Stationary and ambulatory attention patterns are differentially associated with early temperamental risk for socioemotional problems: Preliminary evidence from a multimodal eye-tracking investigation

Youth Generalized Anxiety and Brain Activation States During Socioemotional Processing

Importance

The brain enters distinct activation states to support differential cognitive and emotional processes, but little is known about how brain activation states differ in youths with clinical anxiety.

Objective

To characterize brain activation states during socioemotional processing (movie stimuli) and assess associations between state characteristics and movie features and anxiety symptoms.

Design, Setting, and Participants

The Healthy Brain Network is an ongoing cross-sectional study of individuals aged 5 to 21 years experiencing difficulties in school, of whom approximately 45% met criteria for a lifetime anxiety disorder diagnosis. Data used in this study are from the first 9 releases (collected in a nonclinical research setting in the New York City metropolitan area from 2015 to 2020) and include 620 youths aged 5 to 15 years (53% of whom met criteria for a lifetime anxiety disorder diagnosis) who watched an emotional video during functional magnetic resonance imaging and completed questionnaires and clinical evaluation. Of those with functional magnetic resonance imaging data, 432 youths aged 7 to 15 years also self-reported on anxiety symptoms. Data were processed and analyzed between February 2020 and August 2024.

Main Outcomes and Measures

A hidden Markov model was trained to identify brain activation states across participants during video watching. Time spent in each state and the moment-to-moment probability of being in each state were extracted. Videos were annotated for emotion-specific and nonspecific information using the EmoCodes system. Self-reported anxiety symptoms were assessed using the Screen for Child Anxiety Related Disorders. Time spent in each state across the video and during and outside of peaks in negative content correlated with generalized and social anxiety scores.

Results

Among the 620 youths in the overall analysis, 369 were male and the mean (SD) age was 10.4 (2.8) years. In the anxiety symptom analysis, 263 of 432 youths were male and the mean (SD) age was 11.5 (2.2) years. Three brain activation states were identified: a high somatomotor activation state (state 1), a high cingulo-opercular network activation state (state 2), and a high ventral attention and default mode state (state 3). The probability of being in state 3 was correlated with video content that was more negative, quieter, and with less visual motion (ρ < 0.08; P < .001). Increased generalized anxiety was associated with greater time in state 3 (B, 0.10; 95% CI, 0.01 to 0.20; false discovery rate [FDR]-corrected P = .048) and less time in state 2 (B, -0.11; 95% CI, -0.21 to -0.02; FDR-corrected P = .048) when negative social cues were present.

Conclusions and Relevance

Youths entered 3 distinct brain activation states during movie watching, and youths with anxiety spent more time in a state with high ventral attention and default activation during negative socioemotional processing. Youths high in generalized anxiety may be more engaged in deeply processing negative emotional content, which may influence self-regulation. Interventions that focus on changing physiological and psychological state during negative social interactions in youths with anxiety should be considered.

Implementing mobile eye tracking in psychological research: A practical guide

Eye tracking provides direct, temporally and spatially sensitive measures of eye gaze. It can capture visual attention patterns from infancy through adulthood. However, commonly used screen-based eye tracking (SET) paradigms are limited in their depiction of how individuals process information as they interact with the environment in "real life". Mobile eye tracking (MET) records participant-perspective gaze in the context of active behavior. Recent technological developments in MET hardware enable researchers to capture egocentric vision as early as infancy and across the lifespan. However, challenges remain in MET data collection, processing, and analysis. The present paper aims to provide an introduction and practical guide to starting researchers in the field to facilitate the use of MET in psychological research with a wide range of age groups. First, we provide a general introduction to MET. Next, we briefly review MET studies in adults and children that provide new insights into attention and its roles in cognitive and socioemotional functioning. We then discuss technical issues relating to MET data collection and provide guidelines for data quality inspection, gaze annotations, data visualization, and statistical analyses. Lastly, we conclude by discussing the future directions of MET implementation. Open-source programs for MET data quality inspection, data visualization, and analysis are shared publicly.

Evaluating the Link between Visual Attention Bias and Emotion Dysregulation of Young Children

The ability to regulate emotions is vital to successful social interactions. This study explores whether visual attention bias is associated with emotion dysregulation (ED) in early childhood. Parental reports of child ED (Child Behaviour Checklist (CBCL) and Temper Tantrum Scale) were examined in relation to child visual attention bias whilst viewing emotional faces. Results indicated that the level of eye gaze fixation towards emotional images and faces was associated with ED when social function (measured with the Social Responsiveness Scale), gender, age, and attention problems (measured from the CBCL subscale), were adjusted. The modifying effect on visual attention bias was evaluated using interaction analysis in the generalized linear model. The level of visual attention bias, indicated by the proportion of eye gaze fixation time on areas of interest (AOIs) in images displaying unpleasant emotions (such as anger), was inversely associated with the level of externalising problem behaviours (p = .014). Additionally, the association of eye gaze fixation time for AOIs displaying negative emotional cues with the level of externalising problem behaviours varied by age (p = .04), with younger children (aged < 70 months) demonstrating a stronger association than older children (aged ≥ 70 months). Findings suggest that young children with greater ED symptoms look less at unpleasant emotional cues. However, this relationship is attenuated as children become older. Further research to identify objective biomarkers that incorporate eye-tracking tasks may support prediction of ED-related mental health issues in the early years.

Variability in caregiver attention bias to threat: A Goldilocks effect in infant emotional development?

Attention biases to threat are considered part of the etiology of anxiety disorders. Attention bias variability (ABV) quantifies intraindividual fluctuations in attention biases and may better capture the relation between attention biases and psychopathology risk versus mean levels of attention bias. ABV to threat has been associated with attentional control and emotion regulation, which may impact how caregivers interact with their child. In a relatively diverse sample of infants (50% White, 50.7% female), we asked how caregiver ABV to threat related to trajectories of infant negative affect across the first 2 years of life. Families were part of a multi-site longitudinal study, and data were collected from 4 to 24 months of age. Multilevel modeling examined the effect of average caregiver attention biases on changes in negative affect. We found a significant interaction between infant age and caregiver ABV to threat. Probing this interaction revealed that infants of caregivers with high ABV showed decreases in negative affect over time, while infants of caregivers with low-to-average ABV showed potentiated increases in negative affect. We discuss how both high and extreme patterns of ABV may relate to deviations in developmental trajectories.

Cross-cultural applicability of eye-tracking in assessing attention to emotional faces in preschool-aged children

Humans show an attention bias toward emotional versus neutral information, which is considered an adaptive pattern of information processing. Deviations from this pattern have been observed in children with socially withdrawn behaviors, with most research being conducted in controlled settings among children from urban areas. The goal of the current study was to examine the cross-cultural applicability of two eye-tracking-based measures in assessing attention biases and their relations to children's symptoms of socially withdrawn behaviors in two independent and diverse samples of preschool children. The cross-cultural comparison was conducted between the Navajo Birth Cohort study (NBCS), an indigenous cohort with relatively low socioeconomic status (SES), and the Illinois Kids Development study (IKIDS), a primarily Non-Hispanic White and high SES cohort. Children in both cohorts completed eye-tracking tasks with pictures of emotional faces, and mothers reported on children's symptoms of socially withdrawn behaviors. Results showed that general patterns of attention biases were mostly the same across samples, reflecting heightened attention toward emotional versus neutral faces. The differences across two samples mostly involved the magnitude of attention biases. NBCS children were slower to disengage from happy faces when these emotional faces were paired with neutral faces. Additionally, socially withdrawn children in the NBCS sample showed a pattern of attentional avoidance for emotional faces. The comparability of overall patterns of attention biases provides initial support for the cross-cultural applicability of the eye-tracking measures and demonstrates the robustness of these methods across clinical and community settings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Relations between social attention, expressed positive affect and behavioral inhibition during play

Flexible social attention, including visually attending to social interaction partners, coupled with positive affect may facilitate adaptive social functioning. However, most research assessing social attention relies on static computer-based paradigms, overlooking the dynamics of social interactions and limiting understanding of individual differences in the deployment of naturalistic attention. The current study used mobile eye-tracking to examine relations between social attention, expressed affect, and behavioral inhibition during naturalistic play in young children. Children (N = 28, Mage = 6.12, 46.4% girls, 92.9% White) participated in a 5-min free play with a novel age- and sex-matched peer while mobile eye-tracking data were collected. Interactions were coded for social attention and expressed affect and modeled second-by-second, generating 4,399 observations. Children spent more time dwelling on toys than on peers or anywhere else in the room. Further analyses demonstrated children were almost twice as likely to gaze at their peer when simultaneously self-expressing positive affect. Additionally, children were more than twice as likely and more than three times as likely to self-express positive affect when dwelling on peer or in the presence of peer-expressed positive affect, respectively. Behavioral inhibition was not significantly related to social attention. However, children higher in behavioral inhibition were less likely to self-express positive affect in the presence of peer-expressed positive affect. The current results provide a snapshot of relations between social attention, expressed affect and individual differences during play and provide guidance for future work assessing the roles of social attention and positive affect in facilitating positive social interactions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Do you see what I mean?: Using mobile eye tracking to capture parent-child dynamics in the context of anxiety risk

Temperamental behavioral inhibition (BI) is a robust endophenotype for anxiety characterized by increased sensitivity to novelty. Controlling parenting can reinforce children's wariness by rewarding signs of distress. Fine-grained, dynamic measures are needed to better understand both how children perceive their parent's behaviors and the mechanisms supporting evident relations between parenting and socioemotional functioning. The current study examined dyadic attractor patterns (average mean durations) with state space grids, using children's attention patterns (captured via mobile eye tracking) and parental behavior (positive reinforcement, teaching, directives, intrusion), as functions of child BI and parent anxiety. Forty 5- to 7-year-old children and their primary caregivers completed a set of challenging puzzles, during which the child wore a head-mounted eye tracker. Child BI was positively correlated with proportion of parent's time spent teaching. Child age was negatively related, and parent anxiety level was positively related, to parent-focused/controlling parenting attractor strength. There was a significant interaction between parent anxiety level and child age predicting parent-focused/controlling parenting attractor strength. This study is a first step to examining the co-occurrence of parenting behavior and child attention in the context of child BI and parental anxiety levels.

Mobile Eye Tracking Captures Changes in Attention Over Time During a Naturalistic Threat Paradigm in Behaviorally Inhibited Children

Attentional biases to and away from threat are considered hallmarks of temperamental Behavioral Inhibition (BI), which is a documented risk factor for social anxiety disorder. However, most research on affective attentional biases has traditionally been constrained to computer screens, where stimuli often lack ecological validity. Moreover, prior research predominantly focuses on momentary presentations of stimuli, rather than examining how attention may change over the course of prolonged exposure to salient people and objects. Here, in a sample of children oversampled for BI, we used mobile eye-tracking to examine attention to an experimenter wearing a "scary" or novel gorilla mask, as well as attention to the experimenter after mask removal as a recovery from exposure. Conditional growth curve modeling was used to examine how level of BI related to attentional trajectories over the course of the exposure. We found a main effect of BI in the initial exposure to the mask, with a positive association between level of BI and proportion of gaze allocated to the stranger's masked face over time. Additionally, there was a main effect of BI on proportion of gaze allocated to the stranger's face plus their mask during the recovery period when the mask was removed.

Adults with higher social anxiety show avoidant gaze behaviour in a real-world social setting: A mobile eye tracking study

Attentional biases are a core characteristic of social anxiety (SA). However, research has yielded conflicting findings and failed to investigate these biases in real, face-to-face social situations. Therefore, this study examined attentional biases in SA by measuring participants’ eye gaze within a novel eye-tracking paradigm during a real-life social situation. Student participants (N = 30) took part in what they thought was a visual search study, when a confederate posing as another participant entered the room. Whilst all participants avoided looking at the confederate, those with higher SA fixated for a shorter duration during their first fixation on him, and executed fewer fixations and saccades overall as well as exhibiting a shorter scanpath. These findings are indicative of additional avoidance in the higher SA participants. In contrast to previous experimental work, we found no evidence of social hypervigilance or hyperscanning in high SA individuals. The results indicate that in unstructured social settings, avoidance rather than vigilance predominates, especially in those with higher SA.

Profiles of Naturalistic Attentional Trajectories Associated with Internalizing Behaviors in School-Age Children: A Mobile Eye Tracking Study

The temperament profile Behavioral Inhibition (BI) is a strong predictor of internalizing behaviors in childhood. Patterns of attention towards or away from threat are a commonality of both BI and internalizing behaviors. Attention biases are traditionally measured with computer tasks presenting affective stimuli, which can lack ecological validity. Recent studies suggest that naturalistic visual attention need not mirror findings from computer tasks, and, more specifically, children high in BI may attend less to threats in naturalistic tasks. Here, we characterized latent trajectories of naturalistic visual attention over time to a female stranger, measured with mobile eye tracking, among kindergarteners oversampled for BI. Group-based trajectory modeling (GBTM) revealed two latent trajectories: 1) high initial orienting to the stranger, gradual decay, and recovery, and 2) low initial orienting and continued avoidance. Higher probability of membership to the "avoidant" group was linked to greater report of internalizing behaviors. We demonstrate the efficacy of mobile eye tracking in quantifying naturalistic patterns of visual attention to social novelty, as well as the importance of naturalistic measures of attention in characterizing socioemotional risk factors.

Using mobile eye-tracking technology to examine adolescent daughters' attention to maternal affect during a conflict discussion

Attention to socio-emotional stimuli (i.e., affect-biased attention) is an integral component of emotion regulation and human communication. Given the strong link between maternal affect and adolescent behavior, maternal affect may be a critical influence on adolescent affect-biased attention during mother-child interaction. However, prior methodological constraints have precluded fine-grained examinations of factors such as maternal affect on adolescent attention during real-world social interaction. Therefore, this pilot study capitalized on previously validated technological advances by using mobile eye-tracking and facial affect coding software to quantify the influence of maternal affect on adolescents' attention to the mother during a conflict discussion. Results from 7,500 to 9,000 time points sampled for each mother-daughter dyad (n = 28) indicated that both negative and positive maternal affect, relative to neutral, elicited more adolescent attentional avoidance of the mother (ORs = 2.68-9.20), suggesting that typically developing adolescents may seek to avoid focusing on maternal affect of either valence during a conflict discussion. By examining the moment-to-moment association between in vivo displays of maternal affect and subsequent adolescent attention toward the mother's face, these results provide preliminary evidence that maternal affect moderates adolescent attention. Our findings are consistent with cross-species approach-avoidance models suggesting that offspring respond to affectively charged conversations with greater behavioral avoidance or deference.

Eye tracking in human interaction: Possibilities and limitations

There is a long history of interest in looking behavior during human interaction. With the advance of (wearable) video-based eye trackers, it has become possible to measure gaze during many different interactions. We outline the different types of eye-tracking setups that currently exist to investigate gaze during interaction. The setups differ mainly with regard to the nature of the eye-tracking signal (head- or world-centered) and the freedom of movement allowed for the participants. These features place constraints on the research questions that can be answered about human interaction. We end with a decision tree to help researchers judge the appropriateness of specific setups.

Vigilant or avoidant? Children's temperamental shyness, patterns of gaze, and physiology during social threat

Temperamental shyness is characterized by fear, wariness, and the perception of threat in response to social novelty. Previous work has been inconsistent regarding attentional patterns to social threat among shy children, with evidence for both avoidance and vigilance. We examined relations between children's shyness and gaze aversion during the approach of a stranger (i.e., a context of social novelty), and tested whether these patterns of gaze moderated relations between shyness and autonomic reactivity and recovery. Participants included 152 typically-developing children (M_age  = 7.82 years, SD = 0.44 years) who had their respiratory sinus arrhythmia (RSA) recorded during baseline, social novelty, and recovery. Children's shyness correlated with increases in self-reported nervousness from baseline to social novelty, providing support for perceived threat. Results revealed that children's proportion of gaze aversion from social novelty was related to shyness in a U-shape pattern such that both low levels of gaze aversion (i.e., attentional vigilance) and high levels of gaze aversion (i.e., attentional avoidance) were related to higher levels of shyness. Further, we found that children's shyness was directly related to decreases in RSA from baseline to social novelty, whereas quadratic gaze to social novelty moderated the relation between shyness and RSA recovery. Specifically, shyness was related to greater RSA recovery among children who exhibited attentional vigilance during the novel social interaction. Our findings provide support for both avoidance of, and vigilance to, social threat among different shy children, and these gaze strategies may be differentially related to physiological regulation during novel social encounters.

Understanding the Emergence of Social Anxiety in Children With Behavioral Inhibition

Behavioral inhibition (BI) is a temperament characterized in early childhood by distress to novelty and avoidance of unfamiliar people, and it is one of the best-known risk factors for the development of social anxiety. However, nearly 60% of children with BI do not go on to meet criteria for social anxiety disorder. In this review we present an approach to understanding differential developmental trajectories among children with BI. We review research using laboratory-based tasks that isolate specific attention processes that enhance versus mitigate risk for social anxiety among behaviorally inhibited children and studies that suggest that BI is associated with heightened detection of novelty or threat. Moreover, stimulus-driven control processes, which we term "automatic control," increase the probability that behaviorally inhibited children display socially reticent behavior and develop social anxiety. In contrast, goal-driven control processes, which we term "planful control," decrease risk for anxiety. We suggest that these three categories of processes (detection, automatic control, and planful control) function together to determine whether behaviorally inhibited children are able to flexibly regulate their initial reactions to novelty, and in turn, decrease risk for social anxiety. Although laboratory-based tasks have identified these processes underlying risk and resilience, the challenge is linking them to the emotions, thoughts, and behaviors of behaviorally inhibited children in real-world contexts.

Multimodal examination of emotion processing systems associated with negative affectivity across early childhood

High Temperamental Negative Affectivity in early childhood has been found to predict later emotion dysregulation. While much work has been conducted to separately probe bio-behavioral systems associated with Negative Affectivity, very little work has examined the relations among multiple systems across age. In this study, we use multi-modal methods to index neurobiological systems associated with Negative Affectivity in 53 4-7-year-old children. Prefrontal activation during emotion regulation was measured using functional near-infrared spectroscopy over the lateral prefrontal cortex (PFC) while children played a game designed to elicit frustration in Social (Happy and Angry faces) and Nonsocial contexts. Gaze behaviors while free-viewing Happy and Angry faces were also measured. Finally, Negative Affectivity was indexed using a score composite based on factor analysis of parent-reported temperament. Using mixed-effects linear models, we found an age-dependent association between Negative Affectivity and both PFC activation during frustration and fixation duration on the mouth area of Happy faces, such that older children high in Negative Affectivity spent less time looking at the mouths of Happy faces and had lower PFC activation in response to frustration (ps<0.034). These results provide further insight to how Negative Affectivity may be associated with changes in affective neurobiological systems across early childhood.

Variable- and person-centered approaches to affect-biased attention in infancy reveal unique relations with infant negative affect and maternal anxiety

Affect-biased attention is an automatic process that prioritizes emotionally or motivationally salient stimuli. Several models of affect-biased attention and its development suggest that it comprises an individual's ability to both engage with and disengage from emotional stimuli. Researchers typically rely on singular tasks to measure affect-biased attention, which may lead to inconsistent results across studies. Here we examined affect-biased attention across three tasks in a unique sample of 193 infants, using both variable-centered (factor analysis; FA) and person-centered (latent profile analysis; LPA) approaches. Using exploratory FA, we found evidence for two factors of affect-biased attention: an Engagement factor and a Disengagement factor, where greater maternal anxiety was related to less engagement with faces. Using LPA, we found two groups of infants with different patterns of affect-biased attention: a Vigilant group and an Avoidant group. A significant interaction noted that infants higher in negative affect who also had more anxious mothers were most likely to be in the Vigilant group. Overall, these results suggest that both FA and LPA are viable approaches for studying distinct questions related to the development of affect-biased attention, and set the stage for future longitudinal work examining the role of infant negative affect and maternal anxiety in the emergence of affect-biased attention.

Detection of eye contact with deep neural networks is as accurate as human experts

Eye contact is among the most primary means of social communication used by humans. Quantification of eye contact is valuable as a part of the analysis of social roles and communication skills, and for clinical screening. Estimating a subject's looking direction is a challenging task, but eye contact can be effectively captured by a wearable point-of-view camera which provides a unique viewpoint. While moments of eye contact from this viewpoint can be hand-coded, such a process tends to be laborious and subjective. In this work, we develop a deep neural network model to automatically detect eye contact in egocentric video. It is the first to achieve accuracy equivalent to that of human experts. We train a deep convolutional network using a dataset of 4,339,879 annotated images, consisting of 103 subjects with diverse demographic backgrounds. 57 subjects have a diagnosis of Autism Spectrum Disorder. The network achieves overall precision of 0.936 and recall of 0.943 on 18 validation subjects, and its performance is on par with 10 trained human coders with a mean precision 0.918 and recall 0.946. Our method will be instrumental in gaze behavior analysis by serving as a scalable, objective, and accessible tool for clinicians and researchers.

Psychometric properties of threat-related attentional bias in young children using eye-tracking

Anxiety is one of the most common forms of child psychopathology associated with persistent impairment across the lifespan. Therefore, investigating mechanisms that underlie anxiety in early childhood may improve prevention and intervention efforts. Researchers have linked selective attention toward threat (i.e., attentional bias to threat) with the development of anxiety. However, previous work on attentional bias has used less reliable, reaction time (RT)-based measures of attention. Additionally, few studies have used eye-tracking to measure attentional bias in young children. In the present study, we investigated the psychometric properties of an eye-tracking measure of attentional bias in a sample of young children between 6- and 9-years-old and explored if trait and clinical anxiety were related to attentional biases to threat. Results showed good psychometric properties for threat and neutral attentional biases, comparable to those found in adult eye-tracking studies. Temperamental and clinical anxiety did not significantly relate to threat/neutral dwell time and attentional biases. The significance of these null findings was discussed in relation to existing developmental theories of attentional biases. Future studies should explore if temperamental or clinical anxiety prospectively predict threat attentional bias and the onset of anxiety in older children using a longitudinal design.

Navigating through the experienced environment: Insights from mobile eye tracking

Researchers are acutely interested in how people engage in social interactions and navigate their environment. However, in striving for experimental or laboratory control, we often instead present individuals with representations of social and environmental constructs and infer how they would behave in more dynamic and contingent interactions. Mobile eye-tracking (MET) is one approach to connecting the laboratory to the experienced environment. MET superimposes gaze patterns captured through head or eye-glass mounted cameras pointed at the eyes onto a separate camera that captures the visual field. As a result, MET allows researchers to examine the world from the point of view of the individual in action. This review touches on the methods and questions that can be asked with this approach, illustrating how MET can provide new insight into social, behavioral, and cognitive processes from infancy through old age.

Validating a mobile eye tracking measure of integrated attention bias and interpretation bias in youth

Introduction

This study sought to validate a real-world speech task designed to assess attention and interpretation bias in an integrated and ecologically valid manner.

Methods

Thirty adolescent girls gave a speech in front of an emotionally ambiguous judge and a positive judge while wearing mobile eye tracking glasses to assess how long they looked at each judge (i.e., attention bias). They also reported their interpretations of the ambiguous judge and distress associated with the task (i.e., interpretation bias).

Results

These task-based measures correlated with self-report of interpretation bias and mother-report of attentional control, demonstrating convergent validity. They did not correlate with frustration or high intensity pleasure, indicating discriminant validity. Task-based measures of interpretation bias also showed predictive and incremental validity in relation to child distress during the speech.

Discussion

This proof-of-concept study demonstrates the initial validity of a novel task designed to assess attention and interpretation bias as they manifest in real-world social interactions.