Evaluating the role of visual attention bias in emotion dysregulation of young children

Background: This study aims to determine whether visual attention bias is associated with the level of emotion dysregulation (ED) in children and which individual attributes may modify their relationship. Methods: A community-based sample of 50 children aged 3-8 years old was recruited. The level of ED in children was measured using the parental report measures: Child Behaviour Checklist and Temper Tantrum Scale. Visual attention bias measured as eye gaze fixation time in response to images showing various emotional expressions was measured using an eye-tracking task. Generalized linear models were used to evaluate whether visual attention bias was associated with ED when social function (measured with the Social Responsiveness Scale, gender, age, and attention problem (measured from the CBCL subscale), were adjusted. The modifying effect on visual attention bias was evaluated using the interaction analysis in the generalized linear model. Results: The level of visual attention bias, indicated by the proportion of eye gaze fixation time on areas of interest (AOIs) in images displaying unpleasant emotions (such as anger), was inversely associated with the level of externalising problem behaviours (p = .014). Additionally, the association of eye gaze fixation time for AOI displaying negative emotional cues with the level of externalising problem behaviours varied by age (p = .04), with younger children (aged <70 months) demonstrating a stronger association than older children (aged ≥ 70 months). Conclusions: There is a significant inverse correlation between visual attention bias towards unpleasant emotional cues and ED in younger children. However, this relationship is attenuated as children age. While further research is needed, these results have implications for the development of objective biomarkers incorporating eye-tracking tasks for prediction and targeted support for ED-related mental health issues in the early years.