Heightened facial muscle reactivity in preadolescent girls with pathological anxiety

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.