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Piccolo A, De Domenico C, Di Cara M, Settimo C, Corallo F, Leonardi S, Impallomeni C, Tripodi E, Quartarone A, Cucinotta F. Parental involvement in robot-mediated intervention: a systematic review. Front Psychol 2024; 15:1355901. [PMID: 39049952 PMCID: PMC11267593 DOI: 10.3389/fpsyg.2024.1355901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 06/17/2024] [Indexed: 07/27/2024] Open
Abstract
Introduction Over the years, the conceptual approach to pediatric rehabilitation has reevaluated the parent's role in the therapeutic process, considering parental involvement as a necessary condition for the effectiveness of the intervention. In the field of pediatric intervention, the therapeutic use of robots represents a growing clinical interest, but the feasibility and applicability of these robotic interventions, including those involving parents, remain unclear. This systematic review aims to investigate parental involvement in robot-mediated interventions (RMI) for children and adolescents in the current literature. Our main goal is to analyze and summarize all existing studies to discuss and draw future research directions and implications for clinical practice. Method After collecting results from 1,106 studies, the studies selected were analyzed using thematic analysis. The literature review was conducted in accordance with the PRISMA guidelines by searching databases such as PubMed and Web of Science until 07 February 2023. Studies that met the following inclusion criteria were included: (1) the use of a robot as a therapeutic-rehabilitation tool and (2) the presence/involvement of parents/caregivers in child-robot therapeutic sessions. Results A total of 10 articles were included. The extracted data included study design, participant characteristics, type of robot used, outcome measures, aim, and type of intervention. The results reveal that parental involvement in RMI could be feasible and useful in improving intervention efficacy, particularly in improving the child's social-communicative abilities and the caregiver's educational skills. Discussion RMI intervention with parental participation could be a useful therapeutic strategy in pediatrics. However, to date, few studies have investigated this specific topic, and the reported results may enhance future research to understand its effectiveness in specific areas of use. Systematic review registration identifier: CRD42024553214.
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Simons LE, Harrison LE, Boothroyd DB, Parvathinathan G, Van Orden AR, O’Brien SF, Schofield D, Kraindler J, Shrestha R, Vlaeyen JW, Wicksell RK. A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain. Pain 2024; 165:177-191. [PMID: 37624900 PMCID: PMC10840960 DOI: 10.1097/j.pain.0000000000003010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/16/2023] [Indexed: 08/27/2023]
Abstract
ABSTRACT Graded exposure treatment (GET) is a theory-driven pain treatment that aims to improve functioning by exposing patients to activities previously feared and avoided. Combining key elements of GET with acceptance-based exposure, GET Living (GL) was developed for adolescents with chronic pain (GL). Based on robust treatment effects observed in our single-case experimental design pilot trial of GL (NCT01974791), we conducted a 2-arm randomized clinical trial comparing GL with multidisciplinary pain management (MPM) comprised of cognitive behavioral therapy and physical therapy for pain management (NCT03699007). A cohort of 68 youth with chronic musculoskeletal pain (M age 14.2 years; 81% female) were randomized to GL or MPM. Owing to COVID-19 restrictions, 54% of participants received zoom video delivered care. Assessments were collected at baseline, discharge, as well as at 3-month and 6-month follow-up. Primary outcomes were self-reported pain-related fear and avoidance. Secondary outcomes were child functional disability and parent protective responses to child pain. As hypothesized, GL improved in primary and secondary outcomes at 3-month follow-up. Contrary to our superiority hypothesis, there was no significant difference between GL and MPM. Patients reported both GL and MPM (in person and video) as credible and were highly satisfied with the treatment experience. Next steps will involve examining the single-case experimental design data embedded in this trial to facilitate an understanding of individual differences in treatment responses (eg, when effects occurred, what processes changed during treatment within the treatment arm). The current findings support GET Living and MPM for youth with chronic pain.
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Affiliation(s)
- Laura E. Simons
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA
| | - Lauren E. Harrison
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA
| | - Derek B. Boothroyd
- Quantitative Statistical Unit, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Gomathy Parvathinathan
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA
| | - Amanda R. Van Orden
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA
| | - Shannon F. O’Brien
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA
| | - Deborah Schofield
- Center for Economic Impacts of Genomic Medicine, Department of Economics, Macquarie University, Sydney, Australia
| | - Joshua Kraindler
- Center for Economic Impacts of Genomic Medicine, Department of Economics, Macquarie University, Sydney, Australia
| | - Rupendra Shrestha
- Center for Economic Impacts of Genomic Medicine, Department of Economics, Macquarie University, Sydney, Australia
| | - Johan W.S. Vlaeyen
- Center for Economic Impacts of Genomic Medicine, Department of Economics, Macquarie University, Sydney, Australia
| | - Rikard K. Wicksell
- Research group Behavior Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden & Pain Clinic, Capio St Goran Hospital, Stockholm, Sweden
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Akdeniz S, Pece AH, Kusderci HS, Dogru S, Tulgar S, Suren M, Okan I. Is Pain Perception Communicated through Mothers? Maternal Pain Catastrophizing Scores Are Associated with Children's Postoperative Circumcision Pain. J Clin Med 2023; 12:6187. [PMID: 37834831 PMCID: PMC10573225 DOI: 10.3390/jcm12196187] [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: 08/19/2023] [Revised: 09/20/2023] [Accepted: 09/23/2023] [Indexed: 10/15/2023] Open
Abstract
The aim of this study was to evaluate the relation of maternal pain catastrophizing score with children who underwent circumcision postoperative pain. This prospective cohort study was performed between March 2022 and March 2023 at Samsun University, Turkey. Demographic characteristics of mothers and children, mothers' education level, presence of chronic pain, and Beck Depression Inventory scores were recorded preoperatively. Pain catastrophizing was assessed by applying the pain catastrophizing scale (PCS) to the mothers of children who experienced postoperative circumcision pain. The mothers were divided into low-pain catastrophizing (Group 1) and high-pain catastrophizing (Group 2) group. A total of 197 mothers and sons participated in the study, with 86 (43.6%) in Group 1 and 111 (56.4%) in Group 2. Significant differences were found between the two groups in terms of the mothers' PCS scores (p < 0.001), education levels (p = 0.004), chronic pain scores (p = 0.022), and Beck Depression Inventory scores (p < 0.001). Our findings showed that children with high pain catastrophizing mothers experience greater postoperative pain than those with low pain catastrophizing mothers. This may be attributable to a mother's specific cognitive style for coping with pain, which is associated with the child's responses to painful experiences.
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Affiliation(s)
- Sevda Akdeniz
- Department of Anesthesiology and Reanimation, Samsun Training and Research Hospital, Samsun University, 55090 Samsun, Turkey; (A.H.P.); (H.S.K.); (S.T.); (M.S.)
| | - Ahmet Haydar Pece
- Department of Anesthesiology and Reanimation, Samsun Training and Research Hospital, Samsun University, 55090 Samsun, Turkey; (A.H.P.); (H.S.K.); (S.T.); (M.S.)
| | - Hatice Selcuk Kusderci
- Department of Anesthesiology and Reanimation, Samsun Training and Research Hospital, Samsun University, 55090 Samsun, Turkey; (A.H.P.); (H.S.K.); (S.T.); (M.S.)
| | - Serkan Dogru
- Department of Anesthesiology and Reanimation, Mersin City Hospital, 33240 Mersin, Turkey;
| | - Serkan Tulgar
- Department of Anesthesiology and Reanimation, Samsun Training and Research Hospital, Samsun University, 55090 Samsun, Turkey; (A.H.P.); (H.S.K.); (S.T.); (M.S.)
| | - Mustafa Suren
- Department of Anesthesiology and Reanimation, Samsun Training and Research Hospital, Samsun University, 55090 Samsun, Turkey; (A.H.P.); (H.S.K.); (S.T.); (M.S.)
| | - Ismail Okan
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, 34720 Istanbul, Turkey;
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GÜLLER B, YAYLACI F. İletişim bozukluğu tanılı çocuklarda duygusal davranışsal sorunlar, ebeveyn tutum özellikleri, ebeveyn stres düzeyi ve ilişkili faktörlerin sağlıklı kontrollerle karşılaştırılması. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1125720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Purpose: We aimed to compare emotional and behavioral problems, parental attitude characteristics, and the risk of parental anxiety and depression between children diagnosed with a communication disorder and healthy controls.
Materials and Methods: A total of 117 children diagnosed with a communication disorder in the psychiatric evaluation according to the DSM-5 diagnostic criteria and their parents were included in the communication disorder group, whereas 105 children who presented to the outpatient clinics other than child psychiatry and were not diagnosed with a communication disorder, and their parents formed the control group. Sociodemographic Data Form, Child Adjustment and Parent Efficacy Scale (CAPES-TR), The Parenting Styles and Dimensions Questionnaire-Short Form (PSDQSF), and Hospital Anxiety Depression Scale (HADS) were filled in by the parents.
Results: Psychiatric comorbidity was found in 27.3% of the children in the communication disorder group, with the most common diagnoses being Attention deficit and hyperactivity disorder (n=17, 15.5%) and Conduct disorder (n=4, 3.6%). CAPES-TR child adjustment total difficulty score and the mean scores of emotional problems and behavioral problems were higher in the communication disorder group. The mean CAPES-TR parental self-efficacy score was lower in the communication disorder group. In the communication disorder group, democratic parenting attitudes were lower , whereas authoritarian and permissive parenting attitudes were higher. HAD-D mean score was higher in the communication disorder group.
Conclusion: Our study provides essential information such as an increase in emotional and behavioral problems, more authoritarian or permissive parenting attitudes, a decrease in parental self-efficacy, an increased risk of depression in parents in the presence of communication disorder, and studies that deal with these areas together are limited in the literature. Our findings will contribute to the literature regarding the assessment and planning of appropriate intervention programs for factors that are not only child-focused but also related to parental mental health and parenting skills in the presence of communication disorders.
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Fernandes CC, Martins AT, Santa-Rita A, Faísca L. The influence of parental variables and child behavioral inhibition on social anxiety in preschool children: The moderator effects of gender. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03247-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Aktar E, Nimphy CA, van Bockstaele B, Pérez‐Edgar K. The social learning of threat and safety in the family: Parent-to-child transmission of social fears via verbal information. Dev Psychobiol 2022; 64:e22257. [PMID: 35312048 PMCID: PMC8944018 DOI: 10.1002/dev.22257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/22/2021] [Accepted: 01/21/2022] [Indexed: 11/18/2022]
Abstract
Parental verbal threat (vs. safety) information regarding the social world may impact a child's fear responses, evident in subjective, behavioral, cognitive, and physiological indices of fear. In this study, primary caregivers provided standardized verbal threat or safety information to their child (N = 68, M = 5.27 years; 34 girls) regarding two strangers in the lab. Following this manipulation, children reported fear beliefs for each stranger. Physiological and behavioral reactions were recorded as children engaged with the two strangers (who were blind to their characterization) in a social interaction task. Child attention to the strangers was measured in a visual search task. Parents also reported their own, and their child's, social anxiety symptoms. Children reported more fear for the stranger paired with threat information, but no significant differences were found in observed child fear, attention, or heart rate. Higher social anxiety symptoms on the side of the parents and the children exacerbated the effect of parental verbal threat on observed fear. Our findings reveal a causal influence of parental verbal threat information only for child-reported fear and highlight the need to further refine the conditions under which acquired fear beliefs persist and generalize to behavior/physiology or get overruled by nonaversive real-life encounters.
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Affiliation(s)
- Evin Aktar
- Department of Clinical PsychologyLeiden UniversityLeidenThe Netherlands
- Leiden Institute for Brain and Cognition (LIBC)Leiden UniversityLeidenThe Netherlands
| | - Cosima A. Nimphy
- Department of Clinical PsychologyLeiden UniversityLeidenThe Netherlands
| | - Bram van Bockstaele
- Department of Child Development and EducationUniversity of AmsterdamAmsterdamThe Netherlands
| | - Koraly Pérez‐Edgar
- Department of PsychologyChild Study CenterThe Pennsylvania State UniversityState CollegePennsylvaniaUSA
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Perlman SB, Lunkenheimer E, Panlilio C, Pérez-Edgar K. Parent-to-Child Anxiety Transmission Through Dyadic Social Dynamics: A Dynamic Developmental Model. Clin Child Fam Psychol Rev 2022; 25:110-129. [PMID: 35195833 PMCID: PMC9990140 DOI: 10.1007/s10567-022-00391-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 12/15/2022]
Abstract
The intergenerational transmission of psychopathology is one of the strongest known risk factors for childhood disorder and may be a malleable target for prevention and intervention. Anxious parents have distinct parenting profiles that impact socioemotional development, and these parenting effects may result in broad alterations to the biological and cognitive functioning of their children. Better understanding the functional mechanisms by which parental risk is passed on to children can provide (1) novel markers of risk for socioemotional difficulties, (2) specific targets for intervention, and (3) behavioral and biological indices of treatment response. We propose a developmental model in which dyadic social dynamics serve as a key conduit in parent-to-child transmission of anxiety. Dyadic social dynamics capture the moment-to-moment interactions between parent and child that occur on a daily basis. In shaping the developmental trajectory from familial risk to actual symptoms, dyadic processes act on mechanisms of risk that are evident prior to, and in the absence of, any eventual disorder onset. First, we discuss dyadic synchrony or the moment-to-moment coordination between parent and child within different levels of analysis, including neural, autonomic, behavioral, and emotional processes. Second, we discuss how overt emotion modeling of distress is observed and internalized by children and later reflected in their own behavior. Thus, unlike synchrony, this is a more sequential process that cuts across levels of analysis. We also discuss maladaptive cognitive and affective processing that is often evident with increases in child anxiety symptoms. Finally, we discuss additional moderators (e.g., parent sex, child fearful temperament) that may impact dyadic processes. Our model is proposed as a conceptual framework for testing hypotheses regarding dynamic processes that may ultimately guide novel treatment approaches aimed at intervening on dyadically linked biobehavioral mechanisms before symptom onset.
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8
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Gerdes ABM, Fraunfelter LA, Braband M, Alpers GW. Girls' Stuff? Maternal Gender Stereotypes and Their Daughters' Fear. Front Psychol 2022; 12:741348. [PMID: 35069322 PMCID: PMC8770317 DOI: 10.3389/fpsyg.2021.741348] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/02/2021] [Indexed: 12/12/2022] Open
Abstract
One of the most robust findings in psychopathology is the fact that specific phobias are more prevalent in women than in men. Although there are several theoretical accounts for biological and social contributions to this gender difference, empirical data are surprisingly limited. Interestingly, there is evidence that individuals with stereotypical feminine characteristics are more fearful than those with stereotypical masculine characteristics; this is beyond biological sex. Because gender role stereotypes are reinforced by parental behavior, we aimed to examine the relationship of maternal gender stereotypes and children’s fear. Dyads of 38 mothers and their daughters (between ages 6 and 10) were included. We assessed maternal implicit and explicit gender stereotypes as well as their daughters’ self-reported general fearfulness, specific fear of snakes, and approach behavior toward a living snake. First, mothers’ fear of snakes significantly correlated with their daughters’ fear of snakes. Second, mothers’ gender stereotypes significantly correlated with their daughters’ self-reported fear. Specifically, maternal implicit gender stereotypes were associated with daughters’ fear of snakes and fear ratings in response to the snake. Moreover, in children, self-reported fear correlated with avoidance of the fear-relevant animal. Together, these results provide first evidence for a potential role of parental gender stereotypes in the development and maintenance of fear in their offspring.
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Affiliation(s)
- Antje B M Gerdes
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | | | - Melissa Braband
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Georg W Alpers
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
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Elfström S, Ahlen J. Development and validation of the Modeling of Parental Anxiety Questionnaire. J Anxiety Disord 2022; 85:102515. [PMID: 34929432 DOI: 10.1016/j.janxdis.2021.102515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/06/2021] [Indexed: 12/17/2022]
Abstract
Parental anxious modeling is assumed to be a risk factor for child anxiety. Until now there has been no self-assessment scale available that measures parental modeling of anxiety in a comprehensive way. Our aim with this study was to bridge this gap by developing the Modeling of Parental Anxiety Questionnaire (MPAQ). To do this, we generated an item pool containing 51 statements covering different aspects of parental modeling of anxious and non-anxious behaviors. A sample of Swedish parents (N = 1092) of children aged 4-12, answered an online survey comprising the generated item pool, the Parental Overprotection Scale (OP) and the PROMIS Anxiety short forms (the adult version and the parent proxy report scale). A factor analysis of the items of parental modeling indicated a structure with four separate factors. These factors formed the final four subscales of MPAQ; (1) being curios and content, (2) being on guard, (3) displaying anxiety and avoidance, and (4) displaying stress. The Cronbach's alpha coefficients of the subscale scores ranged from moderate to good. Linear regression analysis showed that the displaying anxiety and avoidance-subscale had the strongest association with child anxiety symptoms. These findings show that MPAQ demonstrates adequate psychometric properties and has potential for being used in research and clinical settings, for example to identify potential targets for parenting interventions and to measure mediation effects.
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Affiliation(s)
- Sigrid Elfström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Johan Ahlen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Center for Epidemiology and Community Medicine, Health Care Services Stockholm County, Sweden
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Skversky-Blocq Y, Haaker J, Shechner T. Watch and Learn: Vicarious Threat Learning across Human Development. Brain Sci 2021; 11:brainsci11101345. [PMID: 34679409 PMCID: PMC8533719 DOI: 10.3390/brainsci11101345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/04/2021] [Accepted: 10/08/2021] [Indexed: 12/21/2022] Open
Abstract
Vicarious threat learning is an important pathway in learning about safety and danger in the environment and is therefore critical for survival. It involves learning by observing another person's (the demonstrator) fearful responses to threat and begins as early as infancy. The review discusses the literature on vicarious threat learning and infers how this learning pathway may evolve over human development. We begin by discussing the methods currently being used to study observational threat learning in the laboratory. Next, we focus on the social factors influencing vicarious threat learning; this is followed by a review of vicarious threat learning among children and adolescents. Finally, we examine the neural mechanisms underpinning vicarious threat learning across human development. To conclude, we encourage future research directions that will help elucidate how vicarious threat learning emerges and how it relates to the development of normative fear and pathological anxiety.
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Affiliation(s)
- Yael Skversky-Blocq
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Haifa 3498838, Israel;
| | - Jan Haaker
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany;
| | - Tomer Shechner
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Haifa 3498838, Israel;
- Correspondence:
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Peris TS, Thamrin H, Rozenman MS. Family Intervention for Child and Adolescent Anxiety: A Meta-analytic Review of Therapy Targets, Techniques, and Outcomes. J Affect Disord 2021; 286:282-295. [PMID: 33756306 DOI: 10.1016/j.jad.2021.02.053] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 02/02/2021] [Accepted: 02/22/2021] [Indexed: 11/25/2022]
Abstract
Parent- and family-level correlates of youth anxiety are well-documented, and they highlight potential targets for family-focused intervention. Although family-based approaches for treating youth anxiety generally are considered efficacious for achieving symptom reduction, they vary in format and approach and it remains unclear whether they offer an advantage over individual child treatment. To better understand the current state of the evidence, we used meta-analytic methods to examine the therapeutic approaches described in existing family interventions for child and adolescent anxiety, whether they mapped to the major mechanisms proposed in the literature, and the timeline along which relevant parent/family variables were measured. We examined how these mechanism-focused family interventions performed in RCTs relative to individual child CBT and whether they shifted symptoms and relevant parenting behaviors. A total of 11 randomized controlled trials (RCTs) compared individual cognitive behavior therapy (CBT) to CBT+ a family component (CBT + FAM) and included a youth anxiety measure at pre- and post-treatment; only half of these (n=6) also included a parent/family functioning measure at both pre- and post-treatment (across both primary and secondary outcome papers). Only a single study included anxiety measures at a mid-treatment time point, and none included parent measures at a mid-treatment time point. Findings are discussed in terms of design considerations and advancing the field of family intervention for youth anxiety.
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Affiliation(s)
- Tara S Peris
- Division of Child & Adolescent Psychiatry, Jane & Terry Semel Institute for Neuroscience at UCLA, Los Angeles, CA 90024.
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Effects of tryptophan depletion on anxiety, a systematic review. Transl Psychiatry 2021; 11:118. [PMID: 33574223 PMCID: PMC7878770 DOI: 10.1038/s41398-021-01219-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 10/30/2020] [Accepted: 11/16/2020] [Indexed: 12/11/2022] Open
Abstract
Vulnerability markers for onset of anxiety disorders are scarce. In depression, patients at risk tend to respond with a negative mood to 'acute tryptophan depletion' (ATD), while healthy volunteers and current patients do not. The serotonergic system thus provides indications for vulnerability for depression. It is unknown whether ATD reveals vulnerability in anxiety too. This study systematically reviews the effects of ATD on anxiety and assesses whether challenging anxiety modifies the response. PubMed, Embase and PsychInfo were systematically searched up to April 2019 for studies in which (1) healthy volunteers or patients with a (remitted) anxiety disorder underwent ATD and (2) levels of anxiety were reported. In total, 21 studies were included. Studies conducted in healthy volunteers (n = 13), and patients with a remitted (n = 6) or current (panic, social or generalised) anxiety disorder (n = 4). Studies were mostly of poor quality and heterogeneous regarding population, challenge test used and outcome measures. ATD did not consistently affect anxiety in any of the groups. Moreover, a challenge test after ATD (n = 17 studies) did not consistently provoke anxiety in healthy volunteers or remitted patients. A 35% CO2 challenge did consistently increase anxiety in patients with a current panic disorder (PD). To conclude, this systematic review found no clear indications that ATD provokes anxiety in those at risk for anxiety disorders. Hence, unlike in depression, ATD does not indicate vulnerability to develop an anxiety disorder. Because included studies were heterogeneous and mostly of poor quality, there is an urgent need for high quality research in homogeneous samples.
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Adolph D, Margraf J, Schneider S. Your Fear is My Fear: The Relationship Between Parental and Offspring Anxieties. Child Psychiatry Hum Dev 2021; 52:772-781. [PMID: 32948972 PMCID: PMC8405516 DOI: 10.1007/s10578-020-01060-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/12/2020] [Indexed: 11/26/2022]
Abstract
Contrary to the well-documented link between parental and offspring clinical anxiety, little is known about the relationship between parental everyday-life anxieties (e.g., concerning family, finances, health) and offspring anxieties. To close this gap, we assessed the frequency of parental symptoms of DSM-IV anxiety disorders and everyday-life anxieties, as well as the frequency of offspring anxiety symptoms in a representative sample by self-report. Parents reported that 48.4% of the children were free of specific symptoms of DSM-IV anxiety disorders within the last 12 months, 39.2% showed low symptom load (1-3 symptoms) and 12.4% were moderately or severely strained (4-10 symptoms). Replicating previous studies, parental DSM-IV symptoms increased offspring risk for the same symptoms. In addition, parental everyday-life anxieties showed a positive relationship with offspring symptom severity. Demographic variables (female sex, low socioeconomic status and younger age) and parental anxiety markers explained 18% of variance in offspring symptom severity. The data are discussed in light of current models of familial transmission.
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Affiliation(s)
- Dirk Adolph
- Mental Health Research and Treatment Center, Ruhr-University Bochum, Massenbergstrasse 9-13, 44847, Bochum, Germany.
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Ruhr-University Bochum, Massenbergstrasse 9-13, 44847, Bochum, Germany
| | - Silvia Schneider
- Mental Health Research and Treatment Center, Ruhr-University Bochum, Massenbergstrasse 9-13, 44847, Bochum, Germany
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Suzuki K, Hiratani M. The Association of Mental Health Problems With Preventive Behavior and Caregivers' Anxiety About COVID-19 in Children With Neurodevelopmental Disorders. Front Psychiatry 2021; 12:713834. [PMID: 34335341 PMCID: PMC8322613 DOI: 10.3389/fpsyt.2021.713834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/17/2021] [Indexed: 01/26/2023] Open
Abstract
We examined the association of mental health problems with preventive behavior and caregivers' anxiety in children with neurodevelopmental disorders (NDD) and their caregivers during the coronavirus disease 2019 (COVID-19) pandemic. Data were obtained from 227 pairs of children with NDD and their caregivers in a clinic in Fukui Prefecture, Japan, from October 1 to December 31, 2020. During this period, the activities of children and caregivers were not strongly restricted by the public system. Caregivers' anxiety about children's activities was positively associated with caregivers' and children's fears of COVID-19 and children's depressive symptoms. Children's preventive behavior was negatively associated with children's depressive symptoms. These findings suggested that caregivers' fear of COVID-19 stemmed from worry about the relationship between children's activity and COVID-19 infection, and children might have reflected caregivers' expressions of concern. In schools and clinics, practitioners educate children on how to engage in preventive behavior against COVID-19. Our results support the effectiveness of such practices in mitigating mental health problems in children with NDD.
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Affiliation(s)
- Kota Suzuki
- Faculty of Education, Shitennoji University, Habikino, Japan
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Silvers JA, Callaghan BL, VanTieghem M, Choy T, O'Sullivan K, Tottenham N. An exploration of amygdala-prefrontal mechanisms in the intergenerational transmission of learned fear. Dev Sci 2020; 24:e13056. [PMID: 33103280 DOI: 10.1111/desc.13056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 11/30/2022]
Abstract
Humans learn about their environments by observing others, including what to fear and what to trust. Observational fear learning may be especially important early in life when children turn to their parents to gather information about their world. Yet, the vast majority of empirical research on fear learning in youth has thus far focused on firsthand classical conditioning, which may fail to capture one of the primary means by which fears are acquired during development. To address this gap in the literature, the present study examined observational fear learning in youth (n = 33; age range: 6-17 years) as they watched videos of their parent and an "unfamiliar parent" (i.e., another participant's parent) undergo fear conditioning. Youth demonstrated stronger fear learning when observing their parent compared to an unfamiliar parent, as indicated by changes in their self-reported liking of the stimuli to which their parents were conditioned (CS+, a geometric shape paired with an aversive noise; CS-, a geometric shape never paired with an aversive noise) and amygdala responses. Parent trait anxiety was associated with youth learning better (i.e., reporting a stronger preference for the CS- relative to CS+), and exhibiting stronger medial prefrontal-amygdala connectivity. Neuroimaging data were additionally acquired from a subset of parents during firsthand conditioning, and parental amygdala and mPFC activation were associated with youth's neural recruitment. Together, these results suggest that youth preferentially learn fears via observation of their parents, and this learning is associated with emotional traits and neural recruitment in parents.
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Affiliation(s)
- Jennifer A Silvers
- Department of Psychology, University of California-Los Angeles, Los Angeles, CA, USA
| | - Bridget L Callaghan
- Department of Psychology, University of California-Los Angeles, Los Angeles, CA, USA
| | | | - Tricia Choy
- Graduate School of Education, University of California-Riverside, Riverside, CA, USA
| | | | - Nim Tottenham
- Department of Psychology, Columbia University, New York, NY, USA
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16
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Þórðarson Ó, Ævarsson FM, Helgadóttir S, Lauth B, Wessman I, Sigurjónsdóttir SA, Smárason O, Harðardóttir HH, Skarphedinsson G. Icelandic translation and reliability data on the DSM-5 version of the schedule for affective disorders and schizophrenia for school-aged children - present and lifetime version (K-SADS-PL). Nord J Psychiatry 2020; 74:423-428. [PMID: 32134350 DOI: 10.1080/08039488.2020.1733660] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND The Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) is a semi-structured interview based on the Diagnostic and Statistical Manual of Mental Disorders (DSM), and assesses past and present symptoms in children aged 6-18 years old. It has been translated into more than 20 languages and is widely used in clinical work. The K-SADS-PL has recently been revised by adopting new DSM-5 disorders and modifying probes accordingly. However, research on this revision is critically limited. The objective of this study was to examine the inter-rater reliability of the DSM-5 K-SADS-PL when administered by postgraduate students after receiving thorough training and supervision. METHOD The DSM-5 K-SADS-PL was applied in a clinical sample of two outpatient units: The outpatient unit of the Department of Child and Adolescent Psychiatry at the Landspítali University Hospital in Reykjavík, Iceland and The Icelandic Anxiety Centre for Children, Adolescents and Young Adults. RESULTS Fourty-one (80%) consecutive patients aged 6-18 years consented and were included. Cohen's κ was calculated to estimate inter-rater reliability, with estimates ranging from fair to excellent (κ = 0.57-0.90), with most diagnoses in the excellent range (κ > 0.75). CONCLUSIONS These results indicate that the Icelandic translation of the DSM-5 K-SADS-PL can be reliably administered by postgraduate students.
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Affiliation(s)
- Ólafur Þórðarson
- Reykjavík Municipal Service Centre for Breiðholt, Reykjavík, Iceland
| | | | | | - Bertrand Lauth
- Reykjavík Municipal Service Centre for Breiðholt, Reykjavík, Iceland.,Child and Adolescent Psychiatric Unit, Akureyri Hospital, Akureyri, Iceland
| | - Inga Wessman
- Reykjavík Municipal Service Centre for Breiðholt, Reykjavík, Iceland.,Department of School and Leisure, Reykjavík, Iceland
| | | | - Orri Smárason
- Reykjavík Municipal Service Centre for Breiðholt, Reykjavík, Iceland.,Child and Adolescent Psychiatric Unit, Akureyri Hospital, Akureyri, Iceland
| | - Harpa Hrönn Harðardóttir
- Reykjavík Municipal Service Centre for Breiðholt, Reykjavík, Iceland.,Reykjavík Municipal Service Centre for Laugadalur and Háaleiti, Reykjavík, Iceland
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17
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Van Gampelaere C, Luyckx K, Van Ryckeghem DML, van der Straaten S, Laridaen J, Goethals ER, Casteels K, Vanbesien J, den Brinker M, Cools M, Goubert L. Mindfulness, Worries, and Parenting in Parents of Children With Type 1 Diabetes. J Pediatr Psychol 2020; 44:499-508. [PMID: 30590544 DOI: 10.1093/jpepsy/jsy094] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/31/2018] [Accepted: 11/05/2018] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE Parents of children with type 1 diabetes (T1D) often experience distress and worries, which may negatively impact their parenting behaviors. The current study investigates parental mindfulness (i.e., an enhanced attention to and awareness of current experiences or present reality) as a resilience mechanism. Using a daily diary approach, the predictive role of parental mindfulness for daily diabetes-related worries was examined, its impact upon protective parenting behaviors, and its buffering role in the relationship between daily worries and protective parenting behaviors. METHODS Participants were 56 parents of 40 children with T1D (2-12 years). Trait mindfulness was assessed with the Mindful Attention Awareness Scale. Subsequently, parents completed a diary for 14 consecutive days, assessing parental worries about hypo- and hyperglycemia and general and diabetes-specific parental protective behavior. RESULTS Multilevel analyses showed that parental diabetes-related worries fluctuated substantially across days and positively predicted daily protective behavior. Higher levels of parental mindfulness predicted less daily worries about hypoglycemia and lower engagement in general protective behavior and hypoglycemia avoidance behavior. In addition, the relationship between worries about hyperglycemia and general protective behavior was moderated by parental mindfulness. CONCLUSIONS The present findings highlight the importance of daily parental worries in explaining parental protective behaviors on a daily basis. Mindfulness emerged as a promising resilience factor in parents of children with T1D, resulting in less daily worries and protective parenting. These results have important clinical implications and point to the promising role of mindfulness interventions in this context.
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Affiliation(s)
| | - Koen Luyckx
- Department of School Psychology and Development in Context, University of Leuven.,UNIBS, University of the Free State
| | - Dimitri M L Van Ryckeghem
- Department of Experimental, Clinical and Health Psychology, Ghent University.,Institute for Health and Behavior, INSIDE, University of Luxembourg
| | | | - Jolien Laridaen
- Department of Medical Child and Adolescent Psychology, Ghent University Hospital
| | - Eveline R Goethals
- Department of School Psychology and Development in Context, University of Leuven.,Department of Pediatric Diabetes, University Hospital Leuven.,Joslin Diabetes Center, Harvard Medical School, Boston, United States of America
| | - Kristina Casteels
- Department of Pediatric Diabetes, University Hospital Leuven.,Department of Development and Regeneration, University of Leuven
| | | | | | - Martine Cools
- Division of Pediatric Endocrinology, Department of Pediatrics, Ghent University Hospital.,Department of Internal Medicine and Pediatrics, Ghent University
| | - Liesbet Goubert
- Department of Experimental, Clinical and Health Psychology, Ghent University
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18
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Abstract
This review challenges the traditional interpretation of infants' and young children's responses to three types of potentially "fear-inducing" stimuli-snakes and spiders, heights, and strangers. The traditional account is that these stimuli are the objects of infants' earliest developing fears. We present evidence against the traditional account, and provide an alternative explanation of infants' behaviors toward each stimulus. Specifically, we propose that behaviors typically interpreted as "fearful" really reflect an array of stimulus-specific responses that are highly dependent on context, learning, and the perceptual features of the stimuli. We speculate about why researchers so commonly misinterpret these behaviors, and conclude with future directions for studying the development of fear in infants and young children. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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19
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Thompson EH, Robertson P, Curtis R, Frick MH. Students with Anxiety: Implications for Professional School Counselors. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/2156759x150160402] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Anxiety is one of the most pervasive mental health concerns affecting students, yet a significant number of students with anxiety disorders remain underserved. If left untreated, anxiety can hinder students’ personal/social, academic, and career development. The purpose of this article is to provide professional school counselors with helpful information about the etiology of anxiety disorders and brief, evidence-based prevention and intervention options. The authors discuss specific recommendations for the identification, assessment, and treatment of anxiety that fit within the unique school environment.
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Affiliation(s)
| | | | - Russ Curtis
- Department of Human Services, Western Carolina
University
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20
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Chapman HR, Kirby-Turner N. Psychological Intrusion - An Overlooked Aspect of Dental Fear. Front Psychol 2018; 9:501. [PMID: 29719519 PMCID: PMC5913370 DOI: 10.3389/fpsyg.2018.00501] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 03/26/2018] [Indexed: 12/12/2022] Open
Abstract
Dental fear/anxiety is a widely recognised problem affecting a large proportion of the population. It can result in avoidance and/or difficulty accepting dental care. We believe that psychological intrusion may play a role in the aetiology and maintenance of dental fear for at least some individuals. In this narrative review we will take a developmental perspective in order to understand its impact across the lifespan. We will consider the nature of 'self,' parenting styles, the details of intrusive parenting or parental psychological control, and briefly touch upon child temperament and parental anxiety. Finally, we draw together the supporting (largely unrecognised) evidence available in the dental literature. We illustrate the paper with clinical examples and discuss possibly effective ways of addressing the problem. We conclude that psychological intrusion appears to play an important role in dental fear, for at least some individuals, and we call for detailed research into the extent and exact nature of the problem. A simple means of identifying individuals who are vulnerable to psychological intrusion would be useful for dentists.
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Affiliation(s)
- Helen R. Chapman
- School of Psychology, University of Lincoln, Lincoln, United Kingdom
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21
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Lang AJ, Gartstein MA. Intergenerational transmission of traumatization: Theoretical framework and implications for prevention. J Trauma Dissociation 2018; 19:162-175. [PMID: 28509617 DOI: 10.1080/15299732.2017.1329773] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Intergenerational transmission of traumatization (ITT) occurs when traumatized parents have offspring with increased risk for emotional and behavioral problems. Although fetal exposure to the maternal biological milieu is known to be one factor in ITT, PTSD-driven parent-child interactions represent an additional important and potentially modifiable contributor. The Perinatal Interactional Model of ITT presented herein proposes that PTSD leads to social learning and suboptimal parent-child interactions, which undermine child regulatory capacity and increase distress, largely explaining poor social-emotional outcomes for offspring of parents with PTSD. Psychosocial intervention, particularly when delivered early in pregnancy, holds the possibility of disrupting ITT.
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Affiliation(s)
- Ariel J Lang
- a VA San Diego Center of Excellence for Stress and Mental Health (CESAMH) , University of California San Diego , San Diego , California , USA
| | - Maria A Gartstein
- b Department of Psychology , Washington State University , Pullman , Washington , USA
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22
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Understanding the Impact of Paediatric Asthma on Families: Development of a Theoretical Model. BEHAVIOUR CHANGE 2018. [DOI: 10.1017/bec.2018.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The experience of paediatric asthma is associated with increased stress and emotional difficulties for both the child and family. The current study aimed to qualitatively explore parents’ views of their child's asthma experience, from initial diagnosis onwards, to enhance our understanding of how families emotionally adjust and adapt to the diagnosis and management of asthma. Semi-structured interviews were conducted with 17 parents of children (<18 years) with physician-diagnosed asthma. Questionnaires were used to capture demographic information and anxiety symptom status of parents (State Trait Anxiety Inventory — Form Y [STAI-Y1/Y2]) and children (Spence Children's Anxiety Scale — Parent reported [SCAS-P]). Grounded theory was used to analyse the results. Analysis saw three themes emerge as important in understanding the impact of asthma on the family: (1) the experience of obtaining an asthma diagnosis, (2) parents’ belief in their competence to manage asthma, and (3) parents’ behaviour in response to the asthma. A model was developed that posits adaptive parental adjustment to asthma is determined in part by the circumstances around the time of diagnosis, the level of knowledge and skills, and the controllability of the asthma. This model can guide medical and allied health professionals to specific areas where intervention may reduce stress and emotional difficulties associated with asthma and its management for affected families.
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23
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Parental Responses to Children’s Avoidance in Fear-Provoking Situations: Relation to Child Anxiety and Mediators of Intervention Response. CHILD & YOUTH CARE FORUM 2018. [DOI: 10.1007/s10566-018-9440-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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Tottenham N. The Fundamental Role of Early Environments to Developing an Emotionally Healthy Brain. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/2372732217745098] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The quality of early socioemotional environments has a clear link to emotional health. Findings from neuroscientific and behavioral studies explain this enduring link, and findings focus on the plasticity of emotional brain development. Implications include (a) prioritizing individuals as early as possible and throughout development, (b) remaining mindful that stable caregiving is a basic need for children, and (c) supporting children’s emotional development which means supporting their families. Addressing these needs is a large task, but not addressing these needs confers an even larger mental health cost to the individual as well as to society more broadly.
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25
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Brennan E, Luke A, Murphy Y, Francazio S, Flessner C. Examining the Relationship Between Anxiogenic Parenting Practices and Cognitive Flexibility in Youth. Behav Modif 2017; 42:864-884. [DOI: 10.1177/0145445517748558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Cognitive flexibility (CF), a subdomain of executive functioning (EF), involves abilities such as set shifting and reversal learning. Some variability in CF is normative across youth due to the gradual refinement of broader EF along with the prefrontal cortex. Prior research has suggested that a supportive parenting environment contributes to strong EF, whereas harsh/controlling parenting is associated with deficits. The current investigation explores whether certain parenting practices (e.g., parental accommodation, over-involvement, modeling) are associated with such deficits. Anxiogenic parenting and CF were assessed in 112 youth aged 9 to 17 years, with results demonstrating that parenting practices were not predictive of CF in these youth. Age accounted for the majority of differences in set shifting performance, potentially emphasizing the influence of parenting at different stages of development. Accordingly, future research is necessary to determine the potential impact of anxiogenic parenting at specific points in the development of CF.
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Affiliation(s)
| | - Anna Luke
- Kent State University, Kent, OH, USA
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26
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Cunningham A, Renk K. I’m Uncomfortable, You’re Uncomfortable, We’re Uncomfortable: An Integrative Family Approach to the Treatment of Tourette’s Disorder and Separation Anxiety Disorder in a Young Child. Clin Case Stud 2017. [DOI: 10.1177/1534650117732143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This case study follows a 6-year old Caucasian Hispanic male who presented with symptoms of Tourette’s disorder and separation anxiety disorder. Given the young age of the child, a critical focus was placed on parental involvement and parental mastery of the treatment components within an attachment-focused conceptualization as the foundation for all treatment delivery. To address all issues presented by the family of this young child, a behavioral treatment was utilized to target symptoms of Tourette’s disorder, and components of cognitive-behavioral therapy were used to address symptoms associated with separation anxiety disorder (in the young child). Further, components of an attachment-based parenting program, Circle of Security–Parenting, were inserted throughout treatment to keep this young child’s parents in tune with their relationship with their young child. Following completion of treatment, this young child displayed significant decreases in his symptoms across both disorders. Further, this young child and his parents demonstrated a mastery of treatment concepts and coping skills. The family reported both qualitative and quantitative improvements in the young child’s overall emotional and behavioral functioning. This study displayed the effectiveness of an integrative family-based approach in the treatment of a young child with symptoms of both Tourette’s disorder and separation anxiety disorder.
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27
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Beato A, Pereira AI, Barros L. Parenting Strategies to Deal with Children's Anxiety: Do Parents Do What They Say They Do? Child Psychiatry Hum Dev 2017; 48:423-433. [PMID: 27485099 DOI: 10.1007/s10578-016-0670-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Parents' perceptions about their strategies to deal with children's anxiety have been minimally explored. Based on a mixed-method approach, the current study compared the strategies that parents said they use more frequently to deal with their child's anxious behaviors and the strategies they actually used during two mildly anxiogenic interactions with their child. Forty-two parents of children with anxiety disorders, aged 9-12 years, participated in the study. Semi-structured interviews were administered to identify parental perceptions about their strategies to deal with their children's anxiety. Subsequently dyadic interactions were observed and coded by two independent coders. We found discrepancies relating to four strategies. Significantly more parents used strategies based on overinvolvement and anxious behavior during the interactions than had been reported by them in the interviews. In contrast, reassurance and reinforcement of avoidance/dependence were used in interactions by fewer parents than would be expected, according to the interviews. Relevant implications for assessment and intervention with families of anxious children are suggested.
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Affiliation(s)
- Ana Beato
- Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013, Lisbon, Portugal.
| | - Ana Isabel Pereira
- Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013, Lisbon, Portugal
| | - Luísa Barros
- Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013, Lisbon, Portugal
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28
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Boerner KE, Chambers CT, McGrath PJ, LoLordo V, Uher R. The Effect of Parental Modeling on Child Pain Responses: The Role of Parent and Child Sex. THE JOURNAL OF PAIN 2017; 18:702-715. [DOI: 10.1016/j.jpain.2017.01.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 01/09/2017] [Accepted: 01/17/2017] [Indexed: 10/20/2022]
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29
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Lebowitz ER. Mother and Child Ratings of Child Anxiety: Associations With Behavioral Avoidance and the Role of Family Accommodation. PARENTING, SCIENCE AND PRACTICE 2017; 17:124-142. [PMID: 34262406 PMCID: PMC8276776 DOI: 10.1080/15295192.2017.1304784] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study compared mother and child ratings of child anxiety to each other and to an objective measure of the child's avoidant behavior, using a novel motion-tracking paradigm. The study also examined the moderating role of family accommodation for the link between mother ratings of child anxiety and child behavioral avoidance. DESIGN Participants were 98 children (7- to 14-years-old) and their mothers. Children met criteria for a primary anxiety disorder. Measures included parent and child versions of the Multi-Dimensional Anxiety Scale for Children and the Screen for Child Anxiety Related Emotional Disorders. Children also completed the Spider Phobia Questionnaire for children and the Family Accommodation Scale for Anxiety-Child Report. The Yale Interactive Kinect Environment Software platform was used to measure children's behavioral avoidance of spider images. RESULTS Mother and child ratings of child anxiety were moderately correlated. Only child ratings of child anxiety were associated with child behavioral avoidance. Child-rated family accommodation moderated the association between parent ratings and child avoidance. When accommodation was low parent ratings correlated with child avoidance, but not when accommodation was high. CONCLUSIONS The findings contribute to understanding commonly reported discrepancies between mother and child ratings of child anxiety symptoms.
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Affiliation(s)
- Eli R Lebowitz
- Yale Child Study Center, 230 S. Frontage Rd. New Haven, CT 06520
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30
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Sicouri G, Sharpe L, Hudson JL, Dudeney J, Jaffe A, Selvadurai H, Lorimer S, Hunt C. Threat interpretation and parental influences for children with asthma and anxiety. Behav Res Ther 2016; 89:14-23. [PMID: 27846417 DOI: 10.1016/j.brat.2016.11.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 10/05/2016] [Accepted: 11/09/2016] [Indexed: 12/01/2022]
Abstract
Anxiety disorders are highly prevalent in children with asthma yet very little is known about the cognitive and parent factors that may underpin this relationship. The present study investigated interpretation biases in children with asthma and anxiety and their parents, and whether parent-child discussions influenced children's interpretations. Eighty-nine parent-child dyads were included across four groups: children with asthma and anxiety, children with anxiety only, children with asthma only and healthy children (aged between 8 and 13 years old). Interpretation bias was assessed using ambiguous scenarios. Children with anxiety showed an interpretation bias in the general threat scenarios, whereas children with asthma showed an interpretation bias in the asthma threat scenarios. Parental predictions of their child's responses showed similar results. Parent-child discussions increased avoidance for children with anxiety and no asthma across all scenarios, but only for children with asthma and anxiety in the asthma threat scenarios. The results provide partial support for a cognitive theory of asthma and anxiety in children and suggest that parents play a role in influencing children's thinking styles. Treatment programs could thus aim to target and modify interpretation biases in children with anxiety, and include parents as part of treatment.
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Affiliation(s)
- Gemma Sicouri
- School of Psychology, The University of Sydney, NSW, Australia
| | - Louise Sharpe
- School of Psychology, The University of Sydney, NSW, Australia
| | | | - Jo Dudeney
- School of Psychology, The University of Sydney, NSW, Australia
| | - Adam Jaffe
- Discipline of Paediatrics, School of Women's and Children's Health, Medicine, University of New South Wales, NSW, Australia; Department of Paediatric Respiratory Medicine, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Hiran Selvadurai
- The Children's Hospital at Westmead Clinical School, Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, NSW, Australia; Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Sarah Lorimer
- School of Psychology, The University of Sydney, NSW, Australia
| | - Caroline Hunt
- School of Psychology, The University of Sydney, NSW, Australia.
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31
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Fear of pain in children and adolescents with neuropathic pain and complex regional pain syndrome. Pain 2016; 157 Suppl 1:S90-S97. [PMID: 26785161 DOI: 10.1097/j.pain.0000000000000377] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A significant proportion of children and adolescents with chronic pain endorse elevated pain-related fear. Pain-related fear is associated with high levels of disability, depressive symptoms, and school impairment. Because of faulty nerve signaling, individuals with neuropathic pain and complex regional pain syndrome may be more prone to develop pain-related fear as they avoid use of and neglect the affected body area(s), resulting in exacerbated symptoms, muscle atrophy, maintenance of pain signaling, and ongoing pain-related disability. Not surprisingly, effective treatments for elevated pain-related fears involve exposure to previously avoided activities to downregulate incorrect pain signaling. In the context of intensive interdisciplinary pain treatment of youth with neuropathic pain, decreasing pain-related fear is associated with improved physical and psychological functioning, whereas high initial pain-related fear is a risk factor for less treatment responsiveness. An innovative approach to targeting pain-related fear and evidence of a neural response to treatment involving decoupling of the amygdala with key fear circuits in youth with complex regional pain syndrome suggest breakthroughs in our ability to ameliorate these issues.
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32
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Blair KS, Otero M, Teng C, Geraci M, Lewis E, Hollon N, Blair RJR, Ernst M, Grillon C, Pine DS. Learning from other people's fear: amygdala-based social reference learning in social anxiety disorder. Psychol Med 2016; 46:2943-2953. [PMID: 27476529 PMCID: PMC5063696 DOI: 10.1017/s0033291716001537] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Social anxiety disorder involves fear of social objects or situations. Social referencing may play an important role in the acquisition of this fear and could be a key determinant in future biomarkers and treatment pathways. However, the neural underpinnings mediating such learning in social anxiety are unknown. Using event-related functional magnetic resonance imaging, we examined social reference learning in social anxiety disorder. Specifically, would patients with the disorder show increased amygdala activity during social reference learning, and further, following social reference learning, show particularly increased response to objects associated with other people's negative reactions? METHOD A total of 32 unmedicated patients with social anxiety disorder and 22 age-, intelligence quotient- and gender-matched healthy individuals responded to objects that had become associated with others' fearful, angry, happy or neutral reactions. RESULTS During the social reference learning phase, a significant group × social context interaction revealed that, relative to the comparison group, the social anxiety group showed a significantly greater response in the amygdala, as well as rostral, dorsomedial and lateral frontal and parietal cortices during the social, relative to non-social, referencing trials. In addition, during the object test phase, relative to the comparison group, the social anxiety group showed increased bilateral amygdala activation to objects associated with others' fearful reactions, and a trend towards decreased amygdala activation to objects associated with others' happy and neutral reactions. CONCLUSIONS These results suggest perturbed observational learning in social anxiety disorder. In addition, they further implicate the amygdala and dorsomedial prefrontal cortex in the disorder, and underscore their importance in future biomarker developments.
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Affiliation(s)
- K. S. Blair
- Address for correspondence: K. S. Blair, Ph.D., Department of Health and Human Services, National Institute of Mental Health, National Institutes of Health, 15K North Drive, Room 115A, MSC 2670, Bethesda, MD 20892-2670, USA. ()
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33
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Jackson MF, Allen RS, Boothe AB, Nava ML, Coates A. Innovative Analyses and Interventions in the Treatment of Selective Mutism. Clin Case Stud 2016. [DOI: 10.1177/1534650103259676] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The authors present a successful, 25-session, multidimensional intervention for the treatment of selectivemutismin a 6-year-old male with a 1-year observational follow-up. They also include an evaluative review of the extant literature of the treatment of selective mutism from 1950 to the present. Their assessment approach utilized behavioral, cognitive, systems, and psychodynamic components. Treatment efficacy was assessed through videotaped observation of behavioral time-samples of the client during therapeutic interaction, self-report, parental report, and real-time behavioral observations at school. Results indicated a significant increase in verbal behaviors during therapy sessions, paired t(17) = 2.31, p= .033. In addition, the client was observed to be verbally interacting with peers and teachers at school at 1-year follow-up. These results suggest that the authors’ multidimensional approach to the treatment of selectivemutismmay offer a successful, brief intervention for those families in which parents decline use of pharmacotherapy in a child.
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Lebowitz ER, Leckman JF, Silverman WK, Feldman R. Cross-generational influences on childhood anxiety disorders: pathways and mechanisms. J Neural Transm (Vienna) 2016; 123:1053-67. [PMID: 27145763 DOI: 10.1007/s00702-016-1565-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 04/29/2016] [Indexed: 12/14/2022]
Abstract
Anxiety disorders are common across the lifespan, cause severe distress and impairment, and usually have their onset in childhood. Substantial clinical and epidemiological research has demonstrated the existence of links between anxiety and its disorders in children and parents. Research on the pathways and mechanisms underlying these links has pointed to both behavioral and biological systems. This review synthesizes and summarizes several major aspects of this research. Behavioral systems include vicarious learning, social referencing, and modeling of parental anxiety; overly protective or critical parenting styles; and aspects of parental responses to child anxiety including family accommodation of the child's symptoms. Biological systems include aspects of the prenatal environment affected by maternal anxiety, development and functioning of the oxytocinergic system, and genetic and epigenetic transmission. Implications for the prevention and treatment of child anxiety disorders are discussed, including the potential to enhance child anxiety treatment outcomes through biologically informed parent-based interventions.
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Affiliation(s)
- Eli R Lebowitz
- Yale Child Study Center, 230 S. Frontage Rd., New Haven, CT, 06515, USA.
| | - James F Leckman
- Yale Child Study Center, 230 S. Frontage Rd., New Haven, CT, 06515, USA
| | - Wendy K Silverman
- Yale Child Study Center, 230 S. Frontage Rd., New Haven, CT, 06515, USA
| | - Ruth Feldman
- Gonda Brain Research, Bar Ilan University, Ramat Gan, Israel
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Chow ET, Otis JD, Simons LE. The Longitudinal Impact of Parent Distress and Behavior on Functional Outcomes Among Youth With Chronic Pain. THE JOURNAL OF PAIN 2016; 17:729-38. [PMID: 26993960 DOI: 10.1016/j.jpain.2016.02.014] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 02/02/2016] [Accepted: 02/23/2016] [Indexed: 01/30/2023]
Abstract
UNLABELLED Accumulating evidence supports the concurrent association between parent distress and behavior and child functioning in the context of chronic pain, with existing longitudinal studies limited to a pediatric surgical context that identify parent catastrophizing as influential. In this study, we examined how parent factors assessed at a multidisciplinary pediatric pain clinic evaluation affect child psychological and functional outcomes over time. A cohort of 195 patients with chronic pain (ages 8-17 years) and their parents who presented for a multidisciplinary evaluation completed measures at baseline and at 4-month follow-up. Patients completed measures of pain catastrophizing, pain-related fear and avoidance, generalized anxiety, depressive symptoms, and functional disability. Parents completed measures of pain catastrophizing, pain-related fear and avoidance, and protective responses to child pain. Parent-reported child school functioning was also collected. Parent distress and behavior was concurrently associated with child distress and functioning at evaluation. After controlling for baseline child functioning, baseline parent avoidance and protective behavior emerged as significant predictors of child functioning at 4-month follow-up. Parent distress and behavior influence child distress and functioning over time and these findings identify key parent domains to target in the context of a child's pain treatment. PERSPECTIVE Parent behavior, specifically avoidance and protective responses, influence child distress and functioning over time. Child pain treatment interventions should include influential parent factors to ensure successful outcomes.
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Affiliation(s)
- Erika T Chow
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts; Boston University School of Medicine, Boston, Massachusetts
| | - John D Otis
- Research Division, VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts; Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Laura E Simons
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; P.A.I.N. Group, Boston Children's Hospital and Center for Pain and the Brain, Boston, Massachusetts.
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Babkirk S, Saunders LV, Solomon B, Kessel EM, Crossman A, Gokhan N, Dennis TA. Executive Function and Temperamental Fear Concurrently Predict Deception in School-Aged Children. JOURNAL OF MORAL EDUCATION 2015; 44:425-439. [PMID: 26880858 PMCID: PMC4752122 DOI: 10.1080/03057240.2015.1087393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The decision to intentionally withhold truthful information, or deception, is a key component of moral development and may be a precursor to more serious anti-social tendencies. Two factors, executive function and temperamental fear are each thought to influence childhood deception. Few studies, however, have explored deception in relation to both of these factors simultaneously. This was the goal of the present study. Executive function, as measured by a working memory task, and temperamental fear, as measured via maternal report were assessed in relation to observed deceptive behavior among 6 - 9-year-old children (N = 43). Results showed that children displaying high working memory capacity and high temperamental fear were more likely to exhibit deceptive behavior. Implications for predictors of childhood deception and applications for moral education are discussed.
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Affiliation(s)
- Sarah Babkirk
- Graduate Center, The City University of New York; Hunter College, The City University of New York
| | | | | | | | - Angela Crossman
- John Jay College of Criminal Justice, The City University of New York
| | - Nurper Gokhan
- LaGuardia Community College, The City University of New York
| | - Tracy A Dennis
- Hunter College, The City University of New York; Graduate Center, The City University of New York
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Salcuni S, Dazzi C, Mannarini S, Di Riso D, Delvecchio E. Parents' perception of children's fear: from FSSC-IT to FSSC-PP. Front Psychol 2015; 6:1199. [PMID: 26322004 PMCID: PMC4532920 DOI: 10.3389/fpsyg.2015.01199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 07/28/2015] [Indexed: 11/13/2022] Open
Abstract
Studies involving parents' reports about children's fears and multiple informant comparisons are less extended than investigations on children's self-reporting fear schedules. Starting with the Italian version of FSSC-R, the FSSC-IT, the main aims of this study were to adapt a schedule for parents' perception of their children's fear: the FSSC-Parent Perception. Its psychometric properties were examined in a large sample of parents (N = 2970) of children aged 8-10 years. Exploratory and confirmatory factorial structures were examined and compared with the Italian children's ones. Mother vs. father, children's gender and school age group effects were analyzed. The confirmatory factor analysis confirmed a four correlated factors solution model (Fear of Danger and Death; Fear of Injury and Animals; Fear of Failure and Criticism; Fear of the unknown and Phobic aspects). Some effects related to child gender, age group, mother vs. father, were found. The FSSC-PP properties supported its use by parents to assess their children's fears. A qualitative analysis of the top 10 fears most endorsed by parents will be presented and compared with children's fears. Clinical implications about the quality of parent-child relationships where discussed, comparing mothers and fathers, and parents' perception about daughters' and sons' most endorsed fears.
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Affiliation(s)
- Silvia Salcuni
- Dipartimento di Psicologia dello Sviluppo e della SocializzazionePadova, Italia
| | - Carla Dazzi
- Dipartimento di Psicologia Applicata, FISSPAPadova, Italia
| | | | - Daniela Di Riso
- Dipartimento di Psicologia dello Sviluppo e della SocializzazionePadova, Italia
| | - Elisa Delvecchio
- Dipartimento di Psicologia dello Sviluppo e della SocializzazionePadova, Italia
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Variations in the influence of parental socialization of anxiety among clinic referred children. Child Psychiatry Hum Dev 2015; 46:474-84. [PMID: 25159312 DOI: 10.1007/s10578-014-0487-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study examined the relations between parental socialization of child anxious behaviors (i.e., reinforcement, punishment, modeling, transmission of information) and child anxiety and related problems at varying child sensitivity levels. Data corresponding to 70 clinic-referred children (M age = 9.86 years; 50% girls; 49% Hispanic/Latino, 51% Caucasian) showed that for children with low (but not high) anxiety sensitivity, anxiety-related parental socialization behaviors were associated with more child anxiety and depression symptoms. Findings also indicated that parental socialization of anxious behaviors and anxiety sensitivity functioned similarly in the prediction of anxiety and depression across Caucasian and Hispanic/Latino children. There were no significant mean level variations across child sociodemographic characteristics in general, but anxiety-promoting parenting behaviors were twice as high in Hispanic/Latino compared to Caucasian families.
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Lebowitz ER, Shic F, Campbell D, MacLeod J, Silverman WK. Avoidance moderates the association between mothers' and children's fears: findings from a novel motion-tracking behavioral assessment. Depress Anxiety 2015; 32:91-8. [PMID: 25424469 DOI: 10.1002/da.22333] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 10/13/2014] [Accepted: 10/14/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fear and anxiety in children are associated with similar symptoms in parents. Parental modeling of fearful or avoidant behavior is believed to contribute to this association. We employed a novel motion-tracking experimentation platform to test the hypothesis that mothers' behavioral avoidance of spiders moderates the association between fear of spiders in mothers and children. METHOD Participants were 86 children (aged 7-17) presenting with an anxiety disorder, and their mothers. Children and mothers completed the Spider Phobia Questionnaire. Mothers completed a motion-tracking assessment of behavioral avoidance of spiders. RESULTS Fear of spiders in mothers was associated with fear of spiders in children (r85 = 0.48, 95%CI 0.30 - 0.63, P < 0.001). Two metrics of behavioral avoidance in mothers were associated with mothers' self-reported fear of spiders (r = -0.49, 95% CI 0.31-0.64, P < 0.001; and r = 0.42, 95%CI 0.23 - 0.58 P < 0.001). Mothers' behavioral avoidance moderated the association between fear of spiders in mothers and in children. When mothers' avoidance was intermediate or high the association was significant, and as mothers' behavioral avoidance increased the strength of the association increased. Fear of spiders in mothers with low behavioral avoidance was not associated with fear of spiders in their children. CONCLUSIONS The study demonstrates that behavioral avoidance can be measured using the motion-tracking platform and can be useful in understanding the links between symptoms of anxiety in mothers and children. Reducing parents' overt expressions of avoidance may lower the risk of fears being transmitted to children.
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Affiliation(s)
- Eli R Lebowitz
- Child Study Center, Yale University, Child Study Center, New Haven, Connecticut
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Muris P, Ollendick TH, Roelofs J, Austin K. The short form of the fear survey schedule for children-revised (FSSC-R-SF): an efficient, reliable, and valid scale for measuring fear in children and adolescents. J Anxiety Disord 2014; 28:957-65. [PMID: 25445086 DOI: 10.1016/j.janxdis.2014.09.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 09/09/2014] [Accepted: 09/26/2014] [Indexed: 01/29/2023]
Abstract
The present study examined the psychometric properties of the Short Form of the Fear Survey Schedule for Children-Revised (FSSC-R-SF) in non-clinical and clinically referred children and adolescents from the Netherlands and the United States. Exploratory as well as confirmatory factor analyses of the FSSC-R-SF yielded support for the hypothesized five-factor structure representing fears in the domains of (1) failure and criticism, (2) the unknown, (3) animals, (4) danger and death, and (5) medical affairs. The FSSC-R-SF showed satisfactory reliability and was capable of assessing gender and age differences in youths' fears and fearfulness that have been documented in previous research. Further, the convergent validity of the scale was good as shown by substantial and meaningful correlations with the full-length FSSC-R and alternative childhood anxiety measures. Finally, support was found for the discriminant validity of the scale. That is, clinically referred children and adolescents exhibited higher scores on the FSSC-R-SF total scale and most subscales as compared to their non-clinical counterparts. Moreover, within the clinical sample, children and adolescents with a major anxiety disorder generally displayed higher FSSC-R-SF scores than youths without such a diagnosis. Altogether, these findings indicate that the FSSC-R-SF is a brief, reliable, and valid scale for assessing fear sensitivities in children and adolescents.
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Affrunti NW, Woodruff-Borden J. Parental Perfectionism and Overcontrol: Examining Mechanisms in the Development of Child Anxiety. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2014; 43:517-29. [DOI: 10.1007/s10802-014-9914-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Meffert H, Brislin SJ, White SF, Blair JR. Prediction errors to emotional expressions: the roles of the amygdala in social referencing. Soc Cogn Affect Neurosci 2014; 10:537-44. [PMID: 24939872 DOI: 10.1093/scan/nsu085] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 06/13/2014] [Indexed: 11/13/2022] Open
Abstract
Social referencing paradigms in humans and observational learning paradigms in animals suggest that emotional expressions are important for communicating valence. It has been proposed that these expressions initiate stimulus-reinforcement learning. Relatively little is known about the role of emotional expressions in reinforcement learning, particularly in the context of social referencing. In this study, we examined object valence learning in the context of a social referencing paradigm. Participants viewed objects and faces that turned toward the objects and displayed a fearful, happy or neutral reaction to them, while judging the gender of these faces. Notably, amygdala activation was larger when the expressions following an object were less expected. Moreover, when asked, participants were both more likely to want to approach, and showed stronger amygdala responses to, objects associated with happy relative to objects associated with fearful expressions. This suggests that the amygdala plays two roles in social referencing: (i) initiating learning regarding the valence of an object as a function of prediction errors to expressions displayed toward this object and (ii) orchestrating an emotional response to the object when value judgments are being made regarding this object.
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Affiliation(s)
- Harma Meffert
- Section of Affective and Cognitive Neuroscience, National Institutes of Health, Bethesda, MD 20892, and Clinical Psychology Program, Florida State University, Tallahassee, FL 32306
| | - Sarah J Brislin
- Section of Affective and Cognitive Neuroscience, National Institutes of Health, Bethesda, MD 20892, and Clinical Psychology Program, Florida State University, Tallahassee, FL 32306
| | - Stuart F White
- Section of Affective and Cognitive Neuroscience, National Institutes of Health, Bethesda, MD 20892, and Clinical Psychology Program, Florida State University, Tallahassee, FL 32306
| | - James R Blair
- Section of Affective and Cognitive Neuroscience, National Institutes of Health, Bethesda, MD 20892, and Clinical Psychology Program, Florida State University, Tallahassee, FL 32306
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43
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Lin YL, Yen YY, Chen HS, Liu YC, Chang CS, Chen CM, Chen FL, Hsu CC, Lee CH, Hu CY, Huang HL. Child dental fear in low-income and non-low-income families: A school-based survey study. J Dent Sci 2014. [DOI: 10.1016/j.jds.2013.02.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Brooker RJ, Neiderhiser JM, Ganiban JM, Leve LD, Shaw DS, Reiss D. Birth and adoptive parent anxiety symptoms moderate the link between infant attention control and internalizing problems in toddlerhood. Dev Psychopathol 2014; 26:347-59. [PMID: 24472311 PMCID: PMC3981904 DOI: 10.1017/s095457941300103x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Attention control plays an important role in the development of internalizing symptoms in children. We explored the degree to which infants' genetic and environmentally based risk moderated the link between attention control and internalizing problems during toddlerhood. These associations were examined within a prospective adoption design, enabling the disentanglement of genetic and environmental risk for internalizing problems. Attention control in adopted infants was observed during periods of distress at age 9 months. Birth parents' anxiety symptoms were used as an index of genetic risk, while adoptive parents' anxiety symptoms were used as an index of environmental risk. Adoptive mothers and fathers reported on children's internalizing problems when children were 18 and 27 months old. Greater attention control in infancy appeared to mitigate genetically based risk for internalizing problems during toddlerhood when children were raised by adoptive parents who were low in anxiety. Findings suggest that for genetically susceptible children who are raised in low-risk environments, attention control may provide a protective factor against developing internalizing problems across early life.
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Aktar E, Majdandžić M, de Vente W, Bögels SM. Parental social anxiety disorder prospectively predicts toddlers' fear/avoidance in a social referencing paradigm. J Child Psychol Psychiatry 2014; 55:77-87. [PMID: 23909453 DOI: 10.1111/jcpp.12121] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/10/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Anxiety runs in families. Observational learning of anxious behavior from parents with anxiety disorders plays an important role in the intergenerational transmission of anxiety. We investigated the link between parental anxiety (parental lifetime anxiety disorders and expressed parental anxiety) and toddler fear/avoidance during social referencing (SR) situations. METHOD Toddlers (N = 117) participated with both parents (with lifetime social anxiety disorder, other nonsocial anxiety disorders, lifetime comorbid social and other anxiety disorders, or without anxiety disorders) in a longitudinal study. Behavioral inhibition (BI) was measured at 12 months via observational tasks. At 30 months, children were confronted with a stranger and a remote-control robot in SR situations, separately with each parent. Children's fear and avoidance, and parents' expressions of anxiety, encouragement, and overcontrol were observed. RESULTS Toddlers of parents with lifetime social anxiety disorder (alone and comorbid with other anxiety disorders) showed more fear/avoidance in SR situations than toddlers of parents without anxiety disorders, while the effect of other anxiety disorders alone was not significant. Although expressed parental anxiety at 30 months in SR situations did not significantly predict toddlers' fear/avoidance, higher levels of expressed anxiety at 12 months in SR situations by parents with comorbid social and other anxiety disorders predicted higher levels of fear/avoidance. BI at 12 months predicted toddlers' fear/avoidance only with mothers, but not with fathers. CONCLUSIONS Parental lifetime social anxiety disorders may be a stronger predictor of children's fear/avoidance than parents' expressions of anxiety in SR situations in toddlerhood. End of infancy may be a sensitive time for learning of anxiety from parents with comorbid lifetime social and nonsocial anxiety disorders in SR situations. Fathers are as important as mothers in the transmission of anxiety via SR. Furthermore, children may act relatively free of their early temperament in SR situations with fathers.
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Affiliation(s)
- Evin Aktar
- Cognitive Science Center Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
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Fisak B, Mann A, Heggeli K. The association between perceptions of parent worry and generalised anxiety disorder symptoms in a community sample of adolescents. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2013. [DOI: 10.1080/02673843.2012.690932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Essau CA, Ishikawa SI, Sasagawa S, Otsui K, Sato H, Okajima I, Georgiou GA, O'Callaghan J, Bray D. Psychopathological symptoms in two generations of the same family: a cross-cultural comparison. Soc Psychiatry Psychiatr Epidemiol 2013; 48:2017-26. [PMID: 23494497 DOI: 10.1007/s00127-013-0673-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Accepted: 02/25/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE The main aims of the present study were to compare the frequency and correlates of psychopathological symptoms in two generations of the same family in Japan and in England. METHODS The sample included 689 adolescents and one of their parents/guardians. All participants completed a set of questionnaires to measure psychopathological symptoms, self-construals, and perceived social support. RESULTS In both parent and adolescent data, the Japanese sample reported significantly lower psychopathological symptoms than the English sample. The relationship between parental and adolescent psychopathology was significant in England, but not in Japan. In both countries, perceived social support and independent self-construal were generally associated with less psychopathological symptoms, and interdependent self-construal was associated with more symptoms. Additionally, in England, a significant interaction effect was found between social support and the self-construals. Participants with low independent and high interdependent self-construal had elevated levels of psychopathological symptoms when perceived social support was low. CONCLUSIONS The present study illustrates the importance of culture in the transmission of psychopathological symptoms across different generations in the same family.
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Affiliation(s)
- Cecilia A Essau
- Department of Psychology, Whitelands College, University of Roehampton, Holybourne Avenue, London, SW15 4JD, UK,
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Abstract
The present study aimed to investigate the common fears and their origins among children and adolescents from different age, gender, and socioeconomic levels (SES). The sample was comprised of 642 females (48.8%) and 673 males (51.2%) with a total of 1,315 participants aged between 8 and 18 (M = 13.15; SD = 3.18). The Fear interview was utilised to examine the common fears and the role of conditioning, modelling and negative information in the development of children's fears. The result showed that the most common fear in Turkey was ‘God’, followed by ‘losing my friends’ and ‘going to Hell’. In addition, the findings revealed that Turkish students are more likely to learn fears by modelling rather than negative information transmission and conditioning. The results also indicated that negative information transmission had a more intensifying effect on the children and adolescents’ existing fear rather than modelling and conditioning. Furthermore, multinomial logistic regression was conducted to examine the effects of age, gender and SES on the origins of fear. Results showed that age and gender were significant predictors of origins of fear.
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Vervoort T, Trost Z, Van Ryckeghem DML. Children's selective attention to pain and avoidance behaviour: the role of child and parental catastrophizing about pain. Pain 2013; 154:1979-1988. [PMID: 23792243 DOI: 10.1016/j.pain.2013.05.052] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 05/22/2013] [Accepted: 05/22/2013] [Indexed: 12/25/2022]
Abstract
The present study investigated selective attention to pain in children, its implications for child avoidance behaviour, and the moderating role of dimensions comprising child and parental catastrophizing about pain (ie, rumination, magnification, and helplessness). Participants were 59 children (31 boys) aged 10-16 years and one of their parents (41 mothers). Children performed a dot-probe task in which child facial pain displays of varying pain expressiveness were presented. Child avoidance behaviour was indexed by child pain tolerance during a cold-pressor task. Children and parents completed measures of child and parent pain catastrophizing, respectively. Findings indicated that both the nature of child selective attention to pain and the impact of selective attention upon child avoidance behaviour were differentially sensitive to specific dimensions of child and parental catastrophizing. Specifically, findings showed greater tendency to shift attention away from pain faces (i.e.,, attentional avoidance) among children reporting greater pain magnification. A similar pattern was observed in terms of parental characteristics, such that children increasingly shifted attention away from pain with increasing levels of parental rumination and helplessness. Furthermore, child attentional avoidance was associated with greater avoidance behaviour (i.e., lower pain tolerance) among children reporting high levels of pain magnification and those whose parents reported greater rumination about pain. The current findings corroborate catastrophizing as a multidimensional construct that may differentially impact outcomes and attest to the importance of assessing both child and parental characteristics in relation to child pain-related attention and avoidance behaviour. Further research directions are discussed.
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Affiliation(s)
- Tine Vervoort
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium Department of Clinical Health Psychology, University of North Texas, Denton, TX, USA
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Okita SY. Self–Other's Perspective Taking: The Use of Therapeutic Robot Companions as Social Agents for Reducing Pain and Anxiety in Pediatric Patients. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2013; 16:436-41. [DOI: 10.1089/cyber.2012.0513] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Sandra Y. Okita
- Department of Mathematics, Science and Technology, Teachers College, Columbia University, New York, New York
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