Familial Aggregation of Cognitive Biases for Children with Anxiety Disorders

Maternal Trauma and Psychopathology Symptoms Affect Refugee Children's Mental Health But Not Their Emotion Processing

Refugee children's development may be affected by their parents' war-related trauma exposure and psychopathology symptoms across a range of cognitive and affective domains, but the processes involved in this transmission are poorly understood. Here, we investigated the impact of refugee mothers' trauma exposure and mental health on their children's mental health and attention biases to emotional expressions. In our sample of 324 Syrian refugee mother-child dyads living in Jordan (children's Mage=6.32, SD = 1.18; 50% female), mothers reported on their symptoms of anxiety and depression, and on their children's internalising, externalising, and attention problems. A subset of mothers reported their trauma exposure (n = 133) and PTSD symptoms (n = 124). We examined emotion processing in the dyads using a standard dot-probe task measuring their attention allocation to facial expressions of anger and sadness. Maternal trauma and PTSD symptoms were linked to child internalising and attention problems, while maternal anxiety and depression symptoms were associated with child internalising, externalising, and attention problems. Mothers and children were hypervigilant towards expressions of anger, but surprisingly, mother and child biases were not correlated with each other. The attentional biases to emotional faces were also not linked to psychopathology risk in the dyads. Our findings highlight the importance of refugee mothers' trauma exposure and psychopathology on their children's wellbeing. The results also suggest a dissociation between the mechanisms underlying mental health and those involved in attention to emotional faces, and that intergenerational transmission of mental health problems might involve mechanisms other than attentional processes relating to emotional expressions.

Intergenerational Transmission of Anxious Information Processing Biases: An Updated Conceptual Model

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.