Interpretation Biases and Childhood Anxiety: The Moderating Role of Parasympathetic Nervous System Reactivity

Introduction: Interpretation biases—the predisposition to interpret ambiguous or neutral situations as negative or threatening—are a robust risk factor for the development of childhood anxiety. Yet, the affective processes influencing the association between interpretation biases and anxiety symptoms are poorly understood. The present investigation addressed this gap in knowledge by examining vagal modulation of arousal, as indexed by respiratory sinus arrhythmia (RSA), as a moderator of the covariance between interpretation biases and anxiety disorder symptom severity in a diverse sample of clinically anxious youth. Method: Participants included 105 children with anxiety disorders (M = 10.07 years, SD = 1.22; range = 8 – 12 years; 57.1% female; 61.9% ethnic minority) and their mothers (M = 39.35 years, SD = 7.05; range = 26 – 61 years) enrolled in a federally-funded study of the effects of maternal interpretation biases on childhood anxiety. A battery of measures assessing interpretation biases and anxiety disorder symptom severity was administered. Children also completed a behaviorally-indexed assessment of interpretation biases and participated in an anxiety-provoking speech task. Psychophysiological assessment of RSA was collected at baseline and during the speech task. Results: Analyses revealed a significant interaction between interpretation biases—both behaviorally-indexed and self-reported—and speech RSA (adjusting for baseline RSA) in predicting mother-reported child anxiety disorder symptom severity. Interactions predicting child-reported anxiety disorder symptom severity were not significant. Discussion: Higher levels of interpretation biases coupled with lower speech RSA were associated with more severe mother-reported child anxiety disorder symptoms. Future work should examine whether interventions targeting RSA weaken the association between interpretation biases and anxiety symptoms in youth.