Predicting Anxiety Using Measures of Negative Interpretation Bias in Clinically Anxious Youth: A Pilot Study

Negative interpretation bias is defined as an individual’s tendency to interpret ambiguous events in the environment as negative or threatening (Beard, 2011; Beard & Amir, 2009; Miers, Blote, Bogels, & Westenberg, 2008; Muris & Field, 2008; Rozenman, Amir, & Weersing, 2014). A heightened negative interpretation bias predicts high levels of trait anxiety and clinical levels of anxiety in adults and youth (Amin, Foa, & Coles, 1998; Amir, Prouvost, & Kuckertz, 2012; Muris & Field, 2008). Understanding the psychopathology of anxiety disorders through a lens of underlying information processing biases, including interpretation biases, can allow researchers to take a mechanistic approach to investigating cognitive processes associated with impairment and dysfunction (Muris & Field, 2008), resulting in the identification of potential treatment targets (Pine, 2007). The current study aims to examine associations between several interpretation bias indices and anxiety symptoms in clinically anxious youth, with the hypothesis that, if these measures all tap into the same underlying construct of interpretation bias, resulting bias scores should be strongly related and should also be associated with symptoms of anxiety. Thirty anxious youth were assessed using the Anxiety Disorders Interview Schedule for the DSM-IV (or for the DSM-5), Child Version (ADIS-IV-C/P or ADIS-5-C/P, respectively). Parents and children reported child anxiety symptoms via the Screen for Child Anxiety Related Disorders (SCARED-C/P). Youth also completed implicit (IM), explicit-personally irrelevant (EM), and explicit-personally relevant (ERM) measures of interpretation biases (WSAP; Amir et al., 2012; Beard & Amir, 2009; Rozenman et al., 2014, AIBQ; Miers et al., 2008). Consistent with hypotheses, correlational analyses show a strong relationship between the IM of bias towards threat and the EM of bias towards threat (r = 0.55, p \u3c 0.01) and a negative correlation between the IM of bias away from benign and the EM of bias towards benign (r = -0.49, p \u3c 0.01). Contrary to hypotheses, no association was found between the ERM of negative bias and the other two measures of negative interpretation bias. SCARED-C/P scores were only associated with the ERM of interpretation biases (Total anxiety r= 0.45, p\u3c0.05; Generalized Anxiety Disorder (GAD) symptoms r=0.61, p\u3c0.01). Interpretation bias measures may assess different constructs, with personally relevant explicitly measured negative interpretation bias uniquely relating to anxiety symptomology in anxious youth. Moderation analyses revealed that while females displayed marginally higher total anxiety symptoms than males (t (26) = 1.72, p = 0.098), males showed more intense levels of negative interpretation bias via the IM (t (28) = 1.77, p = 0.07). Hispanic individuals displayed both marginally higher total anxiety symptoms (t (25) = 1.96, p = 0.06) and enhanced negative interpretation bias via the IM (t (27) = 2.297, p \u3c0.05). Results indicate that, while associations exist between the intensity of negative interpretation bias measured via IMs and EMs, only ERMs reliably predict anxiety disorder symptoms in clinically anxious youth. Results also suggest that ethnicity may play an important role in the relevance of negative interpretation bias in assessment and treatment of anxious youth