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Allen KB, Tan PZ, Sullivan JA, Baumgardner M, Hunter H, Glovak SN. An Integrative Model of Youth Anxiety: Cognitive-Affective Processes and Parenting in Developmental Context. Clin Child Fam Psychol Rev 2023; 26:1025-1051. [PMID: 37819403 DOI: 10.1007/s10567-023-00458-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 10/13/2023]
Abstract
Multiple theoretical frameworks have been proposed to provide a more comprehensive picture of the risk factors that influence anxiety-related developmental trajectories. Nonetheless, there remains a need for an integrative model that outlines: (1) which risk factors may be most pertinent at different points in development, and (2) how parenting may maintain, exacerbate, or attenuate an affective style that is characterized by high negative emotional reactivity to unfamiliar, uncertain, and threatening situations. A developmentally informed, integrative model has the potential to guide treatment development and delivery, which is critical to reducing the public health burden associated with these disorders. This paper outlines a model integrating research on many well-established risk mechanisms for anxiety disorders, focusing on (1) the developmental progression from emotional reactivity constructs early in life to those involving higher-level cognitive processes later in youth, and (2) potential pathways by which parenting may impact the stability of youth's cognitive-affective responses to threat-relevant information across development.
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Affiliation(s)
- Kristy Benoit Allen
- Departments of Applied Behavioral Science and Psychology, University of Kansas, Lawrence, KS, USA.
| | - Patricia Z Tan
- Department of Psychiatry/Mental Health, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | | | - Megan Baumgardner
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
| | - Hannah Hunter
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
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Dapprich AL, Becker ES, Derks LM, Legenbauer T, Lange WG. Specific interpretation biases as a function of social anxiety and callous-unemotional traits in a community and a clinical adolescent sample. Child Adolesc Psychiatry Ment Health 2023; 17:46. [PMID: 37004075 PMCID: PMC10064950 DOI: 10.1186/s13034-023-00585-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/28/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Threatening and hostile interpretation biases are seen as causal and maintaining mechanisms of childhood anxiety and aggression, respectively. However, it is unclear whether these interpretation biases are specific to distinct problems or whether they are general psychopathological phenomena. The specificity versus pervasiveness of interpretation biases could also differ depending on mental health status. Therefore, in the current study, we investigated whether social anxiety and callous-unemotional (CU) traits were uniquely related to threatening and hostile interpretation biases, respectively, in both a community and a clinical sample of adolescents. METHODS A total of 161 adolescents between 10 to 15 years of age participated. The community sample consisted of 88 participants and the clinical sample consisted of 73 inpatients with a variety of psychological disorders. Social anxiety and CU-traits were assessed with self-report questionnaires. The Ambiguous Social Scenario Task was used to measure both threatening and hostile interpretations in response to written vignettes. RESULTS Results showed that social anxiety was uniquely related to more threatening interpretations, while CU-traits were uniquely related to more hostile interpretations. These relationships were replicated for the community sample. For the clinical sample, only the link between social anxiety and threatening interpretations was significant. Explorative analyses showed that adolescents with externalizing disorders scored higher on hostile interpretations than adolescents with internalizing disorders. CONCLUSIONS Overall, these results support the content-specificity of threatening interpretation biases in social anxiety and of hostile interpretation biases in CU-traits. Better understanding the roles of interpretation biases in different psychopathologies might open avenues for tailored prevention and intervention paradigms.
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Affiliation(s)
- Anna L Dapprich
- Behavioural Science Institute, Radboud University, 500 HB, Nijmegen, The Netherlands.
| | - Eni S Becker
- Behavioural Science Institute, Radboud University, 500 HB, Nijmegen, The Netherlands
| | - Laura M Derks
- Behavioural Science Institute, Radboud University, 500 HB, Nijmegen, The Netherlands
- LWL-University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr-University Bochum, Bochum, Germany
| | - Tanja Legenbauer
- LWL-University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr-University Bochum, Bochum, Germany
| | - Wolf-Gero Lange
- Behavioural Science Institute, Radboud University, 500 HB, Nijmegen, The Netherlands
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Zhang Q. The Moderation Effect of Cognitive Tendencies on the Relationship Between Fear of COVID-19 and Post-Traumatic Stress Symptoms in Chinese Children. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:1-9. [PMID: 36785698 PMCID: PMC9909653 DOI: 10.1007/s40653-023-00518-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
COVID-19 pandemic is a public health emergency with potential traumatizing effects on children. However, not many studies have been devoted to investigating the association between fear of COVID-19 and post-traumatic stress symptoms (PTSS) in children during the pandemic. Also, if the association is modulated by cognitive tendencies to focus on negative and positive information in children is unknown. The study recruited 122 native Chinese children from a primary school in mainland China. Self-reported psychological inventories were used to assess the above variables. The prevalence rate of PTSS in Chinese children was approximately 15.1%. Girls had higher post-traumatic stress levels than boys. Fear of COVID-19 was associated with higher level of post-traumatic stress in children. Only cognitive tendency to focus on negative information was significantly associated with the level of post-traumatic stress in children. Moreover, cognitive tendency to focus on negative information was a significant moderator of the relationship between fear of COVID-19 and PTSS. Generalization of the results to adults should be cautious. It was concluded that stronger fear of COVID-19 was related to more PTSS in children. The association of fear of COVID-19 with PTSS was significant only for children with strong tendency to focus on negative information. Cognitive interventions for PTSS may need to be delivered to children who have both strong fear of COVID-19 and strong tendency to focus on negative information.
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Affiliation(s)
- Qiaochu Zhang
- Department of Social and Behavioural Sciences, College of Humanities and Social Sciences, City University of Hong Kong, Floor 7, AC1, Tat Chee Avenue Kowloon, Hong Kong
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Anuroj K, Chongbanyatcharoen S, Chiencharoenthanakij R. "Severe Anemia: A Case Report of an Uncommon Precipitant of Schizophrenia Relapse". J Blood Med 2023; 14:329-336. [PMID: 37123984 PMCID: PMC10132291 DOI: 10.2147/jbm.s407722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/11/2023] [Indexed: 05/02/2023] Open
Abstract
A 48-year-old patient with stable residual schizophrenia experienced a syndromic psychosis relapse following an episode of severe combined immunohemolytic and pure red cell aplastic anemia, with a hemoglobin level of 4.7 g/dl. The anemia was attributed to her anti-HIV medication zidovudine. Her HIV infection had been well-controlled; no other organic precipitant of the psychosis was found. Following transfusion of 2 units of leukocyte-poor packed red cells, schizophrenia symptoms promptly recovered to her baseline. This was maintained at 3- and 6-month follow-ups without any need for antipsychotic dose adjustment. Following zidovudine discontinuation and a short course of oral prednisolone, her anemia gradually recovered.
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Affiliation(s)
- Krittisak Anuroj
- Department of Psychiatry, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
- Correspondence: Krittisak Anuroj, Department of Psychiatry, Faculty of Medicine, Srinakharinwirot University, 62 Moo 7 Ongkharak Subdistrict, Ongkharak District, Nakhon Nayok, 26120, Thailand, Tel +6637385085 Ext. 60804, Email
| | - Siwat Chongbanyatcharoen
- Department of Psychiatry, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
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Subar AR, Humphrey K, Rozenman M. Is interpretation bias for threat content specific to youth anxiety symptoms/diagnoses? A systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2022; 31:1341-1352. [PMID: 33616762 DOI: 10.1007/s00787-021-01740-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 02/08/2021] [Indexed: 11/27/2022]
Abstract
Anxiety is the most common mental health problem in youth. Numerous studies have identified that youth anxiety is associated with interpretation bias or the attribution of threatening meaning to ambiguity. Interpretation bias has been proposed as a mechanism underlying the development and maintenance of pediatric anxiety. Theoretically, interpretation bias should be content-specific to individual youth anxiety symptom domains. However, extant studies have reported conflicting findings of whether interpretation bias is indeed content specific to youth anxiety symptoms or diagnoses. The present meta-analysis aimed to synthesize the literature and answer the question: is the relationship between interpretation bias and anxiety content specific? Search of PubMed and PsycINFO databases from January 1, 1960 through May 28, 2019 yielded 9967 citations, of which 19 studies with 20 comparisons and 2976 participants met eligibility criteria. Meta-analysis with random effects models was conducted to examine an overall effect (Pearson r) between anxiety domain and content-specific interpretation bias in single sample studies, and an overall effect size difference (Cohen's d) in studies comparing anxious to non-anxious youth. Results support a content specific correlation between interpretation bias and anxiety symptom domain in single sample studies (r = 0.18, p = 0.03). However, it is currently undetermined whether this relationship holds in studies that compare the relationship between content-specific interpretation bias and anxiety in anxious versus non-anxious youth. A variety of methodologic considerations across studies are discussed, with implications for further investigation of interpretation bias and youth anxiety.
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Affiliation(s)
- Anni R Subar
- Behavioral Research for Anxiety InterVention Efficiency (BRAVE) Lab, Department of Psychology, University of Denver, 2155 S. Race St., Denver, CO, 80210, USA.
| | - Kaeli Humphrey
- Behavioral Research for Anxiety InterVention Efficiency (BRAVE) Lab, Department of Psychology, University of Denver, 2155 S. Race St., Denver, CO, 80210, USA
| | - Michelle Rozenman
- Behavioral Research for Anxiety InterVention Efficiency (BRAVE) Lab, Department of Psychology, University of Denver, 2155 S. Race St., Denver, CO, 80210, USA
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Segal SC, Gobin KC. Threat-biased attention in childhood anxiety: A cognitive-affective developmental model. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Elucidating the neural correlates of emotion recognition in children with sub-clinical anxiety. J Psychiatr Res 2021; 143:75-83. [PMID: 34461352 DOI: 10.1016/j.jpsychires.2021.08.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 05/31/2021] [Accepted: 08/17/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND The pervasiveness of subclinical anxiety in children, highlights the need to identify its neurobiological underpinnings to better inform interventions. Given the now well-established link between aberrant emotion processing and anxiety disorders and yet limited neurobiologically-informed research in this area, this study examined the neural correlates of emotion recognition (ER) in children with sub-clinical anxiety. METHOD Ninety children (aged 9-11 years) with sub-clinical anxiety, completed an emotion recognition task whilst undergoing functional magnetic resonance imaging. The ER task required participants to match shapes and match emotional faces in the context of shape distractors. Participants also completed the Spence Children's Anxiety Scale (SCAS). RESULTS Greater blood oxygenation level dependent (BOLD) changes associated with ER were observed in the lateral occipital cortex, middle frontal gyrus, superior middle frontal gyrus, inferior frontal gyrus, superior parietal lobule, inferior parietal lobule, superior temporal gyrus, and middle temporal gyrus symmetrically. The clusters also included posterior cingulate cortex, insula, hippocampus, amygdala and cerebellum during matching emotions than those matching shapes. Females showed greater BOLD changes associated with ER than males in the right middle frontal gyrus. The BOLD changes associated with ER in the right middle frontal gyrus and right insula were greater in children with SCAS subscale (physical injury fear) scores in the normal range than those with elevated scores. DISCUSSION The findings in this study implicate the right middle frontal gyrus and insula as key regions in the neurobiological underpinnings of sub-clinical anxiety as they relate to attention impairments in anxious children. CONCLUSION The results of this study indicate there are gender differences in young participants during emotion processing and provides a neurobiological target for attention impairments in anxious children.
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Emerging Domain-Based Treatments for Pediatric Anxiety Disorders. Biol Psychiatry 2021; 89:716-725. [PMID: 33451677 DOI: 10.1016/j.biopsych.2020.08.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/19/2020] [Accepted: 08/19/2020] [Indexed: 12/25/2022]
Abstract
Domain-specific cognitive training treatments for pediatric anxiety disorders rely on accurate and reliable identification of specific underlying deficits and biases in neurocognitive functions. Once identified, such biases can serve as specific targets for therapeutic intervention. Clinical translations typically reflect mechanized training protocols designed to rectify the identified biases. Here, we review and synthesize research on key neurocognitive processes that emerge as potential targets for specialized cognitive training interventions in pediatric anxiety disorders in the domains of attention, interpretation, error monitoring, working memory, and fear learning. For each domain, we describe the current status of target establishment (i.e., an association between pediatric anxiety and a specific neurocognitive process), and then review extant translational efforts regarding these targets and the evidence supporting their clinical utility in youths. We then localize each of the domains within the path leading to efficacious, evidence-supported treatments for pediatric anxiety, providing a roadmap for future research. The review indicates that specific cognitive targets in pediatric anxiety have been established in all the reviewed domains except for fear learning, where a clear target is yet to be elucidated. In contrast, evidence for clinical efficacy emerged only in the threat-related attention domain, with some preliminary findings in the domains of interpretation and working memory. The path to clinical translation in the domain of error monitoring is yet unclear. Implications and potential avenues for future research and translation are discussed.
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McLean MA, Van den Bergh BR, Baart M, Vroomen J, van den Heuvel MI. The late positive potential (LPP): A neural marker of internalizing problems in early childhood. Int J Psychophysiol 2020; 155:78-86. [DOI: 10.1016/j.ijpsycho.2020.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 05/16/2020] [Accepted: 06/11/2020] [Indexed: 10/24/2022]
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Ronchi L, Banerjee R, Lecce S. Theory of mind and peer relationships: The role of social anxiety. SOCIAL DEVELOPMENT 2020. [DOI: 10.1111/sode.12417] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Luca Ronchi
- Department of Brain and Behavioral Sciences University of Pavia Pavia Italy
| | | | - Serena Lecce
- Department of Brain and Behavioral Sciences University of Pavia Pavia Italy
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11
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Trait social anxiety as a conditional adaptation: A developmental and evolutionary framework. DEVELOPMENTAL REVIEW 2020. [DOI: 10.1016/j.dr.2019.100886] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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12
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Content-specific interpretation biases in clinically anxious children. Behav Res Ther 2019; 121:103452. [DOI: 10.1016/j.brat.2019.103452] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 07/26/2019] [Accepted: 08/09/2019] [Indexed: 11/19/2022]
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Tyler JM, Panichelli-Mindel SM, Sperrazza C, Levitt MF. A Pilot Study Exploring the Relationship Between Perfectionism and Anxiety in an Urban Middle School. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2019. [DOI: 10.1177/0734282918819949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to identify whether maladaptive perfectionism predicts elevated symptoms of anxiety in a sample of primarily Puerto Rican middle school students. Participants included students ( N = 128) from Grades 6 through 8 (48% male; average age = 11.9 years) who attended an urban, bilingual, public, charter school. Results suggested both general and specific links between maladaptive perfectionism and anxiety disorder symptoms. More specifically, socially-prescribed perfectionism (SPP) uniquely predicted symptoms of panic whereas self oriented perfectionism (SOP) uniquely predicted symptoms of social anxiety across the sample. These findings provide support for the previously established connection between various anxiety symptoms and perfectionism and demonstrate that such a connection exists in Latino adolescents. Given the strong relationship between different types of maladaptive perfectionism and anxiety, theoretical and cultural considerations should be considered to help better understand the nature of how perfectionism is linked to anxiety disorder manifestations. Future studies implementing more control and longitudinal designs may be useful to better understand how perfectionism may function as a transdiagnostic mechanism in the development and maintenance of anxiety in adolescents, and specifically those who identify as Latino.
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Fliek L, Roelofs J, van Breukelen G, Muris P. A Longitudinal Study on the Relations Among Fear-Enhancing Parenting, Cognitive Biases, and Anxiety Symptoms in Non-clinical Children. Child Psychiatry Hum Dev 2019; 50:631-646. [PMID: 30767154 PMCID: PMC6589147 DOI: 10.1007/s10578-019-00868-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
This longitudinal study explored the relations between fear-enhancing parenting behaviors (modeling and threat information transmission) and children's cognitive biases and anxiety symptoms on three subsequent time points over a one-year period. Participants were 216 children aged 7-12 years (114 boys and 102 girls), and their mothers (n = 199) and/or fathers (n = 117). On each time point, children and parents completed the Parental Enhancement of Anxious Cognitions scale, which measures parental modeling and threat information transmission. Furthermore, children filled in a measure of anxiety disorder symptoms. In addition, confirmation bias and interpretation bias were measured by means of a number of computerized tasks. The results yielded support for a circular model in which cognitive biases enhanced anxiety symptoms, which in turn promoted cognitive biases on each of the three time points. However, no evidence was found for longitudinal effects of cognitive biases on anxiety or vice versa. In contrast to what we expected, cognitive biases and anxiety appeared to promote parental modeling and threat information rather than the other way around. These findings extend research on the relations between parenting behaviors, cognitive biases, and childhood anxiety symptoms, and suggest valuable leads for assessment and intervention.
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Affiliation(s)
- Lorraine Fliek
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Jeffrey Roelofs
- 0000 0001 0481 6099grid.5012.6Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Gerard van Breukelen
- 0000 0001 0481 6099grid.5012.6Department of Methodology & Statistics, Faculty of Psychology and Neuroscience & CAPHRI School for Care and Public Health, Maastricht University, Maastricht, The Netherlands
| | - Peter Muris
- 0000 0001 0481 6099grid.5012.6Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands ,0000 0001 2214 904Xgrid.11956.3aStellenbosch University, Stellenbosch, South Africa
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Klein AM, Bakens R, van Niekerk RE, Ouwens MA, Rapee RM, Bögels SM, Becker ES, Rinck M. The relation between generalized anxiety disorder symptoms and content-specific interpretation biases for auditory stimuli in children. J Behav Ther Exp Psychiatry 2018; 61:121-127. [PMID: 29990681 DOI: 10.1016/j.jbtep.2018.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 06/22/2018] [Accepted: 06/29/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Cognitive theories of fear suggest that biases in interpretation are content-specific: Fearful children should only interpret materials negatively if they are specifically related to the content of their fear. So far, there are only a few studies available that report on this postulated content-specificity of interpretation processes in childhood fear. The goal of this study was to examine interpretation bias and its content-specificity in children with varying levels of Generalized Anxiety Disorder (GAD) symptoms. METHODS In an Auditory Interpretation Task (AIT), two words that differ by one phoneme are acoustically blended so that one can hear only one of the words. In the current AIT, we included GAD-related blends, negatively-valenced fear-related blends and positive blends. Multiple-choice (n = 371) or open-ended (n = 295) responses were collected from 666 nonclinical children between 7 and 13 years of age. RESULTS Children with higher levels of self-reported GAD showed significantly more negative interpretations of ambiguous GAD-related blends in the multiple-choice version than children with lower levels of GAD. There were no differences when interpreting the other ambiguous blends. This result was not found with the open-ended version. LIMITATIONS Effects were relatively small, some GAD-stimuli were sub-optimal, and the task was administered in a classroom setting. Even though we ensured that all children were able to hear all words clearly, this may have impacted the results. CONCLUSIONS The findings only partly support the idea that fearful children display cognitive biases specific for fear-relevant stimuli, and more research is needed to replicate the results and test the usability of the AIT.
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Affiliation(s)
- Anke M Klein
- Behavioural Science Institute, Radboud University Nijmegen, the Netherlands; University of Amsterdam, the Netherlands.
| | - Rian Bakens
- Behavioural Science Institute, Radboud University Nijmegen, the Netherlands
| | | | | | - Ronald M Rapee
- Centre for Emotional Health, Macquarie University, Sydney, Australia
| | | | - Eni S Becker
- Behavioural Science Institute, Radboud University Nijmegen, the Netherlands
| | - Mike Rinck
- Behavioural Science Institute, Radboud University Nijmegen, the Netherlands
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Stuijfzand S, Creswell C, Field AP, Pearcey S, Dodd H. Research Review: Is anxiety associated with negative interpretations of ambiguity in children and adolescents? A systematic review and meta-analysis. J Child Psychol Psychiatry 2018; 59:1127-1142. [PMID: 29052865 PMCID: PMC6849625 DOI: 10.1111/jcpp.12822] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND The tendency to interpret ambiguity as threat (negative interpretation) has been implicated in cognitive models of anxiety. A significant body of research has examined the association between anxiety and negative interpretation, and reviews suggest there is a robust positive association in adults. However, evidence with children and adolescents has been inconsistent. This study aimed to provide a systematic quantitative assessment of the association between anxiety and negative interpretation in children and adolescents. METHOD Following systematic searches and screening for eligibility, 345 effects sizes from 77 studies were meta-analysed. RESULTS Overall a medium positive association was found between anxiety and negative interpretation in children and adolescents ( d ^ = .62). Two variables significantly moderated this effect. Specifically, the association increased in strength with increasing age and when the content of ambiguous scenarios matched the anxiety subtype under investigation. CONCLUSIONS Results extend findings from adult literature by demonstrating an association in children and adolescents with evidence for content specificity in the association. Age effects imply a role for development. Results raise considerations for when and for whom clinical treatments for anxiety focusing on interpretation bias are appropriate. The vast majority of studies included in the review have used correlational designs and there are a limited number of studies with young children. The results should be considered with these limitations in mind.
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Affiliation(s)
- Suzannah Stuijfzand
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Cathy Creswell
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | | | - Samantha Pearcey
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Helen Dodd
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
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Ege S, Reinholdt-Dunne ML. Improving Treatment Response for Paediatric Anxiety Disorders: An Information-Processing Perspective. Clin Child Fam Psychol Rev 2018; 19:392-402. [PMID: 27585811 DOI: 10.1007/s10567-016-0211-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cognitive behavioural therapy (CBT) is considered the treatment of choice for paediatric anxiety disorders, yet there remains substantial room for improvement in treatment outcomes. This paper examines whether theory and research into the role of information-processing in the underlying psychopathology of paediatric anxiety disorders indicate possibilities for improving treatment response. Using a critical review of recent theoretical, empirical and academic literature, the paper examines the role of information-processing biases in paediatric anxiety disorders, the extent to which CBT targets information-processing biases, and possibilities for improving treatment response. The literature reviewed indicates a role for attentional and interpretational biases in anxious psychopathology. While there is theoretical grounding and limited empirical evidence to indicate that CBT ameliorates interpretational biases, evidence regarding the effects of CBT on attentional biases is mixed. Novel treatment methods including attention bias modification training, attention feedback awareness and control training, and mindfulness-based therapy may hold potential in targeting attentional biases, and thereby in improving treatment response. The integration of novel interventions into an existing evidence-based protocol is a complex issue and faces important challenges with regard to determining the optimal treatment package. Novel interventions targeting information-processing biases may hold potential in improving response to CBT for paediatric anxiety disorders. Many important questions remain to be answered.
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Affiliation(s)
- Sarah Ege
- Sørlandet Sykehus HF, Kristiansand, Norway
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Scott BG, Pina AA, Parker JH. Reluctance to express emotion explains relation between cognitive distortions and social competence in anxious children. BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2017; 36:402-417. [PMID: 29235136 DOI: 10.1111/bjdp.12227] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 09/26/2017] [Indexed: 11/28/2022]
Abstract
Guided by social information processing and affective social competence models, the focal objective of this research was to examine the relations among anxious children's cognitive distortions, social skill competence, and reluctance to express emotion. In addition, we explored whether children's attention control played any meaningful role. Using a sample of 111 anxious children (Mage = 9.63, SD = 0.73; 75.7% girls; 56% Hispanic/Latino), we found that cognitive distortions were negatively related to social competence. In addition, tests of moderated mediation showed that the negative association between cognitive distortions and social skill competence was indirect via reluctance to express emotion, but this only was the case for anxious children with high attention control and for distortions in the academic domain. The findings of this study may set the stage for new ways to conceptualize the role of higher attention control among anxious youth. Statement of contribution What is already known on this subject? Cognitive errors are prevalent in anxious youth Anxious children show socio-emotion deficits What does this study add? Cognitive errors are related to socio-emotion deficits in anxious youth Relations depend on attention control.
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Affiliation(s)
- Brandon G Scott
- Department of Psychology, Montana State University, Bozeman, Montana, USA
| | - Armando A Pina
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - Julia H Parker
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
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Parker JH, Van Lenten SA, Pina AA. Control Over Anxiety and Dispositional Coping Tendencies Are Associated With Presleep Arousal Among Children Referred for Anxiety Problems. Behav Sleep Med 2017; 15:318-329. [PMID: 27088561 DOI: 10.1080/15402002.2015.1133419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Anxious youth typically experience sleep-related difficulties, but little is known about the role children's coping and perceived control over anxiety may play in these relations. We examined children's perceived levels of control over external anxiety-provoking events and internal anxious emotional reactions, as well as two dispositional coping tendencies (avoidant, support-seeking), and whether these were associated with anxious children's (N = 86) presleep arousal. Low perceived control over anxiety was significantly associated with high levels of presleep arousal. For children with low perceived control, higher avoidance was associated with greater presleep arousal, whereas lower avoidance was associated with lower presleep arousal levels. Findings suggest that efforts to avoid stressful life events may contribute to presleep arousal, especially under conditions where anxious arousal seems uncontrollable.
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Affiliation(s)
- Julia H Parker
- a Department of Psychology , Arizona State University , Tempe , Arizona
| | | | - Armando A Pina
- a Department of Psychology , Arizona State University , Tempe , Arizona
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20
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Gonzalez A, Rozenman M, Langley AK, Kendall PC, Ginsburg GS, Compton S, Walkup JT, Birmaher B, Albano AM, Piacentini J. Social Interpretation Bias in Children and Adolescents with Anxiety Disorders: Psychometric Examination of the Self-report of Ambiguous Social Situations for Youth (SASSY) Scale. CHILD & YOUTH CARE FORUM 2017; 46:395-412. [PMID: 28740356 PMCID: PMC5521277 DOI: 10.1007/s10566-016-9381-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Anxiety disorders are among the most common mental health problems in youth, and faulty interpretation bias has been positively linked to anxiety severity, even within anxiety-disordered youth. Quick, reliable assessment of interpretation bias may be useful in identifying youth with certain types of anxiety or assessing changes on cognitive bias during intervention. OBJECTIVE This study examined the factor structure, reliability, and validity of the Self-report of Ambiguous Social Situations for Youth (SASSY) scale, a self-report measure developed to assess interpretation bias in youth. METHODS Participants (N=488, age 7 to 17) met diagnostic criteria for Social Phobia, Generalized Anxiety Disorder, and/or Separation Anxiety Disorder. An exploratory factor analysis was performed on baseline data from youth participating in a large randomized clinical trial. RESULTS Exploratory factor analysis yielded two factors (Accusation/Blame, Social Rejection). The SASSY full scale and Social Rejection factor demonstrated adequate internal consistency, convergent validity with social anxiety, and discriminant validity as evidenced by non-significant correlations with measures of non-social anxiety. Further, the SASSY Social Rejection factor accurately distinguished children and adolescents with Social Phobia from those with other anxiety disorders, supporting its criterion validity, and revealed sensitivity to changes with treatment. Given the relevance to youth with social phobia, pre- and post-intervention data were examined for youth social phobia to test sensitivity to treatment effects; results suggested that SASSY scores reduced for treatment responders. CONCLUSIONS Findings suggest the potential utility of the SASSY Social Rejection factor as a quick, reliable, and efficient way of assessing interpretation bias in anxious youth, particularly as related to social concerns, in research and clinical settings.
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Affiliation(s)
- Araceli Gonzalez
- California State University, Long Beach, Department of Psychology
| | - Michelle Rozenman
- University of California, Los Angeles Semel Institute for Neuroscience and Human Behavior, Division of Child and Adolescent Psychiatry
| | - Audra K. Langley
- University of California, Los Angeles Semel Institute for Neuroscience and Human Behavior, Division of Child and Adolescent Psychiatry
| | | | | | - Scott Compton
- Duke University Medical Center, Department of Psychiatry and Biobehavioral Sciences
| | - John T. Walkup
- Weill Cornell Medical College, Division of Child and Adolescent Psychiatry
| | - Boris Birmaher
- Western Psychiatric Institute and Clinics, University of Pittsburgh Medical Center
| | | | - John Piacentini
- University of California, Los Angeles Semel Institute for Neuroscience and Human Behavior, Division of Child and Adolescent Psychiatry
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Klein AM, de Voogd L, Wiers RW, Salemink E. Biases in attention and interpretation in adolescents with varying levels of anxiety and depression. Cogn Emot 2017; 32:1478-1486. [PMID: 28366048 DOI: 10.1080/02699931.2017.1304359] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This is the first study to investigate multiple cognitive biases in adolescence simultaneously, to examine whether anxiety and depression are associated with biases in attention and interpretation, and whether these biases are able to predict unique variance in self-reported levels of anxiety and depression. A total of 681 adolescents performed a Dot Probe Task (DPT), an Emotional Visual Search Task (EVST), and an Interpretation Recognition Task. Attention and interpretation biases were significantly correlated with anxiety. Mixed results were reported with regard to depression: evidence was found for an interpretation bias, and for an attention bias as measured with the EVST but not with the DPT. Furthermore, interpretation and attention biases predicted unique variance in anxiety and depression scores. These results indicate that attention and interpretation biases are unique processes in anxiety and depression. They also suggest that anxiety and depression are partly based on similar underlying cognitive mechanisms.
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Affiliation(s)
- Anke M Klein
- a Developmental Psychology , University of Amsterdam , Amsterdam , The Netherlands
| | - Leone de Voogd
- a Developmental Psychology , University of Amsterdam , Amsterdam , The Netherlands
| | - Reinout W Wiers
- a Developmental Psychology , University of Amsterdam , Amsterdam , The Netherlands
| | - Elske Salemink
- a Developmental Psychology , University of Amsterdam , Amsterdam , The Netherlands
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22
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Rozenman M, Vreeland A, Iglesias M, Mendez M, Piacentini J. The tell-tale heart: physiological reactivity during resolution of ambiguity in youth anxiety. Cogn Emot 2017; 32:389-396. [PMID: 28278737 DOI: 10.1080/02699931.2017.1289152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In the past decade, cognitive biases and physiological arousal have each been proposed as mechanisms through which paediatric anxiety develops and is maintained over time. Preliminary studies have found associations between anxious interpretations of ambiguity, physiological arousal, and avoidance, supporting theories that link cognition, psychophysiology, and behaviour. However, little is known about the relationship between youths' resolutions of ambiguity and physiological arousal during acute stress. Such information may have important clinical implications for use of verbal self-regulation strategies and cognitive restructuring during treatments for paediatric anxiety. In this brief report, we present findings suggesting that anxious, but not typically developing, youth select avoidant goals via non-threatening resolution of ambiguity during a stressor, and that this resolution of ambiguity is accompanied by physiological reactivity (heart rate, heart rate variability, and respiratory sinus arrhythmia). We propose future empirical research on the interplay between interpretation bias, psychophysiology, and child anxiety, as well as clinical implications.
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Affiliation(s)
- Michelle Rozenman
- a Division of Child & Adolescent Psychiatry , UCLA Semel Institute for Neuroscience & Human Behavior , Los Angeles , CA , USA
| | - Allison Vreeland
- a Division of Child & Adolescent Psychiatry , UCLA Semel Institute for Neuroscience & Human Behavior , Los Angeles , CA , USA
| | - Marisela Iglesias
- a Division of Child & Adolescent Psychiatry , UCLA Semel Institute for Neuroscience & Human Behavior , Los Angeles , CA , USA
| | - Melissa Mendez
- a Division of Child & Adolescent Psychiatry , UCLA Semel Institute for Neuroscience & Human Behavior , Los Angeles , CA , USA
| | - John Piacentini
- a Division of Child & Adolescent Psychiatry , UCLA Semel Institute for Neuroscience & Human Behavior , Los Angeles , CA , USA
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23
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Klein AM, van Niekerk R, Ten Brink G, Rapee RM, Hudson JL, Bögels SM, Becker ES, Rinck M. Biases in attention, interpretation, memory, and associations in children with varying levels of spider fear: Inter-relations and prediction of behavior. J Behav Ther Exp Psychiatry 2017; 54:285-291. [PMID: 27783965 DOI: 10.1016/j.jbtep.2016.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 10/01/2016] [Accepted: 10/04/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Cognitive theories suggest that cognitive biases may be related and together influence the anxiety response. However, little is known about the interrelations of cognitive bias tasks and whether they allow for an improved prediction of fear-related behavior in addition to self-reports. This study simultaneously addressed several types of cognitive biases in children, to investigate attention bias, interpretation bias, memory bias and fear-related associations, their interrelations and the prediction of behavior. METHODS Eighty-one children varying in their levels of spider fear completed the Spider Anxiety and Disgust Screening for Children and performed two Emotional Stroop tasks, a Free Recall task, an interpretation task including size and distance indication, an Affective Priming Task, and a Behavioral Assessment Test. RESULTS We found an attention bias, interpretation bias, and fear-related associations, but no evidence for a memory bias. The biases showed little overlap. Attention bias, interpretation bias, and fear-related associations predicted unique variance in avoidance of spiders. Interpretation bias and fear-related associations remained significant predictors, even when self-reported fear was included as a predictor. LIMITATIONS Children were not seeking help for their spider fear and were not tested on clinical levels of spider phobia. CONCLUSIONS This is the first study to find evidence that different cognitive biases each predict unique variance in avoidance behavior. Furthermore, it is also the first study in which we found evidence for a relation between fear of spiders and size and distance indication. We showed that this bias is distinct from other cognitive biases.
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Affiliation(s)
- Anke M Klein
- Behavioural Science Institute, Radboud University Nijmegen, The Netherlands.
| | - Rianne van Niekerk
- Behavioural Science Institute, Radboud University Nijmegen, The Netherlands
| | - Giovanni Ten Brink
- Behavioural Science Institute, Radboud University Nijmegen, The Netherlands
| | - Ronald M Rapee
- Centre for Emotional Health, Macquarie University, Australia
| | | | | | - Eni S Becker
- Behavioural Science Institute, Radboud University Nijmegen, The Netherlands
| | - Mike Rinck
- Behavioural Science Institute, Radboud University Nijmegen, The Netherlands
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Rozenman M, Vreeland A, Piacentini J. Thinking anxious, feeling anxious, or both? Cognitive bias moderates the relationship between anxiety disorder status and sympathetic arousal in youth. J Anxiety Disord 2017; 45:34-42. [PMID: 27923164 PMCID: PMC5863750 DOI: 10.1016/j.janxdis.2016.11.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 11/01/2016] [Accepted: 11/15/2016] [Indexed: 01/10/2023]
Abstract
Cognitive bias and physiological arousal are two putative markers that may underlie youth anxiety. However, data on relationships between cognitive bias and arousal are limited, and typically do not include behavioral measurement of these constructs in order to tap real-time processes. We aimed to examine the relationship between performance-based cognitive bias and sympathetic arousal during stress in clinically anxious and typically-developing youth. The sample included children and adolescents ages 9 to 17 (Mean age=13.18, SD=2.60) who either met diagnostic criteria for primary generalized anxiety, social phobia, or separation anxiety (N=24) or healthy controls who had no history of psychopathology (N=22). Youth completed performance-based measures of attention and interpretation bias. Electrodermal activity was assessed while youth participated in the Trier Social Stress Test for Children (TSST-C; Buske-Kirschbaum, Jobst, & Wustmans, 1997). A mixed models analysis indicated significant linear and non-linear changes in skin conductance, with similar slopes for both groups. Interpretation bias, but not attention bias, moderated the relationship between group status and sympathetic arousal during the TSST-C. Arousal trajectories did not differ for anxious and healthy control youth who exhibited high levels of threat interpretation bias. However, for youth who exhibited moderate and low levels of interpretation bias, the anxious group demonstrated greater arousal slopes than healthy control youth. Results provide initial evidence that the relationship between anxiety status and physiological arousal during stress may be moderated by level of interpretation bias for threat. These findings may implicate interpretation bias as a marker of sympathetic reactivity in youth. Implications for future research and limitations are discussed.
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Affiliation(s)
- Michelle Rozenman
- Division of Child & Adolescent Psychiatry, UCLA Semel Institute for Neuroscience & Human Behavior, United States.
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25
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Göbel A, Henning A, Möller C, Aschersleben G. The Relationship between Emotion Comprehension and Internalizing and Externalizing Behavior in 7- to 10-Year-Old Children. Front Psychol 2016; 7:1917. [PMID: 28018262 PMCID: PMC5152120 DOI: 10.3389/fpsyg.2016.01917] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 11/22/2016] [Indexed: 11/13/2022] Open
Abstract
The influence of internalizing and externalizing problems on children’s understanding of others’ emotions has mainly been investigated on basic levels of emotion comprehension. So far, studies assessing more sophisticated levels of emotion comprehension reported deficits in the ability to understand others’ emotions in children with severe internalizing or externalizing symptoms. The aim of this study was to investigate the relation between emotion comprehension and interindividual differences, with a focus on internalizing and externalizing behavior in children aged 7–10 years from the general population. A sample of 135 children was tested for emotion understanding using the Test of Emotion Comprehension. Information on internalizing and externalizing behavior was assessed with the Child Behavior Checklist 4/18. Age, bilingual upbringing, and amount of paternal working hours were significant control variables for emotion comprehension. In contrast to prior research, overall level of emotion understanding was not related to externalizing symptoms and correlated positively with elevated levels of somatic complaints and anxious/depressed symptoms. In addition, and in line with previous work, higher levels of social withdrawal were associated with worse performance in understanding emotions elicited by reminders. The present results implicate not only an altered understanding of emotions among more specific internalizing symptoms, but also that these alterations occur already on a low symptom level in a community based sample.
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Affiliation(s)
- Ariane Göbel
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf Hamburg, Germany
| | - Anne Henning
- Early Intervention Institute, SRH College of Health Gera, Germany
| | - Corina Möller
- Department of Psychology, Developmental Psychology Unit, Saarland University Saarbrücken, Germany
| | - Gisa Aschersleben
- Department of Psychology, Developmental Psychology Unit, Saarland University Saarbrücken, Germany
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26
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Gindt M, Chanquoy L, Garcia R. Modulation of Inhibitory Processing by Posttraumatic Stress Symptoms and Anxiety in a Subclinical Sample of Children. Percept Mot Skills 2016; 123:589-605. [PMID: 27555363 DOI: 10.1177/0031512516666256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In adults, pathologies of anxiety such as posttraumatic stress symptoms (PTSS) involve deficits in information processing that may reflect hypervigilance and deficient inhibitory control, specifically for negative information. However, little is known about inhibitory processing in children, particularly regarding the inhibition of emotional information. This study investigated whether children with PTSS or anxiety show impairments in executive control in an inhibition task. A total of 45 children (M age = 9.2 year, SD = 0.7, range: 8-11) completed an inhibition task involving emotional-happy, angry, and fearful-and neutral stimuli and clinical scales for PTSS and anxiety. The results indicated that the percentage of correct answers was modulated by PTSS status, particularly in the happiness task. PTSS and anxiety altered the inhibition of fearful information in children. These data suggest different types of inhibitory deficits depending on clinical symptoms, and implications are discussed.
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Affiliation(s)
- Morgane Gindt
- Laboratoire Bases, Corpus, Langage, Université Nice Sophia Antipolis and CNRS, Nice, France
| | - Lucile Chanquoy
- Laboratoire Bases, Corpus, Langage, Université Nice Sophia Antipolis and CNRS, Nice, France
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27
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Cognitive styles and psychological functioning in rural South African school students: Understanding influences for risk and resilience in the face of chronic adversity. J Adolesc 2016; 49:38-46. [PMID: 26994348 DOI: 10.1016/j.adolescence.2016.01.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 01/27/2016] [Accepted: 01/31/2016] [Indexed: 01/22/2023]
Abstract
Adverse childhood experiences can show lasting effects on physical and mental health. Major questions surround how children overcome adverse circumstances to prevent negative outcomes. A key factor determining resilience is likely to be cognitive interpretation (how children interpret the world around them). The cognitive interpretations of 1025 school children aged 10-12 years in a rural, socioeconomically disadvantaged area of South Africa were examined using the Cognitive Triad Inventory for Children (CTI-C). These were examined in relation to psychological functioning and perceptions of the school environment. Those with more positive cognitive interpretations had better psychological functioning on scales of depression, anxiety, somatization and sequelae of potentially traumatic events. Children with more negative cognitions viewed the school-environment more negatively. Children living in poverty in rural South Africa experience considerable adversity and those with negative cognitions are at risk for psychological problems. Targeting children's cognitive interpretations may be a possible area for intervention.
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28
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Sonuga-Barke EJS, Cortese S, Fairchild G, Stringaris A. Annual Research Review: Transdiagnostic neuroscience of child and adolescent mental disorders--differentiating decision making in attention-deficit/hyperactivity disorder, conduct disorder, depression, and anxiety. J Child Psychol Psychiatry 2016; 57:321-49. [PMID: 26705858 PMCID: PMC4762324 DOI: 10.1111/jcpp.12496] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND Ineffective decision making is a major source of everyday functional impairment and reduced quality of life for young people with mental disorders. However, very little is known about what distinguishes decision making by individuals with different disorders or the neuropsychological processes or brain systems underlying these. This is the focus of the current review. SCOPE AND METHODOLOGY We first propose a neuroeconomic model of the decision-making process with separate stages for the prechoice evaluation of expected utility of future options; choice execution and postchoice management; the appraisal of outcome against expectation; and the updating of value estimates to guide future decisions. According to the proposed model, decision making is mediated by neuropsychological processes operating within three domains: (a) self-referential processes involved in autobiographical reflection on past, and prospection about future, experiences; (b) executive functions, such as working memory, inhibition, and planning, that regulate the implementation of decisions; and (c) processes involved in value estimation and outcome appraisal and learning. These processes are underpinned by the interplay of multiple brain networks, especially medial and lateralized cortical components of the default mode network, dorsal corticostriatal circuits underpinning higher order cognitive and behavioral control, and ventral frontostriatal circuits, connecting to brain regions implicated in emotion processing, that control valuation and learning processes. FINDINGS AND CONCLUSION Based on clinical insights and considering each of the decision-making stages in turn, we outline disorder-specific hypotheses about impaired decision making in four childhood disorders: attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), depression, and anxiety. We hypothesize that decision making in ADHD is deficient (i.e. inefficient, insufficiently reflective, and inconsistent) and impulsive (biased toward immediate over delayed alternatives). In CD, it is reckless and insensitive to negative consequences. In depression, it is disengaged, perseverative, and pessimistic, while in anxiety, it is hesitant, risk-averse, and self-deprecating. A survey of current empirical indications related to these disorder-specific hypotheses highlights the limited and fragmentary nature of the evidence base and illustrates the need for a major research initiative in decision making in childhood disorders. The final section highlights a number of important additional general themes that need to be considered in future research.
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Affiliation(s)
- Edmund J S Sonuga-Barke
- Developmental Brain-Behaviour Laboratory, Academic Unit of Psychology, University of Southampton, Southampton, UK
| | - Samuele Cortese
- Developmental Brain-Behaviour Laboratory, Academic Unit of Psychology, University of Southampton, Southampton, UK
- Child Study Center at NYU Langone Medical Center, New York, NY, USA
| | - Graeme Fairchild
- Developmental Brain-Behaviour Laboratory, Academic Unit of Psychology, University of Southampton, Southampton, UK
| | - Argyris Stringaris
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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29
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30
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Interpretation modification training reduces social anxiety in clinically anxious children. Behav Res Ther 2015; 75:78-84. [PMID: 26580081 DOI: 10.1016/j.brat.2015.10.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 10/15/2015] [Accepted: 10/20/2015] [Indexed: 11/20/2022]
Abstract
The present study was designed to examine the effects of training in positive interpretations in clinically anxious children. A total of 87 children between 7 and 12 years of age were randomly assigned to either a positive cognitive bias modification training for interpretation (CMB-I) or a neutral training. Training included 15 sessions in a two-week period. Children with an interpretation bias prior to training in the positive training group showed a significant reduction in interpretation bias on the social threat scenarios after training, but not children in the neutral training group. No effects on interpretation biases were found for the general threat scenarios or the non-threat scenarios. Furthermore, children in the positive training did not self-report lower anxiety than children in the neutral training group. However, mothers and fathers reported a significant reduction in social anxiety in their children after positive training, but not after neutral training. This study demonstrated that clinically anxious children with a prior interpretation bias can be trained away from negative social interpretation biases and there is some evidence that this corresponds to reductions in social anxiety. This study also highlights the importance of using specific training stimuli.
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31
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Valadão Dias F, Oliveira RV, Leal I, Maroco J. Positive and Negative Thoughts in Ambiguous Anxiety-Related Stories: The Child’s Perspective. PSYCHOLOGY, COMMUNITY & HEALTH 2015. [DOI: 10.5964/pch.v4i1.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aim To evaluate the presence/absence, frequency of cognitive products (positive, negative and neutral thoughts) in a Portuguese community sample of children aged 10 and 11 years. Method A total of 274 children participated in this study, 151 girls and 123 boys, from the 5th and 6th grades, aged 10 and 11 years. Cognitive products were accessed through children’s cognitive responses to the Nine Ambiguous Stories. Results The answers to the nine stories produced 6,633 thoughts (positive - 2,570, negative - 4,063, neutral - 32). The number of positive and negative thoughts varied according to the stories. The absence of either positive or negative thoughts was observed in a very small number of children. The simultaneous presence of positive and negative thoughts per child occurred in all stories. More than half of the children showed more negative thoughts in all stories except for stories 2 and 6. Conclusion The results of this study contribute to the understanding of cognitive development of children, based on what is known and observed in the child and calls attention to the importance of the research of positive and negative content of thoughts shown by children and their impact on childhood anxiety.
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32
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Micco JA. Information-Processing Biases in Children and Adolescents:An Introduction to the Special Issue. J Cogn Psychother 2015; 29:167-170. [PMID: 32755945 DOI: 10.1891/0889-8391.29.3.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This special issue focuses on new developments in research on information-processing biases in children and adolescents. Prior research suggests that attention and interpretation biases in response to emotional stimuli may be associated with the etiology and maintenance of anxiety and depression in youth. Although our understanding of youth biases has burgeoned over the past decade, questions remain regarding mixed findings across studies, heterogeneity of biases across individuals, specific factors that contribute to and maintain biases, and how best to maximize the efficacy of interventions designed to modify biases. Through the use of innovative methods and technology, the articles in this special issue illustrate progress being made toward filling these gaps in our knowledge and showcase some of the exciting new developments in this area of research.
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Affiliation(s)
- Jamie A Micco
- Massachusetts General Hospital, Boston Harvard Medical School, Boston, Massachusetts
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33
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Performance-based interpretation bias in clinically anxious youths: relationships with attention, anxiety, and negative cognition. Behav Ther 2014; 45:594-605. [PMID: 25022771 DOI: 10.1016/j.beth.2014.03.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 01/22/2014] [Accepted: 03/01/2014] [Indexed: 11/21/2022]
Abstract
This preliminary investigation sought to examine basic interpretive biases, as assessed via performance-based means, in the context of anxious symptomatology, attention, and negative cognition in children and adolescents. At a single assessment, 26 youths diagnosed with primary separation anxiety, social phobia, or generalized anxiety disorder completed performance-based assessments of interpretation and attention. Youths and parents also completed diagnostic interviews and youths completed a measure of negative self-statements. Components of interpretation (threat-valence judgments and speed of responding) were examined, and interpretation was explored as a correlate of youth anxiety, attention bias, and negative self-statements. Results found percentage of negative interpretations endorsed as the strongest predictor of anxiety symptoms; this index was also correlated with attention bias. Slower rejection of benign interpretations was also associated with youth-reported negative self-statements.This initial investigation provides support for a relationship between interpretation bias and anxiety and preliminary evidence for a relationship between attention and interpretation biases. Continued research dismantling the stages of basic cognition within the chain of information processing may provide a better understanding of the mechanisms underlying anxiety disorders in youths and lead to continued development and refinement of cognitive interventions.
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34
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De Voogd EL, Wiers RW, Prins PJM, Salemink E. Visual search attentional bias modification reduced social phobia in adolescents. J Behav Ther Exp Psychiatry 2014; 45:252-9. [PMID: 24361543 DOI: 10.1016/j.jbtep.2013.11.006] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Revised: 11/25/2013] [Accepted: 11/26/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES An attentional bias for negative information plays an important role in the development and maintenance of (social) anxiety and depression, which are highly prevalent in adolescence. Attention Bias Modification (ABM) might be an interesting tool in the prevention of emotional disorders. The current study investigated whether visual search ABM might affect attentional bias and emotional functioning in adolescents. METHODS A visual search task was used as a training paradigm; participants (n = 16 adolescents, aged 13-16) had to repeatedly identify the only smiling face in a 4 × 4 matrix of negative emotional faces, while participants in the control condition (n = 16) were randomly allocated to one of three placebo training versions. An assessment version of the task was developed to directly test whether attentional bias changed due to the training. Self-reported anxiety and depressive symptoms and self-esteem were measured pre- and post-training. RESULTS After two sessions of training, the ABM group showed a significant decrease in attentional bias for negative information and self-reported social phobia, while the control group did not. There were no effects of training on depressive mood or self-esteem. LIMITATIONS No correlation between attentional bias and social phobia was found, which raises questions about the validity of the attentional bias assessment task. Also, the small sample size precludes strong conclusions. CONCLUSIONS Visual search ABM might be beneficial in changing attentional bias and social phobia in adolescents, but further research with larger sample sizes and longer follow-up is needed.
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Affiliation(s)
- E L De Voogd
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands.
| | - R W Wiers
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands.
| | - P J M Prins
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands.
| | - E Salemink
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands.
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Seager I, Rowley AM, Ehrenreich-May J. Targeting Common Factors Across Anxiety and Depression Using the Unified Protocol for the Treatment of Emotional Disorders in Adolescents. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2014. [DOI: 10.1007/s10942-014-0185-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hessels C, van den Hanenberg D, de Castro BO, van Aken MAG. Relationships: empirical contribution. Understanding personality pathology in adolescents: the five factor model of personality and social information processing. J Pers Disord 2014; 28:121-42. [PMID: 24344893 DOI: 10.1521/pedi.2014.28.1.121] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study seeks to integrate two research traditions that lie at the base of the understanding of personality pathology in adolescents. The first research tradition refers to normal personality according to the Five Factor Model (FFM). The second tradition specifies the key feature of personality disorder as the capacity to mentalize, which can be reflected in Social Information Processing (SIP). In a clinical sample of 96 adolescents, the authors investigated response generation, coping strategy, and memories of past frustrating experiences as part of SIP, as mediator in the relationship between personality and personality pathology, and a possible moderating role of personality on the relationship between SIP and personality pathology. The hypothesized mediation, by which the effects of personality dimensions on personality pathology was expected to be mediated by SIP variables, was found only for the effect of Neuroticism, most specifically on BPD, which appeared to be mediated by memories the patients had about past frustrating conflict situations with peers. Some moderating effects of personality on the relationship between SIP variables and personality pathology were found, suggesting that high Agreeableness and sometimes low Neuroticism can buffer this relationship. These results suggest that personality dimensions and social cognitions both independently and together play a role in adolescents' personality pathology.
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Dirks MA, Treat TA, Weersing VR. Youth’s Responses to Peer Provocation: Links to Symptoms of Anxiety and Depression. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2014. [DOI: 10.1007/s10862-014-9406-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Creswell C, Murray L, Cooper P. Interpretation and expectation in childhood anxiety disorders: age effects and social specificity. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2014; 42:453-65. [PMID: 24293002 PMCID: PMC3936123 DOI: 10.1007/s10802-013-9795-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Theory and treatment for childhood anxiety disorders typically implicates children's negative cognitions, yet little is known about the characteristics of thinking styles of clinically anxious children. In particular, it is unclear whether differences in thinking styles between children with anxiety disorders and non-anxious children vary as a function of child age, whether particular cognitive distortions are associated with childhood anxiety disorders at different child ages, and whether cognitive content is disorder-specific. The current study addressed these questions among 120 7-12 year old children (53% female) who met diagnostic criteria for social anxiety disorder, other anxiety disorder, or who were not currently anxious. Contrary to expectations, threat interpretation was not inflated amongst anxious compared to non-anxious children at any age, although older (10-12 year old) anxious children did differ from non-anxious children on measures of perceived coping. The notion of cognitive-content specificity was not supported across the age-range. The findings challenge current treatment models of childhood anxiety, and suggest that a focus on changing anxious children's cognitions is not warranted in mid-childhood, and in late childhood cognitive approaches may be better focussed on promoting children's perceptions of control rather than challenging threat interpretations.
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Affiliation(s)
- Cathy Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6AL, UK,
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Brown HM, Eley TC, Broeren S, Macleod C, Rinck M, Hadwin JA, Lester KJ. Psychometric properties of reaction time based experimental paradigms measuring anxiety-related information-processing biases in children. J Anxiety Disord 2014; 28:97-107. [PMID: 24486916 DOI: 10.1016/j.janxdis.2013.11.004] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 10/29/2013] [Accepted: 11/16/2013] [Indexed: 10/26/2022]
Abstract
Theoretical frameworks highlight the importance of threat-related information-processing biases for understanding the emergence of anxiety in childhood. The psychometric properties of several tasks measuring these biases and their associations with anxiety were examined in an unselected sample of 9-year-old children (N=155). In each task, threat bias was assessed using bias scores reflecting task performance on threat versus non-threat conditions. Reliability was assessed using split-half and test-retest correlations of mean reaction times (RTs), accuracy and bias indices. Convergence between measures was also examined. Mean RTs showed substantial split-half and test-retest correlations. Bias score reliability coefficients were near zero and non-significant, suggesting poor reliability in children of this age. Additionally, associations between bias scores and anxiety were weak and inconsistent and performance between tasks showed little convergence. Bias scores from RT based paradigms in the current study lacked adequate psychometric properties for measuring individual differences in anxiety-related information-processing in children.
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Affiliation(s)
- H M Brown
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, United Kingdom
| | - T C Eley
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, United Kingdom
| | - S Broeren
- Department of Public Health, Erasmus Medical Centre, Rotterdam, Netherlands
| | - C Macleod
- Centre for the Advancement of Research on Emotion, University of Western Australia, Australia
| | - M Rinck
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - J A Hadwin
- Department of Psychology, University of Southampton, United Kingdom
| | - K J Lester
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, United Kingdom.
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Sharma S, Woolfson LM, Hunter SC. Maladaptive cognitive appraisals in children with high-functioning autism: associations with fear, anxiety and theory of mind. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2013; 18:244-54. [PMID: 24092841 DOI: 10.1177/1362361312472556] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Despite the well-documented success of cognitive restructuring techniques in the treatment of anxiety disorders, there is still little clarity on which cognitions underpin fear and anxiety in children with high-functioning autism spectrum disorder. This study examined whether certain cognitive appraisals, known to be associated with fear and anxiety in typically developing groups, may help explain these emotions in children with high-functioning autism spectrum disorder. It also investigated relations between these cognitive appraisals and theory of mind. Appraisals, fear and anxiety were assessed using a vignette approach in 22 children with high-functioning autism spectrum disorders and 22 typically developing children. The two groups differed significantly on all four appraisal types. Anxiety was negatively correlated with future expectancy and positively with problem-focused coping potential in the high-functioning autism spectrum disorder group but was not correlated with appraisals in the typically developing group. The two appraisals associated with fear were emotion-focused coping potential (in the high-functioning autism spectrum disorder group only) and self-accountability (in the typically developing group only). Linear regression analysis found that appraisals of emotion-focused coping potential, problem-focused coping potential and future expectancy were significant predictors of theory-of-mind ability in the high-functioning autism spectrum disorders group. These findings indicate that specific, problematic patterns of appraisal may characterise children with high-functioning autism spectrum disorders.
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Lu W, Daleiden E, Pratt S, Shay A, Stone B, Asaku-Yeboah M. Life events and internalizing problems among Chinese school children: An examination of the cognitive diathesis model. ASIAN JOURNAL OF SOCIAL PSYCHOLOGY 2013. [DOI: 10.1111/ajsp.12036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Weili Lu
- University of Medicine and Dentistry of New Jersey; Scotch Plains New Jersey USA
| | | | - Sarah Pratt
- Dartmouth Medical School; Hanover New Hampshire USA
| | - Alexander Shay
- University of Medicine and Dentistry of New Jersey; Scotch Plains New Jersey USA
| | - Brittany Stone
- University of Medicine and Dentistry of New Jersey; Scotch Plains New Jersey USA
| | - Michael Asaku-Yeboah
- University of Medicine and Dentistry of New Jersey; Scotch Plains New Jersey USA
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Goal internalization and outcome expectancy in adolescent anxiety. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2013; 41:389-97. [PMID: 23054131 DOI: 10.1007/s10802-012-9685-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Anxiety has been conceptualized in terms of increased avoidance motivation and higher expectancies of undesirable outcomes. However, anxiety research has hitherto not examined an important qualitative aspect of motivation: the degree to which reasons for goal pursuit are experienced as controlling and originating outside the core self. We asked 70 adolescents (34 boys, 36 girls; aged 16-18 years) to list their important approach and avoidance goals, and rate the extent to which they pursued each goal for intrinsic, identified, introjected and external reasons. Participants also rated goal importance, expectancies for goal outcomes, and completed an anxious symptom measure. Broadly in line with predictions, anxiety was significantly associated with introjected reasons for pursuing approach goals and external reasons for pursuing avoidance goals but not with autonomous reasons for goal pursuit. As predicted, anxiety was significantly associated with heightened expectancies of undesirable avoidance goal outcomes, but not with expectancies for desirable approach goal outcomes. Results suggest that the salient role of avoidance-based motivation in anxiety extends to introjected reasons underlying approach goal pursuit. Our findings point to the theoretical and clinical importance of addressing controlled reasons for goal pursuit in adolescent anxiety.
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Maniglio R. Child sexual abuse in the etiology of anxiety disorders: a systematic review of reviews. TRAUMA, VIOLENCE & ABUSE 2013; 14:96-112. [PMID: 23262751 DOI: 10.1177/1524838012470032] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
There is considerable controversy about the role of child sexual abuse in the etiology of anxiety disorders. Although a growing number of research studies have been published, these have produced inconsistent results and conclusions regarding the nature of the associations between child sexual abuse and the various forms of anxiety problems as well as the potential effects of third variables, such as moderators, mediators, or confounders. This article provides a systematic review of the several reviews that have investigated the literature on the role of child sexual abuse in the etiology of anxiety disorders. Seven databases were searched, supplemented with hand search of reference lists from retrieved papers. Four meta-analyses, including 3,214,482 subjects from 171 studies, were analyzed. There is evidence that child sexual abuse is a significant, although general and nonspecific, risk factor for anxiety disorders, especially posttraumatic stress disorder, regardless of gender of the victim and severity of abuse. Additional biological or psychosocial risk factors (such as alterations in brain structure or function, information processing biases, parental anxiety disorders, family dysfunction, and other forms of child abuse) may interact with child sexual abuse or act independently to cause anxiety disorders in victims in abuse survivors. However, child sexual abuse may sometimes confer additional risk of developing anxiety disorders either as a distal and indirect cause or as a proximal and direct cause. Child sexual abuse should be considered one of the several risk factors for anxiety disorders and included in multifactorial etiological models for anxiety disorders.
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Affiliation(s)
- Roberto Maniglio
- Department of Pedagogic, Psychological, and Didactic Sciences, University of Salento, Lecce, Italy.
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Abstract
Abstract
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Klein AM, Kleinherenbrink AV, Simons C, de Gier E, Klein S, Allart E, Bögels SM, Becker ES, Rinck M. Subjective fear, interference by threat, and fear associations independently predict fear-related behavior in children. J Behav Ther Exp Psychiatry 2012; 43:952-8. [PMID: 22465881 DOI: 10.1016/j.jbtep.2012.02.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Revised: 02/24/2012] [Accepted: 02/29/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Several information-processing models highlight the independent roles of controlled and automatic processes in explaining fearful behavior. Therefore, we investigated whether direct measures of controlled processes and indirect measures of automatic processes predict unique variance components of children's spider fear-related behavior. METHOD Seventy-seven children between 8 and 13 years performed an Affective Priming Task (APT) measuring associative bias, a pictorial version of the Emotional Stroop Task (EST) measuring attentional bias, filled out the Spider Anxiety and Disgust Screening for Children (SADS-C) in order to assess self-perceived fear, and took part in a Behavioral Assessment Test (BAT) to measure avoidance of spiders. RESULTS The SADS-C, EST, and APT did not correlate with each other. Spider fear-related behavior was best explained by SADS-C, APT, and EST together; they explained 51% of the variance in BAT behavior. LIMITATIONS No children with clinical levels of spider phobia were tested. The direct and the different indirect measures did no correlate with each other. CONCLUSIONS These results indicate that both direct and indirect measures are useful for predicting unique variance components of fear-related behavior in children. The lack of relations between direct and indirect measures may explain why some earlier studies did not find stronger color-naming interference or stronger fear associations in children with high levels of self-reported fear. It also suggests that children with high levels of spider-fearful behavior have different fear-related associations and display higher interference by spider stimuli than children with non-fearful behavior.
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Affiliation(s)
- Anke M Klein
- Behavioural Science Institute, Radboud University Nijmegen, The Netherlands.
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Moshe K, Karni A, Tirosh E. Anxiety and methylphenidate in attention deficit hyperactivity disorder: a double-blind placebo-drug trial. ACTA ACUST UNITED AC 2012; 4:153-8. [DOI: 10.1007/s12402-012-0078-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 05/07/2012] [Indexed: 11/24/2022]
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Muris P, van Doorn M. “Danger is Lurking Everywhere, Even in Parts of a Jigsaw Puzzle”: Anxiety-related Threat Perception Abnormalities in Children: Their Assessment with Projective Material. BEHAVIOUR CHANGE 2012. [DOI: 10.1375/bech.20.3.151.24835] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractThe present study examined the relationship between anxiety and depression, on the one hand, and reduced evidence for danger (RED) bias and other threat perception abnormalities, on the other hand. A nonclinical sample of school children (N = 138) completed a brief measure of childhood anxiety and depression symptoms and were then exposed to a series of pictures taken from projective tests. Results showed that (a) anxiety was accompanied by RED bias and other threat perception abnormalities, (b) depression was less convincingly associated with such cognitive distortions, and (c) anxiety-related threat perception abnormalities were not merely the result of a stronger tendency to give affirmative responses. The role of threat perception abnormalities in the pathogenesis of childhood anxiety as well as the clinical implications of these cognitive phenomena are briefly discussed.
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Micco JA, Hirshfeld-Becker DR, Henin A, Ehrenreich-May J. Content Specificity of Threat Interpretation in Anxious and Non-Clinical Children. COGNITIVE THERAPY AND RESEARCH 2012. [DOI: 10.1007/s10608-012-9438-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
BACKGROUND Childhood worry is common, and yet little is known about why some children develop pathological worry and others do not. Two theories of adult worry that are particularly relevant to children are Davey's problem-solving model in which perseverative worry occurs as a result of thwarted problem-solving attempts, and Wells' metacognitive model, in which positive and negative beliefs about worry interact to produce pathological worry. AIMS The present study aimed to test hypotheses that levels of worry in young children are associated with poor or avoidant solution generation for social problems, and poor problem-solving confidence. It also aimed to explore beliefs about worry in this age group, and to examine their relationships with worry, anxiety and age. METHOD Fifty-seven young children (6-10 years) responded to open ended questions about social problem-solving situations and beliefs about worry, and completed measures of worry, anxiety and problem-solving confidence. RESULTS Children with higher levels of worry and anxiety reported using more avoidant solutions in social problem situations and children's low confidence in problem solving was associated with high levels of worry. Children as young as 6 years old reported both positive and negative beliefs about worry, but neither were associated with age, gender, or level of anxiety or worry. CONCLUSIONS RESULTS indicate similarities between adults and children in the relationships between problem-solving variables and worry, but not in relationships between beliefs about worry and worry. This may be due to developmental factors, or may be the result of measurement issues.
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Cheie L, Visu-Petra L. Relating Individual Differences in Trait-Anxiety to Memory Functioning in Young Children. JOURNAL OF INDIVIDUAL DIFFERENCES 2012. [DOI: 10.1027/1614-0001/a000079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
There is extensive evidence indicating cognitive biases at several stages of information processing in high-anxious children. Little research, however, has investigated a potential memory bias toward negative information in high-anxious young children. We studied immediate and delayed verbal recall as well as delayed visual recognition in a sample of high-trait-anxious (HA) and low-trait-anxious (LA) preschoolers (N = 76, mean age = 65 months), using stimuli containing task-irrelevant emotional valence (positive, negative, neutral). The findings revealed that, compared to their LA counterparts, HA preschoolers displayed (1) a tendency to be less accurate in the immediate verbal recall task, (2) poorer recall of negative words in the immediate condition and poorer recall of neutral words in the delayed condition, (3) impaired delayed recognition of identities with happy facial expressions and a tendency to better recognize identities expressing anger. Results are discussed considering the dynamic interplay between personality, emotion and cognitive factors during early development.
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Affiliation(s)
- Lavinia Cheie
- Developmental Psychology Lab, Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Laura Visu-Petra
- Developmental Psychology Lab, Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
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