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Wang Y, Tian J, Yang Q. Experiential Avoidance Process Model: A Review of the Mechanism for the Generation and Maintenance of Avoidance Behavior. PSYCHIAT CLIN PSYCH 2024; 34:179-190. [PMID: 39165887 PMCID: PMC11332439 DOI: 10.5152/pcp.2024.23777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/09/2023] [Indexed: 08/22/2024] Open
Abstract
Experiential avoidance refers to a phenomenon in which individuals exhibit an unwillingness to engage with certain personal experiences, including physical sensations, emotions, thoughts, memories, and behavioral tendencies. They employ cognition and emotions to avoid these experiences. Extensive research has linked experiential avoidance to various mental diseases, conduct disorder, and posttraumatic stress disorder. While the existing literature highlights the significance of understanding experiential avoidance as a central mechanism underlying psychological symptomatology development and maintenance, further investigation is required to comprehend its dimensions and mechanisms fully. Therefore, this article aims to provide a comprehensive review of the current theories and empirical evidence on experiential avoidance while elucidating its association with psychopathology. We propose a model of experiential avoidance processes based on an extensive review and critical analysis of the previous emotion regulation model that integrates expressive suppression and cognitive reappraisal during emotion regulation through experiential avoidance. This proposed model seeks to explain both the formation and maintenance aspects of experiential avoidance by offering valuable insights for future research. We also examined the association between experiential avoidance and various psychiatric disorders, including anxiety, depression, obsessive-compulsive disorder, and posttraumatic stress disorder. Elaborating on these mechanisms provides a roadmap for future research endeavors and clinical interventions.
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Affiliation(s)
- Yi Wang
- Weinan Normal University, School of Physical Education, Weinan, China
| | - Jing Tian
- Weinan Normal University, School of Foreign Languages, Weinan, China
| | - Qingxuan Yang
- Department of Physical Education, Chang’an University, Xi’an, China
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2
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Thomas KS, Jones CRG, Williams MO, Vanderwert RE. Associations between disordered eating, internalizing symptoms, and behavioral and neural correlates of response inhibition in preadolescence. Dev Psychobiol 2024; 66:e22477. [PMID: 38433461 DOI: 10.1002/dev.22477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 03/05/2024]
Abstract
Response inhibition difficulties are reported in individuals with eating disorders (EDs), anxiety, and depression. Although ED symptoms and internalizing symptoms co-occur in preadolescence, there is limited research examining associations between these symptoms and response inhibition in this age group. This study is the first to investigate the associations between behavioral and neural markers of response inhibition, disordered eating (DE), and internalizing symptoms in a community sample of preadolescents. Forty-eight children (M age = 10.95 years, 56.3% male) completed a Go/NoGo task, whereas electroencephalography was recorded. Self-report measures of DE and internalizing symptoms were collected. Higher levels of anxiety and depression were associated with neural markers of suboptimal response inhibition (attenuated P3NoGo amplitudes) in preadolescence. In contrast, higher levels of depression were associated with greater response inhibition at a behavioral level. These findings suggest internalizing symptoms in preadolescence are associated with P3-indexed difficulties in evaluation and monitoring, but these are not sufficient to disrupt behavioral performance on a response inhibition task. This pattern may reflect engagement of compensatory processes to support task performance. DE was not significantly associated with response inhibition, suggesting that difficulties in response inhibition may only be reliably observed in more chronic and severe DE and ED presentations.
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Affiliation(s)
- Kai S Thomas
- School of Psychology, Cardiff University, Cardiff, UK
| | | | | | - Ross E Vanderwert
- School of Psychology, Cardiff University, Cardiff, UK
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, UK
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3
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Ramos ML, Zhou AM, Lytle MN, Myruski S, Pérez-Edgar K, Buss KA. Interactions among stress, behavioral inhibition, and delta-beta coupling predict adolescent anxiety during the COVID-19 pandemic. Dev Psychobiol 2024; 66:e22485. [PMID: 38483054 PMCID: PMC11000197 DOI: 10.1002/dev.22485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 09/27/2023] [Accepted: 02/26/2024] [Indexed: 04/10/2024]
Abstract
The COVID-19 pandemic brought about unprecedented changes and uncertainty to the daily lives of youth. The range of adjustment in light of a near-universal experience of COVID restrictions highlights the importance of identifying factors that may render some individuals more susceptible to heightened levels of anxiety during stressful life events than others. Two risk factors to consider are temperamental behavioral inhibition (BI) and difficulties in emotion regulation (ER). As such, the current paper focused on BI examined prior to COVID, because of its developmental link to anxiety and ER, as difficulties may be associated with differences in anxiety. We examined a neurocognitive marker of ER processes, delta-beta coupling (DBC). The current paper had two goals: (1) to examine BI in relation to COVID-related worry and social anxiety experienced during the pandemic, and (2) to explore the role of individual differences in early DBC in the relationship between BI and anxiety outcomes 6 months apart during COVID-19 (n = 86; T1 Mage = 15.95, SD = 1.73; T6 Mage = 16.43, SD = 1.73). We found support for the moderating role of DBC in the relationship between BI levels and social anxiety disorder (SAD) symptom severity during the pandemic. Here, high BI was predictive of increased SAD symptom levels in adolescents with stronger DBC.
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Affiliation(s)
- Michelle L Ramos
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Anna M Zhou
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Marisa N Lytle
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Sarah Myruski
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Koraly Pérez-Edgar
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Kristin A Buss
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
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4
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Allen KB, Tan PZ, Sullivan JA, Baumgardner M, Hunter H, Glovak SN. An Integrative Model of Youth Anxiety: Cognitive-Affective Processes and Parenting in Developmental Context. Clin Child Fam Psychol Rev 2023; 26:1025-1051. [PMID: 37819403 DOI: 10.1007/s10567-023-00458-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 10/13/2023]
Abstract
Multiple theoretical frameworks have been proposed to provide a more comprehensive picture of the risk factors that influence anxiety-related developmental trajectories. Nonetheless, there remains a need for an integrative model that outlines: (1) which risk factors may be most pertinent at different points in development, and (2) how parenting may maintain, exacerbate, or attenuate an affective style that is characterized by high negative emotional reactivity to unfamiliar, uncertain, and threatening situations. A developmentally informed, integrative model has the potential to guide treatment development and delivery, which is critical to reducing the public health burden associated with these disorders. This paper outlines a model integrating research on many well-established risk mechanisms for anxiety disorders, focusing on (1) the developmental progression from emotional reactivity constructs early in life to those involving higher-level cognitive processes later in youth, and (2) potential pathways by which parenting may impact the stability of youth's cognitive-affective responses to threat-relevant information across development.
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Affiliation(s)
- Kristy Benoit Allen
- Departments of Applied Behavioral Science and Psychology, University of Kansas, Lawrence, KS, USA.
| | - Patricia Z Tan
- Department of Psychiatry/Mental Health, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | | | - Megan Baumgardner
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
| | - Hannah Hunter
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
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5
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Anaya B, Neiderhiser JM, Pérez-Edgar K, Leve LD, Ganiban JM, Reiss D, Natsuaki MN, Shaw DS. Developmental trajectories of behavioral inhibition from infancy to age seven: The role of genetic and environmental risk for psychopathology. Child Dev 2023; 94:e231-e245. [PMID: 37017208 PMCID: PMC10332342 DOI: 10.1111/cdev.13924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
The present study leveraged data from a longitudinal adoption study of 361 families recruited between 2003 and 2010 in the United States. We investigated how psychopathology symptoms in birth parents (BP; Mage = 24.1 years; 50.5-62.9% completed high school) and adoptive parents (AP; Mage = 37.8 years; 80.9% completed college; 94% mother-father couples) influenced children's behavioral inhibition (BI) trajectories. We used latent growth models of observed BI at 18 and 27 months, and 4.5 and 7 years in a sample of adopted children (Female = 42%, White = 57%, Black = 11%, Multi-racial = 21%, Latinx = 9%). BI generally decreased over time, yet there was substantial variability in these trajectories. Neither BP nor AP psychopathology symptoms independently predicted systematic differences in BI trajectories. Instead, we found that AP internalizing symptoms moderated the effects of BP psychopathology on trajectories of BI, indicating a gene by environment interaction.
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Affiliation(s)
| | | | | | | | | | - David Reiss
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
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Ren T, Ye X, Li Z, Li Q, Zhang X, Dou W, Jia X, Li BM, Wang C. Associations between physical activity and proactive control and the modulating role of working memory. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 66:102374. [PMID: 37665846 DOI: 10.1016/j.psychsport.2022.102374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/29/2022] [Accepted: 12/28/2022] [Indexed: 09/06/2023]
Abstract
Accumulating evidence indicates positive associations between physical activity (PA) and cognitive control. Proactive control, the ability to maintain goal-relevant information in preparation of upcoming task demands, is a critical component of cognitive control. However, little research has examined the association between PA and proactive control. To address this issue, a total of 132 university students were recruited and divided into two groups based on reported regular PA during past week. All participants completed two common cognitive control tasks: the AX Continuous Performance Task (AX-CPT) and the Cued Task-Switching Paradigm (CTS). In comparison with the low PA group, the high PA group showed greater proactive control efficiency on both tasks. Moreover, proactive control indices significantly correlated between the two tasks for the high but not for the low PA group. Further, working memory significantly modulated the association between PA and proactive control efficiency of CTS. Although the present cross-section design does not allow us to test the causal relationship between PA and proactive control, these findings may have important implications for developing effective intervention strategies which aim to promote proactive control through increasing PA or to promote PA through increasing proactive control. Moreover, individual differences in working memory are important to consider when we aim to design such interventions.
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Affiliation(s)
- Tian Ren
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China; Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, China
| | - Xuejian Ye
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
| | - Zheng Li
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
| | - Qingyi Li
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
| | - Xinyuan Zhang
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
| | - Wenjie Dou
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
| | - Xi Jia
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
| | - Bao-Ming Li
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
| | - Chunjie Wang
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China.
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7
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Cardinale EM, Bezek J, Morales S, Filippi C, Smith AR, Haller S, Valadez EA, Harrewijn A, Phillips D, Chronis-Tuscano A, Brotman MA, Fox NA, Pine DS, Leibenluft E, Kircanski K. Cross-sectional and Longitudinal Associations of Anxiety and Irritability With Adolescents' Neural Responses to Cognitive Conflict. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:436-444. [PMID: 35358745 PMCID: PMC9764223 DOI: 10.1016/j.bpsc.2022.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 04/12/2023]
Abstract
BACKGROUND Psychiatric symptoms are commonly comorbid in childhood. The ability to disentangle unique and shared correlates of comorbid symptoms facilitates personalized medicine. Cognitive control is implicated broadly in psychopathology, including in pediatric disorders characterized by anxiety and irritability. To disentangle cognitive control correlates of anxiety versus irritability, the current study leveraged both cross-sectional and longitudinal data from early childhood into adolescence. METHODS For this study, 89 participants were recruited from a large longitudinal research study on early-life temperament to investigate associations of developmental trajectories of anxiety and irritability symptoms (from ages 2 to 15) as well as associations of anxiety and irritability symptoms measured cross-sectionally at age 15 with neural substrates of conflict and error processing assessed at age 15 using the flanker task. RESULTS Results of whole-brain multivariate linear models revealed that anxiety at age 15 was uniquely associated with decreased neural response to conflict across multiple regions implicated in attentional control and conflict adaptation. Conversely, irritability at age 15 was uniquely associated with increased neural response to conflict in regions implicated in response inhibition. Developmental trajectories of anxiety and irritability interacted in relation to neural responses to both error and conflict. CONCLUSIONS Our findings suggest that neural correlates of conflict processing may relate uniquely to anxiety and irritability. Continued cross-symptom research on the neural correlates of cognitive control could stimulate advances in individualized treatment for anxiety and irritability during child and adolescent development.
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Affiliation(s)
| | - Jessica Bezek
- National Institute of Mental Health, Bethesda, Maryland
| | - Santiago Morales
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland; Department of Psychology, University of Southern California, Los Angeles, California
| | | | | | - Simone Haller
- National Institute of Mental Health, Bethesda, Maryland
| | - Emilio A Valadez
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland
| | - Anita Harrewijn
- National Institute of Mental Health, Bethesda, Maryland; Department of Clinical Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | | | - Andrea Chronis-Tuscano
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland
| | | | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland
| | - Daniel S Pine
- National Institute of Mental Health, Bethesda, Maryland
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8
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Fox NA, Zeytinoglu S, Valadez EA, Buzzell GA, Morales S, Henderson HA. Annual Research Review: Developmental pathways linking early behavioral inhibition to later anxiety. J Child Psychol Psychiatry 2023; 64:537-561. [PMID: 36123776 PMCID: PMC10690832 DOI: 10.1111/jcpp.13702] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2022] [Indexed: 11/29/2022]
Abstract
Behavioral Inhibition is a temperament identified in the first years of life that enhances the risk for development of anxiety during late childhood and adolescence. Amongst children characterized with this temperament, only around 40 percent go on to develop anxiety disorders, meaning that more than half of these children do not. Over the past 20 years, research has documented within-child and socio-contextual factors that support differing developmental pathways. This review provides a historical perspective on the research documenting the origins of this temperament, its biological correlates, and the factors that enhance or mitigate risk for development of anxiety. We review as well, research findings from two longitudinal cohorts that have identified moderators of behavioral inhibition in understanding pathways to anxiety. Research on these moderators has led us to develop the Detection and Dual Control (DDC) framework to understand differing developmental trajectories among behaviorally inhibited children. In this review, we use this framework to explain why and how specific cognitive and socio-contextual factors influence differential pathways to anxiety versus resilience.
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Affiliation(s)
- Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Selin Zeytinoglu
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Emilio A. Valadez
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - George A. Buzzell
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Santiago Morales
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
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9
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Rayson H, Ryan ZJ, Dodd HF. Behavioural inhibition and early neural processing of happy and angry faces interact to predict anxiety: a longitudinal ERP study. Dev Cogn Neurosci 2023; 60:101207. [PMID: 36764038 PMCID: PMC9929676 DOI: 10.1016/j.dcn.2023.101207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/17/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Limited prospective research has examined whether attention biases to emotion moderate associations between Behavioural Inhibition (BI) and anxiety in preschool-aged children. Furthermore, there has been an over-reliance on behavioral measures in previous studies. Accordingly, we assessed anxiety in a sample of preschool-aged children (3-4 years) at baseline, and again approximately 6 and 11 months later, after they started school. At baseline, children completed an assessment of BI and an EEG task where they were presented with angry, happy, and neutral faces. EEG analyses focused on ERPs (P1, P2, N2) associated with specific stages of attention allocation. Interactions between BI and emotion bias (ERP amplitude for emotional versus neutral faces) were found for N2 and P1. For N2, BI was significantly associated with higher overall anxiety when an angry bias was present. Interestingly for P1, BI was associated with higher overall anxiety when a happy bias was absent. Finally, interactions were found between linear time and happy and angry bias for P1, with a greater linear decrease in anxiety over time when biases were high. These results suggest that attention to emotional stimuli moderates the BI-anxiety relationship across early development.
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Affiliation(s)
- Holly Rayson
- Institut des Sciences Cognitives Marc Jeannerod, CNRS / Université Claude Bernard Lyon, France.
| | - Zoe J Ryan
- School of Psychology and Clinical Language Sciences, University of Reading, UK
| | - Helen F Dodd
- School of Psychology and Clinical Language Sciences, University of Reading, UK; Children and Young People's Mental Health Research Collaboration (ChYMe), Exeter Medical School, University of Exeter, UK
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10
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Tang A, Harrewijn A, Benson B, Haller SP, Guyer AE, Perez-Edgar KE, Stringaris A, Ernst M, Brotman MA, Pine DS, Fox NA. Striatal Activity to Reward Anticipation as a Moderator of the Association Between Early Behavioral Inhibition and Changes in Anxiety and Depressive Symptoms From Adolescence to Adulthood. JAMA Psychiatry 2022; 79:1199-1208. [PMID: 36287532 PMCID: PMC9607981 DOI: 10.1001/jamapsychiatry.2022.3483] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/07/2022] [Indexed: 01/14/2023]
Abstract
Importance The early childhood temperament of behavioral inhibition (BI), characterized by inhibited and fearful behaviors, has been associated with heightened risk for anxiety and depression across the lifespan. Although several neurocognitive correlates underlying vulnerability to the development of anxiety among inhibited children have been identified, little is known about the neurocognitive correlates underlying vulnerability to the development of depression. Objective To examine whether blunted striatal activation to reward anticipation, a well-documented neurocognitive vulnerability marker of depression, moderates the association between early BI and the developmental changes in depression and anxiety from adolescence to adulthood. Design, Setting, and Participants Participants in this prospective longitudinal study were recruited at age 4 months between 1989 and 1993 in the US. Follow-up assessments extended into 2018 (age 26 years). Data were analyzed between September 2021 to March 2022. Main Outcomes and Measures BI was measured through an observation paradigm in infancy (ages 14 and 24 months). Neural activity to anticipated rewards during a monetary incentive delay task was measured using functional magnetic resonance imaging in adolescence (between ages 15-18 years; 83 individuals had usable data). Anxiety and depressive symptoms were self-reported across adolescence to young adulthood (ages 15 and 26 years; n = 108). A latent change score model, accounting for the interdependence between anxiety and depression, tested the moderating role of striatal activity to reward anticipation in the association between early BI and changes in anxiety and depressive symptoms. A region of interest approach limited statistical tests to regions within the striatum (ie, nucleus accumbens, caudate head, caudate body, putamen). Results Of 165 participants, 84 (50.1%) were female and 162 (98%) were White. Preliminary analyses revealed significant increases in anxiety and depressive symptoms across ages 15 to 26 years, as well as individual variation in the magnitude of changes. Main analyses showed that reduced activity in the nucleus accumbens to reward anticipation moderated the association between early BI and increases in depressive (β = -0.32; b = -4.23; 95% CI, -7.70 to -0.76; P = .02), and more depressive symptoms at age 26 years (β = -0.47; b = -5.09; 95% CI, -7.74 to -2.43; P < .001). However, there were no significant interactions associated with latent changes in anxiety across age nor anxiety at age 26 years. Activity in the caudate and putamen did not moderate these associations. Conclusions and Relevance Blunted reward sensitivity in the ventral striatum may be a developmental risk factor connecting an inhibited childhood temperament and depression over the transition to adulthood. Future studies should examine the efficacy of prevention programs, which target maladaptive reward processing and motivational deficits among anxious youths, in reducing risks for later depression.
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Affiliation(s)
- Alva Tang
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park
- Department of Psychology, University of Texas at Dallas, Richardson
| | - Anita Harrewijn
- National Institutes of Mental Health, Intramural Research Program, Bethesda, Maryland
| | - Brenda Benson
- National Institutes of Mental Health, Intramural Research Program, Bethesda, Maryland
| | - Simone P. Haller
- National Institutes of Mental Health, Intramural Research Program, Bethesda, Maryland
| | - Amanda E. Guyer
- Department of Human Ecology and Center for Mind and Brain, University of California, Davis, Davis
| | | | - Argyris Stringaris
- Department of Psychiatry, University College London, London, United Kingdom
| | - Monique Ernst
- National Institutes of Mental Health, Intramural Research Program, Bethesda, Maryland
| | - Melissa A. Brotman
- National Institutes of Mental Health, Intramural Research Program, Bethesda, Maryland
| | - Daniel. S. Pine
- National Institutes of Mental Health, Intramural Research Program, Bethesda, Maryland
| | - Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park
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11
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Valadez EA, Morales S, Buzzell GA, Troller-Renfree SV, Henderson HA, Chronis-Tuscano A, Pine DS, Fox NA. Development of Proactive Control and Anxiety Among Behaviorally Inhibited Adolescents. J Am Acad Child Adolesc Psychiatry 2022; 61:1466-1475. [PMID: 35490841 PMCID: PMC9613813 DOI: 10.1016/j.jaac.2022.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 01/26/2022] [Accepted: 04/21/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Behavioral inhibition (BI) is an infant temperament characterized by heightened reactivity and negative affect in response to novel people and situations. BI is among the earliest and strongest predictors of future anxiety problems. However, not all children with a history of BI will manifest anxiety problems. A growing body of evidence suggests that proactive control skills may help buffer youth with BI from future anxiety difficulties; yet, it remains unclear how temperament may interact with the development of cognitive control to influence anxiety risk. The present study tested whether enhancements in proactive control occurring during adolescence may reduce risk for anxiety among youth with a history of BI. METHOD Participants included 185 adolescents (56% female) whose temperament was assessed during toddlerhood. In adolescence, participants completed anxiety assessments and an AX Continuous Performance Test (AX-CPT) to assess cognitive control strategy. Both assessments were administered at age 13 years and again at 15 years. RESULTS Latent change score modeling revealed that, on average, participants increasingly used proactive control strategies and experienced worsening anxiety from age 13-15 years. Early BI was associated with a smaller anxiety increase from 13-15 years, but only among participants whose proactive control skills improved at mean or greater rates. CONCLUSION The present findings suggest that greater proactive control development during adolescence protects youth with high BI from age-related increases in anxiety. Results support a framework that highlights cognitive control as a key moderator of anxiety risk among children with a history of high BI.
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Affiliation(s)
| | | | | | | | | | | | - Daniel S Pine
- National Institute of Mental Health, Bethesda, Maryland
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12
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Zainal NH, Newman MG. Executive Functioning Constructs in Anxiety, Obsessive-Compulsive, Post-Traumatic Stress, and Related Disorders. Curr Psychiatry Rep 2022; 24:871-880. [PMID: 36401677 PMCID: PMC9676877 DOI: 10.1007/s11920-022-01390-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2022] [Indexed: 11/20/2022]
Abstract
PURPOSE OF REVIEW We synthesize theories proposing complex relations between cognitive functioning and anxiety-related concepts. We evaluate vulnerability theories suggesting that deficits in various cognitive functioning domains predict future anxiety-associated concepts. We examine scar theories asserting the opposite direction of effects (i.e., anxiety predicting cognitive dysfunction). Furthermore, we examine more novel frameworks on this topic. RECENT FINDINGS Reliable evidence exists for the scar and vulnerability theories. This includes mounting data on diverse anxiety symptoms predicting cognitive dysfunction (and conversely) unfolding at between- and within-person levels (dynamic mutualism theory). It also includes data on the stronger effects or central influence of anxiety (versus non-anxiety) symptoms on executive functioning (EF; i.e., higher-order cognitive control governing myriad thinking and action repertoires) versus non-EF domains and vice versa (network theory). In addition, it reviews emerging evidence that enhanced cognitive control can correlate with higher anxiety among children (overgeneralized control theory). The generally inverse relations between anxiety symptoms and cognitive dysfunction are bidirectional and complex within and between persons. Plausible mediators and moderators merit more attention, including immune, metabolism, and neural markers and the social determinants of health.
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Affiliation(s)
| | - Michelle G Newman
- The Pennsylvania State University, 371 Moore Building, University Park, PA, 16802, USA.
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13
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Valadez EA, Pine DS, Fox NA, Bar-Haim Y. Attentional biases in human anxiety. Neurosci Biobehav Rev 2022; 142:104917. [PMID: 36252826 PMCID: PMC9756271 DOI: 10.1016/j.neubiorev.2022.104917] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/20/2022]
Abstract
Across clinical and subclinical samples, anxiety has been associated with increased attentional capture by cues signaling danger. Various cognitive models attribute the onset and maintenance of anxiety symptoms to maladaptive selective information processing. In this brief review, we 1) describe the evidence for the relations between anxiety and attention bias toward threat, 2) discuss the neurobiology of anxiety-related differences in threat bias, 3) summarize work investigating the developmental origins of attention bias toward threat, and 4) examine efforts to translate threat bias research into clinical intervention. Future directions in each area are discussed, including the use of novel analytic approaches improving characterization of threat-processing-related brain networks, clarifying the role of cognitive control in the development of attention bias toward threat, and the need for larger, well-controlled randomized clinical trials examining moderators and mediators of treatment response. Ultimately, this work has important implications for understanding the etiology of and for intervening on anxiety difficulties among children and adults.
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Affiliation(s)
- Emilio A Valadez
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA.
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Yair Bar-Haim
- School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Filippi CA, Valadez EA, Fox NA, Pine DS. Temperamental risk for anxiety: emerging work on the infant brain and later neurocognitive development. Curr Opin Behav Sci 2022; 44:101105. [PMID: 35342779 PMCID: PMC8955382 DOI: 10.1016/j.cobeha.2022.101105] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Behavioral inhibition (BI), an infant temperament characterized by distress to novelty, is amongst the strongest early risk markers for future anxiety. In this review, we highlight three ways that recent research elucidates key details about the pathophysiology of anxiety in individuals with BI. First, atypical amygdala connectivity during infancy may be related to BI. Second, developmental shifts in cognitive control may portend risk for anxiety for children with BI. Lastly, distinct cognitive control processes moderate the BI-anxiety relation in different ways. Studying the intersection of these three streams of work may inform prevention or intervention work.
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Affiliation(s)
- Courtney A Filippi
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, 20892, United States
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, 20742, United States
- Indicates shared first authorship
- Present address: Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, Maryland, 20892
| | - Emilio A Valadez
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, 20742, United States
- Indicates shared first authorship
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, 20742, United States
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, 20892, United States
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