxiety among adolescents and young adults with FXS. Methods Participants included 21 male adolescents with FXS ages 15–20 years who completed an adapted eye‐tracking task that measured attentional bias towards fearful faces of varied emotional intensity. Results Among participants without anxiety disorders, attentional bias towards fear increased across age, similar to non‐FXS paediatric anxiety samples. In contrast, participants with anxiety disorders exhibited greater stability in fear‐related attentional biases across age. Across analyses, subtle fear stimuli were more sensitive to within‐group anxiety variability than full‐intensity stimuli. Conclusions Our results provide novel evidence that although threat‐related attentional biases may correspond with anxiety outcomes in FXS, these associations are complex and vary across developmental and task factors. Future studies are needed to characterise these associations in more robust longitudinal samples, informing whether and how eye‐tracking tasks might be optimised to reliably predict and track anxiety in FXS.