Neurophysiological evidence for distinct biases in emotional face processing associated with internalizing and externalizing symptoms in children.

Attentional bias to threat has been implicated in both internalizing and externalizing disorders. This study utilizes event-related potentials to examine early stages of perceptual attention to threatening (angry or fearful) versus neutral faces among a sample of 200 children ages 6-8 years from a low-income, urban community. Although both internalizing and externalizing symptoms were associated with processing biases, the nature of the bias differed between these two symptom domains. Internalizing symptoms were associated with heightened early attentional selection (P1) and later perceptual processing (P2) of fearful faces. In contrast, externalizing symptoms were associated with reduced early attentional selection (P1) of fearful faces and enhanced perceptual processing (P2) of neutral faces, possibly indicative of a hostile interpretation bias for ambiguous social cues. These results provide insight into the distinct cognitive-affective processes that may contribute to the etiology and maintenance of internalizing and externalizing psychopathology.