Emotion Socialization in Anxious Youth: Parenting Buffers Emotional Reactivity to Peer Negative Events

Maternal Social Phobia, but not Generalized Anxiety, Symptoms Interact with Early Childhood Error-Related Negativity to Prospectively Predict Child Anxiety Symptoms

The error-related negativity (ERN) has been called a putative neural marker of anxiety risk in children, with smaller ERN amplitudes denoting greater risk in early childhood. Children of anxious mothers are at elevated risk for anxiety problems compared to children of non-anxious mothers. Still unknown is whether discrete maternal symptoms interact with child ERN to predict different forms of child anxiety risk, knowledge of which could increase our understanding of the specificity of known conditions and pathways for transgenerational effects. Targeting two of the most prevalent forms of anxiety problems across children and adults, we tested whether maternal generalized anxiety disorder (GAD) and social phobia (SP) symptoms when children were 3 years old interacted with child ERN at age 4 years to predict child symptoms of overanxiousness and separation anxiety at age 5 years. We found that greater maternal SP, but not GAD, symptoms along with smaller (i.e., less negative) child ERN predicted more separation anxiety and overanxious symptoms in children, suggesting some specificity in prediction but less specificity in outcomes regarding the transmission of anxiety risk from mothers to offspring.

The Role of Neural Sensitivity to Social Evaluation in Understanding "for Whom" Social Media Use May Impact Emotional Health During Adolescence

There is much interest in the role of social media (SM) in the current mental health crisis among teens. In this review, we focus on the question of "for whom" SM experiences have the strongest impact on emotional health, considering neural sensitivity to social evaluation as a potential vulnerability factor that makes youth more susceptible to the effects of SM. We first present behavioral evidence showing that sensitivity to social evaluation moderates the link between SM use and emotional health in youth. Next, we show that the brain's affective salience network responds to simulated online social threats in ways that predict emotional health. Finally, we show evidence that neural sensitivity to online social evaluation moderates the effects of peer social experiences on emotional health, with implications for social media experiences. We end with recommendations for fully testing the model.

A Systematic Review of Parent Socialization of Negative Affect in Clinical Child Samples: Relations to Youth Emotion Regulation Abilities

Emotion-focused parenting practices, known as parent emotion socialization, play a crucial role in shaping youth's emotion regulation (ER) abilities. The impact of parent emotion socialization behaviors (ESB) on youth ER has been studied extensively in community samples. However, research on these relations in clinical samples is more limited, albeit growing. The current systematic review sought to evaluate the existing literature examining parent ESB of negative affect in various clinical child and adolescent samples. A literature search was conducted in April 2023, resulting in 1153 abstracts being reviewed. Two reviewers independently screened the titles and abstracts to identify relevant papers, with 152 articles being independently reviewed in full, of which 26 articles met inclusion criteria and are included in the current review. Studies (16 cross-sectional, 6 longitudinal, 4 intervention) utilized multi-methods of assessing youth ER, including questionnaires, physiological, and observational measures in a range of clinical samples, including youth diagnosed with internalizing, externalizing, and neurodevelopmental disorders, as well as youth at-risk for clinical diagnoses such as physically abused children. Overall, results support significant, negative associations between parent ESB practices and youth emotion dysregulation (rs = .22-.35) and negativity/lability (rs = .19-.60), and positive associations with youth ER abilities (rs = .18-.76). Some studies highlighted varying impacts of parental ESB on children with versus without clinical disorders/symptomology, with effects being more pronounced within clinical populations. Implications for these findings and future research directions are discussed, including the significance of focusing on parent ESB in intervention work with clinical child populations.

Adolescents' Sexual Orientation and Behavioral and Neural Reactivity to Peer Acceptance and Rejection: The Moderating Role of Family Support

Sexual-minority adolescents frequently endure peer rejection, yet scant research has investigated sexual-orientation differences in behavioral and neural reactions to peer rejection and acceptance. In a community sample of adolescents approximately 15 years old (47.2% female; same-sex attracted: n = 36, exclusively other-sex attracted: n = 310), we examined associations among sexual orientation and behavioral and neural reactivity to peer feedback and the moderating role of family support. Participants completed a social-interaction task while electroencephalogram data were recorded in which they voted to accept/reject peers and, in turn, received peer acceptance/rejection feedback. Compared with heterosexual adolescents, sexual-minority adolescents engaged in more behavioral efforts to ingratiate after peer rejection and demonstrated more blunted neural reactivity to peer acceptance at low, but not medium or high, levels of family support. By using a simulated real-world social-interaction task, these results demonstrate that sexual-minority adolescents display distinct behavioral and neural reactions to peer acceptance and rejection.

Impact of prolonged chronic social isolation stress on behavior and multifractal complexity of metabolic rate in Octodon degus

Social interaction can improve animal performance through the prevention of stress-related events, the provision of security, and the enhancement of reproductive output and survival. We investigated the effects of prolonged chronic social isolation stress on behavioral, cognitive, and physiological performance in the social, long-lived rodent Octodon degus. Degu pups were separated into two social stress treatments: control (CTRL) and chronically isolated (CI) individuals from post-natal and post-weaning until adulthood. We quantified anxiety-like behavior and cognitive performance with a battery of behavioral tests. Additionally, we measured their basal metabolic rate (BMR) and analyzed the multifractal properties of the oxygen consumption time series using Multifractal Detrended Fluctuation Analysis, a well-known method for assessing the fractal characteristics of biological signals. Our results showed that CI induced a significant increase in anxiety-like behaviors and led to a reduction in social and working memory in male degus. In addition, CI-treated degus reduced the multifractal complexity of BMR compared to CTRL, which implies a decrease in the ability to respond to environmental stressors and, as a result, an unhealthy state. In contrast, we did not observe significant effects of social stress on BMR. Multivariate analyses showed a clear separation of behavior and physiological variables into two clusters, corresponding to CI and CTRL degus. This study provides novel insights into the effects of prolonged chronic social isolation stress on behavior, cognitive performance, and metabolic complexity in this rodent animal model. To the best of our knowledge, it is the first study to integrate cognitive-behavioral performance and multifractal dynamics of a physiological signal in response to prolonged social isolation. These findings highlight the importance of social interactions for the well-being and overall performance of social animals.

Non-Disclosure and Suicidal Ideation in Adolescent Victims of Bullying: An Analysis from the Family and School Context

In recent years, suicide rates among bullying victims have raised much concern among educators and health professionals. Suicide is the fourth leading cause of preventable death among adolescents, data that warn about the need to monitor the signs before victims' suicidal behavior to prevent this fatal outcome. In the present study, the role of victims' silence about their victimization situation was analysed, as well as the particular impact of family and school environments. More specifically, we examined the mediating role of the victim's non-disclosure between the parental styles (observing the father's and mother's roles separately) and the school climate, concerning suicidal ideation in victims. The sample consisted of 2,977 adolescents (48.5% boys), aged 11-17 years (M = 14.1, SD = 1.42), of whom 635 (21.3%) reported having been victims of bullying in the past year. The results showed that parental styles of rejection and indifference were positively related to victims' non-disclosure of bullying and suicidal ideation. Conversely, a positive school climate showed a negative relationship with victims' disclosure of the bullying situation and suicidal ideation. The findings also indicated that non-disclosure mediates the relationship between the mother's parental style and suicidal ideation. These findings expand knowledge about the role of bullying victims' social context and the variable disclosure with regards to suicidal ideation in adolescents victimized by peers at school.

Maternal mental health mediates links between socioeconomic status and child development

The impact of socioeconomic status (SES) on early child development is well-established, but the mediating role of parental mental health is poorly understood. Data were obtained from The Avon Longitudinal Study of Parents and Children (ALSPAC; n = 13,855), including measures of early SES (age 8 months), key aspects of development during mid-late childhood (ages 7-8 years), and maternal mental health during early childhood (ages 0-3 years). In the first year of life, better maternal mental health was shown to weaken the negative association between SES and child mental health. Better maternal mental health was additionally shown to weaken the association between SES and child cognitive ability. These findings highlight the variability and complexity of the mediating role of parental mental health on child development. They further emphasise the importance of proximal factors in the first year of life, such as parental mental health, in mediating key developmental outcomes.

Impact of Bullying-Victimization and Gender over Psychological Distress, Suicidal Ideation, and Family Functioning of Mexican Adolescents

Bullying victimization is strongly associated with increased psychological distress and suicide in adolescents and poor family functioning. Knowledge of gender differences influencing these factors will improve the prevention of mental problems and suicide in victimized adolescents. A total of 1685 Mexican secondary students, 12-17 years old (m = 13.65), of whom 54% were girls, responded to a standardized scale questionnaire to analyze such differences. Based on the statistical analysis, girls reported significantly lower family functioning and higher psychological distress and suicidal ideation than boys. The cluster analysis classified adolescents into high (5.78%), moderate (24.07%), and no-victimization (69.76%) groups. Boys predominated in the high (3.1%) and moderate-victimization (12.4%) clusters, and girls in the no-victimization group (39.51%). Multivariate statistical analyses found significant differences between the three groups, with the highest means of psychological distress and suicidal ideation and lowest family functioning in the high-victimization group. Only for suicidal ideation, there was an interaction between gender and the degree of victimization, with girls showing a higher increase of suicidal ideation than boys in the same cluster. Conclusions: Early detection and intervention in bullying-victimized adolescents, aiming to decrease psychological distress and suicidal ideation and strengthen family functioning, should consider contextual gender differences for effective prevention of mental health problems and suicide in adolescents.

Impact of stress and parenting on respiratory sinus arrythmia trajectories in early adolescence

The effects of stress and parenting on 1-year trajectories of physiological emotion regulation capacity among adolescents were examined. Consistent with the vulnerability-stress and allostatic load models, stress (chronic family and marital) was hypothesized to be associated with less favorable trajectories of basal respiratory sinus arrhythmia (RSA) over 1 year. This relationship was further hypothesized to be moderated by parenting practices (warmth, neglect, and rejection) and adolescent sex. Participants included 150 adolescents (51.3% female), 11-15 years of age (M = 13.04, SD = 0.89). Basal RSA and stress were assessed four times across 1 year. Results indicated a significant decrease in RSA over the course of 1 year (β = -0.15, p = .010). Warm parenting style was associated with lower RSA in environments of low marital stress and was also related with higher RSA in environments of high marital stress (β = 0.86, p = .021). Rejecting parenting styles were associated with higher RSA in environments of low family stress and lower RSA in environments of high family stress (β = -0.60, p = .014). These findings may be explained by the Yerkes-Dodson law of optimal stress, suggesting that sufficient environmental challenge is needed to catalyze regulatory development.

Familial Factors in the Development of Social Anxiety Disorder

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.].

Parents' Perceived Impact of the Societal Lockdown of COVID-19 on Family Well-Being and on the Emotional and Behavioral State of Walloon Belgian Children Aged 4 to 13 Years: An Exploratory Study

This exploratory study assessed parents' perceptions of the emotional and behavioral impacts of the COVID-19 lockdown on their children. The total sample included 749 children, aged 4 to 13 years old (353 girls, 396 boys); 524 parents took part. The emotional and behavioral changes observed during the societal lockdown, family coexistence, the impact of COVID-19 on family well-being, and the frequency of social contacts before and during this lockdown were investigated. Results show that the most frequently reported difficulties were worry, agitation, anxiety, sadness, loneliness, nervousness, arguing, anger, frustration, boredom, irritability, behavioral problems, and laziness. Family coexistence declined significantly during this lockdown, and parents mentioned that COVID-19 had an impact on family well-being. Various ordinal logistic regressions showed that family coexistence, children's nervousness due to COVID-19, the impact of COVID-19 on family well-being, age, and social contacts before and during this lockdown seemed to explain the various emotional and behavioral changes observed in children during the societal lockdown. These results are discussed and recommendations are made.

"Live together, die alone": The effect of re-socialization on behavioural performance and social-affective brain-related proteins after a long-term chronic social isolation stress

Loneliness affects group-living mammals triggering a cascade of stress-dependent physiological disorders. Indeed, social isolation stress is a major risk factor for several neuropsychiatric disorders including anxiety and depression. Furthermore, social isolation has a negative impact on health and fitness. However, the neurobiological consequences of long-term chronic social isolation stress (LTCSIS) manifested during the adulthood of affected individuals are not fully understood. Our study assessed the impact of LTCSIS and social buffering (re-socialization) on the behavioural performance and social-affective brain-related proteins in diurnal, social, and long-lived Octodon degus (degus). Thereby, anxiety-like and social behaviour, and social recognition memory were assessed in male and female animals subjected to a variety of stress-inducing treatments applied from post-natal and post-weaning until their adulthood. Additionally, we evaluated the relationship among LTCSIS, Oxytocin levels (OXT), and OXT-Ca2+-signalling proteins in the hypothalamus, the hippocampus, and the prefrontal cortex. Our findings suggest that LTCSIS induces anxiety like-behaviour and impairs social novelty preference whereas sociability is unaffected. On the other hand, re-socialization can revert both isolation-induced anxiety and social memory impairment. However, OXT and its signalling remained reduced in the abovementioned brain areas, suggesting that the observed changes in OXT-Ca2+ pathway proteins were permanent in male and female degus. Based on these findings, we conclude degus experience social stress differently, suggesting the existence of sex-related mechanisms to cope with specific adaptive challenges.

Cultural Values Influence Relations Between Parent Emotion Socialization and Adolescents' Neural Responses to Peer Rejection

Adolescents' responses to negative social experiences can be influenced by parenting behaviors. This includes how parents react to their child's expression of emotions, an aspect of parenting referred to as emotion socialization. Emotion socialization may intersect with cultural values, particularly collectivism, a socially-relevant attitude that emphasizes the importance of interpersonal relationships. Examination of a neural measure called the feedback-related negativity (FRN), thought to reflect the degree to which feedback is experienced as aversive, could help elucidate neural contributions to and consequences of the role of collectivism in such family dynamics. Thus, this study examined whether adolescents' endorsement of collectivism moderated the association of parents' dismissive emotion socialization responses (called override responses) and FRN following peer rejection. A community sample of 83 Latinx (n = 32), Asian American (n = 20), and non-Latinx White (n = 31) adolescents ages 13-17 completed a computerized peer feedback task while continuous electroencephalogram was recorded. Their parents completed a battery of self-report questionnaires. Regression analyses demonstrated that adolescents' endorsement of collectivism moderated the association of override responses and FRN following peer rejection, such that FRN was enhanced as override responses increased for adolescents endorsing low and moderate levels of collectivism. Results suggest that there is cultural variation in the association of the emotion socialization strategy of override and adolescents' neural responses to socially-salient events. Findings have implications for parenting interventions designed to enhance adolescents' emotion regulation abilities.

Gene-environment interaction: New insights into perceived parenting and social anxiety among adolescents

Background.

Social anxiety symptoms (SAS) are among the most common mental health problems during adolescence, and it has been shown that parenting influences the adolescent’s level of social anxiety. In addition, it is now widely assumed that most mental health problems, including social anxiety, originate from a complex interplay between genes and environment. However, to date, gene–environment (G × E) interactions studies in the field of social anxiety remain limited. In this study, we have examined how 274 genes involved in different neurotransmission pathways interact with five aspects of perceived parenting as environmental exposure (i.e., support, proactive control, psychological control, punitive control, and harsh punitive control) to affect SAS during adolescence.

Methods.

We have applied an analytical technique that allows studying genetic information at the gene level, by aggregating data from multiple single-nucleotide-polymorphisms within the same gene and by taking into account the linkage disequilibrium structure of the gene. All participants were part of the STRATEGIES cohort of 948 Flemish adolescents (mean age = 13.7), a population-based study on the development of problem behaviors in adolescence. Relevant genes were preselected based on prior findings and neurotransmitter-related functional protein networks.

Results.

The results suggest that genes involved in glutamate (SLC1A1), glutathione neurotransmission (GSTZ1), and oxidative stress (CALCRL), in association with harsh punitive parenting, may contribute to social anxiety in adolescence. Isolated polymorphisms in these genes have been related to anxiety and related disorders in earlier work.Conclusions: Taken together, these findings provide new insights into possible biological pathways and environmental risk factors involved in the etiology of social anxiety symptoms’ development.

Conclusions.

Taken together, these findings provide new insights into possible biological pathways and environmental risk factors involved in the etiology of social anxiety symptoms’ development.

Suicidal Ideation Among Anxious Youth: A Preliminary Investigation of the Role of Neural Processing of Social Rejection in Interaction with Real World Negative Social Experiences

Suicidal ideation increases in adolescence, especially for anxious youth, and is a frequent precursor to suicide. This study examined whether neural processing of social rejection interacted with negative social experiences to predict suicidal ideation. Thus, to our knowledge this is the first study to examine how brain function may interact with the environment to contribute to suicidal ideation in youth, consistent with a developmental psychopathology perspective. Thirty-six anxious youth (ages 11 to 16) completed diagnostic interviews and questionnaires, an ecological momentary assessment (EMA) protocol, and a functional magnetic resonance imaging paradigm. Results showed that youth experienced greater severity of suicidal ideation when they exhibited heightened activation to social rejection in the right anterior insula and also experienced high levels of peer victimization or EMA-measured daily negative social experiences. Findings provide preliminary evidence that alterations in neural processing of social rejection interacts with exposure to negative social experiences to contribute to suicidal ideation.

Effect of Parenting and Peer Stressors on Cognitive Vulnerability and Risk for Depression among Youth

Parenting behaviors influence clinical depression among youth, but little is known about the developmental processes that may account for this association. This study investigated whether parenting is associated with the onset of clinical depression and depressive symptoms through negative cognitive style, particularly under conditions of high exposure to stressors, in a community sample of children and adolescents (N = 275; 59% girls). Observational methods were used to assess positive and negative parenting during a laboratory social-evaluative stressor task. Depressive symptoms and clinical depressive episodes were repeatedly assessed over an 18-month prospective follow-up period. Results supported a conditional indirect effect in which low levels of observed positive parenting during a youth stressor task were indirectly associated with an increased likelihood of experiencing an episode of depression and worsening depressive symptoms over the course of the study through youth negative cognitive style, but only for youth who also experienced a high number of peer stressors. These findings elucidate mechanisms through which problematic parenting may contribute to risk for the development of clinical depression during the transition into and across adolescence. Implications for depression interventions are discussed.

Stress and parenting predict changes in adolescent respiratory sinus arrhythmia

Adolescence is a critical period for the development of physiological emotion regulatory systems. While stressful life experiences are known to inhibit adaptive regulation, less is known about how parental socialization of emotion regulation may affect this relation. We examined the effect of stressful life experiences on changes in the resting respiratory sinus arrhythmia (RSA) levels of 107 (M_age  = 12.84, SD = 0.85) young adolescents over a year, moderated by supportive parental responses to negative emotions. The significant interaction (B = 0.02, p = 0.04) indicated that young adolescents who experienced low levels of supportive parenting in the context of high levels of stressful life experiences showed significant decreases in resting RSA over the year, while adolescents who experienced high levels of supportive parenting showed minimal decreases in RSA. Thus, more supportive parenting significantly compensated for the effect of greater stressful life experiences on changes in resting RSA over time.

A Review of Behavioral Observation Coding Approaches for the Trier Social Stress Test for Children

The Trier Social Stress Test (TSST) has become one of the most widely-used protocols for inducing moderate psychosocial stress in laboratory settings. Observational coding has been used to measure a range of behavioral responses to the TSST including performance, reactions to the task, and markers of stress induced by the task, with clear advantages given increased objectivity of observational measurement over self-report measures. The current review systematically examined all TSST and TSST-related studies with children and adolescents published since the original work of Kirschbaum et al. (1993) to identify behavioral observation coding approaches for the TSST. The search resulted in 29 published articles, dissertations, and master's theses with a wide range of coding approaches used. The take-home finding from the current review is that there is no standard way to code the Trier Social Stress Test for Children (TSST-C), which appears to stem from the uniqueness of investigators' research questions and sample demographics. This lack of standardization prohibits conclusive comparisons between studies and samples. We discuss relevant implications and offer suggestions for future research.

Protective Factors Associated with Daily Affective Reactivity and Instability During Adolescence

The daily emotional experiences of adolescents are dynamic, vary significantly across individuals, and are crucial to their psychological adjustment, warranting a need to identify factors that promote adaptive affective responses to stressors and attenuated affective instability. The objective of this study, therefore, was to examine protective factors linked to individual differences in daily affective reactivity and instability utilizing a daily diary design in a national sample of 100 U.S. adolescents (13-17 years; 40% girls; 79% White). Adolescents completed a baseline survey and then 14 daily online surveys. Better mother-adolescent communication predicted lower negative affect reactivity, whereas greater use of problem-focused coping strategies predicted higher positive affect reactivity. Greater trait resilience and instrumental support seeking predicted lower negative affect instability. Conversely, more emotional support seeking predicted higher negative affect instability. No factors were associated with positive affect instability, and father-adolescent communication was unrelated to daily affective reactivity and instability. The findings implicate specific protective factors associated with distinct aspects of affective reactivity and instability.

An experimental test of the impact of adolescent anxiety on parental sick role reinforcement behavior

A large body of work links parental sick role reinforcement behavior to adolescent panic vulnerability. To date, however, little work has examined the role of the adolescent in this process. The current study addressed this gap in the literature, using a novel method to experimentally test the impact of adolescent anxiety during a straw-breathing task on parental propensity to engage in sick role reinforcement behavior. An unselected sample of 51 early adolescents (26 female, 10-14 years) and their parents participated in the study. Adolescents were trained to mimic a straw-breathing task, and adolescent reactions to the task were scripted. Parents were randomly assigned to watch their adolescent react either a) anxiously or b) non-anxiously to the straw-breathing task. Parents who viewed their adolescent react anxiously ended the task earlier, reported that they would reinforce more sick role behavior, and reported more negatively valenced reactions during the task than parents who viewed their adolescent react non-anxiously to the task. No group differences emerged in terms of parental self-reported or physiological arousal during the task. Results suggest that adolescent anxiety increases parental sick role reinforcement behavior. Findings are discussed in terms of future directions for reducing parenting behaviors thought to increase vulnerability for panic among adolescents.

Emotional reactivity to daily events in youth with anxiety disorders

BACKGROUND

Although research supports associations between anxiety and emotional reactivity in adults (Cisler, J. M., Olatunji, B. O., Feldner, M. T., & Forsyth, J. P. (2010). Emotion regulation and the anxiety disorders: an integrative review. Journal of Psychopathology and Behavioral Assessment, 32(1), 68-82.), few studies have examined emotional reactivity in anxious youth (e.g., Carthy et al., 2010; Tan, P. Z., Forbes, E. E., Dahl, R. E., Ryan, N. D., Siegle, G. J., Ladouceur, C. D., & Silk, J. S. (2012). Emotional reactivity and regulation in anxious and nonanxious youth: a cell-phone ecological momentary assessment study. Journal of Child Psychology and Psychiatry, 53(2), 197-206.).

METHODS

Using daily diary methodology, this study examined both negative affect (NA) and positive affect (PA) reactivity to daily events in youth diagnosed with anxiety (N = 68; 60% female; 78% non-Hispanic White; M age = 11.18 years, SD = 3.17). We also examined whether parent-reported emotion regulation would predict emotional reactivity.

RESULTS

Participants reported more NA on days they experienced more negative parent and teacher events and less PA on days that they experienced more negative peer events. Additionally, better emotion regulation was associated with less NA reactivity to negative teacher events and to both negative and positive academic events.

CONCLUSIONS

Interpersonal events have a salient effect on daily affect for anxious youth. Youth anxiety therapists should target emotion regulation associated with negative events involving adults and address barriers to developing and maintaining positive peer relationships.

Parental reactions to children's negative affect: The moderating role of parental GAD

The impact of parental anxiety disorders has been explored in broad categories of parenting behaviors; however, less is known about the impact of parental anxiety on emotion socialization behaviors. The current study tested the conditional effect of parental Generalized Anxiety Disorder (GAD) on one aspect of emotion socialization, parents' reactions to their child's negative affect. Participants were 89 children between ages 3 and 12 and their parents, from a community sample. Parents completed the Anxiety Disorders Interview Schedule-IV (ADIS-IV), an interaction task with their child, and the Beck Anxiety Inventory-II (BAI-II). Overall, the data supported study hypotheses. Parental GAD moderated the relationship between child's negative affect and parental over control and emotional discouragement. Specifically, children's negative affect was positively related to parental emotional discouragement for parents with GAD, but not for parents without a diagnosis. Conversely, children's negative affect was not predictive of parental overcontrol for parents with GAD, but increases in children's negative affect did predict increases in parental overcontrol for parents without a diagnosis. The present findings suggest parents diagnosed with GAD are discouraging of their children's emotional experiences and fail to adjust their level of guidance throughout situations which induce negative affect, leaving children to cope with negative emotions on their own.

The role of day-to-day emotions, sleep, and social interactions in pediatric anxiety treatment

Do day-to-day emotions, social interactions, and sleep play a role in determining which anxious youth respond to supportive child-centered therapy (CCT) versus cognitive behavioral therapy (CBT)? We explored whether measures of day-to-day functioning (captured through ecological momentary assessment, sleep diary, and actigraphy), along with clinical and demographic measures, were predictors or moderators of treatment outcome in 114 anxious youth randomized to CCT or CBT. We statistically combined individual moderators into a single, optimal composite moderator to characterize subgroups for which CCT or CBT may be preferable. The strongest predictors of better outcome included: (a) experiencing higher positive affect when with one's mother and (b) fewer self-reported problems with sleep duration. The composite moderator indicated that youth for whom CBT was indicated had: (a) more day-to-day sleep problems related to sleep quality, efficiency, and waking, (b) day-to-day negative events related to interpersonal concerns, (c) more DSM-IV anxiety diagnoses, and (d) college-educated parents. These findings illustrate the value of both day-to-day functioning characteristics and more traditional sociodemographic and clinical characteristics in identifying optimal anxiety treatment assignment. Future studies will need to enhance the practicality of real-time measures for use in clinical decision making and evaluate additional anxiety treatments.