Anxiety in young children: cognitive biases, development and assessment

Anxiety is one of the most prevalent disorders to affect children. To understand how anxiety develops and what factors cause and/or maintain anxiety it is important to study anxiety in young children. Currently, there is a relative lack of studies focusing on anxiety and cognitive biases in children below 8 years old, in part due to a lack of methods for assessing anxiety subtypes and cognitive biases at this age. The primary aim of this thesis is to examine the associations between anxiety and cognitive biases in children aged between 4 and 8 years. A secondary aim is to develop a brief measure of early signs of social anxiety in young children. These aims are realised across four papers. In Paper 1 a meta-analysis of the current literature on anxiety-related interpretation bias in children and adolescents is presented. A robust relationship was found, that was moderated by age. The study highlighted the need for more studies with younger children. Following this, a novel measure of interpretation bias using ambiguous tones was used in Paper 2 to assess the presence of an anxiety related interpretation bias in children aged 4 to 8. Anxiety differences in interpretation bias were only seen once developmental confounds were accounted for. Paper 3 used eye-tracking to assess the presence of an anxiety related attention bias in 4 to 8 year olds. Evidence of nuanced patterns of attention bias between anxiety groups were found. In Paper 4 a measure of social worries was adapted and validated for children ages 4 to 8. Together, the studies provide new methods for the study of cognitive biases and anxiety in young children and new insights into their association. The work leads directly to several suggestions for future research including longitudinal work that tracks biases, anxiety and developmental factors over time