Don’t look away: Study shows teenage girls who avoid potentially negative feedback prone to higher anxiety

LAWRENCE — To better understand anxiety, a psychologist from the University of Kansas studied 90 teenage girls in sessions spanning three years, using wearable eye-tracking glasses as the subjects gave a speech to two judges: one who responded positively and one who responded potentially negatively. In other words, one judge maintained a neutral facial expression, occasionally looked around the room, and shifted in their seat. 

The takeaway? Teenage girls who avoided looking at this potentially negative feedback during their speeches reported the most anxiety three years later, even accounting for their initial baseline level of anxiety.

The findings, recently published in the Journal of Anxiety Disorders, run counter to prevailing wisdom in the field.

“When we think about what puts kids at risk for anxiety, one of the things we look at is how they pay attention to the world around them,” said Kristy Allen, assistant professor of clinical child psychology at KU. “Past research suggests that adults who focus on things in their environment that seem more threatening may be at greater risk. For example, in a crowd of people, if one person has a negative or angry expression, or even an ambiguous expression you can’t quite read, some individuals will focus more on that face than others. There’s evidence suggesting that adults who habitually focus on overtly negative or potentially negative cues may be more likely to develop heightened levels of anxiety. The literature is decidedly more mixed in youth, however, which this study tried to better understand.”

Allen said this idea is called “attention bias.”  In other words, it’s a slant in how you direct your focus across environments.

“That was the background for this particular study,” she said. “But interestingly, we found almost the opposite of what is commonly seen in adults. Specifically, adolescent girls who avoided potentially threatening information, both immediately at the start of the task and across the 2 minutes, showed the greatest increase in anxiety symptoms over time.” 

Girls are thought to be particularly sensitive to social feedback, which could contribute to the onset of anxiety disorders in adolescence. That’s why the study focused on girls, who by the third year of the study were ages 13-15.

“For this particular paper, we focused on what we call the ‘attention task,’” said the KU researcher. “We tell participants to imagine they’re auditioning for a reality TV show for kids, and they need to convince us why we should choose them for the show. We only give them two minutes to prepare a two-minute speech, which is intentional — it’s hard to prepare under that kind of time pressure. The goal is to make it a somewhat stressful situation so we can observe how it impacts where they direct their attention.”

Two “judges” listened to the subjects’ speeches. What participants didn’t know was that the judges were trained ahead of time to behave in specific ways. Allen said one judge was the “positive judge,” following a set of instructions so that every 10 seconds, they did something nonverbal but encouraging — smiling, nodding, giving warm, positive feedback. The second judge was the “potentially critical judge.” This judge maintained a neutral expression the whole time. 

“Not smiling, not frowning, not looking disgusted, just flat,” Allen said. “But in a stressful situation like giving a speech, even neutrality can feel negative or critical.”

Most research in this field is based on youth responses to static images presented via computerized tasks. Allen and her team sought to create a real-world situation that more closely mimics what attention bias might look like in a teenager’s daily life. Mobile eye-tracking glasses enable such innovation.

Allen performed the initial study during postdoctoral training. 

“This study’s task is one that I developed in collaboration with my postdoctoral mentor at the University of Pittsburgh, and so we started the collection of this data while I was still there as a postdoc, and we’re now continuing to write studies underpinned by that data,” Allen said. 

Allen’s collaborators, all from the University of Pittsburgh, were lead author Emily Hutchinson, Erica Huynh, Mary Woody, Dev Chopra, Amelia Lint, Enoch Du, Cecile Ladouceur and Jennifer Silk. 

The research into gaze-directed attention using eye-tracking glasses continues now that Allen is at KU.

“A big focus of my research is looking at the intergenerational transmission of anxiety — really trying to understand why anxiety tends to cluster in families,” she said. “While genetics are certainly important, environmental factors actually account for more of this effect.”

Now, Allen is analyzing the eye-tracking data of mothers as they observed their daughters’ speeches to the judges, drawn from the same experimental data as the current paper.

“We had mothers in the room with their adolescent daughters,” Allen said. “The moms also wore eye-tracking glasses so we could monitor how they attended to potential threats and how that attention might shape their interactions with their child. The mothers actually helped their daughters prepare for the task. Our hypothesis is that moms who are more vigilant to threat may approach stressful situations in ways that make them even more stressful for their child. For example, they might try to take over the task rather than giving their child the autonomy to work through it themselves.”

Next, the KU researcher hopes to bring fathers into the Families, Anxiety, Cognition, and Treatment (FACT) Lab at KU.

“I’ve got a different set of hardware, but similar eye-tracking glasses, and the goal is to understand the unique role of dads,” Allen said. “We know anxiety can flow through the paternal side as well, and I want to better understand how these attention biases in parents shape outcomes for the next generation.”

A current study in Allen’s lab uses electrophysiology to better understand how the brains of moms and children respond when they observe ambiguous stimuli like the potentially critical judge from the attention task. For more information on eligibility, check out the Brains, Emotions, and Thoughts Study.

 

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