Distress Evokes a Visual Attention Bias to Treatment-Related Scenes in Children and Adolescents Treated for a Posterior Fossa Brain Tumour.
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OBJECTIVE: Distress following treatment is common in children and adolescents treated for a brain tumour, reflecting underlying difficulties with emotion regulation. However, the medical factors that evoke distress remain poorly understood. Cranial radiation therapy (CRT), administered for malignant tumours, is associated with a high treatment burden and poor emotion regulation. This study investigates the effect of CRT on distress compared to non-CRT treatment and typically developing children (TDC), using self-report and eye-tracking measures. METHOD: Data were collected from 18 TDC and 36 children and adolescents treated for a posterior fossa brain tumour, including 17 who received CRT and 19 who did not. Participants completed a questionnaire assessing distress and then free-viewed treatment-related and emotional scenes while their eyes were tracked. Visual avoidance of a scene type served as a behavioural indicator of implicit emotion regulation. RESULTS: Participants treated with CRT reported distress more frequently (84.21%) compared to those treated without CRT (58.82%) and TDC (52.94%). Distressed participants exhibited greater visual avoidance of treatment-related scenes than their non-distressed counterparts. Participants treated with CRT also demonstrated more visual avoidance than those treated without CRT or TDC. CONCLUSION: The high treatment burden associated with CRT likely contributes to increased distress and visual avoidance of treatment-related scenes, which may reflect attempts to regulate unpleasant emotional responses. Accumulating medical procedures may heighten threat sensitivity and reinforce avoidance as a strategy for emotion regulation. Thus, visual avoidance may serve as a behavioural marker of distress and help identify patients who are at an elevated risk.