Heightened facial muscle reactivity in preadolescent girls with pathological anxiety

Abstract Objectives Anticipatory anxiety and heightened responses to uncertainty are central features of anxiety disorders (ADs) that contribute to clinical impairment. Anxiety symptoms typically emerge during childhood, and even subthreshold‐AD symptoms are associated with distress and risk for future psychopathology. This study compared facial emotional response to threat and uncertainty between preadolescent girls with ADs, girls with subthreshold‐AD symptoms, and controls. Methods Facial emotional responding was characterized in preadolescent girls (age 8–11) with a range of anxiety symptoms: no/low anxiety (controls, n = 41), subthreshold‐AD ( n = 73), and DSM‐5 diagnoses of separation, social, and/or generalized ADs ( n = 45). A threat anticipation paradigm examined how image valence (negative/neutral) and image anticipation (uncertain/certain timing) impacted activity of the corrugator supercilii, a forehead muscle implicated in the “frown” response that is modulated by emotional stimuli (negative > neutral). Corrugator magnitude and corrugator timecourse were compared between groups. Results Findings demonstrate greater corrugator activity during anticipation and viewing of negative stimuli, as well as increased corrugator reactivity in subthreshold‐AD and AD girls. Timecourse analyses of negative versus neutral stimuli revealed that AD and subthreshold‐AD girls had greater uncertainty‐related increases in corrugator activity compared to controls. Conclusion Results extend the physiological characterization of childhood pathological anxiety, highlighting the impact of subthreshold‐AD symptoms.