The correlates and consequences of early appearing social anxiety in young children

Indicated Prevention for Children Screened in Routine Health Care: Effectiveness of a Social Skills Program on Social Anxiety and Depressive Symptoms

Social anxiety is common in childhood and potentially transitions into clinical disorders including depression. The present study aimed to examine the effectiveness of an indicated prevention program for children screened in routine care. Data came from the PROMPt project, a prospective implementation study (10/2018-09/2022) that explored a novel care chain, starting with screening with the Strengths and Difficulties Questionnaire (SDQ) as part of regular health check-ups, followed by indicated assignment and participation in a prevention program. Questionnaires assessing anxiety and depression symptoms were administered shortly after screening or before program participation (T0), six months after screening or after program participation (T1) and at a follow-up, six months after T1 (T2). Children who participated in a group cognitive-behavioral social skills program (TT; n = 145) were compared using mixed model analyses with non-participating children who were either screened as normal (NOR; n = 894) or refused program participation despite indication (NoTT; n = 67). TT scores improved from T0 to T1 compared to NOR and NoTT (anxiety β = -0.71 and β = -0.71, social anxiety β = -0.46 and β = -0.52, depression β = -0.52 and β = -0.73). Improvement was maintained at T2. Moderation analyses showed a trend toward greater benefit for participants with higher baseline scores. Indicated prevention can improve anxiety and depression symptoms in children identified by screening in routine care. Systematic screening and targeted prevention may positively affect mental health of children on a population level.

Assessing anxiety problems in a community sample during toddlerhood: The impact of child temperament and maternal intrusiveness

Previous research indicates that child temperament and maternal behaviors are related to internalizing behaviors in children. We assessed whether maternal intrusiveness (MI) observed at 10-months would moderate the impact of temperamental fear and the impact of inhibitory control (IC) at 24 months on anxiety problems at 36 months. A mother-child interaction task was coded for MI. Behavioral tasks were given to assess children's IC. Parents completed questionnaires about their children's temperamental fear and anxiety problems. Results showed that greater temperamental fear reported at 24 months predicted greater anxiety problems reported at 36 months, regardless of MI levels. Lower levels of IC at 24 months predicted more anxiety problems reported at 36 months when children experienced greater MI. These findings illustrate the importance of examining both intrinsic and extrinsic factors, independently and interactively, that contribute to children's anxiety problems in toddlerhood.

Social feedback biases emerge during recall but not prediction and shift across the development of social anxiety

Memory is a reconstructive process that can result in events being recalled as more positive or negative than they actually were. While positive recall biases may contribute to well-being, negative recall biases may promote internalizing symptoms, such as social anxiety. Adolescence is characterized by increased salience of peers and peak incidence of social anxiety. Symptoms often wax and wane before becoming more intractable during adulthood. Open questions remain regarding how and when biases for social feedback are expressed and how individual differences in biases may contribute to social anxiety across development. Two studies used a social feedback and cued response task to assess biases about being liked or disliked when retrieving memories vs. making predictions. Findings revealed a robust positivity bias about memories for social feedback, regardless of whether memories were true or false. Moreover, memory bias was associated with social anxiety in a developmentally sensitive way. Among adults (study 1), more severe symptoms of social anxiety were associated with a negativity bias. During the transition from adolescence to adulthood (study 2), age strengthened the positivity bias in those with less severe symptoms and strengthened the negativity bias in those with more severe symptoms. These patterns of bias were isolated to perceived memory retrieval and did not generalize to predictions about social feedback. These results provide initial support for a model by which schemas may infiltrate perceptions of memory for past, but not predictions of future, social events, shaping susceptibility for social anxiety, particularly during the transition into adulthood.

COVID-19-related anxiety and trauma symptoms predict decreases in body image satisfaction in children

The present study investigated short-term longitudinal effects of COVID-19-related trauma and separation, social, and generalized anxiety symptoms on children's body image satisfaction. Participants were 247 Canadian children (121 boys, 123 girls) aged between 7 and 12 years (M = 9.04). Two cohorts of parents were recruited to complete a questionnaire at two time points on their children's body image satisfaction and COVID-19-related trauma and anxiety symptoms. The first cohort (n = 136 children) was recruited in Summer 2020 and the second cohort (n = 111 children) was recruited in Winter 2021. For each cohort, follow-up surveys were completed approximately five months later, therefore covering an entire year with both cohorts. Multilevel regression analyses showed that children's trauma and anxiety at Time 1 predicted significant decreases in body image satisfaction at Time 2. Older children were especially at risk of decreased body image satisfaction as a result of their COVID-19-related trauma, social anxiety and generalized anxiety symptoms. Younger girls were susceptible to decreased body image satisfaction as a result of their separation anxiety symptoms. Given that children's body image dissatisfaction is a precursor to the development of eating disorders, these findings shed light on potential targets for early intervention with children who are at-risk of developing such difficulties.

Longitudinal associations between specific types of emotional reactivity and psychological, physical health, and school adjustment

Using a multimethod, multiinformant longitudinal design, we examined associations between specific forms of positive and negative emotional reactivity at age 5, children's effortful control (EC), emotion regulation, and social skills at age 7, and adolescent functioning across psychological, academic, and physical health domains at ages 15/16 (N = 383). We examined how distinct components of childhood emotional reactivity directly and indirectly predict domain-specific forms of adolescent adjustment, thereby identifying developmental pathways between specific types of emotional reactivity and adjustment above and beyond the propensity to express other forms of emotional reactivity. Age 5 high-intensity positivity was associated with lower age 7 EC and more adolescent risk-taking; age 5 low-intensity positivity was associated with better age 7 EC and adolescent cardiovascular health, providing evidence for the heterogeneity of positive emotional reactivity. Indirect effects indicated that children's age 7 social skills partially explain several associations between age 5 fear and anger reactivity and adolescent adjustment. Moreover, age 5 anger reactivity, low-, and high-intensity positivity were associated with adolescent adjustment via age 7 EC. The findings from this interdisciplinary, long-term longitudinal study have significant implications for prevention and intervention work aiming to understand the role of emotional reactivity in the etiology of adjustment and psychopathology.

The influence of outdoor play spaces in urban parks on children's social anxiety

Urban green spaces are critical to the healthy development of children's social interactions and activities. However, the relationship between urban green spaces for children's activities and the alleviation of children's social anxiety remains unclear. In this study, we aimed to explore the link between spatial characteristics and social anxiety in children. To explore the coupling relationships among green space, play space, and social anxiety, an assessment of children's play spaces and levels of social anxiety was performed using self-reported data, OpenStreetMap captured the characteristic indicators of urban parks, and the ArcGIS and SPSS softwares were used for the mathematical analysis. The results showed that (1) both the NDVI and 10-min accessibility were significantly negatively related to children's social anxiety; (2) the diversity of service facilities, surfacing materials, and the attractiveness and challenge of the environment were negatively related to children's social anxiety; (3) there were significant differences between activity types and social anxiety. These results provide design references and a theoretical basis for improving the benefits of urban green space on children's health and wellbeing.

Comparing the Effectiveness of Brain Structural Imaging, Resting-state fMRI, and Naturalistic fMRI in Recognizing Social Anxiety Disorder in Children and Adolescents

Social anxiety disorder (SAD) is a common anxiety disorder in childhood and adolescence. Studies on SAD in adults have reported both structural and functional aberrancies of the brain at the group level. However, evidence has shown differences in anxiety-related brain abnormalities between adolescents and adults. Since children and adolescents can afford limited scan time, optimizing the scan tasks is essential for SAD research in children and adolescents. Thus, we need to address whether brain structure, resting-state fMRI, and naturalistic imaging enable individualized identification of SAD in children and adolescents, which measurement is more effective, and whether pooling multi-modal features can improve the identification of SAD. We comprehensively addressed these questions by building machine learning models based on parcel-wise brain features. We found that naturalistic fMRI yielded higher classification accuracy (69.17%) than the other modalities and the classification performance showed dependence on the contents of the movie. The classification models also identified contributing brain regions, some of which exhibited correlations with the symptoms scores of SAD. However, pooling brain features from the three modalities did not help enhance the classification accuracy. These results support the application of carefully designed naturalistic imaging in recognizing children and adolescents at risk of SAD.

Psychological Counseling during the COVID-19 Pandemic: Clinical Thoughts and Implications Arisen from an Experience in Italian Schools

During the COVID-19 pandemic, I worked as a psychologist in two schools: a comprehensive school (an institution including three school levels: kindergarten, primary school, and secondary school of first grade) and a Provincial Center for the Education of Adults (CPIA). This paper provides some clinical considerations that arose from this personal experience, focusing on practical implications for school psychological counseling. Among the main points, I noticed that students were eager to disclose information about themselves in a professional space, were not afraid of being ridiculed by classmates for attending the service, and spontaneously used artistic media. Using English (a non-native language for both the Italian psychologist and the CPIA student) emerged as an added value for immigrant students who were not fluent in Italian. This allowed them to attend the psychology service and share their thoughts and feelings despite their difficulties with Italian. In conclusion, psychological counseling services should be implemented in all schools and across all school levels worldwide to favor psychological well-being and spread a culture prone to asking for psychological help. Moreover, using a non-native language might be helpful when working with international students. Finally, sandplay therapy (and art) might be an additional option to verbal counseling in school settings.

Loneliness and mental health in children and adolescents with pre-existing mental health problems: A rapid systematic review

OBJECTIVES

Periods of social isolation are associated with loneliness in children and young people, and loneliness is associated with poor mental and physical health. Children and young people with pre-existing mental health difficulties may be prone to loneliness. Containment of COVID-19 has necessitated widespread social isolation, with unprecedented school closures and restrictions imposed on social interactions. This rapid review aimed to establish what is known about the relationship between loneliness and mental health problems in children and young people with pre-existing mental health problems.

METHODS

We sought to identify all primary research that examined the cross-sectional and longitudinal associations between loneliness/perceived social isolation and mental health in children and young people with pre-existing mental health problems. We also aimed to identify effective interventions that reduce the adverse impact of loneliness. A rapid systematic search was conducted using MEDLINE, PsycINFO, and Web of Science.

RESULTS

Of 4,531 papers screened, 15 included children and young people with pre-existing mental health conditions. These 15 studies included 1,536 children and young people aged between 6 and 23 years with social phobia, anxiety and/or depression, and neurodevelopmental disorders. Loneliness was associated with anxiety and depression both cross-sectionally and prospectively in children and young people with mental health problems and neurodevelopmental conditions. We found preliminary evidence that psychological treatments can help to reduce feelings of loneliness in this population.

CONCLUSIONS

Loneliness is associated with depression and anxiety in children and young people with pre-existing mental health conditions, and this relationship may be bidirectional. Existing interventions to address loneliness and/or mental health difficulties in other contexts may be applied to this population, although they may need adaptation and testing in younger children and adolescents.

PRACTITIONER POINTS

Loneliness is common in children and young people, and during periods of enforced social isolation such as during COVID-19, children and young people report high levels of loneliness (or increased rates of loneliness). The review showed that loneliness is associated, both cross-sectionally and prospectively, in children and young people with mental health problems and also in children and young people with neurodevelopmental conditions, such as autism spectrum disorder. Thus, loneliness is a possible risk factor of which mental health providers should be aware. Maintaining social contact both by direct and by indirect means, especially through the Internet, could be important in mitigating loneliness. Interventions to address loneliness should be further developed and tested to help children and young people with pre-existing mental health problems who are lonely by preventing exacerbation of their mental health difficulties, in particular anxiety and depression.

Do Maternal Parenting Behaviors Indirectly Link Toddler Dysregulated Fear and Child Anxiety Symptoms?

Dysregulated fear (DF), display of high-fear in low-threat contexts, has been shown to predict child anxiety development. Maternal protective, comforting, and intrusive behaviors have also been linked to child anxiety development and may be candidate mechanisms linking DF to anxiety. First, the relation between DF (age 2) and child separation anxiety (age 4) as indirectly linked by maternal protective, comforting, and intrusive behaviors was investigated. Second, the relation between DF and social anxiety (age 4) through parenting behaviors was investigated. Results suggested DF significantly predicted child separation anxiety through maternal intrusive behaviors, above and beyond protective and comforting behaviors. Neither protective nor comforting parenting behavior served as indirect effects between DF and separation anxiety. No parenting behaviors were found to indirectly link the relation between DF and social anxiety. Results suggest that multiple parenting behaviors are involved as environmental mechanisms by which DF predicts separation anxiety.

Pupil Mental Health, Concerns and Expectations About Secondary School as Predictors of Adjustment Across the Transition to Secondary School: A Longitudinal Multi-informant Study

The transition from primary to secondary schooling is challenging and involves a degree of apprehension. The extent to which pre-existing mental health difficulties, as well as pupil, parent, and teacher concerns and expectations about secondary school predict adaptation to secondary school, is unclear. In a three-wave, prospective longitudinal study, we examined associations between pre-transition concerns and expectations about moving to secondary school with mental health difficulties and demographic factors. We then evaluated whether these constructs predicted multiple indicators of adaptive pupil functioning at the end of the first year of secondary school (academic attainment, classmate behaviour rating, school liking and loneliness at school). We found children’s concerns reduced across the transition period. Concurrent associations were identified between both concerns about secondary school and lower parent and teacher expectations that children would settle in well at secondary school, with mental health difficulties and special educational needs. Investigating associations with multiple indicators of adaptive functioning at secondary school, multivariable regression analyses controlling for a range of baseline factors (e.g. special educational needs), found children’s concerns about secondary school to be specifically associated with loneliness. In contrast, children’s mental health difficulties and both parent and teacher expectations of how well children would settle into secondary school were associated with a wider range of indicators of adaptive functioning at secondary school. When examining all predictors simultaneously, primary school teacher expectations showed longitudinal association with a wide range of indicators of successful transition. These findings suggest that assessing primary school teacher expectations may be useful for monitoring and supporting pupils through this transition period and could usefully inform school-based interventions to support transition and mental health.

The role of emotion regulation in socially anxious children and adolescents: a systematic review

While numerous studies suggest that emotion dysregulation is important in maintaining social anxiety among adults, the role of emotion regulation in children and adolescents with social anxiety is not yet well understood. In this systematic review, we use the process model of emotion regulation as a framework for understanding emotion regulation in children and adolescents with social anxiety. We performed a systematic literature search in the electronic data bases Medline and PsycINFO. Additional studies were identified by hand search. We identified 683 studies, screened their titles and abstracts, viewed 142 studies, and included 55 of these. Study results indicate that children and adolescents with social anxiety disorder or high social anxiety show emotion dysregulation across all five domains of emotion regulation, such as enhanced social avoidance, more safety behaviors, repetitive negative thinking, biased attention and interpretation of social information, and reduced emotional expression. While enhanced social avoidance seems to be specific to childhood social anxiety, other maladaptive emotion regulation strategies, such as repetitive negative thinking, seem to occur transdiagnostically across different childhood anxiety disorders. Implications for current theory, interventions and future research are discussed.

Behavioral inhibition system and self-esteem as mediators between shyness and social anxiety

Shyness has been demonstrated to be an important factor associating with social anxiety. However, it is less clear on the mechanisms responsible for such association. The aim of the present study was to examine whether behavioral inhibition system (BIS) and self-esteem mediated the relationship between shyness and social anxiety. A sample of 521 healthy volunteers in the age range of 18-25 years completed self-report measures of BIS, self-esteem, shyness and social anxiety. Our correlational analyses showed that shyness was positively associated with social anxiety, supporting the overlapping and continuum hypotheses. Furthermore, BIS was positively correlated with shyness and social anxiety while self-esteem was negatively related to them, indicating that BIS and self-esteem were different in the relation between shyness and social anxiety. Importantly, results from structural equation modeling revealed that the relation between shyness and social anxiety was partially mediated by BIS and self-esteem, which suggested that they might play important roles in the relation between shyness and social anxiety.

Early adolescents' relationships with parents, teachers, and peers and increases in social anxiety symptoms

Previous research on social anxiety has clearly identified interpersonal relationships as important for social anxiety symptoms. Few studies, however, have utilized longitudinal designs and have examined mechanisms that might explain links between negative interpersonal relationships and changes in youths' social anxiety over time. Recent models of social anxiety suggest that negative interpersonal relationships are linked to social anxiety through effects on social skills and behaviors. Using an autoregressive design and a sample of 416 two-parent families (51% female, 91% White), this study examined whether connections among parent-adolescent hostility, teacher support (6th grade), and changes in early adolescent social anxiety symptoms (6th to 8th grades) are mediated by youths' compliance with peers (7th grade). Results indicated that youths who experienced greater parent-adolescent hostility and lower teacher support engaged in greater compliance with peers. In turn, those who engaged in greater compliance with peers experienced increases in social anxiety symptoms. Significant indirect effects were substantiated for only parent-adolescent hostility. Associations were unique to adolescent social anxiety after accounting for depressive symptoms. Associations did not differ for early adolescent girls and boys. The results reveal that nuanced social processes involving social behaviors and relationships with parents and teachers have important and potentially unique implications for changes in early adolescent social anxiety symptoms. (PsycINFO Database Record

Social Anxiety Symptoms in Young Children: Investigating the Interplay of Theory of Mind and Expressions of Shyness

Children’s early onset of social anxiety may be associated with their social understanding, and their ability to express emotions adaptively. We examined whether social anxiety in 48-month-old children (N = 110; 54 boys) was related to: a) a lower level of theory of mind (ToM); b) a lower proclivity to express shyness in a positive way (adaptive); and c) a higher tendency to express shyness in a negative way (non-adaptive). In addition, we investigated to what extent children’s level of social anxiety was predicted by the interaction between ToM and expressions of shyness. Children’s positive and negative expressions of shyness were observed during a performance task. ToM was measured with a validated battery, and social anxiety was assessed using both parents’ reports on questionnaires. Socially anxious children had a lower level of ToM, and displayed more negative and less positive shy expressions. However, children with a lower level of ToM who expressed more positive shyness were less socially anxious. Additional results show that children who displayed shyness only in a negative manner were more socially anxious than children who expressed shyness only in a positive way and children who did not display any shyness. Moreover, children who displayed both positive and negative expressions of shyness were more socially anxious than children who displayed shyness only in a positive way. These findings highlight the importance of ToM development and socio-emotional strategies, and their interaction, on the early development of social anxiety.

Emotional Competence and Anxiety in Childhood and Adolescence: A Meta-Analytic Review

Anxiety is conceptualized as a state of negative emotional arousal that is accompanied by concern about future threat. The purpose of this meta-analytic review was to evaluate the evidence of associations between emotional competence and anxiety by examining how specific emotional competence domains (emotion recognition, emotion expression, emotion awareness, emotion understanding, acceptance of emotion, emotional self-efficacy, sympathetic/empathic responses to others' emotions, recognition of how emotion communication and self-presentation affect relationships, and emotion regulatory processes) relate to anxiety in childhood and adolescence. A total of 185 studies were included in a series of meta-analyses (N's ranged from 573 to 25,711). Results showed that anxious youth are less effective at expressing (r = -0.15) and understanding emotions (r = -0.20), less aware of (r = -0.28) and less accepting of their own emotions (r = -0.49), and report less emotional self-efficacy (r = -0.36). More anxious children use more support-seeking coping strategies (r = 0.07) and are more likely to use less adaptive coping strategies including avoidant coping (r = 0.18), externalizing (r = 0.18), and maladaptive cognitive coping (r = 0.34). Emotion acceptance and awareness, emotional self-efficacy, and maladaptive cognitive coping yielded the largest effect sizes. Some effects varied with children's age. The findings inform intervention and treatment programs of anxiety in youth and identify several areas for future research.

Distinguishing types of social withdrawal in children: Internalizing and externalizing outcomes of conflicted shyness versus social disinterest across childhood

Little research has examined the effect of subtypes of social withdrawal on the development of psychopathology across childhood. Parents of 493 children (220 females) completed a measure of their child's conflicted shyness and social disinterest as well as the Child Behaviour Checklist (CBCL) when their child was age 3, and again at age 6. When children were age 9, parents completed the CBCL. From 3 to 6, conflicted shyness predicted increases in anxiety symptoms in boys and girls, and predicted depressive symptoms in boys. From 6 to 9, social disinterest predicted increases in anxiety symptoms in girls and boys, and predicted increases in depressive symptoms in boys. In addition, in boys, conflicted shyness at age 6 predicted increases in externalizing symptoms at age 9. Conflicted shyness appears to be particularly problematic in early to middle childhood, while social disinterest appears to be more maladaptive in later childhood, with some differences by gender.

Processes and conditions underlying the link between shyness and school adjustment among Turkish children

This study examined the underlying processes and conditions that contribute to the school adjustment of shy children in Turkey, where children's interpersonal relationships in social settings and academic achievement are highly emphasized. First, we examined the unique mediating roles of children's feelings of social anxiety, depressive symptoms, and loneliness in the associations between shyness and indices of school outcomes (academic achievement and school liking/avoidance). Second, we explored the moderating role of children's peer acceptance in these associations. Fourth- and fifth-grade children (N = 599; M_age  = 10.11 years, SD = 0.65; 48% girls) provided information on shyness, social anxiety, depressive symptoms, loneliness, and school liking/avoidance. Head teachers in each classroom reported on students' academic performance. The peer nomination method was used to assess children's peer relationships. Results revealed that when children displayed shy behaviours, they reported more depressive symptoms that were, in turn, associated with poorer academic performance, less school liking, and higher school avoidance. Moreover, shyness negatively predicted school liking at low levels of peer acceptance, suggesting that difficulties in peer relationships increased shy children's risk of school dissatisfaction. Overall, our findings support the importance of the interpersonal relationship context for children's adjustment within the Turkish cultural context. Statement of contribution What is already known on this subject? Shy children have difficulties initiating and maintaining social interactions, which put them at risk for a wide range of socio-emotional difficulties. Shy children have poor academic performance and experience school adjustment difficulties in North America. What does this study add? Shyness is an important risk factor for poorer academic performance and adjustment among children in Turkey. The association between shyness and difficulties at school is explained by children's experience of depressive symptoms. Difficulties with peer relationships increase shy children's risk of school dissatisfaction.

Social Anxiety and Sociometric Nomination in Spanish Students of Compulsory Secondary Education

Adolescents with social anxiety can manifest great interference in their relationship with classmates and other peers, as well as in their school performance. The aim of this study was to analyze the sociometric nominations and assessment of students with high social anxiety by their peers and teachers, and to determine whether these assessments differ significantly between evaluators (peers vs. teachers), in a sample of 2022 (51.1% male) Spanish adolescents aged between 12 and 16 years. Social anxiety was assessed using the Social Phobia and Anxiety Inventory questionnaire. Sociometric identification and assessment of various educational aspects of the students was performed through the Socio program and Teacher assessment scales, respectively. Results show that students with high social anxiety were nominated by peers as popular, rejected and neglected with the same frequency and proportionately less nominated as leaders, friendly, cooperative, and quarrelsome students than those without high social anxiety (d .97). Finally, peers significantly nominated students with high social anxiety more as leaders, cooperative, quarrelsome, obedient and good students than their teachers (d < .42). In conclusion, this study shows that adolescents with high social anxiety are valued and nominated by their peers and teachers differently.

Exploring the longitudinal association between interventions to support the transition to secondary school and child anxiety

School transition at around 11-years of age can be anxiety-provoking for children, particularly those with special educational needs (SEN). The present study adopted a longitudinal design to consider how existing transition strategies, categorized into cognitive, behavioral or systemic approaches, were associated with post-transition anxiety amongst 532 typically developing children and 89 children with SEN. Multiple regression analysis indicated that amongst typically developing pupils, systemic interventions were associated with lower school anxiety but not generalized anxiety, when controlling for prior anxiety. Results for children with SEN differed significantly, as illustrated by a Group × Intervention type interaction. Specifically, systemic strategies were associated with lower school anxiety amongst typically developing children and higher school anxiety amongst children with SEN. These findings highlight strategies that schools may find useful in supporting typically developing children over the transition period, whilst suggesting that children with SEN might need a more personalized approach.

The Social Anxiety and Depression Life Interference-24 Inventory: Classical and modern psychometric evaluations

Two instrument validation studies broadened the research literature exploring the factor structure, internal consistency reliability, and concurrent validity of scores on the Social Anxiety and Depression Life Interference-24 Inventory (SADLI-24; Osman, Bagge, Freedenthal, Guiterrez, & Emmerich, 2011). Study 1 (N = 1065) was undertaken to concurrently appraise three competing factor models for the instrument: a unidimensional model, a two-factor oblique model and a bifactor model. The bifactor model provided the best fit to the study sample data. Study 2 (N = 220) extended the results from Study 1 with an investigation of the convergent and discriminant validity for the bifactor model of the SADLI-24 with multiple regression analyses and scale-level exploratory structural equation modeling. This project yields data that augments the initial instrument development investigations for the target measure.

Predictors of Childhood Anxiety: A Population-Based Cohort Study

Background

Few studies have explored predictors of early childhood anxiety.

Objective

To determine the prenatal, postnatal, and early life predictors of childhood anxiety by age 5.

Methods

Population-based, provincial administrative data (N = 19,316) from Manitoba, Canada were used to determine the association between demographic, obstetrical, psychosocial, medical, behavioral, and infant factors on childhood anxiety.

Results

Risk factors for childhood anxiety by age 5 included maternal psychological distress from birth to 12 months and 13 months to 5 years post-delivery and an infant 5-minute Apgar score of ≤7. Factors associated with decreased risk included maternal age < 20 years, multiparity, and preterm birth.

Conclusion

Identifying predictors of childhood anxiety is a key step to early detection and prevention. Maternal psychological distress is an early, modifiable risk factor. Future research should aim to disentangle early life influences on childhood anxiety occurring in the prenatal, postnatal, and early childhood periods.

A longitudinal study of psychological functioning and academic attainment at the transition to secondary school

This longitudinal study of adolescents in the first year of secondary school, examined the relationship between psychological functioning at the beginning of year 7 (mean age 11.25 years) with attainment at the end of year 7 (mean age 11.78 years). Depressive symptoms, school liking and conduct problems predicted lower attainment across time having controlled for the temporal stability in psychological functioning and attainment. School concerns predicted lower attainment for boys only, and the effects of depressive symptoms on later attainment were significantly stronger for boys compared to girls. School liking - and school concerns for boys - remained significant predictors of attainment when controlling for conduct problems. The transition to secondary school may represent a window of opportunity for developing interventions aimed at improving both pupil psychological functioning and attainment.

Interpersonal behaviors and complementarity in interactions between teachers and kindergartners with a variety of externalizing and internalizing behaviors

The present study investigated whether the complementarity principle (mutual interactive behaviors are opposite on control and similar on affiliation) applies to teacher-child interactions within the kindergarten classroom. Furthermore, it was examined whether interactive behaviors and complementarity depended on children's externalizing and internalizing behaviors, interaction time, and interaction frequency. A total of 48 teachers and 179 selected kindergartners with a variety of externalizing and internalizing behaviors were observed in a small group task setting in the natural ecology of the classroom. Teachers' and children's interactive behaviors were rated by independent observers. Teachers reported about children's externalizing and internalizing behaviors. Multilevel analyses indicated that both teachers and children reacted complementarily on the control dimension but not on the affiliation dimension. Teachers showed more control and more affiliation toward children with higher levels of internalizing behavior. In addition, teachers displayed less affiliation toward children with higher levels of externalizing behavior, whereas those children did not show less affiliation themselves. Teachers' and children's complementarity tendencies on control were weaker if children had higher levels of externalizing behavior.

Self-Disclosure and Mental Health Service Use in Socially Anxious Adolescents

Social anxiety disorder is highly prevalent in adolescence, persistent into adulthood, and associated with multiple impairments. Despite the development of efficacious treatments for socially anxious youth, few affected adolescents receive such treatment. This study examined service use in a sample of high school students (n = 1,574), as well as predictors of treatment delay and factors associated with adolescents' disclosure of social difficulties. Self-report measures of social anxiety and service utilization were administered by study staff to 10th- and 11th-grade classrooms across three public high schools. Consistent with the literature, results indicated low treatment utilization (14 %) and lengthy delays in treatment initiation. Symptom severity, impairment, and disclosing anxiety to school personnel were significant predictors of service utilization. Several demographic and illness-specific factors were associated with a higher likelihood of disclosing social discomfort. These findings underscore the important role of school personnel in identifying and referring youth with anxiety disorders. Implications are discussed for increasing access to services, including school-wide screenings and training of school personnel to recognize and provide intervention for anxious youth.

The Perfectionistic Self-Presentation Scale–Junior Form

This study assessed the psychometric characteristics and correlates of the Perfectionistic Self-Presentation Scale–Junior Form (PSPS-JR). The PSPS-JR was designed for use with children and adolescents, but its psychometric properties and applications among early adolescents have not been investigated. The PSPS-JR has three subscales assessing the perfectionistic self-promotion (i.e., the need to appear perfect), the need to avoid displaying imperfections, and the need to avoid disclosing imperfections to others. A sample of 88 adolescents in Grades 7 and 8 completed the PSPS-JR, the Child–Adolescent Perfectionism Scale, the Dysfunctional Attitudes Scale for Children, and a three-factor measure of social anxiety. Psychometric analyses indicated that two of the PSPS-JR subscales had acceptable levels of internal consistency, but the nondisclosure of imperfection subscale had relatively low internal consistency. Significant links were found between the PSPS-JR subscales and trait perfectionism and dysfunctional attitudes, thus attesting to the concurrent validity of this new measure. Finally, perfectionistic self-presentation was associated robustly with all three social anxiety factors and predicted unique variance in social anxiety, above and beyond trait perfectionism. The findings support the continued use of the PSPS-JR and the assessment of individual differences in perfectionistic self-presentation among early adolescents.

Development and evaluation of the Social Anxiety and Depression Life Interference-24 (SADLI-24) inventory

We describe the development of a new self-report instrument, the Social Anxiety and Depression Life Interference-24 (SADLI-24) inventory. We initially retained 30 content specific items for the instrument (Study 1). In Study 2 (N = 438), we established a 2-factor solution, Social Anxiety Life Interference-12 (SALI-12) and Depression Life Interference-12 (DLI-12). We also examined estimates of known-groups and concurrent validity. Confirmatory factor analysis in Study 3 (N = 430) provided support for the oblique two-factor structure. In Study 4 (N = 179), we provided additional support for estimates of known-groups validity. In Study 5 (N = 63), we evaluated estimates of test-retest reliability. Both SADLI-24 scale scores showed good estimates of internal consistency.

Threat-detection in child development: an evolutionary perspective

Evidence for developmental aspects of fear-targets and anxiety suggests a complex but stable pattern whereby specific kinds of fears emerge at different periods of development. This developmental schedule seems appropriate to dangers encountered repeatedly during human evolution. Also consistent with evolutionary perspective, the threat-detection systems are domain-specific, comprising different kinds of cues to do with predation, intraspecific violence, contamination-contagion and status loss. Proper evolutionary models may also be relevant to outstanding issues in the domain, notably the connections between typical development and pathology.