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Visual scanpaths predict treatment response in children and adolescents with social anxiety disorder

Kleberg, Johan Lundin ; Nord, Martina ; Cervin, Matti LU ; Serlachius, Eva LU and Högström, Jens (2026) In Development and Psychopathology
Abstract

Treatment response in pediatric social anxiety disorder (SAD) is highly variable, and symptoms may be maintained by maladaptive attention. A previous study found that youth with SAD scan a more restricted area of faces than healthy controls during emotion recognition, potentially limiting interpretation of social cues. The current study followed up on these results by examining whether restricted face scanning 1) predicts response to psychological treatment, and 2) changes with successful treatment. Youth with SAD (n = 59) were assessed prior to treatment with internet-delivered cognitive behavioral therapy (ICBT) or supportive therapy (ISUPPORT) and then again three months after treatment. Restricted scanning of faces predicted a... (More)

Treatment response in pediatric social anxiety disorder (SAD) is highly variable, and symptoms may be maintained by maladaptive attention. A previous study found that youth with SAD scan a more restricted area of faces than healthy controls during emotion recognition, potentially limiting interpretation of social cues. The current study followed up on these results by examining whether restricted face scanning 1) predicts response to psychological treatment, and 2) changes with successful treatment. Youth with SAD (n = 59) were assessed prior to treatment with internet-delivered cognitive behavioral therapy (ICBT) or supportive therapy (ISUPPORT) and then again three months after treatment. Restricted scanning of faces predicted a smaller symptom reduction, independent of treatment arm. Scanpath distribution was moderately stable from T1 to T2 and did not change with treatment. Restricted scanning of faces may be a risk factor for sustained SAD symptoms after therapy. As the visual scanpath is a key aspect of human visual processing, inflexible scanning could potentially interfere with information processing. Implications for theories of attention in pediatric SAD are discussed.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Children and adolescents, eye tracking, internet delivered cognitive behavioral therapy (CBT), social anxiety disorder (SAD), treatment response
in
Development and Psychopathology
publisher
Cambridge University Press
external identifiers
  • scopus:105029121603
  • pmid:41572731
ISSN
0954-5794
DOI
10.1017/S0954579425101089
language
English
LU publication?
yes
id
1e52fc00-ed4a-466c-9ee8-be8c14ee6c11
date added to LUP
2026-02-20 15:09:56
date last changed
2026-02-21 03:00:04
@article{1e52fc00-ed4a-466c-9ee8-be8c14ee6c11,
  abstract     = {{<p>Treatment response in pediatric social anxiety disorder (SAD) is highly variable, and symptoms may be maintained by maladaptive attention. A previous study found that youth with SAD scan a more restricted area of faces than healthy controls during emotion recognition, potentially limiting interpretation of social cues. The current study followed up on these results by examining whether restricted face scanning 1) predicts response to psychological treatment, and 2) changes with successful treatment. Youth with SAD (n = 59) were assessed prior to treatment with internet-delivered cognitive behavioral therapy (ICBT) or supportive therapy (ISUPPORT) and then again three months after treatment. Restricted scanning of faces predicted a smaller symptom reduction, independent of treatment arm. Scanpath distribution was moderately stable from T1 to T2 and did not change with treatment. Restricted scanning of faces may be a risk factor for sustained SAD symptoms after therapy. As the visual scanpath is a key aspect of human visual processing, inflexible scanning could potentially interfere with information processing. Implications for theories of attention in pediatric SAD are discussed.</p>}},
  author       = {{Kleberg, Johan Lundin and Nord, Martina and Cervin, Matti and Serlachius, Eva and Högström, Jens}},
  issn         = {{0954-5794}},
  keywords     = {{Children and adolescents; eye tracking; internet delivered cognitive behavioral therapy (CBT); social anxiety disorder (SAD); treatment response}},
  language     = {{eng}},
  publisher    = {{Cambridge University Press}},
  series       = {{Development and Psychopathology}},
  title        = {{Visual scanpaths predict treatment response in children and adolescents with social anxiety disorder}},
  url          = {{http://dx.doi.org/10.1017/S0954579425101089}},
  doi          = {{10.1017/S0954579425101089}},
  year         = {{2026}},
}