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Dapprich AL, Derks LM, Holtmann M, Lange WG, Legenbauer T, Becker ES. Hostile and threatening interpretation biases in adolescent inpatients are specific to callous-unemotional traits and social anxiety. Eur Child Adolesc Psychiatry 2024; 33:1143-1150. [PMID: 37256378 PMCID: PMC11032296 DOI: 10.1007/s00787-023-02227-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/05/2023] [Indexed: 06/01/2023]
Abstract
Psychopathological syndromes, such as disruptive behavior and anxiety disorders in adolescence, are characterized by distorted cognitions and problematic behavior. Biased interpretations of ambiguous social situations can elicit both aggressive and avoidance behavior. Yet, it is not well understood whether different interpretation biases are specific to different syndromes, or whether they can co-occur. We assessed both hostile and threatening interpretation biases in identical social situations, and proposed that they are uniquely related to callous-unemotional (CU) traits and social anxiety, respectively. We also explored the role of gender and age herein. The sample consisted of 390 inpatients between 10 and 18 years of age with a variety of psychiatric disorders. Hostile and threatening interpretations were assessed with the Ambiguous Social Scenario Task (ASST) consisting of 10 written vignettes. Both CU-traits and social anxiety were assessed with self-report questionnaires. Results showed that, overall, CU-traits were related to more hostile interpretations, whereas social anxiety was related to more threatening interpretations. In addition, in boys, hostile and threatening interpretations correlated significantly positive with each other. Age was not related to interpretation biases. Together, these results generally support the content-specificity of interpretation biases in concepts relevant to disruptive behavior disorders and anxiety disorders, and indicate that different interpretation biases can co-occur specifically in boys.
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Affiliation(s)
- Anna L Dapprich
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
| | - Laura M Derks
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- LWL-University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr-University Bochum, Bochum, Germany
| | - Martin Holtmann
- LWL-University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr-University Bochum, Bochum, Germany
| | - Wolf-Gero Lange
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Tanja Legenbauer
- LWL-University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr-University Bochum, Bochum, Germany
| | - Eni S Becker
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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2
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Fredrick JW, Luebbe AM. Prospective Associations Between Fears of Negative Evaluation, Fears of Positive Evaluation, and Social Anxiety Symptoms in Adolescence. Child Psychiatry Hum Dev 2024; 55:195-205. [PMID: 35790648 PMCID: PMC9255539 DOI: 10.1007/s10578-022-01396-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/2022] [Indexed: 12/12/2022]
Abstract
Fear of negative evaluation (FNE) and fear of positive evaluation (FPE) are independently associated with social anxiety symptoms in adolescence, though no study has tested these relations longitudinally. The current study examined longitudinal relations between FNE, FPE, and social anxiety symptoms using a multi-informant design, in addition to testing adolescent gender as a moderator. Adolescents (N = 113; Mage = 12.39; Girls = 44.2%) and parents completed measures of FNE, FPE, and two ratings of social anxiety approximately 6 months apart. FNE and FPE demonstrated significant stability over time, but neither predicted change in the other construct. Adolescent and parent-reported FNE, but not FPE, predicted increased social anxiety symptoms. Adolescent report of social anxiety symptoms predicted increased FPE over time, whereas parent report of social anxiety symptoms predicted increased FNE. Contrary to hypothesis, gender did not moderate any of the pathways in the model. Findings provide the first evidence that FNE may function as a risk factor for increased social anxiety in adolescence.
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Affiliation(s)
- Joseph W Fredrick
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Aaron M Luebbe
- Department of Psychology, Miami University, Oxford, OH, USA
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Elorza CLC, dos Santos A, Celeri EHRV. Quality of life, depression and anxiety in children and adolescents with CKD and their primary caregivers. J Bras Nefrol 2023; 45:335-343. [PMID: 36745054 PMCID: PMC10697160 DOI: 10.1590/2175-8239-jbn-2022-0036en] [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] [Received: 04/01/2022] [Accepted: 11/17/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) requires long-lasting treatments and severe changes in the routine of children, which may favor a low quality of life (QoL) and damage to their mental health and that of their primary caregivers (PC). The present study aimed to investigate the presence of anxiety and depression and to analyze the QoL of children and adolescents diagnosed with CKD at stages 3, 4, and 5, and their PC. METHODS We carried out an observational case-control study with 29 children and adolescents and their PC as the case group and 53 as the control group. International instruments, validated for the Brazilian population, were used: Child Anxiety Inventory (STAI-C), Pediatric Quality of Life Inventory (PEDSQL), Child Depression Inventory (CDI), Beck Anxiety and Depression Inventory (BAI; BDI), and the WHOQOL-bref. RESULTS The study identified statistically significant differences in the PEDSQL total score (control group, 72.7 ± 19.5; case group, 63.3 ± 20.6; p = 0.0305) and in the psychosocial (control group, 70.5 ± 20.5 and case group, 61.4 ± 19.7; p = 0.0420) and school health dimensions (control group, 72.9 ± 21.0 and case group, 55.2 ± 19.8; p = 0.0003) and the presence of psychiatric comorbidity (depression and anxiety symptoms) in the case group (p = 0.02). As for PC, the study showed statistical significance for the prevalence of depression (p = 0.01) and anxiety (p = 0.02) symptoms. CONCLUSION Patients with CKD have lower QoL indices and more psychiatric comorbidities, and their PC are affected by the disease, with higher indices of depression and anxiety.
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Affiliation(s)
- Cibele Longobardi Cutinhola Elorza
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas,
Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Campinas, SP,
Brazil
| | - Amilton dos Santos
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas,
Departamento de Psicologia Médica e Psiquiatria, Campinas, SP, Brazil
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Dapprich AL, Becker ES, Derks LM, Legenbauer T, Lange WG. Specific interpretation biases as a function of social anxiety and callous-unemotional traits in a community and a clinical adolescent sample. Child Adolesc Psychiatry Ment Health 2023; 17:46. [PMID: 37004075 PMCID: PMC10064950 DOI: 10.1186/s13034-023-00585-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/28/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Threatening and hostile interpretation biases are seen as causal and maintaining mechanisms of childhood anxiety and aggression, respectively. However, it is unclear whether these interpretation biases are specific to distinct problems or whether they are general psychopathological phenomena. The specificity versus pervasiveness of interpretation biases could also differ depending on mental health status. Therefore, in the current study, we investigated whether social anxiety and callous-unemotional (CU) traits were uniquely related to threatening and hostile interpretation biases, respectively, in both a community and a clinical sample of adolescents. METHODS A total of 161 adolescents between 10 to 15 years of age participated. The community sample consisted of 88 participants and the clinical sample consisted of 73 inpatients with a variety of psychological disorders. Social anxiety and CU-traits were assessed with self-report questionnaires. The Ambiguous Social Scenario Task was used to measure both threatening and hostile interpretations in response to written vignettes. RESULTS Results showed that social anxiety was uniquely related to more threatening interpretations, while CU-traits were uniquely related to more hostile interpretations. These relationships were replicated for the community sample. For the clinical sample, only the link between social anxiety and threatening interpretations was significant. Explorative analyses showed that adolescents with externalizing disorders scored higher on hostile interpretations than adolescents with internalizing disorders. CONCLUSIONS Overall, these results support the content-specificity of threatening interpretation biases in social anxiety and of hostile interpretation biases in CU-traits. Better understanding the roles of interpretation biases in different psychopathologies might open avenues for tailored prevention and intervention paradigms.
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Affiliation(s)
- Anna L Dapprich
- Behavioural Science Institute, Radboud University, 500 HB, Nijmegen, The Netherlands.
| | - Eni S Becker
- Behavioural Science Institute, Radboud University, 500 HB, Nijmegen, The Netherlands
| | - Laura M Derks
- Behavioural Science Institute, Radboud University, 500 HB, Nijmegen, The Netherlands
- LWL-University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr-University Bochum, Bochum, Germany
| | - Tanja Legenbauer
- LWL-University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr-University Bochum, Bochum, Germany
| | - Wolf-Gero Lange
- Behavioural Science Institute, Radboud University, 500 HB, Nijmegen, The Netherlands
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5
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Elorza CLC, Santos Junior AD, Celeri EHRV. Qualidade de vida, depressão e ansiedade em crianças e adolescentes com DRC e seus cuidadores primários. J Bras Nefrol 2023. [DOI: 10.1590/2175-8239-jbn-2022-0036pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
RESUMO Introdução: A doença renal crônica (DRC) requer tratamentos duradouros e alterações severas na rotina de crianças, o que pode favorecer baixa qualidade de vida (QV) e danos à sua saúde mental e à de seus cuidadores primários (CP). O presente estudo teve como objetivo investigar a presença de ansiedade e depressão e analisar a QV de crianças e adolescentes diagnosticados com DRC nos estágios 3, 4, 5, e seus CP. Métodos: Realizamos estudo observacional de caso-controle com 29 crianças e adolescentes e seus CP como grupo de casos e 53 como grupo controle. Utilizamos instrumentos internacionais, validados para a população brasileira: Inventário de Ansiedade Traço-Estado Infantil (IDATE-C), Questionário Pediatric Quality of Life (PEDSQL), Inventário de Depressão Infantil (CDI), Inventário de Ansiedade e Depressão de Beck (BAI; BDI), e o WHOQOL-bref. Resultados: O estudo identificou diferenças estatisticamente significativas no escore total do PEDSQL (grupo controle, 72,7 ± 19,5; grupo de casos, 63,3 ± 20,6; p = 0,0305), no psicossocial (grupo controle, 70,5 ± 20,5; grupo de casos, 61,4 ± 19,7; p = 0,0420), nas dimensões de saúde escolar (grupo controle, 72,9 ± 21,0; grupo de casos, 55,2 ± 19,8; p = 0,0003) e na presença de comorbidade psiquiátrica (sintomas de depressão e ansiedade) no grupo de casos (p = 0,02). Quanto aos CP, o estudo demonstrou significância estatística para a prevalência de sintomas de depressão (p = 0,01) e ansiedade (p = 0,02). Conclusão: Pacientes com DRC apresentam índices mais baixos de QV e mais comorbidades psiquiátricas, e seus CP são afetados pela doença, com índices maiores de depressão e ansiedade.
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Herzig KA, Stewart CE, Treadwell KRH. Why worry with friends? Problem talk and anxiety in late adolescent friendships. J Adolesc 2023; 95:382-396. [PMID: 36372961 DOI: 10.1002/jad.12120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/12/2022] [Accepted: 10/30/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study investigated a theoretically derived peer conversation style, problem anxiety talk, to examine the emotional regulation of anxiety in dyads as a possible mechanism of anxiety contagion that occurs between adolescent friends. METHODS In Study 1, 376 late adolescents residing in the United States, ages 17-24 with 68% female, responded to measures of anxiety, worry, friendship quality, depression, co-rumination, and a new measure of problem anxiety talk. In Study 2 problem anxiety talk, stress, anxiety and depression were evaluated in 481 late adolescents, ages 17-24 with 64% female. RESULTS Once controlling for worry and co-rumination, problem anxiety talk with a close friend predicted anxiety, stress and depression for both samples of late adolescents. Factor analysis in each sample supported problem anxiety talk as a single factor with high internal consistency. CONCLUSIONS Findings indicate that problem anxiety talk is a distinct construct representing interpersonal disclosures between friends involving threat perception, likelihood of negative events, and lack of coping skills; results also indicate that problem anxiety talk is associated with anxiety, stress, worry, and depression. Implications of problem anxiety talk in its potential role in the etiology and spread of anxiety are discussed.
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Affiliation(s)
- Kathleen A Herzig
- Yale Mental Health and Counseling, Yale Health, Yale University, New Haven, Connecticut, USA
| | - Catherine E Stewart
- Division of Psychology, Department of Psychiatry and Behavioral Sciences & Department of Anesthesia, Critical Care and Pain Medicine Boston Children's Hospital & Harvard Medical School, Waltham, Massachusetts, USA
| | - Kimberli R H Treadwell
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
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Interpretation Bias and Anticipated Distress in the Face of Ambiguity: Predictors of Change in Cognitive Behavioral Therapy for Youth Anxiety. Child Psychiatry Hum Dev 2022; 53:479-488. [PMID: 33635413 DOI: 10.1007/s10578-021-01147-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/14/2021] [Indexed: 10/22/2022]
Abstract
This study examined associations among children's anxiety, interpretation bias, and anticipated distress before and after cognitive behavioral therapy (CBT) and investigated baseline levels of interpretation bias and anticipated distress as well as changes in these cognitive biases following treatment as predictors of treatment outcome. Clinically anxious youth (N = 39) were treated with brief CBT augmented with a smartphone app. Children completed measures assessing their anxiety, interpretation bias, and anticipated distress at baseline, post-treatment, and 2-month follow-up. Children's anxiety, interpretation bias, and anticipated distress significantly decreased following treatment. Anticipated distress was associated with higher anxiety at all time points; however, interpretation bias was not significantly associated with anxiety before or after treatment. Reductions in anticipated distress following treatment predicted concurrent and prospective reductions in anxiety. Reduced anticipated distress following treatment may contribute to enhanced treatment outcomes and may be more strongly related to the maintenance of youth anxiety than interpretation bias.
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8
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Wei Q, Zhang S, Pan Y, Hu H, Chen F, Yin W, Lin Q, Pan S, Tham C, Wu J. Epidemiology of gaming disorder and its effect on anxiety and insomnia in Chinese ethnic minority adolescents. BMC Psychiatry 2022; 22:260. [PMID: 35413829 PMCID: PMC9006600 DOI: 10.1186/s12888-022-03894-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/28/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The growing popularity and frequency of online game use have resulted in a large number of studies reporting various mental problems associated with game abuse in adolescents. In this article, we examined the prevalence of gaming disorder (GD) and explored the associations of GD with anxiety and insomnia symptoms in minority youth in China. METHODS A total of 1494 students completed the Problematic Online Gaming Questionnaire Short-Form (POGQ-SF), the Generalized Anxiety Disorder 7-item questionnaire (GAD-7), and Athens Insomnia Scale (AIS). Chi-square and binary logistic regression analyses were used to explore the associations between gaming disorder and anxiety/insomnia. RESULTS A total of 356 (23.83%) respondents reported that they had gaming disorder. Chi-square analysis showed that gender, grade, marital status of parents and exercise situation were significantly associated with GD. Binary logistic regression analysis showed that those who had GD were at significantly higher risk for anxiety and insomnia than those without GD. CONCLUSION We found a high incidence of GD and a positive association among anxiety, insomnia and GD. Thus, special attention should be paid to those who have suffered from GD. It is worth addressing the adverse effects of GD on anxiety and insomnia.
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Affiliation(s)
- Qiaoyue Wei
- grid.256607.00000 0004 1798 2653Department of Psychology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021 China
| | - Shengjie Zhang
- grid.256607.00000 0004 1798 2653Department of Graduate Management, Guangxi Medical University Cancer Hospital, 71 Hedi Road, Nanning, 530021 China
| | - Yuli Pan
- grid.418332.fDepartment of Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, 18 Jinzhou Road, Nanning, 530028 China
| | - Hong Hu
- grid.256607.00000 0004 1798 2653Department of Psychology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021 China
| | - Fenglan Chen
- grid.256607.00000 0004 1798 2653Department of Guangxi Medical University Wuming Hospital, 26 Yongning Road, 530199 Nanning, China
| | - Wenwen Yin
- grid.256607.00000 0004 1798 2653Department of Psychology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021 China
| | - Qinghong Lin
- grid.256607.00000 0004 1798 2653Department of Psychology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021 China
| | - Shuibo Pan
- grid.256607.00000 0004 1798 2653Department of Psychology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021 China
| | - Chingyuan Tham
- grid.256607.00000 0004 1798 2653Department of Psychology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021 China
| | - Junduan Wu
- Department of Psychology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China.
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9
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Abstract
The purpose of the current article is to explore familial factors that influence the development of social anxiety disorder (SAD) in children and adolescents, including parenting, sibling relationships, and family environment. A multitude of interrelated genetic and familial factors have been found to cause and maintain SAD in children and adolescents. There are many challenges in diagnosing and treating the disorder. Knowledge and awareness of familial factors provide insight on targeted treatments that prevent or ameliorate SAD. [Journal of Psychosocial Nursing and Mental Health Services, 59(7), 23-34.].
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10
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Gu R, Ao X, Mo L, Zhang D. Neural correlates of negative expectancy and impaired social feedback processing in social anxiety. Soc Cogn Affect Neurosci 2021; 15:285-291. [PMID: 32232371 PMCID: PMC7236026 DOI: 10.1093/scan/nsaa038] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 02/29/2020] [Accepted: 03/23/2020] [Indexed: 02/07/2023] Open
Abstract
Social anxiety has been associated with abnormalities in cognitive processing in the literature, manifesting as various cognitive biases. To what extent these biases interrupt social interactions remains largely unclear. This study used the Social Judgment Paradigm that could separate the expectation and experience stages of social feedback processing. Event-related potentials (ERPs) in these two stages were recorded to detect the effect of social anxiety that might not be reflected by behavioral data. Participants were divided into two groups according to their social anxiety level. Participants in the high social anxiety (HSA) group were more likely to predict that they would be socially rejected by peers than did their low social anxiety (LSA) counterparts (i.e. the control group). Compared to the ERP data of the LSA group, the HSA group showed: (a) a larger P1 component to social cues (peer faces) prior to social feedback presentation, possibly indicating an attention bias; (b) a difference in feedback-related negativity amplitude between unexpected social acceptance and unexpected social rejection, possibly indicating an expectancy bias; and (c) a diminished sensitivity of the P3 amplitude to social feedback valence (be accepted/be rejected), possibly indicating an experience bias. These results could help understand the cognitive mechanisms that comprise and maintain social anxiety.
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Affiliation(s)
- Ruolei Gu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xiang Ao
- School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Licheng Mo
- School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Dandan Zhang
- School of Psychology, Shenzhen University, Shenzhen 518060, China.,Shenzhen Institute of Neuroscience, Shenzhen 518060, China
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11
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Halldorsson B, Hill C, Waite P, Partridge K, Freeman D, Creswell C. Annual Research Review: Immersive virtual reality and digital applied gaming interventions for the treatment of mental health problems in children and young people: the need for rigorous treatment development and clinical evaluation. J Child Psychol Psychiatry 2021; 62:584-605. [PMID: 33655534 DOI: 10.1111/jcpp.13400] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/08/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Mental health problems in children and young people are common and can lead to poor long-term outcomes. Despite the availability of effective psychological interventions for mental health disorders, only a minority of affected children and young people access treatment. Digital interventions, such as applied games and virtual reality (VR), that target mental health problems in children and young people may hold a key to increasing access to, engagement with, and potentially the effectiveness of psychological treatments. To date, several applied games and VR interventions have been specifically developed for children and young people. This systematic review aims to identify and synthesize current data on the experience and effectiveness of applied games and VR for targeting mental health problems in children and young people (defined as average age of 18 years or below). METHODS Electronic systematic searches were conducted in Medline, PsycINFO, CINAHL, and Web of Science. RESULTS Nineteen studies were identified that examined nine applied games and two VR applications, and targeted symptoms of anxiety, depression, and phobias using both quantitative and qualitative methodologies. Existing evidence is at a very early stage and studies vary extensively in key methodological characteristics. For applied games, the most robust evidence is for adolescent depressive symptoms (medium clinical effect sizes). Insufficient research attention has been given to the efficacy of VR interventions in children and young people. CONCLUSIONS The evidence to date is at a very early stage. Despite the enthusiasm for applied games and VR, existing interventions are limited in number and evidence of efficacy, and there is a clear need for further co-design, development, and evaluation of applied games and VR before they are routinely offered as treatments for children and young people with mental health problems.
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Affiliation(s)
- Brynjar Halldorsson
- Department of Experimental Psychology, University of Oxford, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK.,Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | - Claire Hill
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Polly Waite
- Department of Experimental Psychology, University of Oxford, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK.,School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Kate Partridge
- CAMHS Anxiety and Depression Pathway, Berkshire Healthcare Foundation Trust, University of Reading, Reading, UK
| | - Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, UK.,Oxford Health NHS Foundation Trust, Oxford, UK
| | - Cathy Creswell
- Department of Experimental Psychology, University of Oxford, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK
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12
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Yu M, Westenberg PM, Wang Y, Wang J, Miers AC. Psychometric properties of the adolescents’ interpretation and belief questionnaire (AIBQ) for measuring interpretation Bias in Chinese adolescents. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01346-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Golombek K, Lidle L, Tuschen-Caffier B, Schmitz J, Vierrath V. The role of emotion regulation in socially anxious children and adolescents: a systematic review. Eur Child Adolesc Psychiatry 2020; 29:1479-1501. [PMID: 31201527 DOI: 10.1007/s00787-019-01359-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/27/2019] [Indexed: 01/04/2023]
Abstract
While numerous studies suggest that emotion dysregulation is important in maintaining social anxiety among adults, the role of emotion regulation in children and adolescents with social anxiety is not yet well understood. In this systematic review, we use the process model of emotion regulation as a framework for understanding emotion regulation in children and adolescents with social anxiety. We performed a systematic literature search in the electronic data bases Medline and PsycINFO. Additional studies were identified by hand search. We identified 683 studies, screened their titles and abstracts, viewed 142 studies, and included 55 of these. Study results indicate that children and adolescents with social anxiety disorder or high social anxiety show emotion dysregulation across all five domains of emotion regulation, such as enhanced social avoidance, more safety behaviors, repetitive negative thinking, biased attention and interpretation of social information, and reduced emotional expression. While enhanced social avoidance seems to be specific to childhood social anxiety, other maladaptive emotion regulation strategies, such as repetitive negative thinking, seem to occur transdiagnostically across different childhood anxiety disorders. Implications for current theory, interventions and future research are discussed.
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Affiliation(s)
- Kristin Golombek
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr 41, Freiburg, 79106, Germany
| | - Leonie Lidle
- Department of Psychology, Clinical Child and Adolescent Psychology, Leipzig University, Leipzig, Germany.,Leipzig Research Center for Early Child Development, Leipzig University, Leipzig, Germany
| | - Brunna Tuschen-Caffier
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr 41, Freiburg, 79106, Germany
| | - Julian Schmitz
- Department of Psychology, Clinical Child and Adolescent Psychology, Leipzig University, Leipzig, Germany.,Leipzig Research Center for Early Child Development, Leipzig University, Leipzig, Germany
| | - Verena Vierrath
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr 41, Freiburg, 79106, Germany.
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Abstract
The Coping Questionnaire (CQ)-child and parent version-is an idiographic measure of youth's perceived ability to cope in anxiety provoking situations. Participants (N = 442; aged 7-17) met DSM-IV criteria for separation anxiety disorder, generalized anxiety disorder, or social anxiety disorder. The internal consistency of the CQ was supported, and retest reliability and parent/child agreement were, as expected, modest. The CQ scores were significantly correlated in the expected direction with measures of anxiety symptoms and functioning, providing evidence of convergent and divergent validity. The criterion validity of the CQ also was supported: the CQ scores were significantly correlated with the clinical severity rating of the youth's principal diagnosis on ADIS. There was a significant correlation between change in CQ scores and in anxiety severity and symptoms following treatment. Results support the CQ as a measure to assess coping efficacy in anxious youths as part of evidence-based assessment.
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15
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Makover HB, Kendall PC, Olino T, Carper MM, Albano AM, Piacentini J, Peris T, Langley AK, Gonzalez A, Ginsburg GS, Compton S, Birmaher B, Sakolsky D, Keeton C, Walkup J. Mediators of youth anxiety outcomes 3 to 12 years after treatment. J Anxiety Disord 2020; 70:102188. [PMID: 32078966 PMCID: PMC10783175 DOI: 10.1016/j.janxdis.2020.102188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/13/2019] [Accepted: 01/07/2020] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Test changes in perceived coping efficacy, negative self-statements, and interpretive biases to threat during treatment as potential mediators of the relationship between randomly assigned treatment conditions and long-term anxiety follow-ups. Age at randomization was also tested as a moderator of mediational relationships. METHOD Participants included 319 youth (ages 7-17) from the Child/Adolescent Multimodal Study (CAMS) who participated in a naturalistic follow-up beginning an average of 6.5 years after the end of the CAMS intervention. The intervention conditions included cognitive behavioral therapy (CBT; Coping Cat), pharmacotherapy (sertraline), combined CBT and sertraline, and pill placebo. Putative mediators were measured four times during the intervention phase. Follow-up consisted of four annual assessments of current anxiety. RESULTS Reductions on a measure of interpretive bias to threat over the course of the combined condition intervention, as compared to the placebo condition, mediated anxiety outcomes at the first follow-up visit. This mediated effect was not significant for the CBT-only or sertraline-only conditions when compared to the placebo condition. No other significant mediated effects were found for putative mediators. Age did not significantly moderate any mediated effects. CONCLUSION Changes in youth-reported interpretive biases to threat over the course of combined youth anxiety interventions, as compared to a placebo intervention, may be associated with lower anxiety an average of 6.5 years following treatment.
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Affiliation(s)
- Heather B Makover
- Department of Psychology, Temple University, 1301 North 13th Street, Philadelphia, PA, 19122, USA.
| | - Philip C Kendall
- Department of Psychology, Temple University, 1301 North 13th Street, Philadelphia, PA, 19122, USA.
| | - Thomas Olino
- Department of Psychology, Temple University, 1301 North 13th Street, Philadelphia, PA, 19122, USA
| | - Matthew M Carper
- Department of Psychology, Temple University, 1301 North 13th Street, Philadelphia, PA, 19122, USA
| | - Anne Marie Albano
- Columbia University Clinic for Anxiety and Related Disorders, 1775 Broadway, Suite 601, New York, NY, 10019, USA
| | - John Piacentini
- UCLA Semel Institute, 760 Westwood Blvd, Rm 67-439, Los Angeles, CA, 90024, USA
| | - Tara Peris
- UCLA Semel Institute, 760 Westwood Blvd, Rm 67-439, Los Angeles, CA, 90024, USA
| | - Audra K Langley
- UCLA Semel Institute, 760 Westwood Blvd, Rm 67-439, Los Angeles, CA, 90024, USA
| | - Araceli Gonzalez
- UCLA Semel Institute, 760 Westwood Blvd, Rm 67-439, Los Angeles, CA, 90024, USA
| | - Golda S Ginsburg
- The Johns Hopkins University School of Medicine, Division of Child and Adolescent Psychiatry, 550 North Broadway, Suite 202, Baltimore, MD, 21205, USA
| | - Scott Compton
- Duke University Medical Center, Department of Psychiatry and Behavioral Sciences, DUMC Box 3527, Durham, NC, 27710, USA
| | - Boris Birmaher
- University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Dara Sakolsky
- University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Courtney Keeton
- The Johns Hopkins University School of Medicine, Division of Child and Adolescent Psychiatry, 550 North Broadway, Suite 202, Baltimore, MD, 21205, USA
| | - John Walkup
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences at Northwestern University Feinberg School of Medicine, 446 East Ontario, Suite 7-200, Chicago, IL, 60611, USA
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Emotional/Behavioral Indicators in Children and Adolescents With and Without Vocal Problems: Self-Evaluation and Parental Evaluation. J Voice 2020; 35:664.e1-664.e9. [PMID: 31980293 DOI: 10.1016/j.jvoice.2019.12.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 12/27/2019] [Accepted: 12/30/2019] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To verify the relationships between voice, behavior, and social skills in children and adolescents with and without voice disorders based on their self-reports and their parents/guardians' reports. METHODS The study comprised 575 individuals, with 347 parents/guardians of children and adolescents aged 6-18 years who responded the parent version of the Strengths and Difficulties Questionnaire and 228 children and adolescents aged 11-18 years, who responded its report version. RESULTS Children and adolescents with vocal problem scored higher on hyperactivity/inattention, emotional symptoms, peer relationship, and conduct problems domains; and in the internalization, externalization, and difficulties scales. Children with vocal problem scored lower on the skills scale in the self-report. Parents/guardians in the group with vocal problem reported peer relationship problems not perceived by their children. Parents/guardians in the group without vocal problem did not perceive the signs of hyperactivity/inattention reported in their children and adolescents' self-reports. CONCLUSIONS The presence of vocal problems in the pediatric and adolescent population may be a risk factor for mental health due to the higher scores on behavior problems scales, both in their internalization and externalization aspects.
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Schwarz J, Schreiber F, Kühnemund M, Weber C, Stangier U, Melfsen S. [Cognition in children with social anxiety disorder experiencing stress]. ZEITSCHRIFT FUR KINDER- UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2020; 48:145-157. [PMID: 31920179 DOI: 10.1024/1422-4917/a000702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Cognition in children with social anxiety disorder experiencing stress Abstract. Empirical data on cognitions of children with social anxiety disorder (SAD) are inconclusive. Objective: The present study examines the significance of cognition in children with SAD. Method: Thirty children suffering from SAD and 30 control children free of diagnosis (HC) aged between 9 and 15 years took part in an experiment. Their cognition was assessed before, during, and after a stress-inducing social situation. The assessment method was a self-report measurement. Coping perception was also assessed. Results: Children with SAD did not report a higher level of negative or coping cognition than those in the HC group. An interaction was apparent on the positive cognition scale: Older children (11-12 or 13-15 years) with SAD reported less positive cognition than those in the HC group, and younger children with SAD (9-10 years) reported more than those in the HC group. No group differences were found for perceived coping. Conclusions: The findings are important to the cognitive model and for the psychological treatment of SAD in children.
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Affiliation(s)
- Judith Schwarz
- Abteilung für Klinische Psychologie und Psychotherapie, Goethe-Universität Frankfurt am Main, Deutschland
| | - Franziska Schreiber
- Abteilung für Klinische Psychologie und Psychotherapie, Goethe-Universität Frankfurt am Main, Deutschland
| | - Martina Kühnemund
- Abteilung für Klinische Psychologie und Psychotherapie, Goethe-Universität Frankfurt am Main, Deutschland
| | - Christoph Weber
- Institut für mathematische Stochastik, Otto-von-Guericke-Universität Magdeburg, Deutschland
| | - Ulrich Stangier
- Abteilung für Klinische Psychologie und Psychotherapie, Goethe-Universität Frankfurt am Main, Deutschland
| | - Siebke Melfsen
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Psychiatrische Universitätsklinik Zürich, Schweiz
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Zentrum für Psychische Gesundheit, Universitätsklinikum Würzburg, Deutschland
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18
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Content-specific interpretation biases in clinically anxious children. Behav Res Ther 2019; 121:103452. [DOI: 10.1016/j.brat.2019.103452] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 07/26/2019] [Accepted: 08/09/2019] [Indexed: 11/19/2022]
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19
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Neil L, White H, Warren K, Pellicano E. Anxiety and Interpretation of Ambiguity in Autistic Children, Typical Children and Their Mothers. J Autism Dev Disord 2019; 49:1035-1047. [PMID: 30406913 PMCID: PMC6394784 DOI: 10.1007/s10803-018-3781-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Anxiety is highly prevalent in autistic children. Yet interpretation biases implicated in anxiety in non-autistic individuals have received little research attention in this group. Twenty-two autistic children and 25 typical children completed an ambiguous scenarios interview and questionnaire-based measures of anxiety. A subsample of mothers completed parent-report and adult relevant versions of the interview and anxiety questionnaires. Autistic children self-reported similar interpretations of ambiguous scenarios, and similar levels of anxiety, to their typical peers. In contrast, mothers of autistic children reported greater levels of anxiety, and more negative interpretations of ambiguous scenarios in both their children and themselves, relative to mothers of typical children. These data highlight the importance of including autistic children's self-reports when measuring and treating anxiety.
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Affiliation(s)
- Louise Neil
- Centre for Research in Autism and Education (CRAE), UCL Institute of Education, University College London, London, UK.
- Department of Clinical, Educational, and Health Psychology, University College London, 26 Bedford Way, London, WC1H 0AP, UK.
| | - Hannah White
- Centre for Research in Autism and Education (CRAE), UCL Institute of Education, University College London, London, UK
| | - Katy Warren
- Centre for Research in Autism and Education (CRAE), UCL Institute of Education, University College London, London, UK
| | - Elizabeth Pellicano
- Centre for Research in Autism and Education (CRAE), UCL Institute of Education, University College London, London, UK
- Department of Educational Studies, Macquarie University, Sydney, Australia
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20
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Halldorsson B, Castelijn S, Creswell C. Are children with social anxiety disorder more likely than children with other anxiety disorders to anticipate poor social performance and reflect negatively on their performance? J Affect Disord 2019; 245:561-568. [PMID: 30445381 DOI: 10.1016/j.jad.2018.11.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/14/2018] [Accepted: 11/03/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND The cognitive theory of social anxiety disorder (SAD) suggests that adults with SAD have a tendency to anticipate poor social performance and reflect negatively on their performance following a social event. While a number of studies with socially anxious adults have supported the role of poor performance anticipation and post-event rumination in SAD, to date, only a few studies have addressed whether this also applies to children with SAD. METHODS Children (7-12 years) diagnosed with SAD (n = 40), other anxious children (n = 40) and non-anxious children (n = 34) were exposed to a social stressor speech task and their pre- and post-performance appraisals assessed, taking into account objective performance ratings. RESULTS Although observers rated some aspects of performance as significantly worse among children with SAD than children with other anxiety disorders, children with SAD were not more likely than their anxious or non-anxious peers to show a general bias in pre- or post-performance appraisals. Furthermore, children with SAD were just as likely as their anxious and non-anxious peers to recognize good performance but were more critical of themselves when their performance was poor. LIMITATIONS The speech task did not involve a same-age peer. Participants were relatively affluent group of predominantly non-minority status. Specificity for SAD in relation to other anxiety disorders remains unclear. CONCLUSIONS Focusing on counteracting pre- and post-event social performance appraisals may potentially be inappropriate for childhood SAD. Children with SAD might benefit from interventions that focus on helping them to become less critical of themselves after social interactions have not gone well.
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Affiliation(s)
- Brynjar Halldorsson
- School of Psychology & Clinical Language Sciences, University of Reading, Reading RG6 6AL, UK.
| | - Saskia Castelijn
- School of Psychology & Clinical Language Sciences, University of Reading, Reading RG6 6AL, UK
| | - Cathy Creswell
- School of Psychology & Clinical Language Sciences, University of Reading, Reading RG6 6AL, UK
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21
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Fliek L, Roelofs J, van Breukelen G, Muris P. A Longitudinal Study on the Relations Among Fear-Enhancing Parenting, Cognitive Biases, and Anxiety Symptoms in Non-clinical Children. Child Psychiatry Hum Dev 2019; 50:631-646. [PMID: 30767154 PMCID: PMC6589147 DOI: 10.1007/s10578-019-00868-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
This longitudinal study explored the relations between fear-enhancing parenting behaviors (modeling and threat information transmission) and children's cognitive biases and anxiety symptoms on three subsequent time points over a one-year period. Participants were 216 children aged 7-12 years (114 boys and 102 girls), and their mothers (n = 199) and/or fathers (n = 117). On each time point, children and parents completed the Parental Enhancement of Anxious Cognitions scale, which measures parental modeling and threat information transmission. Furthermore, children filled in a measure of anxiety disorder symptoms. In addition, confirmation bias and interpretation bias were measured by means of a number of computerized tasks. The results yielded support for a circular model in which cognitive biases enhanced anxiety symptoms, which in turn promoted cognitive biases on each of the three time points. However, no evidence was found for longitudinal effects of cognitive biases on anxiety or vice versa. In contrast to what we expected, cognitive biases and anxiety appeared to promote parental modeling and threat information rather than the other way around. These findings extend research on the relations between parenting behaviors, cognitive biases, and childhood anxiety symptoms, and suggest valuable leads for assessment and intervention.
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Affiliation(s)
- Lorraine Fliek
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Jeffrey Roelofs
- 0000 0001 0481 6099grid.5012.6Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Gerard van Breukelen
- 0000 0001 0481 6099grid.5012.6Department of Methodology & Statistics, Faculty of Psychology and Neuroscience & CAPHRI School for Care and Public Health, Maastricht University, Maastricht, The Netherlands
| | - Peter Muris
- 0000 0001 0481 6099grid.5012.6Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands ,0000 0001 2214 904Xgrid.11956.3aStellenbosch University, Stellenbosch, South Africa
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Haller SPW, Mills KL, Hartwright CE, David AS, Cohen Kadosh K. When change is the only constant: The promise of longitudinal neuroimaging in understanding social anxiety disorder. Dev Cogn Neurosci 2018; 33:73-82. [PMID: 29960860 PMCID: PMC6969264 DOI: 10.1016/j.dcn.2018.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 05/21/2018] [Accepted: 05/23/2018] [Indexed: 12/27/2022] Open
Abstract
Longitudinal studies offer a unique window into developmental change. Yet, most of what we know about the pathophysiology of psychiatric disorders is based on cross-sectional work. Here, we highlight the importance of adopting a longitudinal approach in order to make progress towards identifying the neurobiological mechanisms of social anxiety disorder (SAD). Using examples, we illustrate how longitudinal data can uniquely inform SAD etiology and timing of interventions. The brain's inherently adaptive quality requires that we model risk correlates of disorders as dynamic in their expression. Developmental theories regarding timing of environmental events, cascading effects and (mal)adaptations of the developing brain will be crucial components of comprehensive, integrative models of SAD. We close by discussing analytical considerations when working with longitudinal, developmental data.
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Affiliation(s)
| | | | - Charlotte E Hartwright
- Department of Experimental Psychology, University of Oxford, UK; Aston Brain Center, Aston University, UK
| | - Anthony S David
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Kathrin Cohen Kadosh
- Department of Experimental Psychology, University of Oxford, UK; School of Psychology, University of Surrey, UK.
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23
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Loscalzo Y, Giannini M, Miers AC. Social anxiety and interpretation bias: examining clinical and subclinical components in adolescents. Child Adolesc Ment Health 2018; 23:169-176. [PMID: 32677297 DOI: 10.1111/camh.12221] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/10/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aimed to examine whether different components of interpretation bias are clinical or dimensional features of adolescent social anxiety. The study analyzed the components of this bias at a subclinical level of Social Anxiety Disorder (SAD) and compared these with a clinical sample of adolescents with SAD. METHOD Adolescents in the age range 13-17 years participated. A group with SAD (n = 30) was compared with a group with subclinical SAD (n = 60), and a non-socially anxious group (n = 95). RESULTS Negative interpretation bias for social situations was found to be a dimensional aspect of social anxiety. In contrast, belief in negative interpretations of social situations appears to be a clinical feature. Contrary to expectations, endorsement of positive interpretations did not differ between the three groups. CONCLUSIONS The results suggest that a screening instrument based on negative interpretations of social situations could be useful to detect adolescents at-risk of developing SAD. In a clinical setting, the belief in negative interpretations and the presence of the bias in nonsocial situations should also be considered.
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Affiliation(s)
- Yura Loscalzo
- Department of Health Sciences, School of Psychology, University of Florence, Florence, Italy
| | - Marco Giannini
- Department of Health Sciences, School of Psychology, University of Florence, Florence, Italy
| | - Anne C Miers
- Leiden University, Faculty of Social and Behavioral Sciences, Institute of Psychology, Unit Developmental and Educational Psychology, The Netherlands
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Pearcey S, Alkozei A, Chakrabarti B, Dodd H, Murayama K, Stuijfzand S, Creswell C. Do clinically anxious children cluster according to their expression of factors that maintain child anxiety? J Affect Disord 2018; 229:469-476. [PMID: 29334641 PMCID: PMC5814677 DOI: 10.1016/j.jad.2017.12.078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 12/08/2017] [Accepted: 12/31/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Cognitive Behaviour Therapy (CBT) is an effective treatment for childhood anxiety disorders, yet a significant proportion of children do not benefit from it. CBT for child anxiety disorders typically includes a range of strategies that may not all be applicable for all affected children. This study explored whether there are distinct subgroups of children with anxiety disorders who are characterized by their responses to measures of the key mechanisms that are targeted in CBT (i.e. interpretation bias, perceived control, avoidance, physiological arousal, and social communication). METHODS 379 clinically anxious children (7-12 years) provided indices of threat interpretation, perceived control, expected negative emotions and avoidance and measures of heart rate recovery following a speech task. Parents also reported on their children's social communication difficulties using the Social Communication Questionnaire (SCQ). RESULTS Latent profile analysis identified three groups, reflecting (i) 'Typically anxious' (the majority of the sample and more likely to have Generalized anxiety disorder); (ii) 'social difficulties' (characterized by high SCQ and more likely to have social anxiety disorder and be male); (iii) 'Avoidant' (characterized by low threat interpretation but high avoidance and low perceived control). LIMITATIONS Some measures may have been influenced by confounding variables (e.g. physical variability in heart rate recovery). Sample characteristics of the group may limit the generalizability of the results. CONCLUSIONS Clinically anxious children appear to fall in to subgroups that might benefit from more targeted treatments that focus on specific maintenance factors. Treatment studies are now required to establish whether this approach would lead to more effective and efficient treatments.
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Affiliation(s)
- Samantha Pearcey
- School of Psychology and Clinical Language Sciences, University of Reading, PO Box 238, Reading RG6 6AL, United Kingdom.
| | - Anna Alkozei
- Department of Psychiatry, University of Arizona, 1501 N. Campbell Ave, Tucson, AZ 85721, United States
| | - Bhismadev Chakrabarti
- School of Psychology and Clinical Language Sciences, University of Reading, PO Box 238, Reading RG6 6AL, United Kingdom
| | - Helen Dodd
- School of Psychology and Clinical Language Sciences, University of Reading, PO Box 238, Reading RG6 6AL, United Kingdom
| | - Kou Murayama
- School of Psychology and Clinical Language Sciences, University of Reading, PO Box 238, Reading RG6 6AL, United Kingdom
| | - Suzannah Stuijfzand
- School of Psychology and Clinical Language Sciences, University of Reading, PO Box 238, Reading RG6 6AL, United Kingdom
| | - Cathy Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, PO Box 238, Reading RG6 6AL, United Kingdom
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25
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Scott BG, Pina AA, Parker JH. Reluctance to express emotion explains relation between cognitive distortions and social competence in anxious children. BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2017; 36:402-417. [PMID: 29235136 DOI: 10.1111/bjdp.12227] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 09/26/2017] [Indexed: 11/28/2022]
Abstract
Guided by social information processing and affective social competence models, the focal objective of this research was to examine the relations among anxious children's cognitive distortions, social skill competence, and reluctance to express emotion. In addition, we explored whether children's attention control played any meaningful role. Using a sample of 111 anxious children (Mage = 9.63, SD = 0.73; 75.7% girls; 56% Hispanic/Latino), we found that cognitive distortions were negatively related to social competence. In addition, tests of moderated mediation showed that the negative association between cognitive distortions and social skill competence was indirect via reluctance to express emotion, but this only was the case for anxious children with high attention control and for distortions in the academic domain. The findings of this study may set the stage for new ways to conceptualize the role of higher attention control among anxious youth. Statement of contribution What is already known on this subject? Cognitive errors are prevalent in anxious youth Anxious children show socio-emotion deficits What does this study add? Cognitive errors are related to socio-emotion deficits in anxious youth Relations depend on attention control.
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Affiliation(s)
- Brandon G Scott
- Department of Psychology, Montana State University, Bozeman, Montana, USA
| | - Armando A Pina
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - Julia H Parker
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
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26
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Halldorsson B, Creswell C. Social anxiety in pre-adolescent children: What do we know about maintenance? Behav Res Ther 2017; 99:19-36. [PMID: 28881221 DOI: 10.1016/j.brat.2017.08.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 08/18/2017] [Accepted: 08/28/2017] [Indexed: 10/18/2022]
Abstract
The cognitive theory of social anxiety disorder (SAD) is one of the most widely accepted accounts of the maintenance of the disorder in adults, yet it remains unknown if, or to what extent, the same cognitive and behavioral maintenance mechanisms that occur in adult SAD also apply to SAD among pre-adolescent children. In contrast to the adult literature, current models of SAD in children mostly account for etiology and maintenance processes are given limited attention. Consequently, their clinical utility for the treatment of SAD in children may be limited. This narrative review, first, critically examines the different theoretical conceptualizations of the maintenance of social anxiety in the child and adult literature and illustrates how these have resulted in different treatment approaches and clinical understanding. Second, it reviews the available evidence relating to hypotheses about the maintenance of SAD in children as derived from adult cognitive and etiological models. Third, it highlights the need to attend directly to child specific maintenance mechanisms in SAD, to draw on cognitive theory, and to account for the influence of childhood-specific contextual (e.g. family and school-based interactions) and developmental factors on children's social experiences.
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Affiliation(s)
- Brynjar Halldorsson
- School of Psychology and Clinical Language Sciences, University of Reading, UK.
| | - Cathy Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, UK
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27
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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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Pile V, Haller SPW, Hiu CF, Lau JYF. Young people with higher social anxiety are less likely to adopt the perspective of another: Data from the Director task. J Behav Ther Exp Psychiatry 2017; 55:41-48. [PMID: 27888749 DOI: 10.1016/j.jbtep.2016.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 10/26/2016] [Accepted: 11/03/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Young people with social anxiety display poor social functioning but it is unclear whether this is underscored by difficulties in key social cognitive abilities, such as perspective taking. Here, we examined whether increased social anxiety is associated with reduced accuracy on a perspective taking task and whether this relationship is stronger at particular periods within adolescence. METHODS Fifty-nine adolescents aged 11-19 years completed the computerised Director Task (DT) and the Social Anxiety Scale for Adolescence. In the DT, participants virtually move objects by following either instructions given by the 'Director' (who can see only some objects), or a simple rule to ignore certain objects. RESULTS Participants who scored above the clinical cut-off for social anxiety (n = 17) were less accurate when they had to take the perspective of the Director into account than those scoring below cut-off, yet performed similarly on control trials. Preliminary analysis indicated that poorer performance was most strongly associated with social anxiety in mid-adolescence (14-16.5 years). LIMITATIONS The DT has been used previously to measure online perspective taking but the underlying cognitive mechanisms have not been fully elucidated. Extending these findings using additional measures of perspective taking would be valuable. CONCLUSIONS Adolescents with higher social anxiety were less accurate at taking the perspective of a computerised character, with some suggestion that this relationship is strongest during mid-adolescence. If replicated, these findings highlight the importance of addressing specific social cognitive abilities in the assessment and treatment of adolescent social anxiety.
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Affiliation(s)
- Victoria Pile
- Department of Psychology, Institute of Psychiatry, King's College London, London, UK
| | | | - Chii Fen Hiu
- Department of Experimental Psychology, University of Oxford, UK
| | - Jennifer Y F Lau
- Department of Psychology, Institute of Psychiatry, King's College London, London, UK.
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Attention allocation and social worries predict interpretations of peer-related social cues in adolescents. Dev Cogn Neurosci 2017; 25:105-112. [PMID: 28416273 PMCID: PMC5485637 DOI: 10.1016/j.dcn.2017.03.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 03/14/2017] [Accepted: 03/14/2017] [Indexed: 12/29/2022] Open
Abstract
Across scenes, increasing social anxiety was associated with greater endorsement of negative interpretations. Greater attentional deployment to peers predicted increased endorsements of negative interpretations. Self-relevant scenes yielded more negative interpretations. Older adolescents selected more benign interpretations.
Adolescence is a sensitive period for increases in normative but also debilitating social fears and worries. As the interpretation of interpersonal cues is pertinent to social anxiety, investigating mechanisms that may underlie biases in social cue appraisal is important. Fifty-one adolescents from the community aged 14–19 were presented with self- and other-relevant naturalistic social scenes for 5 s and then required to rate either a negative or a positive interpretation of the scene. Eye-tracking data were collected during the free viewing period to index attentional deployment. Individual differences in social worries were measured via self-report. Social anxiety levels significantly predicted biases in interpretation ratings across scenes. Additionally, cumulative attentional deployment to peer cues also predicted these interpretation biases: participants who spent more time on facial displays perceived more threat, i.e. endorsed more negative and less positive interpretations. Self-relevant scenes yielded greater tendencies to draw negative interpretations. Finally, older adolescents also selected more benign interpretations. Social anxiety is associated with a bias in interpreting social cues; a cognitive bias that is also influenced by attentional deployment. This study contributes to our understanding of the possible attention mechanisms that shape cognitions relevant to social anxiety in this at-risk age group.
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Orchard F, Apetroaia A, Clarke K, Creswell C. Cognitive bias modification of interpretation in children with social anxiety disorder. J Anxiety Disord 2017; 45:1-8. [PMID: 27866085 PMCID: PMC5240849 DOI: 10.1016/j.janxdis.2016.10.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 08/17/2016] [Accepted: 10/28/2016] [Indexed: 11/25/2022]
Abstract
Negative (or a lack of positive) interpretation of ambiguous social situations has been hypothesised to maintain social anxiety disorder in children, yet there is currently limited evidence to support this. Cognitive Bias Modification of Interpretation (CBM-I) provides a means to explore the causal influence of interpretation bias on social anxiety disorder, and has been associated with a reduction in social anxiety symptoms in adults. Seven to twelve year old children with a diagnosis of social anxiety disorder completed CBM-I training, adapted from materials designed for socially anxious children in the community, or no training. Effects on interpretation bias and social anxiety were assessed. The adapted CBM-I training was not associated with significant changes in benign or negative interpretation. Unsurprisingly given the lack of successful interpretation training, there were no significant changes in child or parent reported social anxiety symptoms, clinician-rated severity or diagnoses and change in interpretation was not significantly associated with change in social anxiety. These findings contrast with some studies with community populations although it is possible that more intensive CBM-I training is required to fully test this hypothesis among clinical groups.
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Affiliation(s)
- Faith Orchard
- School of Psychology and Clinical Language Sciences, University of Reading, Whiteknights Road, Reading, RG6 6AL, United Kingdom.
| | - Adela Apetroaia
- Newham College University Centre, London, E15 4HT, United Kingdom
| | - Kiri Clarke
- Division of Psychology and Language Sciences, University College London, London, WC1E 6BT, United Kingdom
| | - Cathy Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, Whiteknights Road, Reading, RG6 6AL, United Kingdom
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Development and Preliminary Validation of the Threat Appraisal Questionnaire for Children (TAQ-C). JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2016. [DOI: 10.1007/s10862-016-9584-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Weeks M, Coplan RJ, Ooi LL. Cognitive biases among early adolescents with elevated symptoms of anxiety, depression, and co-occurring symptoms of anxiety-depression. INFANT AND CHILD DEVELOPMENT 2016. [DOI: 10.1002/icd.2011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Murray Weeks
- Department of Psychology; Carleton University; Ottawa Ontario Canada
| | - Robert J. Coplan
- Department of Psychology; Carleton University; Ottawa Ontario Canada
| | - Laura L. Ooi
- Department of Psychology; Carleton University; Ottawa Ontario Canada
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33
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Giannini M, Loscalzo Y. Social anxiety and adolescence: Interpretation bias in an Italian Sample. Scand J Psychol 2016. [DOI: 10.1111/sjop.12263] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Marco Giannini
- University of Florence; School of Psychology, Department of Health Sciences; Florence Italy
| | - Yura Loscalzo
- University of Florence; School of Psychology, Department of Health Sciences; Florence Italy
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Kendall PC, Cummings CM, Villabø MA, Narayanan MK, Treadwell K, Birmaher B, Compton S, Piacentini J, Sherrill J, Walkup J, Gosch E, Keeton C, Ginsburg G, Suveg C, Albano AM. Mediators of change in the Child/Adolescent Anxiety Multimodal Treatment Study. J Consult Clin Psychol 2016; 84:1-14. [PMID: 26460572 PMCID: PMC4695375 DOI: 10.1037/a0039773] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Test changes in (a) coping efficacy and (b) anxious self-talk as potential mediators of treatment gains at 3-month follow-up in the Child/Adolescent Anxiety Multimodal Treatment Study (CAMS). METHOD Participants were 488 youth (ages 7-17; 50.4% male) randomized to cognitive-behavioral therapy (CBT; Coping cat program), pharmacotherapy (sertraline), their combination, or pill placebo. Participants met Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV) criteria for generalized anxiety disorder, social phobia, and/or separation anxiety disorder. Coping efficacy (reported ability to manage anxiety provoking situations) was measured by youth and parent reports on the Coping Questionnaire, and anxious self-talk was measured by youth report on the Negative Affectivity Self-Statement Questionnaire. Outcome was measured using the Pediatric Anxiety Rating Scale (completed by Independent Evaluators blind to condition). For temporal precedence, residualized treatment gains were assessed at 3-month follow-up. RESULTS Residualized gains in coping efficacy mediated gains in the CBT, sertraline, and combination conditions. In the combination condition, some unique effect of treatment remained. Treatment assignment was not associated with a reduction in anxious self-talk, nor did anxious self-talk predict changes in anxiety symptoms. CONCLUSIONS The findings suggest that improvements in coping efficacy are a mediator of treatment gains. Anxious self-talk did not emerge as a mediator.
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Affiliation(s)
| | | | | | - Martina K Narayanan
- Department of Psychology, The Norwegian Center for Child Behavioral Development
| | | | | | - Scott Compton
- Department of Psychiatry and Behavioral Sciences, Duke University
| | - John Piacentini
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles
| | - Joel Sherrill
- Child and Adolescent Mental Health, National Institute of Mental Health
| | - John Walkup
- Department of Child and Adolescent Psychiatry, Cornell University
| | - Elizabeth Gosch
- Department of Psychology, Philadelphia College of Osteopathic Medicine
| | - Courtney Keeton
- Department of Child and Adolescent Psychiatry, Johns Hopkins University
| | - Golda Ginsburg
- Department of Child and Adolescent Psychiatry, Johns Hopkins University
| | - Cindy Suveg
- Department of Psychology, University of Georgia
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Waite P, Codd J, Creswell C. Interpretation of ambiguity: Differences between children and adolescents with and without an anxiety disorder. J Affect Disord 2015; 188:194-201. [PMID: 26363617 PMCID: PMC4641870 DOI: 10.1016/j.jad.2015.08.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 08/07/2015] [Accepted: 08/11/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Theory and treatment of anxiety disorders in young people are commonly based on the premise that interpretation biases found in anxious adults are also found in children and adolescents. Although there is some evidence that this may be the case, studies have not typically taken age into account, which is surprising given the normative changes in cognition that occur throughout childhood. The aim of the current study was to identify whether associations between anxiety disorder status and interpretation biases differed in children and adolescents. METHODS The responses of children (7-10 years) and adolescents (13-16 years) with and without anxiety disorders (n=120) were compared on an ambiguous scenarios task. RESULTS Children and adolescents with an anxiety disorder showed significantly higher levels of threat interpretation and avoidant strategies than non-anxious children and adolescents. However, age significantly moderated the effect of anxiety disorder status on interpretation of ambiguity, in that adolescents with anxiety disorders showed significantly higher levels of threat interpretation and associated negative emotion than non-anxious adolescents, but a similar relationship was not observed among children. CONCLUSIONS The findings suggest that theoretical accounts of interpretation biases in anxiety disorders in children and adolescents should distinguish between different developmental periods. For both ages, treatment that targets behavioral avoidance appears warranted. However, while adolescents are likely to benefit from treatment that addresses interpretation biases, there may be limited benefit for children under the age of ten.
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Affiliation(s)
- Polly Waite
- School of Psychology and Clinical Language Sciences, University of Reading, Reading RG6 6AL, UK.
| | - Jon Codd
- Talking Therapies, Shinfield Medical Practice, Reading, UK
| | - Cathy Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, Reading RG6 6AL, UK
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Cao J, Gu R, Bi X, Zhu X, Wu H. Unexpected Acceptance? Patients with Social Anxiety Disorder Manifest their Social Expectancy in ERPs During Social Feedback Processing. Front Psychol 2015; 6:1745. [PMID: 26635659 PMCID: PMC4644791 DOI: 10.3389/fpsyg.2015.01745] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 10/30/2015] [Indexed: 12/20/2022] Open
Abstract
Previous studies on social anxiety have demonstrated negative-expectancy bias in social contexts. In this study, we used a paradigm that employed self-relevant positive or negative social feedback, in order to test whether this negative expectancy manifests in event-related potentials (ERPs) during social evaluation among socially anxious individuals. Behavioral data revealed that individuals with social anxiety disorder (SAD) showed more negative expectancy of peer acceptance both in the experiment and in daily life than did the healthy control participants. Regarding ERP results, we found a overally larger P2 for positive social feedback and also a group main effect, such that the P2 was smaller in SAD group. SAD participants demonstrated a larger feedback-related negativity (FRN) to positive feedback than to negative feedback. In addition, SAD participants showed a more positive ΔFRN (ΔFRN = negative – positive). Furthermore, acceptance expectancy in daily life correlated negatively with ΔFRN amplitude, while the Interaction Anxiousness Scale (IAS) score correlated positively with the ΔFRN amplitude. Finally, the acceptance expectancy in daily life fully mediated the relationship between the IAS and ΔFRN. These results indicated that both groups could differentiate between positive and negative social feedback in the early stage of social feedback processing (reflected on the P2). However, the SAD group exhibited a larger FRN to positive social feedback than to negative social feedback, demonstrating their dysfunction in the late stage of social feedback processing. In our opinion, such dysfunction is due to their greater negative social feedback expectancy.
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Affiliation(s)
- Jianqin Cao
- Department of Nursing, Harbin Medical University Daqing, China
| | - Ruolei Gu
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences Beijing, China
| | - Xuejing Bi
- Department of Nursing, Harbin Medical University Daqing, China
| | - Xiangru Zhu
- Institute of Cognition and Behavior, Henan University Kaifeng, China
| | - Haiyan Wu
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences Beijing, China
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Henry JD, Moses E, Castellini J, Scott J. Mental health problems in adolescence and the interpretation of unambiguous threat. PLoS One 2015; 10:e0127167. [PMID: 26039081 PMCID: PMC4454485 DOI: 10.1371/journal.pone.0127167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 04/12/2015] [Indexed: 11/21/2022] Open
Abstract
Aberrant threat perception has been linked to paranoia, anxiety and other mental health problems, and is widely considered to be a core, transdiagnostic feature of psychopathology. However, to date there has been only limited investigation of whether mental health problems are associated with a biased interpretation of stimuli that have explicit (as opposed to ambiguous) connotations of threat. In the present study, 41 adolescents diagnosed with a mental illness and 45 demographically matched controls were asked to provide danger ratings of stimuli normatively rated as being either low or high in potential threat. All participants were also asked to complete background measures of cognitive function, mental health and wellbeing. The results indicated that the two groups did not differ in their capacity to discriminate between low and high threat stimuli, nor did they differ in the absolute level of threat that they attributed to these stimuli. However, for the control group, the overall level of threat perceived in facial stimuli was correlated with two important indices of mental health (depression and anxiety). No associations emerged in the clinical group. These data are discussed in relation to their potential implications for the role of aberrant threat perception in transdiagnostic models of mental health.
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Affiliation(s)
- Julie D. Henry
- School of Psychology, University of Queensland, St Lucia, QLD, Australia
| | - Ernestina Moses
- School of Psychology, University of Queensland, St Lucia, QLD, Australia
| | - Julieta Castellini
- School of Psychology, University of Queensland, St Lucia, QLD, Australia
| | - James Scott
- School of Medicine, The University of Queensland Centre for Clinical Research, St Lucia, QLD, Australia
- Australia Metro North Mental Health, Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia
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Haller SPW, Cohen Kadosh K, Scerif G, Lau JYF. Social anxiety disorder in adolescence: How developmental cognitive neuroscience findings may shape understanding and interventions for psychopathology. Dev Cogn Neurosci 2015; 13:11-20. [PMID: 25818181 PMCID: PMC6989773 DOI: 10.1016/j.dcn.2015.02.002] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 02/06/2015] [Accepted: 02/06/2015] [Indexed: 11/26/2022] Open
Abstract
Social anxiety disorder represents a debilitating condition that has large adverse effects on the quality of social connections, educational achievement and wellbeing. Age-of-onset data suggests that early adolescence is a developmentally sensitive juncture for the onset of social anxiety. In this review, we highlight the potential of using a developmental cognitive neuroscience approach to understand (i) why there are normative increases in social worries in adolescence and (ii) how adolescence-associated changes may 'bring out' neuro-cognitive risk factors for social anxiety in a subset of individuals during this developmental period. We also speculate on how changes that occur in learning and plasticity may allow for optimal acquisition of more adaptive neurocognitive strategies through external interventions. Hence, for the minority of individuals who require external interventions to target their social fears, this enhanced flexibility could result in more powerful and longer-lasting therapeutic effects. We will review two novel interventions that target information-processing biases and their neural substrates via cognitive training and visual feedback of neural activity measured through functional magnetic resonance imaging.
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Affiliation(s)
- Simone P W Haller
- Department of Experimental Psychology, University of Oxford, Oxford, UK.
| | | | - Gaia Scerif
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Jennifer Y F Lau
- Department of Experimental Psychology, University of Oxford, Oxford, UK; Department of Psychology, Institute of Psychiatry, King's College London, London, UK
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40
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Keshavan MS, Giedd J, Lau JYF, Lewis DA, Paus T. Changes in the adolescent brain and the pathophysiology of psychotic disorders. Lancet Psychiatry 2014; 1:549-58. [PMID: 26361314 DOI: 10.1016/s2215-0366(14)00081-9] [Citation(s) in RCA: 132] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 05/23/2014] [Indexed: 10/24/2022]
Abstract
Adolescence is a time of extensive neuroanatomical, functional, and chemical reorganisation of the brain which parallels substantial maturational changes in cognition and affect regulation. This period is characterised by stabilisation of synapses to diminish redundancy and increase efficiency of neural function, fine-tuning of excitatory and inhibitory neurotransmitter systems, beginning of integration between late maturing and early maturing brain structures, and development of effective connections. In effect, these so-called moving parts create a state of dynamic change that might underlie adolescent behaviours. Imbalances or changes in timing of these developmental processes clearly increase the risk for psychiatric disorders. Genetic, environmental, and epigenetic factors that shape brain development and hormonal changes that affect stress reactivity could be reasons why some, but not all, adolescents are at a heightened risk of developing a psychopathological disorder. In this Series paper, we assess the neurobiology of the changing adolescent brain, implications of this knowledge, and future research in major psychiatric disorders, particularly for psychotic disorders.
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Affiliation(s)
- Matcheri S Keshavan
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA.
| | - Jay Giedd
- Brain Imaging Section, Child Psychiatry Branch, NIMH, Bethesda, MD, USA
| | | | - David A Lewis
- Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
| | - Tomáš Paus
- Rotman Research Institute and Departments of Psychology and Psychiatry, University of Toronto, Toronto, ON, Canada
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41
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Dominance as part of self-concept mediates the intergenerational transmission of social anxiety among adolescents under residential care. J Adolesc 2014; 37:577-86. [PMID: 24931560 DOI: 10.1016/j.adolescence.2014.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 04/18/2014] [Accepted: 04/20/2014] [Indexed: 11/20/2022]
Abstract
According to Rapee (1997), maternal social anxiety (SA) is directly associated with adolescent SA because maternal SA causes overprotective and controlling parental behavior. A total of 127 adolescents who were in the process of transitioning to a boarding school for at-risk youth as well as their mothers participated in the current study, 30% of the adolescents had experienced at least one depressive episode; 17.5% had been diagnosed with SA. We analyzed an expanding model of mediation, of maternal SA and depression in which specifically, adolescent self-perception was constructed as a latent factor that was formed by self-reported dominance and self-criticism. The results supported our hypotheses that maternal SA is not directly associated with adolescent SA. Rather, these relationships are mediated by adolescents' self-perception (i.e., dominance and self-criticism). The results call into question Rapee's theoretical arguments and support Gilbert's evolutionary theory.
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42
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Haller SPW, Cohen Kadosh K, Lau JYF. A developmental angle to understanding the mechanisms of biased cognitions in social anxiety. Front Hum Neurosci 2014; 7:846. [PMID: 24653687 PMCID: PMC3949127 DOI: 10.3389/fnhum.2013.00846] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Accepted: 11/20/2013] [Indexed: 11/13/2022] Open
Affiliation(s)
- Simone P W Haller
- Department of Experimental Psychology, University of Oxford Oxford, UK
| | | | - Jennifer Y F Lau
- Department of Experimental Psychology, University of Oxford Oxford, UK ; Department of Psychology, Institute of Psychiatry, King's College London London, UK
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