The relation between generalized anxiety disorder symptoms and content-specific interpretation biases for auditory stimuli in children

Anke M. Klein*, Rian Bakens, Rianne E. van Niekerk, Machteld A. Ouwens, Ronald M. Rapee, Susan M. Bögels, Eni S. Becker, Mike Rinck

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Background and objectives: Cognitive theories of fear suggest that biases in interpretation are content-specific: Fearful children should only interpret materials negatively if they are specifically related to the content of their fear. So far, there are only a few studies available that report on this postulated content-specificity of interpretation processes in childhood fear. The goal of this study was to examine interpretation bias and its content-specificity in children with varying levels of Generalized Anxiety Disorder (GAD) symptoms. Methods: In an Auditory Interpretation Task (AIT), two words that differ by one phoneme are acoustically blended so that one can hear only one of the words. In the current AIT, we included GAD-related blends, negatively-valenced fear-related blends and positive blends. Multiple-choice (n = 371) or open-ended (n = 295) responses were collected from 666 nonclinical children between 7 and 13 years of age. Results: Children with higher levels of self-reported GAD showed significantly more negative interpretations of ambiguous GAD-related blends in the multiple-choice version than children with lower levels of GAD. There were no differences when interpreting the other ambiguous blends. This result was not found with the open-ended version. Limitations: Effects were relatively small, some GAD-stimuli were sub-optimal, and the task was administered in a classroom setting. Even though we ensured that all children were able to hear all words clearly, this may have impacted the results. Conclusions: The findings only partly support the idea that fearful children display cognitive biases specific for fear-relevant stimuli, and more research is needed to replicate the results and test the usability of the AIT.

Original languageEnglish
Pages (from-to)121-127
Number of pages7
JournalJournal of Behavior Therapy and Experimental Psychiatry
Publication statusPublished - Dec 2018


  • child psychopathology
  • generalized anxiety disorder
  • interpretation bias
  • indirect measures
  • auditory stimuli


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