(PS5-52) Interactions Between Child Anxiety and Neighborhood Opportunity in Predicting Physiological Responses to Threat in a Pediatric Heat Pain Paradigm

Threat processing and responding are crucial for survival, but pediatric anxiety involves maladaptive threat processing, characterized by heightened sensitivity to anticipated threats. This often manifests as hypervigilance and a low threshold to potential threats in the environment. Compared to controls, anxious children display heightened physiological responses to potential threats. However, research on threat response considering individual and environmental differences is limited. Environments with scarce resources and low socioeconomic status may expose children to resource-deficient and consistently uncertain environments. Additionally, limited access to resources is related to the severity of psychopathology and treatment outcomes. Thus, it is critical to examine the impact of how threat response predicts anxiety symptoms severity. In the current study, we aimed to examine the effect of childhood neighborhood opportunity on the association between child-reported anxiety and physiological response to known and unknown threats.

33 children (10 clinically anxious, 23 controls) with mean age = 13.53 were analyzed and were predominantly white (57.6%) and mixed race (24.2%). Anxiety symptoms were measured using the Screen for Child Anxiety Related Disorders (SCARED) child report. Physiological arousal was assessed via skin conductance response (SCR) as children engaged in a heat pain task. Here, children were given the opportunity to respond to both known and unknown pain threat severity via the administration of varying degrees of heat. SCR was collected at each condition: low, high, and uncertain heat threats. Child neighborhood opportunity was assessed using the Child Opportunity Index (COI) total normalized score, calculated based on child geographic location and the available resources in education, health and environment, and socioeconomic status. The regression model compared the clinically anxious versus control children’s SCARED score as the predictive variable on SCR, moderating for COI.

A correlation assessed the relationship between SCARED and SCR values in high and uncertain heat threat conditions. A significant correlation between SCARED and high heat r = 0.40, p = 0.02, and uncertain heat threat conditions r = 0.29,  p = 0.10 emerged. However, there were no significant correlation with between threat conditions and COI p > .05. A regression model assessing the effect of COI as a moderator revealed no significant results p > .101. However, there was a significant interaction between COI and group (anxious, control) on uncertain heat threat F(3,28) = 5.8, p = .003, driven by control group t(28) = 2.12, p = .043.

An association between threat condition and anxiety symptoms emerged, but COI did not moderate this association. However, there was an association between uncertain threat conditions and COI driven by the control group. Such results suggest preliminary evidence for COI predicting unique uncertain threat responses for anxious vs. control groups, and the association between threat response and anxiety symptoms. Understanding how an individual’s environment and resource availability impacts behavioral and physiological responses is important in improving treatment adherence and outcomes.