Factors contributing to the emergence of anxiety among behaviorally inhibited children: The role of attention

Anxiety in Williams Syndrome: The Role of Social Behaviour, Executive Functions and Change Over Time

Anxiety is a prevalent mental health issue for individuals with Williams syndrome (WS). Relatively little is known about the developmental course of anxiety, or how it links with core features of WS, namely social and executive functioning (EF). In this study, parent-reports of anxiety were compared across a 4-year period (N = 17), and links between anxiety, social and EF were explored from concurrent parent-reports (N = 26). Results indicated that high anxiety persisted over time, and anxiety was related to impairments in both social and executive functioning. Importantly, results indicated that impairments in EFs may drive the links between anxiety and social functioning. This timely investigation provides new insights into anxiety in WS and highlights potential areas for intervention.

Overprotective/authoritarian maternal parenting is associated with an enhanced error-related negativity (ERN) in emerging adult females

Error monitoring is crucial for survival and adaptation, and can be indexed by the error-related negativity (ERN), a fronto-centrally located negative deflection in the event-related potential (ERP) waveform that differentiates erroneous from correct responses within 100 ms of a response. The ERN is seen as an early neural signal indicating the need to adjust performance and increase executive control. Previous findings indicate that punishing errors increases ERN magnitude, and that punitive parenting predicts an enhanced ERN in children. If punitive parenting can in fact sensitize children to error commission over the long term, an enhanced ERN should be seen in adults who experienced harsh parenting as children. The present study thus sought to establish whether punitive parenting is associated with an enhanced ERN in emerging adulthood. A sample of 70 emerging adult females reported on their mothers' and fathers' parenting styles separately and performed a flanker task to elicit the ERN. Higher reported overprotective/authoritarian maternal behavior was associated with an enhanced ERN. These results provide further support for the hypothesis that punitive parenting may lead to long-term sensitization of neural networks involved in performance monitoring.

When change is the only constant: The promise of longitudinal neuroimaging in understanding social anxiety disorder

Longitudinal studies offer a unique window into developmental change. Yet, most of what we know about the pathophysiology of psychiatric disorders is based on cross-sectional work. Here, we highlight the importance of adopting a longitudinal approach in order to make progress towards identifying the neurobiological mechanisms of social anxiety disorder (SAD). Using examples, we illustrate how longitudinal data can uniquely inform SAD etiology and timing of interventions. The brain's inherently adaptive quality requires that we model risk correlates of disorders as dynamic in their expression. Developmental theories regarding timing of environmental events, cascading effects and (mal)adaptations of the developing brain will be crucial components of comprehensive, integrative models of SAD. We close by discussing analytical considerations when working with longitudinal, developmental data.

Attention to Threat as a Predictor of Shyness in the Context of Internalizing and Externalizing Problems

The duration of children's attention to putative threat has been documented as a consistent predictor of later anxiety in inhibited children across childhood (Fox, 2010; Perez-Edgar & Fox, 2005). However, attention to threat has not been broadly examined within existing behavioral contexts, and has seldom been studied in very early childhood. Whereas toddlers with high levels of internalizing behavior may view fear-inducing stimuli as a threat, toddlers with high levels of externalizing behavior may demonstrate attention out of interest or sensation seeking. Thus, attention to threat was expected to predict increased toddler shyness in the context of either high internalizing problems or low externalizing behavior. We examined 117 24-month-old toddlers to determine whether attention to threat interacted with internalizing and externalizing behavior at 24 months of age to predict toddler shyness one year later. Results indicated that attention to threat predicted toddlers' lower shyness at 36 months when toddlers' externalizing behavior at age 24 months were high, but there was no significant interaction between toddlers' internalizing behavior and their attention to threat in predicting later shyness. These results expand our understanding of the contexts in which attention to threat in early childhood is a viable predictor of later shyness.

Attention Bias to Emotional Faces Varies by IQ and Anxiety in Williams Syndrome

Individuals with Williams syndrome (WS) often experience significant anxiety. A promising approach to anxiety intervention has emerged from cognitive studies of attention bias to threat. To investigate the utility of this intervention in WS, this study examined attention bias to happy and angry faces in individuals with WS (N = 46). Results showed a significant difference in attention bias patterns as a function of IQ and anxiety. Individuals with higher IQ or higher anxiety showed a significant bias toward angry, but not happy faces, whereas individuals with lower IQ or lower anxiety showed the opposite pattern. These results suggest that attention bias interventions to modify a threat bias may be most effectively targeted to anxious individuals with WS with relatively high IQ.

Altered Prefrontal Cortex Function Marks Heightened Anxiety Risk in Children

OBJECTIVE

Anxiety disorders are prevalent and cause substantial disability. An important risk factor for anxiety disorders is inhibited temperament, the tendency to be shy and to avoid new situations. Inhibited adults have heightened amygdala activation and less flexible engagement of the prefrontal cortex (PFC); however, it remains unknown whether these brain alterations are present in inhibited children before the onset of anxiety disorders.

METHOD

A total of 37 children (18 inhibited and 19 uninhibited), 8 to 10 years of age, completed a task testing anticipation and viewing of threat stimuli and social stimuli in the magnetic resonance imaging (MRI) scanner. Brain activation and functional connectivity were measured.

RESULTS

During the anticipation of threat stimuli, inhibited children failed to show the robust PFC engagement observed in the uninhibited children. In contrast, when viewing social stimuli, inhibited children had increased medial PFC and dorsolateral PFC activation. Connectivity analyses revealed a pattern of reduced connectivity between prefrontal and limbic regions and among distinct PFC regions in the inhibited group. The medial PFC emerged as a key hub of the altered PFC circuitry in inhibited children.

CONCLUSION

This study provides new evidence of a neural signature of vulnerability to anxiety disorders. By investigating both anticipation and response to images, we identified that high-risk, inhibited children have widespread alterations in PFC function and connectivity, characterized by an inability to proactively prepare for social threat combined with heightened reactivity to social stimuli. Thus, children at high risk for anxiety show significantly altered prefrontal cortical function and connectivity before the onset of anxiety disorders.

The nature of individual differences in inhibited temperament and risk for psychiatric disease: A review and meta-analysis

What makes us different from one another? Why does one person jump out of airplanes for fun while another prefers to stay home and read? Why are some babies born with a predisposition to become anxious? Questions about individual differences in temperament have engaged the minds of scientists, psychologists, and philosophers for centuries. Recent technological advances in neuroimaging and genetics provide an unprecedented opportunity to answer these questions. Here we review the literature on the neurobiology of one of the most basic individual differences-the tendency to approach or avoid novelty. This trait, called inhibited temperament, is innate, heritable, and observed across species. Importantly, inhibited temperament also confers risk for psychiatric disease. Here, we provide a comprehensive review of inhibited temperament, including neuroimaging and genetic studies in human and non-human primates. We conducted a meta-analysis of neuroimaging findings in inhibited humans that points to alterations in a fronto-limbic-basal ganglia circuit; these findings provide the basis of a model of inhibited temperament neurocircuitry. Lesion and neuroimaging studies in non-human primate models of inhibited temperament highlight roles for the amygdala, hippocampus, orbitofrontal cortex, and dorsal prefrontal cortex. Genetic studies highlight a role for genes that regulate neurotransmitter function, such as the serotonin transporter polymorphisms (5-HTTLPR), as well as genes that regulate stress response, such as corticotropin-releasing hormone (CRH). Together these studies provide a foundation of knowledge about the genetic and neural substrates of this most basic of temperament traits. Future studies using novel imaging methods and genetic approaches promise to expand upon these biological bases of inhibited temperament and inform our understanding of risk for psychiatric disease.

The neural correlates of emotion-based cognitive control in adults with early childhood behavioral inhibition

The present study is the first to assess whether the neural correlates of cognitive control processes differ in adults with and without a behaviorally inhibited temperament during early childhood. Adults with and without childhood behavioral inhibition completed an emotional conflict task while undergoing functional magnetic resonance imaging scanning. While no group differences in behavior were observed, adults with childhood behavioral inhibition, relative to adults without childhood behavioral inhibition, exhibited greater dorsomedial prefrontal cortex activity during conflict detection and greater putamen activity during conflict adaptation. Lifetime psychopathology predicted behavioral, but not brain-related, differences in conflict adaptation. These data suggest that the brain regions underlying cognitive control processes are differentially influenced by childhood behavioral inhibition, and may be differently related to psychopathology.

Integrating etiological models of social anxiety and depression in youth: evidence for a cumulative interpersonal risk model

Models of social anxiety and depression in youth have been developed separately, and they contain similar etiological influences. Given the high comorbidity of social anxiety and depression, we examine whether the posited etiological constructs are a correlate of, or a risk factor for, social anxiety and/or depression at the symptom level and the diagnostic level. We find core risk factors of temperament, genetics, and parent psychopathology (i.e., depression and anxiety) are neither necessary nor sufficient for the development of social anxiety and/or depression. Instead, aspects of children's relationships with parents and/or peers either mediates (i.e., explains) or moderates (i.e., interacts with) these core risks being related to social anxiety and/or depression. We then examine various parent- and peer-related constructs contained in the separate models of social anxiety and depression (i.e., parent-child attachment, parenting, social skill deficits, peer acceptance and rejection, peer victimization, friendships, and loneliness). Throughout our review, we report evidence for a Cumulative Interpersonal Risk model that incorporates both core risk factors and specific interpersonal risk factors. Most studies fail to consider comorbidity, thus little is known about the specificity of these various constructs to depression and/or social anxiety. However, we identify shared, differential, and cumulative risks, correlates, consequences, and protective factors. We then put forth demonstrated pathways for the development of depression, social anxiety, and their comorbidity. Implications for understanding comorbidity are highlighted throughout, as are theoretical and research directions for developing and refining models of social anxiety, depression, and their comorbidity. Prevention and treatment implications are also noted.

Building the blocks of executive functioning: differentiating early developing processes contributing to executive functioning skills

The neural processes that underlie executive function begin to develop in infancy. However, it is unclear how the behavior manifested by these processes are related or if they can be differentiated early in development. This study seeks to examine early emerging executive functioning skills in monkeys (Macaca fascicularis) by using an error analysis approach where traditional measures of the tasks, as well as identification of major error patterns are related. Results show that during the infancy and early juvenile period, two processes that help support set-maintenance could be differentiated: modulation of responses to novelty and persistence despite negative feedback. The results suggest that these two aspects of set-maintenance were largely independent. Modulation of responses to novelty was most prominent in the infancy and early juvenile period. The ability to persist with a response set despite negative feedback emerged in the early juvenile period and was related to task performance until the end of the study.

Cortisol involvement in mechanisms of behavioral inhibition

We studied whether baseline cortisol is associated with post-error slowing, a measure that depends upon brain areas involved in behavioral inhibition. Moreover, we studied whether this association holds after controlling for positive associations with behavioral inhibition scores and error-related negativity (ERN) amplitudes that cortisol and post-error slowing may share. Healthy female volunteers performed a flanker task. Cortisol was independently positively associated with post-error slowing and the ERN, supporting hypotheses that cortisol is involved in behavioral inhibition. Additionally, cortisol mediated an association between ERN and more post-error slowing, which suppressed a direct association between ERN and less post-error slowing. The results are relevant, not only for researchers of behavioral inhibition, but also for researchers of the basic mechanisms of the ERN and post-error slowing, and may bring those literatures together.