Background: A bias to selectively direct attention to threat stimuli is a cognitive characteristic of anxiety
disorders. Recent studies indicate that individual differences in pre-treatment threat attention bias
predict treatment outcomes from cognitive-behavioural therapy (CBT) in anxious individuals. However,
there have been inconsistent findings regarding whether attention bias towards threat predicts better or
poorer treatment outcome.
Method: This longitudinal study examined treatment outcomes in 35 clinically-anxious children
following a 10-week, group-based CBT program, as a function of whether children showed a pretreatment
attention bias towards or away from threat stimuli. The effect of CBT on attention bias was
also assessed.
Results: Both groups showed significant improvement after receiving CBT. However, anxious children
with a pre-treatment attention bias towards threat showed greater reductions not only in anxiety
symptom severity, but also in the likelihood of meeting diagnostic criteria for anxiety disorders at posttreatment
assessment, in comparison with anxious children who showed a pre-treatment attention bias
away from threat. Children who had a pre-treatment bias away from threat showed a reduction in this
bias over the course of CBT.
Conclusions: Findings suggest that pre-existing differences in the direction of attention towards versus
away from threat could have important implications for the treatment of anxious children.