Anxiety and Attentional Bias to Threat in Children at Increased Familial Risk for Autism Spectrum Disorder.

The reaction-time analyses included only 11 high-risk children with autism, 21 high-risk children without autism and 29 low-risk controls, so small group sizes make negative findings hard to interpret. Three children who had met autism criteria at 36 months no longer met criteria at 7 years and were removed from further analyses. No child had a formal anxiety diagnosis, and anxiety was measured only as parent-reported symptoms. The task used non-social threat images, and the authors note that neutral images may have been ambiguous for this population. The authors suggest future studies should ask children to rate the images. The reported analyses used data from the 7-year visit, so they describe associations at one time point rather than change over time. The authors note that parent-reported anxiety may be unreliable in autism and that parents of children with autism may overestimate anxiety severity.

Funded by Autistica, Autism Speaks and the Medical Research Council. The supplied text does not include an author conflict-of-interest declaration.

Do not conclude that threat bias explains anxiety in children with autism, or that this pattern proves a causal mechanism. The anxiety-threat association was driven by the group that did not meet autism criteria; the group that met autism criteria had higher parent-reported anxiety but no significant threat bias.