Temperament Traits and Psychopathology in Young Clinically Referred Children Compared to a General Population Sample

An examination of the relationship between conduct problems and depressive symptoms comorbidity and temperament among elementary school children

Although the comorbidity between conduct problems (CP) and depressive symptoms (DS) is associated with a host of negative outcomes, the factors, such as temperament, that might explain this comorbidity in school-aged boys and girls are poorly understood. This study compared elementary school children presenting co-occurring CP and DS to children with DS only, CP only, and those with low-level symptoms on temperament dimensions, and explored the moderating role of child sex in the associations. Participants are 487 children (M = 8.38 years, SD = 0.92, 52.2% girls) divided into four groups (CP + DS, DS only, CP only, control). Findings suggest that boys with CP and DS presented a lower level of fear than boys with DS and boys from the control group. They also presented higher levels of activity than boys with DS. Girls with CP and DS presented lower levels of fear than girls with DS, lower levels of approach and activity than girls with CP, and higher levels of shyness than girls from the control group. These findings suggest that temperament may discriminate children with comorbid CP and DS from those presenting only CP or DS.

Callous-unemotional behaviors and conduct problems in Chinese preschoolers: the moderating roles of surgency and gender

Introduction

Conduct problems in children are related to callous-unemotional (CU) behaviors. However, results of the relationships between CU behaviors and conduct problems among preschoolers mainly focused on Western countries, no studies have examined whether CU behaviors predict conduct problem in Chinese preschoolers. The primary objective of the current study therefore was to examine the associations between CU behaviors and conduct problems as well as the moderating effects of surgency and child gender in Chinese preschool children.

Methods

The present study randomly selected 2,154 children (1,043 boys, Mage = 56 months, SD = 10.47) from six kindergartens in Shanghai, People's Republic of China. Mothers rated children's surgency and teachers reported children's CU behaviors and conduct problems.

Results

Results demonstrated that CU behaviors were positively associated with conduct problems. Surgency and child gender significantly moderated these associations. Specifically, CU behaviors were positively associated with conduct problems, with a stronger effect found for high levels of surgency. CU behaviors had a positive association with conduct problems, with a stronger effect found for boys.

Discussion

This study indicate that temperament and gender characteristics influence conduct problems in preschoolers who exhibit high levels of CU behaviors. As well, the findings emphasize the significance of considering the meaning and implication of CU behaviors in Chinese culture.

A genetically informed longitudinal study of early-life temperament and childhood aggression

The present study examined the longitudinal associations between three dimensions of temperament - activity, affect-extraversion, and task orientation - and childhood aggression. Using 131 monozygotic and 173 dizygotic (86 same-sex) twin pairs from the Louisville Twin Study, we elucidated the ages, from 6 to 36 months, at which each temperament dimension began to correlate with aggression at age 7. We employed latent growth modeling to show that developmental increases (i.e., slopes) in activity were positively associated with aggression, whereas increases in affect-extraversion and task orientation were negatively associated with aggression. Genetically informed models revealed that correlations between temperament and aggression were primarily explained by common genetic variance, with nonshared environmental variance accounting for a small proportion of each correlation by 36 months. Genetic variance explained the correlations of the slopes of activity and task orientation with aggression. Nonshared environmental variance accounted for almost half of the correlation between the slopes of affect-extraversion and aggression. Exploratory analyses revealed quantitative sex differences in each temperament-aggression association. By establishing which dimensions of temperament correlate with aggression, as well as when and how they do so, our work informs the development of future child and family interventions for children at highest risk of aggression.

Postnatal maternal distress, infant subcortical brain macrostructure and emotional regulation

BACKGROUND

Maternal distress is associated with an increased risk for adverse emotional development in infants, including difficulties with emotion regulation. Prenatal maternal distress has been associated with alterations in infant brain development. However, less is known about these associations with postnatal maternal distress, despite this being an important modifiable risk factor that can promote healthy brain development and emotional outcomes in infants.

METHODS & RESULTS

Infants underwent magnetic resonance imaging (MRI) and mothers completed standardized questionnaires concerning their levels of perceived distress 2-5 months postpartum. Infant emotion regulation was assessed at 8-11 months via maternal report. When examining the associations between maternal distress and infant macrostructure, maternal anxiety was associated with infant right pallidum volumes. Increased display of negative emotions at 8-11 months of age was associated with smaller hippocampal volumes and this association was stronger in girls than boys.

CONCLUSION

Findings suggest that postnatal maternal distress may be associated with early infant brain development and emphasize the importance of maternal mental health, supporting previous work. Furthermore, macrostructural properties of infant subcortical structures may be further investigated as potential biomarkers to identify infants at risk of adverse emotional outcomes.

Maternal Functioning and Child's Externalizing Problems: Temperament and Sex-Based Driven Effects

This study examines how maternal adverse parenting (hostility, neglect, low warmth) and psychological distress explain the associations between child temperament factors and externalizing problems. It also examines if these associations differ according to the child's biological sex. The sample consists of 339 school-age children receiving in-school services for conduct problems. Data were collected through questionnaires completed by mothers at 3 time points, at one-year intervals. Results from path analyses revealed that maternal psychological distress partly explained the associations between each child temperamental factors (negative affectivity, surgency/extraversion, effortful control) and levels of externalizing problems. Specifically, the indirect effect of psychological distress between child negative affectivity and externalizing problems was only significant for boys, not girls. Maternal hostility, on the other hand, mediated the association between child surgency/extraversion and externalizing problems in both boys and girls. Interestingly, neglectful parenting and maternal warmth did not explain the association between child temperamental factors and externalizing problems. The findings suggest small but significant temperament child-driven effects on maternal psychological distress and hostility, in turn, translating into higher levels of externalizing problems. These findings support the relevance of temperament-based interventions for children with conduct problems and of increased mental health support for their mothers. By aiding mothers in developing a larger repertoire of parenting strategies, mothers may be better equipped to respond appropriately to their child's various temperamental characteristics, hence, reducing their psychological distress and hostile behaviors and limiting the development of child externalizing problems.

Behavioral Changes in Preschool- and School-Age Korean Children: A Network Analysis

The relationships between symptoms that comprise behavioral problems in children can be traced longitudinally to provide long-term support. This study identified signs that should be considered important in school age children by tracking changes in the relationships between different symptoms of behavioral problems in preschool and school age children. This study used Gaussian graphical network analysis to clarify the interaction of the overall subscales constituting the K-CBCL (Korean Child Behavior Checklist) and centrality in the network. In the Panel Study on Korean Children (PSKC), the K-CBCL/1.5–5 was used for children up to age six (first grade, elementary school), and the K-CBCL/6–18 was used for older children. In this study, 1323 PSKC samples (boys, n = 671; girls, n = 652) were used to distinguish nonclinical and (sub)clinical groups (T-score ≥ 60) compared to node centrality in each group’s CBCL subscale networks. Depression/anxiety was a persistent core symptom of the behavioral problem network in 5- and 7-year-old children. A new core symptom in 7-year-old children was posttraumatic stress problems added in version CBCL/6-18. Based on these results, it is necessary to consider both anxiety/depression and posttraumatic stress problems in preschool children to support the adaptation of school-age children.

Curvilinear Relations Between Preschool-Aged Children's Effortful Control and Socioemotional Problems: Racial-Ethnic Differences in Functional Form

The majority of studies of preschool-aged children's self-regulation presume that their higher levels of self-regulation are concurrently and prospectively associated with fewer externalizing and internalizing problems. This assumes their relations are only linear in form and negative, but studies with community samples of mostly non-Hispanic White children have found curvilinear or positive relations between self-regulation and socioemotional problems in early childhood. This cross-sectional study tests linear and quadratic relations between children's behavioral battery assessed effortful control and parent rated externalizing and internalizing problems, and whether their functional forms differ across racial-ethnic groups in a diverse sample of 2.5- to 3.5-years-olds (N = 72) from highly educated two-parent households. Child effortful control was negatively related to externalizing, quadratically related to internalizing (albeit marginally), and an interaction between effortful control and race-ethnicity indicated opposite linear relations between effortful control and internalizing problems for different racial-ethnic groups. By integrating tests of curvilinearity and interactions, this study builds on theoretical and empirical work indicating complex relations between the development of self-regulation and psychopathology.

Cultural contributors to negative emotionality: A multilevel analysis from the Joint Effort Toddler Temperament Consortium

This study advances the cross-cultural temperament literature by comparing temperament ratings of toddlers from 14 nations. Multilevel modeling (MLM) procedures were utilized to regress negative emotionality (NE) and component subscales on Hofstede’s cultural value dimensions while controlling for age and gender. More individualistic values were associated with lower NE, and component discomfort, fear, motor activity, perceptual sensitivity, and soothability scales. The discomfort subscale was negatively associated with power distance and positively associated with masculine cultural values. Higher ratings of shyness were related to a more long-term cultural orientation. Results illustrate the feasibility of an MLM approach to cross-cultural research and provide a new perspective on the intersection of culture and temperament development. Limitations and future implications are discussed.

Developmental Paths to Anxiety in an Autism-Enriched Infant Cohort: The Role of Temperamental Reactivity and Regulation

The aim of this study was to explore the associations between temperamental reactivity and regulation and the emergence of anxiety traits in a longitudinal sample of infants enriched for later ASD. Parents of 143 infants who were at high- and low-risk for ASD rated their child’s temperament traits when they were 9, 15 and 24 months old; they rated anxiety and ASD traits when they were 36 months old. The findings suggest that behavioural inhibition may be an early predictor of later anxiety in children with and without ASD and that lower levels of effortful control in children who later develop ASD may contribute to the higher expression of anxiety within this population.

Early Detection of Temperament Risk Factors: A Comparison of Clinically Referred and General Population Children

Despite an extensive literature on associations between early childhood temperament and behavior problems, most of this evidence is based on general population samples. Hence, relatively little is known about the temperament characteristics of children who have been referred for in- or outpatient treatment of emotional and/or behavioral problems. Whether temperament-to-behavior problems identified in community samples would also be found in samples of clinically referred children is poorly understood. To redress this limitation, we compared temperament attributes of a predominantly preschool-aged sample of children referred for treatment of emotional and/or behavioral disorders (N = 87) with those from a similarly-aged general population sample (N = 85) by using the Integrative Child Temperament Screener (ICTS)-a new nine-item scale to identify clinically significant temperament attributes. Behavioral symptoms in the clinical sample were assessed through diagnostic interviews in combination with the Child Behavior Checklist (CBCL), which was also administered to the general population children. Compared with general population children, referred children exhibited substantially higher scores on all ICTS subscales except behavioral inhibition. Furthermore, areas under the curve analyses showed that discrimination of both groups based on CBCL scales could be improved by adding the ICTS. Overall, the findings fill a long-standing gap in evidence regarding temperament characteristics of children with serious emotional and/or behavioral symptoms and suggest a useful role for the ICTS in assessment, screening, and prevention.

Pathways to social-emotional functioning in the preschool period: The role of child temperament and maternal anxiety in boys and girls

Individual differences in social-emotional functioning emerge early and have long-term implications for developmental adaptation and competency. Research is needed that specifies multiple early risk factors and outcomes simultaneously to demonstrate specificity. Using multigroup longitudinal path analysis in a sample of typically developing children (N = 541), we examined child temperament dimensions (surgency, negative affectivity, and regulation/effortful control) and maternal anxiety in infancy and age 2 as predictors of child externalizing, internalizing, dysregulation, and competence behaviors at age 3. Four primary patterns emerged. First, there was stability in temperament dimensions and maternal anxiety from infancy to age 3. Second, negative affectivity was implicated in internalizing problems and surgency in externalizing problems. Third, effortful control at age 2 was a potent mediator of maternal anxiety in infancy on age 3 outcomes. Fourth, there was suggestive evidence for transactional effects between maternal anxiety and child effortful control. Most pathways operated similarly for boys and girls, with some differences, particularly for surgency. These findings expand our understanding of the roles of specific temperamental domains and postnatal maternal anxiety in a range of social-emotional outcomes in the preschool period, and have implications for efforts to enhance the development of young children's social-emotional functioning and reduce risk for later psychopathology.

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.

Exploring childhood temperament as a moderator of the association between adolescent sexual minority status and internalizing and externalizing behavior problems

INTRODUCTION

Sexual minority youth experience worse mental health compared to their heterosexual peers, reflecting the consequences of sexual minority-based stigma. Previous research has focused on contextual variation to understand variability within this vulnerability. Childhood temperament factors such as negative affect, effortful control and surgency/extraversion are important for understanding differential susceptibility to environmental stressors. The objective of the current study was to understand how childhood temperament factors, measured prior to the most difficult developmental period for sexual minority youth, moderated the association between sexual minority status and internalizing and externalizing behavior problems.

METHODS

Youth reporting same-sex attraction in an ongoing longitudinal project on the development of conduct problems in Quebec, Canada were matched with heterosexual peers, for an analytic sample of 280 youth (62% girls). Structural equation models were used to examine (1) the association between youth-reported same-sex attraction (ages 13-16) and parent and youth-reported internalizing and externalizing problems a year later at ages 14-17, and (2) the moderating role of temperament (ages 6-9) in this association between sexual minority status and internalizing and externalizing problems.

RESULTS

Same-sex attraction was associated with higher levels of youth-reported internalizing and externalizing behavior problems. Surgency/extraversion moderated the association between sexual minority status and youth-reported internalizing and externalizing problems.

CONCLUSIONS

These findings suggest that temperament linked to individual visibility may be important for understanding variation in self-reported mental health among sexual minority youth, and supports the use of developmental constructs like temperament to better understand vulnerability to psychosocial difficulties within this population.

Baby preparation and worry scale (Baby-PAWS): Instrument development and psychometric evaluation

BACKGROUND

The Baby Preparation and Worry Scale (Baby-PAWS) addresses expectant mothers' anticipatory worries regarding the transition to parenthood, focusing on practical concerns (i.e., ability to care for the infant, securing childcare, personal wellbeing, and partner involvement).

AIMS

The present study describes measurement development, psychometric evaluation, and predictive and concurrent validity of Baby-PAWS, administered during pregnancy.

STUDY DESIGN

We used a repeated-measures design, with anonymous self-report obtained during the 3rd trimester of pregnancy and at 2 months postpartum.

SUBJECTS

Healthy pregnant women (N = 276) completed Baby-PAWS and measures of depression, general anxiety, and pregnancy-specific anxiety. Demographic, pregnancy, and birth-related information (e.g., complications, gestational age) was also obtained. At postpartum follow-up, the majority (n = 154) met inclusion criteria and provided data on themselves and their infants.

OUTCOME MEASURES

Prenatally, we examined correlations between Baby-PAWS and established measures of general anxiety, pregnancy-specific anxiety, and depression. Postnatally, Baby-PAWS scores were used to predict maternal depression, anxiety, and infant temperament.

RESULTS AND CONCLUSIONS

Two factor-analytic techniques indicated a three-factor structure, with internal consistency for all three components and the overall scale. We labeled the three factors: Self and Partner Worry, Non-parental Childcare Worry, and Baby Caregiving Worry, based on item content. Higher Baby-PAWS scores were associated with greater anxiety and depression in the third trimester. Predictive links with postpartum anxiety/depression symptoms and infant temperament were observed for the overall Baby-PAWS score and Self and Partner Worry factor. Although this instrument requires further evaluation, it offers promising utility in research and clinical settings.

Temperamental Development among Preterm Born Children. An RCT Follow-Up Study

A randomized controlled trial study recruited 146 preterm born children, either to participate in a modified version of the Mother–Infant Transaction Program (MITP-m) or to receive the usual follow-up services, before and after discharge from a neonatal intensive care unit. This follow-up study investigates whether MITP participation is associated with parental perceptions of child temperament from two to seven years. Children’s temperament was reported by mothers and fathers separately at children’s ages of 2, 3, 5, and 7 years. Parents in the MITP-m group reported lower levels of negative emotionality in their children compared to the control group. In maternal reports, a group effect (F(1, 121) = 9.7, p = 0.002) revealed a stable difference in children’s negative emotionality from two to seven years, while a group-by-time interaction related to an increasing difference was detected in reports from fathers (F(1, 94) = 4.8, p = 0.03). Another group difference appeared in fathers’ reports of children’s soothability (F(1, 100) = 14.2, p < 0.0005). MITP-m fathers seemed to perceive their children as easier to soothe at all ages as no interaction with time appeared. Parental reports on children’s sociality, shyness, and activity did not differ between the groups.

New brief temperament guidance program for parents of infants: A pilot evaluation

PROBLEM

Intensive temperament guidance programs have been successfully utilized to improve caregiver understanding of temperament and teach strategies for appropriately responding to temperament traits. However, the effects of providing brief psychoeducational temperament information to parents have not been previously examined.

METHODS

Mothers of 3-12-month infants (n = 35) participated in an intervention examining the impact of a comprehensive temperament brochure on temperament knowledge, program attitudes, and parent-child interactions.

FINDINGS

Mothers demonstrated increased temperament knowledge and were generally accepting of the program. Behavioral changes in mother-child interactions were observed. Sensitivity increased, and interactions shifted from more parent-directed to more balanced following the intervention. Infant gender functioned as a moderator of intervention effects for two mother-infant interaction dynamics. A significant increase in reciprocity was observed between mothers and boys, largely as a function of significantly lower levels of reciprocity preintervention. Child gender also interacted with directedness, in that interactions became more balanced for girls, but remained more mother-directed with boys. Finally, maternal education functioned as a moderator of tempo, as mothers in the higher education group shifted from slower to moderate tempo following the intervention.

CONCLUSIONS

Promising results suggest the need for continued implementation and evaluation of brief temperament interventions.

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.

Temperamental negative affect, emotion-specific regulation, and concurrent internalizing and externalizing pathology among children with ADHD

Children with attention-deficit/hyperactivity disorder (ADHD) experience high rates of temperamental negative affect and comorbid internalizing and externalizing pathology. The current study explored the role of emotion-specific regulation in accounting for the link between temperamental negative affect and psychopathology among children with ADHD. Forty parents of children ages 8-11 (N =29 males, N =11 females) completed measures of child temperament, emotion-specific dysregulation (i.e., anger dysregulation, sadness dysregulation), and psychopathology. Children completed a measure of emotion-specific dysregulation. Results revealed that anger dysregulation fully statistically accounted for the relationship between temperamental negative affect and concurrent externalizing problems. Sadness dysregulation did not account for the relationship between temperamental negative affect and internalizing problems. These novel findings implicate the robust role of anger dysregulation in explaining the link between temperamental negative affect and concurrent externalizing pathology. The results of this study have significant implications for the treatment of emotionally driven externalizing behavior among children with ADHD.

Attentional Orientation Patterns toward Emotional Faces and Temperamental Correlates of Preschool Oppositional Defiant Problems: The Moderating Role of Callous-Unemotional Traits and Anxiety Symptoms

The present study examined the independent contributions and the interaction effects of oppositional defiant problems (ODD), callous unemotional traits (CU) and anxiety symptoms on attentional orienting to emotional faces, in a community sample of preschoolers. Additionally, based on Rothbart's (2007) model of temperament, we analyzed whether fine-grained dimensions of reactivity (fear, anger, discomfort, sadness, activity level, approach, high intensity pleasure, impulsivity) and self-regulation (attentional shifting, attentional focusing, inhibitory control), as well as the higher order temperamental factors of negative affectivity, surgency and effortful control are associated with CU traits and ODD-related problems. Attentional orienting to emotional faces was assessed with pictorial Dot-probe task, while teachers rated CU traits and ODD-related problems. Also, parents reported on ODD-related problems, anxiety and temperament. Results indicated significant interaction effects between ODD-related problems and CU, as well as between CU and anxiety, in predicting attentional orientation patterns for angry, fearful and happy faces. Moreover, temperamental reactivity was positively associated with CU traits and ODD-related problems, whereas temperamental self-regulation was negatively related to CU traits and ODD-related problems. Results of this study have implications for early intervention and prevention approaches targeting preschool oppositional defiant problems.