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Botelho C, Pasion R, Prata C, Barbosa F. Neuronal underpinnings of the attentional bias toward threat in the anxiety spectrum: Meta-analytical data on P3 and LPP event-related potentials. Biol Psychol 2023; 176:108475. [PMID: 36503040 DOI: 10.1016/j.biopsycho.2022.108475] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND This systematic review analyzes brain responses at later stages of neuronal processing (P3 at 300-500 ms, and LPP at 300-700 ms). Both P3 and LPP are implicated in attentional threat bias in disorders grouped into fear and distress dimensions of the anxiety spectrum described by the Hierarchical Taxonomy Model of Psychopathology (HiTOP), but there are no consistent findings so far. METHOD Meta-analyses with between- (32 studies, n = 1631) and within-groups design (31 studies, n = 1699) were performed for assessing P3 and LPP modulation in negative, positive, and neutral stimuli, while also considering differences between controls and anxious individuals. Relevant moderators (e.g., age, sex, task) were controlled for and negative stimuli were further decomposed in terms of category (Relevant, Fear/Threat, or Unpleasant). RESULTS Increased P3 and LPP amplitudes were found for negative and positive stimuli, when compared to neutral stimuli (within-subjects analysis), confirming that both components are elicited by emotionally arousing information. Within-effects for negative and positive stimuli were higher for the anxious groups. Nonetheless, between-groups analyses showed that attentional threat bias occurs only in anxious groups when negative, personally relevant-threat information is presented. The HiTOP fear dimension moderated the findings. LIMITATIONS Potential missed studies; ERPs time windows' heterogeneity; adult sample only; the uneven number of computed effects; categorical analyses. CONCLUSION Attentional bias toward disorder-congruent threatening cues can be a transdiagnostic mechanism of HiTOP fear disorders, clustered within the anxiety spectrum.
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Affiliation(s)
- Catarina Botelho
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences, University of Porto, Rua Alfredo Allen, 535, 4200-135 Porto, Portugal.
| | - Rita Pasion
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences, University of Porto, Rua Alfredo Allen, 535, 4200-135 Porto, Portugal; Digital Human-Environment Interaction Lab (HEI-LAB), Lusófona University, Portugal
| | - Catarina Prata
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences, University of Porto, Rua Alfredo Allen, 535, 4200-135 Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences, University of Porto, Rua Alfredo Allen, 535, 4200-135 Porto, Portugal
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Beard C, Beckham E, Solomon A, Fenley AR, Pincus DB. A Pilot Feasibility Open Trial of an Interpretation Bias Intervention for Parents of Anxious Children. COGNITIVE AND BEHAVIORAL PRACTICE 2022; 29:860-873. [PMID: 36506843 PMCID: PMC9731147 DOI: 10.1016/j.cbpra.2021.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Interpretation bias is a transdiagnostic mechanism underlying anxiety. Theoretical models highlight the role of parental interpretation bias in predicting and maintaining child anxiety. However, very few studies have examined parent interpretation bias as a treatment target. The current pilot study tested the feasibility and acceptability of an interpretation bias intervention delivered by a smartphone app, called HabitWorks, in parents of anxious children who self-reported at least mild symptoms of anxiety and negative interpretation bias. Parents of anxious youth (ages 8 to 16) were recruited from the waitlists of three child anxiety clinics. They were asked to complete interpretation modification exercises via the HabitWorks app 3 times per week for 1 month. Participants completed assessments at pre- and post-intervention and 1-month follow-up to assess changes in interpretation bias, anxiety symptoms, and overall perceptions of HabitWorks. Participants (N=14) (Mage=44.36; 14.29% men, 85.71% women) completed an average of 13.29 exercises out of the 12 prescribed. Acceptability ratings were high. Interpretation bias, as measured by an assessment version of the intervention exercise, significantly improved from pre- to posttreatment, and these improvements were maintained at the 1-month follow-up. Anxiety symptoms significantly improved from the "mild" severity range to the "none to minimal" range. In this pilot feasibility study in parents of anxious youth, HabitWorks was a feasible and acceptable low-intensity intervention. These preliminary results support a future controlled trial of HabitWorks for parents. Future studies are also needed to test whether targeting interpretation bias in parents has downstream effects on maladaptive parent behaviors and ultimately, child interpretation bias and anxiety.
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Affiliation(s)
| | | | | | - Alicia R Fenley
- Center for Anxiety and Related Disorders at Boston University
| | - Donna B Pincus
- Center for Anxiety and Related Disorders at Boston University
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Aktar E. Intergenerational Transmission of Anxious Information Processing Biases: An Updated Conceptual Model. Clin Child Fam Psychol Rev 2022; 25:182-203. [PMID: 35218453 PMCID: PMC8948131 DOI: 10.1007/s10567-022-00390-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 11/28/2022]
Abstract
Anxiety disorders are globally one of the most prevalent and disabling forms of psychopathology in adults and children. Having a parent with an anxiety disorder multiplies the risk of anxiety disorders in the offspring, although the specific mechanisms and processes that play a role in this intergenerational transmission remain largely unknown. According to information processing theories, threat-related biases in cognitive processing are a causal mechanism in the development and maintenance of anxiety. These theories propose that individuals with anxiety are more likely to cognitively process novel stimuli in their environment as threatening. Creswell and colleagues proposed a theoretical model that highlighted the role of these cognitive biases as a mechanism in the intergenerational transmission of anxiety (Creswell et al., in Hadwin, Field (eds) Information processing biases and anxiety: a developmental perspective, Wiley, pp 279-295, 2010). This model postulated significant associations between (1) parents' and children's threat-related cognitive biases (2) parents' threat-related cognitive biases in their own and their child's environment, (3) parents' threat-related cognitive biases and parenting behaviors that convey anxiety risk to the offspring (e.g., modeling of fear, and verbal threat information transmission), and (4) parenting behaviors and child threat-related biases. This theoretical review collated the recent empirical work testing these four core hypotheses of the model. Building on the reviewed empirical work, an updated conceptual model focusing on threat-related attention and interpretation is proposed. This updated model incorporates the links between cognition and anxiety in parents and children and addresses the potential bidirectional nature of parent-child influences.
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Affiliation(s)
- Evin Aktar
- Department of Psychology, Clinical Psychology Unit, Leiden, The Netherlands.
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.
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4
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Silverman WK, Marin CE, Rey Y, Jaccard J, Pettit JW. Directional effects of parent and child anxiety 1 year following treatment of child anxiety, and the mediational role of parent psychological control. Depress Anxiety 2021; 38:1289-1297. [PMID: 34464490 PMCID: PMC8664994 DOI: 10.1002/da.23210] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 07/28/2021] [Accepted: 08/03/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND We leveraged a recent efficacy trial to investigate directionality between parent anxiety and child anxiety at posttreatment and 12-month follow-up, and the potential role of parent psychological control as a mediator. We also explored child age and sex as moderators. METHOD Two-hundred and fifty-four children were randomized to individual cognitive behavioral therapy (CBT) or to one of two CBT arms with parent involvement. Parent anxiety was not a treatment target in any of the three arms. RESULTS Child anxiety at posttreatment was associated with parent anxiety and psychological control at 12-month follow-up, providing evidence of child-to-parent directionality. Parent anxiety at posttreatment was associated indirectly with child anxiety at 12-month follow-up through associations with parent psychological control, providing evidence of parent-to-child directionality. At posttreatment, parent psychological control contemporaneously mediated the relation between parent and child anxiety. Neither child age nor sex moderated any association. CONCLUSIONS Findings highlight the directional effects between child anxiety, parent anxiety, and psychological control from posttreatment to 12-month follow-up, even when parent anxiety is not a treatment target. Research and clinical implications are discussed, with an emphasis on enhancing durability following treatment effects.
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Efthymiou V, Kotsikogianni D, Tsitsika AK, Vlachakis D, Chrousos GP, Charmandari E, Bacopoulou F. Validation of the Greek version of the Adolescent Sleep Hygiene Scale (ASHS). EMBNET.JOURNAL 2021; 26:e979. [PMID: 34824996 PMCID: PMC8612368 DOI: 10.14806/ej.26.1.979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Transition from childhood to adolescence is known to bring about many changes in the lifestyle and psycho-emotional state of adolescents. One of the major lifestyle factors that affect adolescents' physical and mental health is sleep. The aim of this study was to validate the Adolescent Sleep Hygiene Scale (ASHS), a tool that measures sleep hygiene, in an adolescent sample living in Greece. The study's sample consisted of 146 Greek adolescents aged 12-18 years. The Adolescent Stress Questionnaire was used for convergent validity and correlation with adolescents' stress. The pilot and the main study demonstrated sufficient internal consistency. Exploratory Factor Analysis showed an adequate adaptation of the original ASHS questionnaire to the Greek adolescents. The findings of this study support the use of ASHS as a reliable and valid tool for evaluating sleep-facilitating and sleep-inhibiting practices of Greek adolescents.
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Affiliation(s)
- Vasiliki Efthymiou
- University Research Institute of Maternal and Child Health & Precision Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitra Kotsikogianni
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Artemis K Tsitsika
- Adolescent Health Unit, Second Department of Pediatrics, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Vlachakis
- University Research Institute of Maternal and Child Health & Precision Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Laboratory of Genetics, Department of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
- Lab of Molecular Endocrinology, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - George P Chrousos
- University Research Institute of Maternal and Child Health & Precision Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
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Xiong W, Liu H, Gong P, Wang Q, Ren Z, He M, Zhou G, Ma J, Guo X, Fan X, Liu M, Yang X, Shen Y, Zhang X. Relationships of coping styles and sleep quality with anxiety symptoms among Chinese adolescents: A cross-sectional study. J Affect Disord 2019; 257:108-115. [PMID: 31301610 DOI: 10.1016/j.jad.2019.07.032] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 06/10/2019] [Accepted: 07/04/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Limited published research has examined the relationships of coping styles and sleep quality with anxiety symptoms in Chinese school adolescents. We aimed to explore the effect of coping styles and sleep quality on anxiety symptoms. Furthermore, we investigated the interactions of coping styles and sleep quality with anxiety symptoms. METHODS The survey was conducted in Jiangxi Province, China. The Simplified Coping Style Questionnaire, Pittsburgh Sleep Quality Index and Chinese Secondary School Students Anxiety Scale were utilized to assess sleep quality, coping styles and anxiety symptoms, respectively. Multiple logistic regression analysis was applied to explore the relationships of coping styles and sleep quality with anxiety symptoms. RESULTS A total of 3081 students participated in this study, 50.8% of whom were boys; the number of participants in grades 1, 2 and 3 were 979, 1085 and 1017, respectively. The prevalence of anxiety symptoms was 27.3%. Individuals with poor sleep quality were 3.558 (95% CI = 2.716-4.660) times as likely to have anxiety symptoms than those with good sleep quality. Higher negative coping style scores increased the prevalence of anxiety symptoms (OR = 2.101, 95% CI = 1.894-2.332), whereas higher positive coping style scores were related to reduced odds of anxiety symptoms (OR = 0.892, 95% CI = 0.800-0.995). Interactions of coping styles and sleep quality with anxiety symptoms were not found (all p > 0.05). The association between negative coping style and anxiety symptoms was mediated by sleep quality. LIMITATIONS This study was cross-sectional and limited to Ganzhou City. CONCLUSIONS The results of our study showed a higher prevalence of anxiety symptoms compared with the result of a previous study in Chinese school adolescents. Negative coping style and poor sleep quality were associated with an increased prevalence of anxiety symptoms, whereas positive coping style was related to a decreased prevalence of anxiety symptoms. Sleep quality was a mediating factor between negative coping style and anxiety symptoms.
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Affiliation(s)
- Wenjing Xiong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Ping Gong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Qi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Zheng Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Ge Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Juan Ma
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xia Guo
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xinwen Fan
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Meitian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xiaodi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yue Shen
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China; China Population Communication Center, Beijing, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
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Mobach L, Rinck M, Becker ES, Hudson JL, Klein AM. Content-Specific Interpretation Bias in Children with Varying Levels of Anxiety: The Role of Gender and Age. Child Psychiatry Hum Dev 2019; 50:803-814. [PMID: 30879167 PMCID: PMC6737177 DOI: 10.1007/s10578-019-00883-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The current study examined whether children varying in their levels of social anxiety, separation anxiety and spider fear exhibit a negative interpretation bias specific for their fears. Furthermore, age and gender were assessed as moderators of this relation. Children (N = 603) of the age of 7-12 years were asked to solve ambiguous scenarios reflecting social threat, separation threat or spider threat. Children's levels of anxiety were assessed with self-report questionnaires. Results indicated that children scoring higher on self-reported social anxiety, separation anxiety or spider fear, displayed a negative interpretation bias for the threat-scenarios pertaining to their specific anxiety or fear, even after controlling for comorbidity with other anxiety subtypes. Contrary to our hypotheses, we did not find moderating effects of age or gender. These results indicate that even in a community sample, content-specificity of negative interpretation biases is present.
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Affiliation(s)
- Lynn Mobach
- Department of Psychology, Behavioural Science Institute, Radboud University, Montessorilaan, 6525 HR, Nijmegen, The Netherlands.
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia.
| | - Mike Rinck
- Department of Psychology, Behavioural Science Institute, Radboud University, Montessorilaan, 6525 HR, Nijmegen, The Netherlands
| | - Eni S Becker
- Department of Psychology, Behavioural Science Institute, Radboud University, Montessorilaan, 6525 HR, Nijmegen, The Netherlands
| | - Jennifer L Hudson
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Anke M Klein
- Department of Psychology, Behavioural Science Institute, Radboud University, Montessorilaan, 6525 HR, Nijmegen, The Netherlands
- Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
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de Lijster JM, Utens EMWJ, Dieleman GC, Alexander TM, Hillegers MHJ, Legerstee JS. Familial Aggregation of Cognitive Biases for Children with Anxiety Disorders. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-10031-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Emerson LM, Ogielda C, Rowse G. A systematic review of the role of parents in the development of anxious cognitions in children. J Anxiety Disord 2019; 62:15-25. [PMID: 30472334 DOI: 10.1016/j.janxdis.2018.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 11/08/2018] [Accepted: 11/13/2018] [Indexed: 10/27/2022]
Abstract
Anxious cognitions and parental behavior are important in the development of child anxiety. The current review aims to appraise the literature on the relationship between parental factors and chid anxious cognitions. Online database searches of PsycInfo, Scopus, ProQuest Dissertations and Web of Science were systematically searched using key terms related to 'parent', 'child', 'anxiety' and 'cognitions'. Included studies (N = 13) were quality assessed and study findings were appraised in line with cognitive behavioral frameworks of the parental pathways to the development of anxious cognitions in children. Reviewed studies confirmed that parental factors have a role in the development of their children's anxious cognitions by modelling fearful responses, reducing their child's autonomy, and indirectly via their own expectations about their child. Limitations of the literature are considered, including issues of measurement. Future research should consider multi-modal assessment of parental factors and examine parental behavior and child anxious cognitions in the context of real-life threatening events.
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Affiliation(s)
- Lisa-Marie Emerson
- School of Applied Psychology, Griffith University, Gold Coast Campus, Australia.
| | - Claire Ogielda
- Clinical Psychology Unit, Vicar Lane, University of Sheffield, UK.
| | - Georgina Rowse
- Clinical Psychology Unit, Vicar Lane, University of Sheffield, UK.
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10
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Stuijfzand S, Creswell C, Field AP, Pearcey S, Dodd H. Research Review: Is anxiety associated with negative interpretations of ambiguity in children and adolescents? A systematic review and meta-analysis. J Child Psychol Psychiatry 2018; 59:1127-1142. [PMID: 29052865 PMCID: PMC6849625 DOI: 10.1111/jcpp.12822] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND The tendency to interpret ambiguity as threat (negative interpretation) has been implicated in cognitive models of anxiety. A significant body of research has examined the association between anxiety and negative interpretation, and reviews suggest there is a robust positive association in adults. However, evidence with children and adolescents has been inconsistent. This study aimed to provide a systematic quantitative assessment of the association between anxiety and negative interpretation in children and adolescents. METHOD Following systematic searches and screening for eligibility, 345 effects sizes from 77 studies were meta-analysed. RESULTS Overall a medium positive association was found between anxiety and negative interpretation in children and adolescents ( d ^ = .62). Two variables significantly moderated this effect. Specifically, the association increased in strength with increasing age and when the content of ambiguous scenarios matched the anxiety subtype under investigation. CONCLUSIONS Results extend findings from adult literature by demonstrating an association in children and adolescents with evidence for content specificity in the association. Age effects imply a role for development. Results raise considerations for when and for whom clinical treatments for anxiety focusing on interpretation bias are appropriate. The vast majority of studies included in the review have used correlational designs and there are a limited number of studies with young children. The results should be considered with these limitations in mind.
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Affiliation(s)
- Suzannah Stuijfzand
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Cathy Creswell
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | | | - Samantha Pearcey
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Helen Dodd
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
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11
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Gonzalez A, Rozenman M, Langley AK, Kendall PC, Ginsburg GS, Compton S, Walkup JT, Birmaher B, Albano AM, Piacentini J. Social Interpretation Bias in Children and Adolescents with Anxiety Disorders: Psychometric Examination of the Self-report of Ambiguous Social Situations for Youth (SASSY) Scale. CHILD & YOUTH CARE FORUM 2017; 46:395-412. [PMID: 28740356 PMCID: PMC5521277 DOI: 10.1007/s10566-016-9381-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Anxiety disorders are among the most common mental health problems in youth, and faulty interpretation bias has been positively linked to anxiety severity, even within anxiety-disordered youth. Quick, reliable assessment of interpretation bias may be useful in identifying youth with certain types of anxiety or assessing changes on cognitive bias during intervention. OBJECTIVE This study examined the factor structure, reliability, and validity of the Self-report of Ambiguous Social Situations for Youth (SASSY) scale, a self-report measure developed to assess interpretation bias in youth. METHODS Participants (N=488, age 7 to 17) met diagnostic criteria for Social Phobia, Generalized Anxiety Disorder, and/or Separation Anxiety Disorder. An exploratory factor analysis was performed on baseline data from youth participating in a large randomized clinical trial. RESULTS Exploratory factor analysis yielded two factors (Accusation/Blame, Social Rejection). The SASSY full scale and Social Rejection factor demonstrated adequate internal consistency, convergent validity with social anxiety, and discriminant validity as evidenced by non-significant correlations with measures of non-social anxiety. Further, the SASSY Social Rejection factor accurately distinguished children and adolescents with Social Phobia from those with other anxiety disorders, supporting its criterion validity, and revealed sensitivity to changes with treatment. Given the relevance to youth with social phobia, pre- and post-intervention data were examined for youth social phobia to test sensitivity to treatment effects; results suggested that SASSY scores reduced for treatment responders. CONCLUSIONS Findings suggest the potential utility of the SASSY Social Rejection factor as a quick, reliable, and efficient way of assessing interpretation bias in anxious youth, particularly as related to social concerns, in research and clinical settings.
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Affiliation(s)
- Araceli Gonzalez
- California State University, Long Beach, Department of Psychology
| | - Michelle Rozenman
- University of California, Los Angeles Semel Institute for Neuroscience and Human Behavior, Division of Child and Adolescent Psychiatry
| | - Audra K. Langley
- University of California, Los Angeles Semel Institute for Neuroscience and Human Behavior, Division of Child and Adolescent Psychiatry
| | | | | | - Scott Compton
- Duke University Medical Center, Department of Psychiatry and Biobehavioral Sciences
| | - John T. Walkup
- Weill Cornell Medical College, Division of Child and Adolescent Psychiatry
| | - Boris Birmaher
- Western Psychiatric Institute and Clinics, University of Pittsburgh Medical Center
| | | | - John Piacentini
- University of California, Los Angeles Semel Institute for Neuroscience and Human Behavior, Division of Child and Adolescent Psychiatry
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12
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Family process and youth internalizing problems: A triadic model of etiology and intervention. Dev Psychopathol 2016; 29:273-301. [DOI: 10.1017/s095457941600016x] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractDespite major advances in the development of interventions for youth anxiety and depression, approximately 30% of youths with anxiety do not respond to cognitive behavioral treatment, and youth depression treatments yield modest symptom decreases overall. Identifying networks of modifiable risk and maintenance factors that contribute to both youth anxiety and depression (i.e., internalizing problems) may enhance and broaden treatment benefits by informing the development of mechanism-targeted interventions. A particularly powerful network is the rich array of family processes linked to internalizing problems (e.g., parenting styles, parental mental health problems, and sibling relationships). Here, we propose a new theoretical model, the triadic modelof family process, to organize theory and evidence around modifiable, transdiagnostic family factors that may contribute to youth internalizing problems. We describe the model's implications for intervention, and we propose strategies for testing the model in future research. The model provides a framework for studying associations among family processes, their relation to youth internalizing problems, and family-based strategies for strengthening prevention and treatment.
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13
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Parental Anxiety Prospectively Predicts Fearful Children's Physiological Recovery from Stress. Child Psychiatry Hum Dev 2015; 46:774-85. [PMID: 25385440 DOI: 10.1007/s10578-014-0519-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Parental anxiety confers risk for the development of an anxiety disorder in children, and this risk may be transmitted through children's stress reactivity. Further, some children may be more vulnerable to reactivity in the presence of parent factors such as anxiety. In this study, we examined whether parents' anxiety symptoms prospectively predict school-aged children's physiological reactivity following stress, assessed through their electrodermal activity (galvanic skin response) during recovery from a performance challenge task, and whether this varies as a function of children's temperamental fearfulness. Parents and their children (N = 68) reported on their anxiety symptoms at Time 1 of data collection, and parents characterized the extent to which their children had fearful temperaments. At Time 2 children completed the performance challenge and two recovery tasks. Greater parental anxiety symptom severity at Time 1 predicted children's higher electrodermal response during both recovery tasks following the failure task. Further, these effects are specific to children with medium and high fearful temperament, whereas for children low in fearfulness, the association between parent anxiety and child reactivity is not significant. Findings provide additional evidence for the diathesis-stress hypothesis and are discussed in terms of their contribution to the literature on developmental psychopathology.
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14
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Anxiety disorders and comorbid sleep problems in school-aged youth: review and future research directions. Child Psychiatry Hum Dev 2015; 46:376-92. [PMID: 24962165 DOI: 10.1007/s10578-014-0478-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This review examines the relationship between anxiety disorders and sleep related problems (SRPs) in school-aged youth. Following an overview of normative sleep patterns and maturational sleep changes, the review addresses issues related to sleep measurement. SRPs are reviewed in relation to executive functions (e.g. affect regulation) as is the shared role of neurological regions in the regulation of anxiety and sleep. Studies of the association between SRPs and anxiety in anxiety-disordered samples are reviewed with explicit consideration of the potential mechanisms underlying the sleep-anxiety relationship (e.g., arousal, sleep hygiene, parental accommodation). Specific cognitive-behavioral treatments for SRPs and anxiety are reviewed with regard to their impact on comorbid anxiety or SRPs. Methodological limitations are noted and recommendations for future research are proposed.
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