Reliability and validity of the children's interview for psychiatric syndromes--parent version in autism spectrum disorders.
Eye-tracking time on subtle fear faces flags anxiety in teens with Fragile X, especially when age is factored in.
01Research in Context
What this study did
Researchers tracked where the kids with Fragile X looked when faces flashed on a screen. Half the kids had an anxiety diagnosis; half did not. The team used eye-tracking cameras to measure how long each child stared at subtle versus obvious fear faces.
The kids were 10–16 years old. Each child saw 96 trials. The computer recorded gaze time in milliseconds.
What they found
Older teens without anxiety looked longer at subtle fear faces than younger kids did. In contrast, anxious kids kept the same high stare-time no matter their age. Subtle fear worked like a magnifying glass: it showed the anxiety difference inside the FXS group better than obvious fear faces did.
The result was mixed. Age mattered, but only for the non-anxious subgroup.
How this fits with other research
Wynne et al. (1988) first noticed that boys with FXS avoid eye contact because they are anxious, not autistic. Bowen et al. (2012) now gives a number to that anxiety: extra milliseconds locked on fear.
Laugeson et al. (2014) extends the idea. They showed FXS kids rate all faces as less approachable and spot negative emotions faster. The new eye-time data fits this negative bias pattern.
Fink et al. (2014) seems to disagree. Their ASD kids recognized emotions fine once verbal IQ was controlled. The difference is diagnosis: Elian studied autism without FXS; N et al. studied FXS with and without anxiety. Fear bias shows up in FXS, not in broader ASD when language is accounted for.
Why it matters
You now have a quick, objective probe for anxiety inside FXS. If a teen stares too long at mild fear, probe further for anxiety even if parents do not report it. Pair the eye task with parent scales to catch the kids who hide their worry. Add subtle fear trials to your social-skills assessments; they are more sensitive than dramatic faces.
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02At a glance
03Original abstract
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.
Journal of autism and developmental disorders, 2012 · doi:10.1007/s10803-012-1442-y