A Longitudinal Study of Inhibited Temperament, Effortful Control, Gender, and Anxiety in Early Childhood

Respiratory Sinus Arrhythmia, Effortful Control, and Child Social Anxiety Symptoms

Emotion dysregulation is implicated in child social anxiety and its etiology. Child emotion dysregulation has been studied via physiological indicators (e.g., respiratory sinus arrhythmia [RSA]) and behavioral indicators (e.g., effortful control). Previous work suggests that physiological indicators of regulation may predict outcomes in a non-linear manner and must be considered within the context of other intrapersonal factors, perhaps including effortful control. To this end, the current study tested effortful control as a moderator of the relation between RSA and child social anxiety, considering both linear and curvilinear patterns and controlling for inhibited temperament, an established predictor of child anxiety. Children (n = 119; 44% female) participated when they were 4 years old and entering school age (5 to 7 years). Mothers reported on children's effortful control (age 4) and social anxiety (school age). Children's RSA (age 4) was calculated from electrocardiogram data when they were at rest (i.e., baseline RSA) and when they were giving a speech. Results indicated that when children were high in effortful control, lower baseline RSA predicted higher social anxiety symptoms. Tentative evidence emerged for a relation between greater suppression of RSA during the speech compared to baseline and higher social anxiety symptoms when children were low in effortful control. Results support assessing the temperamental domain of effortful control as a contextualizing factor in the relation between psychophysiology and child anxiety outcomes.

Effortful Control Moderates the Relation Between Negative Emotionality and Child Anxiety and Depressive Symptom Severity in Children with Anxiety Disorders

The present study investigated the interactive effect of reactive (negative emotionality) and regulatory (effortful control) aspects of temperament in the prediction of child anxiety and depressive symptoms. Clinically anxious children and their mothers completed a battery of questionnaires that included self- and mother-ratings of child effortful control, negative emotionality, anxiety, and depressive symptoms. Multiple regression analyses were conducted to examine the moderating effect of effortful control on the relation between negative emotionality and child anxiety and depressive symptom severity. The interaction between negative emotionality and effortful control was statistically significant and simple slopes revealed that as effortful control increased, the relationship between negative emotionality and anxiety and depressive symptoms weakened. Among anxious children high in negative emotionality, greater effortful control was related to less severe anxiety and depressive symptoms. Future work should evaluate whether targeting effortful control leads to reductions in internalizing symptoms among clinically anxious youth.

Brief Report: Discrete Effortful Control Skills Moderate Relations Between Childhood Behavioural Inhibition and Mental Health Difficulties in Autistic Youth

Studies of the general population suggest that the risk for mental health difficulties conferred by dispositional behavioural inhibition (BI) may be modified by self-regulation; however, this possibility has not been explored in the context of autism. This study investigated the moderating effects of attentional-, activation-, and inhibitory control on the relationship between childhood BI and anxiety and depression among 47 autistic youths (55% male, M_age = 19.09 years, SD = 2.23). Childhood BI was associated with anxiety at low but not high levels of attentional- and activation control, and depression at low but not high levels of attentional control. However, there were no moderating effects of inhibitory control. These preliminary findings are partially consistent with those from the general population and point to avenues for future work.

The Relationships between Personality Disorders and Early Maladaptive Schemas and the Moderating Role of Gender

OBJECTIVE

The aims of this study were to examine the relationship between personality disorders (PDs) and early maladaptive schemas, to determine the early maladaptive schemas that predict PDs, and to investigate the moderating role of gender in the relationship between PDs and early maladaptive schemas.

METHODS

The sample consisted of 654 participants, 368 (56.4%) women and 286 (43.6%) men, aged 18-75 years, determined by the convenience sampling method. Data were collected using Coolidge Axis II Inventory Plus Turkish Short Form and Young Schema Questionnaire-Short Form 3.

RESULTS

From regression analysis, it was determined that each PD had a specific early maladaptive schema profile. According to the analysis, the schema that predicts the most for paranoid, schizotypal, schizoid, antisocial, borderline, obsessive-compulsive, and avoidant PDs is social isolation/mistrust; for histrionic and narcissistic PDs, the schema is approval seeking, and for dependent PD, it is failure. The analysis related to the moderating role of gender indicated that for women, the emotional deprivation schema is a risk factor for paranoid PD, and the schemas of self-sacrifice, punitiveness, and unrelenting standards are the risk factors for avoidant PD.

CONCLUSION

This study discovered that some early maladaptive schemas were predictors of PDs and that gender had a moderating role in the relationship between these variables. It is thought that paying attention to the moderating role of gender and considering the specific schema profiles of each PD will be beneficial for intervention programs for early maladaptive schemas and understanding the etiology of PDs.

The explanatory role of anxiety sensitivity in the association between effortful control and child anxiety and depressive symptoms

The present study examined the underlying role of anxiety sensitivity in the association between effortful control and anxiety and depressive symptoms in a sample of clinically anxious children. It was hypothesized that effortful control would exert an indirect effect through anxiety sensitivity in relation to child anxiety and depressive symptoms. Clinically anxious children (N= 105; Mage = 10.09 years, SD = 1.22; 56.7% female; 61% ethnic minority) and their mothers completed a diagnostic interview and a battery of questionnaires that included self- and mother-ratings of child effortful control, anxiety sensitivity, and anxiety and depressive symptoms. The indirect effect of effortful control via anxiety sensitivity on child anxiety and depressive symptoms was significant across child- and mother-completed measures. Among clinically anxious youth, greater effortful control was related to lower anxiety sensitivity, which was related to lower anxiety and depressive symptoms. Future work should evaluate whether targeting effortful control leads to clinically meaningful reductions in anxiety sensitivity and child anxiety and depressive symptoms.

Cognitive-behavioural interventions for prevention and treatment of anxiety in young children: A systematic review and meta-analysis

BACKGROUND

Anxiety disorders are common and impairing throughout the life course. Propensity to anxiety disorders manifests as distress and avoidance of novel stimuli (called behavioural inhibition) as early as in infancy. Already in preschool children, anxiety disorders impact emotional development and school readiness. Anxiety disorders and behavioural inhibition are prospectively associated with increased risk of mood disorders, substance use, and suicide. Therefore, early targeted prevention and treatment need to be considered. Cognitive-behavioural interventions are effective for anxiety in older age group but their efficacy for preschool children remains to be established.

METHODS

We searched PsycINFO, PubMed, and Embase until September 19th, 2019 using terms describing anxiety, behavioural inhibition, intervention, and young children. We included studies with young children participating in a cognitive-behavioural intervention for anxiety disorders, anxiety symptoms, or behavioural inhibition. We completed random-effects robust meta-analyses to (1) compare anxiety measures before and after intervention and to (2) compare intervention and control groups.

RESULTS

We identified 43 samples including 2656 participants with a mean age of 5.45 (SD = 1.00) years. Anxiety decreased after cognitive-behavioural intervention (standardized mean difference [SMD] = -1.34, 95%CI -1.59 to -1.09, p < 0.0001). Anxiety decreased more in children who received intervention than in children in control conditions (SMD = -0.81, 95%CI -1.00 to -0.63, p < 0.0001). The difference remained significant after correcting for potential publication bias and outliers (SMD = -0.89, 95% CI -1.13 to -0.66, p < 0.0001). The improvement was maintained over follow-up.

CONCLUSIONS

Cognitive-behavioural interventions are effective for prevention and treatment of anxiety in young children.

Grant Report on Anxiety-CBT: Dimensional Brain Behavior Predictors of CBT Outcomes in Pediatric Anxiety

In the following grant report, we describe initial and planned work supported by our National Institute of Mental Health R01-funded, Research Domain Criteria (RDoc) informed project, “Dimensional Brain Behavior Predictors of CBT Outcomes in Pediatric Anxiety”. This project examines response to cognitive behavioral therapy (CBT) in a large sample of anxiety-affected and low-anxious youth ages 7 to 18 years using multiple levels of analysis, including brain imaging, behavioral performance, and clinical measures. The primary goal of the project is to understand how brain-behavioral markers of anxiety-relevant constructs, namely acute threat, cognitive control, and their interaction, associate with CBT response in youth with clinically significant anxiety. A secondary goal is to determine whether child age influences how these markers predict, and/or change, across varying degrees of CBT response. Now in its fourth year, data from this project has informed the examination of (1) baseline (i.e., pre-CBT) anxiety severity as a function of brain-behavioral measures of cognitive control, and (2) clinical characteristics of youth and parents that associate with anxiety severity and/or predict response to CBT. Analysis of brain-behavioral markers before and after CBT will assess mechanisms of CBT effect, and will be conducted once the data collection in the full sample has been completed. This knowledge will help guide the treatment of clinically anxious youth by informing for whom and how does CBT work.

Effortful control, interpretation biases, and child anxiety symptom severity in a sample of children with anxiety disorders

INTRODUCTION

Effortful control-the ability to inhibit impulsive reactions in favor of more adaptive responses-is negatively related to child anxiety severity. One potential explanation is that greater effortful control may "slow down" automatic, threat-laden interpretations, thereby lowering children's anxiety. The present investigation tested this hypothesis by examining associations between effortful control (and its subcomponents) and anxiety symptom severity, mediated by interpretation biases, in a diverse sample of clinically anxious youth.

METHOD

Participants (N = 105; M_age = 10.09 years, SD = 1.22; 56.7% female; 49% ethnic minority) completed a diagnostic interview; self-report measures of temperament, anxiety, and interpretation biases; a performance-based measure of interpretation biases; and a parent-child interaction task for which an index of behavioral anxiety was computed.

RESULTS

Significant indirect effects were found for effortful control, attentional control, and inhibitory control on child self-reported anxiety severity by way of self-reported (but not behaviorally-indexed) interpretation biases. Models predicting behaviorally-indexed child anxiety severity were not significant.

DISCUSSION

Greater effortful control may result in enhanced attentional capacities that allow children to assess automatic cognitions more objectively, potentially lowering their anxiety. Future work should evaluate whether targeting malleable temperamental constructs, such as effortful control, leads to clinically meaningful reductions in interpretation biases and child anxiety symptoms.

Interaction between maternal and paternal parenting styles with infant temperament in emerging behavior problems

This study examined the interaction effects of infant temperament (negative affect, orienting/regulatory capacity, surgency) on the relationship between maternal and paternal parenting styles (authoritative, authoritarian, permissive) and externalizing and internalizing behaviors simultaneously. A diverse sample of mothers (N = 186) and fathers (N = 142) reported on infant temperament of their 6-month-olds and their children's internalizing and externalizing behaviors one year later. Significant interactions revealed: (a) surgency moderated maternal authoritative and paternal permissive parenting style and externalizing behaviors; and (b) surgency moderated maternal authoritarian and paternal authoritative parenting style and internalizing behaviors. No significant interactions were found between maternal and paternal parenting styles and their report of their infants' orienting/regulatory capacity and negative affect. Findings suggest interaction effects may appear beginning in infancy.