Regulatory processes and the development of cognitive representations

Attention bias to reward predicts behavioral problems and moderates early risk to externalizing and attention problems

The current study had three goals. First, we replicated recent evidence that suggests a concurrent relation between attention bias to reward and externalizing and attention problems at age 7. Second, we extended these findings by examining the relations between attention and behavioral measures of early exuberance (3 years), early effortful control (4 years), and concurrent effortful control (7 years), as well as later behavioral problems (9 years). Third, we evaluated the role of attention to reward in the longitudinal pathways between early exuberance and early effortful control to predict externalizing and attention problems. Results revealed that attention bias to reward was associated concurrently and longitudinally with behavioral problems. Moreover, greater reward bias was concurrently associated with lower levels of parent-reported effortful control. Finally, attention bias to reward moderated the longitudinal relations between early risk factors for behavioral problems (gender, exuberance, and effortful control) and later externalizing and attention problems, such that these early risk factors were most predictive of behavioral problems for males with a large attention bias to reward. These findings suggest that attention bias to reward may act as a moderator of early risk, aiding the identification of children at the highest risk for later behavioral problems.

Parent-child negative emotion reciprocity and children's school success: An emotion-attention process model

Research has demonstrated that emotions expressed in parent-child relationships are associated with children's school success. Yet the types of emotional expressions, and the mechanisms by which emotional expressions are linked with children's success in school, are unclear. In the present article, we focused on negative emotion reciprocity in parent-child interactions. Using structural equation modeling of data from 138 parent to child dyads [children's mean age at Time 1 (T1) was 13.44 years, SD = 1.16], we tested children's negative emotionality (CNE) at T1 and low attention focusing (LAF) at Time 2 (T2) as sequential mediators in the relation between parent and child negative emotion reciprocity at T1 and children's grade point average (GPA) and inhibitory control at T2. Our findings supported an emotion-attention process model: parent-child negative emotion reciprocity at T1 predicted CNE at T1, which predicted children's LAF at T2, which was, in turn, related to low inhibitory control at T2. Findings regarding children's GPA were less conclusive but did suggest an overall association of negative reciprocity and the two mediators with children's GPA. Our findings are discussed in terms of emotion regulation processes in children from negatively reciprocating dyads, and the effects of these processes on children's ability to obtain and use skills needed for success in school.

Sensory motor inhibition as a prerequisite for theory-of-mind: A comparison of clinical and normal preschoolers differing in sensory motor abilities

After distinguishing between neocortical abilities for executive control and subcortical sensory motor skills for proprioceptive and vestibular integration, we compare a sample of 116 normal preschoolers with a sample of 31 preschoolers receiving occupational therapeutical treatment. This is done in an experimental design controlled for age (mean: 49 months), sex, SES, linguistic abilities, and intelligence. Inhibition and theory-of-mind are measured with test batteries. Results show that children having deficits in sensory motor inhibition are less competent in conflict inhibition and in theoryof-mind. Regression analyses reveal that in the clinical sample conflict inhibition is a significantly stronger predictor of theory-of-mind than in the control group. These results point at a basic sensory motor inhibitory ability as a prerequisite for the development of theory-of-mind.

The Role of Intelligence Quotient and Emotional Intelligence in Cognitive Control Processes

The relationship between intelligence quotient (IQ) and cognitive control processes has been extensively established. Several studies have shown that IQ correlates with cognitive control abilities, such as interference suppression, as measured with experimental tasks like the Stroop and Flanker tasks. By contrast, there is a debate about the role of Emotional Intelligence (EI) in individuals' cognitive control abilities. The aim of this study is to examine the relation between IQ and EI, and cognitive control abilities evaluated by a typical laboratory control cognitive task, the Stroop task. Results show a negative correlation between IQ and the interference suppression index, the ability to inhibit processing of irrelevant information. However, the Managing Emotions dimension of EI measured by the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT), but not self-reported of EI, negatively correlates with the impulsivity index, the premature execution of the response. These results suggest that not only is IQ crucial, but also competences related to EI are essential to human cognitive control processes. Limitations and implications of these results are also discussed.

Barking up the wrong tree in attentional bias modification? Comparing the sensitivity of four tasks to attentional biases

BACKGROUND AND OBJECTIVES

Attentional bias modification (ABM) is a potentially exciting new development in the treatment of anxiety disorders. However, reported therapeutic benefits have not always been replicated. To gauge the sensitivity of tasks used in ABM treatment and assessment, we used a counterbalanced within-subject design to measure their discriminant sensitivity to neutral and threatening facial expressions, comparing them with other well-known tasks that measure visual attention.

METHODS

We compared two tasks often used in the assessment and treatment of attention bias (the dot-probe and the spatial cueing paradigms) with two well-known visual attention tasks (the irrelevant singleton and attentional blink paradigms), measuring their sensitivity to processing differences between threatening and neutral expressions for non-clinical observers.

RESULTS

The dot-probe, spatial cueing and irrelevant singleton paradigms showed little or no sensitivity to processing differences between facial expressions while the attentional blink task proved very sensitive to such differences. Furthermore, the attentional blink task provided an intriguing picture of the temporal dynamics of attentional biases that the other paradigms cannot do.

LIMITATIONS

These results need to be replicated with larger samples, including a comparison of a group of individuals diagnosed with social anxiety disorder and normal controls.

CONCLUSIONS

Our results indicate that the sensitivity of putative attentional bias measures should be assessed experimentally for more powerful assessment and treatment of such biases. If the attentional blink task is indeed particularly sensitive to attentional biases, as our findings indicate, it is not unreasonable to expect that interventions based on this task may be more effective than those based on the tasks that are currently used.

Longitudinal relations among exuberance, externalizing behaviors, and attentional bias to reward: the mediating role of effortful control

The present study examined the associations between temperamental exuberance during toddlerhood (20 months), attention bias towards reward at the end of kindergarten (76 months), and externalizing behaviors across the kindergarten year. Moreover, we examined the role of effortful control at 48 months on the relation between early exuberance and attention bias. Attention bias towards reward was positively predicted by exuberance, negatively predicted by effortful control, and positively related to externalizing problems. Finally, the longitudinal path between exuberance and attention bias to reward was mediated by effortful control - such that higher toddler exuberance led to increased attention bias towards reward by way of lower effortful control. These results extend the attention bias and socioemotional functioning literature and have implications for the identification of children at risk for behavioral problems.

Behavioral inhibition and developmental risk: a dual-processing perspective

Behavioral inhibition (BI) is an early-appearing temperament characterized by strong reactions to novelty. BI shows a good deal of stability over childhood and significantly increases the risk for later diagnosis of social anxiety disorder (SAD). Despite these general patterns, many children with high BI do not go on to develop clinical, or even subclinical, anxiety problems. Therefore, understanding the cognitive and neural bases of individual differences in developmental risk and resilience is of great importance. The present review is focused on the relation of BI to two types of information processing: automatic (novelty detection, attention biases to threat, and incentive processing) and controlled (attention shifting and inhibitory control). We propose three hypothetical models (Top-Down Model of Control; Risk Potentiation Model of Control; and Overgeneralized Control Model) linking these processes to variability in developmental outcomes for BI children. We argue that early BI is associated with an early bias to quickly and preferentially process information associated with motivationally salient cues. When this bias is strong and stable across development, the risk for SAD is increased. Later in development, children with a history of BI tend to display normative levels of performance on controlled attention tasks, but they demonstrate exaggerated neural responses in order to do so, which may further potentiate risk for anxiety-related problems. We conclude by discussing the reviewed studies with reference to the hypothetical models and make suggestions regarding future research and implications for treatment.

Difficulty in disengaging from threat and temperamental negative affectivity in early life: a longitudinal study of infants aged 12-36 months

Background

Attention disengagement is reportedly influenced by perceiving a fearful facial expression even in the first year of life. In the present study, we examined whether individual differences in disengaging from fearful expressions predict temperamental negative affectivity.

Method

Twenty-six infants were studied longitudinally at 12, 18, 24, and 36 months, using an overlap paradigm and two temperament questionnaires: the Japanese versions of the revised Infant Behavior Questionnaire and Early Childhood Behavior Questionnaire.

Results

The infants fixated significantly more frequently to fearful than to happy or neutral faces. The attentional bias to threat (i.e., the number of fixed responses on fearful faces divided by the total number of fixed responses on faces) at 12 months was significantly positively correlated with negative affect at 12 months, and its relations with negative affect measured later in development was in the expected positive direction at each age. In addition, a moderation analysis indicates that the orienting network and not the executive network marginally moderated the relation between early attentional bias and later fear.

Conclusions

The results suggest that at 12 months, infants with more negative affectivity exhibit greater difficulty in disengaging their attention from fearful faces. We also found evidence that the association between parent-reported fear and disengagement might be modulated in the second year, perhaps because of the differences in temperamental control networks.

Kognitive, sprachliche, mathematische und sozial-emotionale Kompetenzen als Prädiktoren späterer schulischer Leistungen:

Zusammenfassung: Basierend auf der Annahme, dass Schulleistungen sowohl durch kognitive als auch sozial-emotionale Schülermerkmale bedingt sind, untersuchte die vorliegende Studie längsschnittlich anhand einer Stichprobe von 263 Kindern (M Alter = 7.4 Jahre, SD = 0.65 Jahre, Altersspanne 5–10 Jahre; 52 % Mädchen) ob kognitive, sprachliche, mathematische und sozial-emotionale Kompetenzen erfasst anhand der Intelligence Development Scales (IDS) die Schulnoten in den Fächern Mathematik, Deutsch und Sachkunde drei Jahre später vorhersagen können. Die Ergebnisse der Studie zeigten, dass sowohl die kognitiven, als auch die sprachlichen und mathematischen Kompetenzen zuverlässige Prädiktoren für die späteren Schulnoten in allen Fächern darstellten. Darüber hinaus bestätigte die Studie, dass hohe sozial-emotionale Kompetenzen relative Defizite in den kognitiven und sprachlichen Kompetenzen im Hinblick auf die Schulnoten zu kompensieren vermögen.

Relating Individual Differences in Trait-Anxiety to Memory Functioning in Young Children

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.

Child internalizing symptoms: contributions of child temperament, maternal negative affect, and family functioning

Research has traditionally focused on the role of genetic and environmental variables in the development and maintenance of childhood internalizing disorders. Temperament variables, such as negative affect and effortful control have gained considerable interest within the field of developmental psychopathology. Environmental factors such as mother-child interactions and family cohesion have also been linked with internalizing disorders. The current study examines the relationship between child negative affect, effortful control, maternal negative affect, family functioning, and internalizing symptoms in a sample of preschool-aged children using a path analysis approach. Sixty-five children, aged 3-5 years and their mothers completed measures on child temperament, family environment, maternal personality, and child internalizing symptoms. Results support a complex model for the influence of both direct and indirect factors on internalizing symptoms in preschool-aged children.

Behavioral circadian regularity at age 1 month predicts anxiety levels during school-age years

Daily lifestyle regularity is measured using the Social Rhythm Metric (SRM). We developed a Baby SRM, with 59 babies followed for approximately 13years. Baby SRM score at age 1 month significantly predicted the child's school (K-9, 5 time points) anxiety level (more regular=less anxious), and may be mediated through sociability and directed-attention pathways.

Electrophysiological correlates of cognitive control and the regulation of shyness in children

Shyness is associated with social-emotional maladjustment in some, but not all, children. The ability to flexibly regulate attention under conditions of potential conflict may protect shy children from developing internalizing problems. In the current study, the associations between shyness, the N2 event related potential (ERP) response, and social-emotional adjustment were examined in a sample of 36 typically developing 9- to 13-year-old children. It was hypothesized that the N2 amplitude, an ERP measure associated with aspects of cognitive and attention control, would moderate the associations between shyness and social-emotional functioning (negative attribution style, social self-perceptions, social anxiety). Shyness was unrelated to behavioral or ERP measures collected during a modified Flanker task; however, shyness and N2 amplitude were alone and in combination associated with all three measures of social adjustment. In general, shyness was associated with poor outcomes primarily among children with relatively large amplitude, or enhanced, N2 responses. The results are discussed in terms of the role of conflict sensitivity in the regulation of attention and emotions associated with shyness and the importance of studying the combined influences of reactive and self-regulatory aspects of temperament in relation to adjustment in childhood.

Negative affectivity, effortful control, and attention to threat-relevant stimuli

There is increasing recognition of temperamental influences on risk for psychopathology. Whereas the link between the broad temperament construct of negative affectivity (NA) and problems associated with anxiety and depression is now well-established, the mechanisms through which this link operate are not well understood. One possibility involves interactions between reactive and effortful components of temperament, as well as cognitive factors, like attentional biases to threat stimuli. This study tested a predicted relation between high levels of NA, low levels of effortful control (EC), and an attentional bias toward threat in children. A sample of 104 4th through 12th graders, selected from a larger screening sample because they reported high or low levels of trait NA and EC, completed a dot probe detection task. Results indicated that EC moderated the relation between NA and attentional bias; only children with low levels of EC and high levels of NA showed an attentional bias to threat stimuli. This pattern was not moderated by grade level or age.

Changes in the neural bases of emotion regulation associated with clinical improvement in children with behavior problems

Children's behavior problems may stem from ineffective cortical mechanisms for regulating negative emotions, and the success of interventions may depend on their impact on such mechanisms. We examined neurophysiological markers associated with emotion regulation in children comorbid for externalizing and internalizing problems before and after treatment. We hypothesized that treatment success would correspond with reduced ventral prefrontal activation, and increased dorsomedial prefrontal activation, at the time point of an event-related potential (ERP) associated with inhibitory control. Twenty-seven 8- to 12-year-old children (with usable data) were tested before and after a 14-week community-based treatment program and assessed as to improvement status. Fifteen 8- to 12-year-olds from the normal population (with usable data) were tested over the same interval. All children completed an emotion-induction go/no-go task while fitted with a 128-channel electrode net at each test session. ERP amplitudes, and estimates of cortical activation in prefrontal regions of interest, were measured at the peak of the "inhibitory" N2 and compared between improvers, nonimprovers, and nonclinical children. ERP amplitudes showed no group differences. However, improvers showed an overall reduction in ventral prefrontal activation from pretreatment to posttreatment, bringing them in line with nonclinical children, whereas ventral activation remained high for nonimprovers. Both improvers and nonimprovers showed high dorsal activation relative to nonclinical children. Supplementary analyses indicated that only ventral prefrontal regions, and only within the N2 time window, showed decreased activity from pre- to posttreatment, suggesting changes in regulatory processes rather than in overall emotional arousal. These cortically mediated changes may permit a reduction in the overengaged, rigid style of emotion regulation characteristic of children with behavior problems.

Early individual differences in temperamental reactivity and regulation: implications for effortful control in early childhood

This longitudinal study tested the hypothesis that early temperament is associated with later effortful control. Fear reactivity and object orientation was assessed in a sample of 53 children at 8, 12, and 16 months during a stranger-approach paradigm and at 4.5 or 5.5 years on a battery of effortful control tasks. A latent growth curve analysis was used to model change in reactivity and object orientation across infancy and the prediction of each on later effortful control. Infants who increased in fear reactivity were significantly more likely to show poor performance on effortful control tasks in early childhood. Findings are discussed with respect to the importance of examining early temperamental precursors that contribute to the development of regulation.

Biological processes in prevention and intervention: the promotion of self-regulation as a means of preventing school failure

This paper examines interrelations between biological and social influences on the development of self-regulation in young children and considers implications of these interrelations for the promotion of self-regulation and positive adaptation to school. Emotional development and processes of emotion regulation are seen as influencing and being influenced by the development of executive cognitive functions, including working memory, inhibitory control, and mental flexibility important for the effortful regulation of attention and behavior. Developing self-regulation is further understood to reflect an emerging balance between processes of emotional arousal and cognitive regulation. Early childhood educational programs that effectively link emotional and motivational arousal with activities designed to exercise and promote executive functions can be effective in enhancing self-regulation, school readiness, and school success.

Effortful control as a moderator of the relation between contextual risk factors and growth in adjustment problems

Effortful control was examined as a moderator of the relations of three domains of contextual risk factors to growth in internalizing and externalizing problems in a community sample (N = 189) of children (8-12 years at Time 1). Socioeconomic, maternal, and environmental risk factors were examined as predictors of initial levels and growth in children's adjustment problems across 3 years. The effects of the risk factors depended on children's level of effortful control. For children lower in effortful control, socioeconomic risk was related to significantly higher initial levels of internalizing and externalizing problems and decreases over time. However, children lower in effortful control had higher levels of problems at all three time points than children higher in effortful control. Maternal risk was associated with increases in internalizing for children lower in effortful control, and environmental risk was related to increases in internalizing and externalizing problems for children lower in effortful control, but not those higher in effortful control. Children who were lower in effortful control appeared to experience more adverse effects of contextual risk than those higher in effortful control, suggesting that interventions aimed at improving children's effortful control might serve to protect children from increased risk of adjustment problems associated with contextual risk factors.

Neurophysiological mechanisms of emotion regulation for subtypes of externalizing children

Children referred for externalizing behavior problems may not represent a homogeneous population. Our objective was to assess neural mechanisms of emotion regulation that might distinguish subtypes of externalizing children from each other and from their normal age mates. Children with pure externalizing (EXT) problems were compared with children comorbid for externalizing and internalizing (MIXED) problems and with age-matched controls. Only boys were included in the analysis because so few girls were referred for treatment. We used a go/no-go task with a negative emotion induction, and we examined dense-array EEG data together with behavioral measures of performance. We investigated two event-related potential (ERP) components tapping inhibitory control or self-monitoring - the inhibitory N2 and error-related negativity (ERN) - and we constructed source models estimating their cortical generators. The MIXED children's N2s increased in response to the emotion induction, resulting in greater amplitudes than EXT children in the following trial block. ERN amplitudes were greatest for control children and smallest for EXT children with MIXED children in between, but only prior to the emotion induction. These results were paralleled by behavioral differences in response time and performance monitoring. ERP activity was localized to cortical sources suggestive of the dorsal anterior cingulate for control children, posterior cingulate areas for the EXT children, and both posterior cingulate and ventral cingulate/prefrontal regions for the MIXED children. These findings highlight different mechanisms of self-regulation underlying externalizing subtypes and point toward distinct developmental pathways and treatment strategies.

Learning to observe relationships and coping

Milieu relationships provide the critical background presence to staff's attempts to motivate, regulate, and teach patients how to cope with stress. Forging a connection with hospitalized children and adolescents demands attention to how they respond to adults and engage with staff around milieu expectations. Assessment guides that deal with these issues are presented. Important aspects of children's relatedness are presented in the context of their working models of adults and the influence of these representations on their response to staff. Coping skills are explained with particular emphasis on behavioral coping strategies. Tied to the assessment process are interventions that emphasize staff's role in helping patients manage strong affects and avoid the use of nonproductive behavior regulation strategies.

Learning to observe cognition, mastery, and control

On inpatient psychiatric units, intervening with children and adolescents' behaviors demands an understanding of how they take in and process information. The third paper focuses on assessment cues that will help inpatient staff decipher patients' deficits and strengths in information processing, self-efficacy, and inhibitory control. Each assessment area is explained in the context of the supporting cognitive, neurobiologic, and social-learning theory. Inpatient interventions consistent with the assessment are explained and illustrated with clinical applications.

[Treatment of social phobia in childhood and adolescence]

OBJECTIVES

The following article investigates the extent to which the current status of cognitive behavioral research on the treatment of socially phobic children and adolescents is reflected by the currently used guidelines for psychotherapy.

METHODS

The current literature on research in psychotherapy was systematically reviewed.

RESULTS

The results show the significance of single-setting treatment, of cognitive interventions, and of parental participation in the therapy. The results also show the limitations encountered if the treatment consists only of training social competence skills.

CONCLUSIONS

The current treatment recommendations for socially phobic children must be supplemented and modified.

Milieu Management of a Child with Bipolar Illness

During inpatient psychiatric treatment, children with bipolar disorder may present particular management issues. They may experience intense periods of affect regulation that can spiral into frenetic, aggressive behaviors that are difficult to interrupt with de-escalation techniques. This case study presents such a child and the behavior patterns that resulted in seclusion and PRN medication. Also presented is the plan that staff derived which eventually helped this young boy regulate his behavior.

Attention in preschoolers: associations with effortful control and motivation

The current study examined how individual differences in children's temperament and motivation relate to attention skills in children from economically disadvantaged families. A total of 73 mother-child dyads participated in this study. Children were between the ages of 3 and 5, and all attended a Head Start program. Using multiple hierarchical regression analyses, the hypotheses that effortful control (an aspect of temperament) and motivation would individually and collectively relate to attention skills were supported. The current study supports the importance of understanding attention as a multifaceted concept (Posner & Petersen, 1990) that relates to cognitive, socioemotional, and motivational systems. The utility of applying a systems approach to school readiness issues in children of poverty is discussed.

Pre-attack symptomatology and temperament as predictors of children's responses to the September 11 terrorist attacks

BACKGROUND

The aims of this study were to assess the psychological response of children following the September 11, 2001 terrorist attacks in New York and Washington, DC and to examine prospective predictors of children's post-attack responses.

METHOD

Children's responses were assessed in a community sample of children in Seattle, Washington, participating in an ongoing study. Symptomatology and temperament assessed prior to the attacks were examined as prospective predictors of post-attack post-traumatic stress (PTS), anxiety, depression and externalizing problems.

RESULTS

Children demonstrated PTS symptoms and worries at levels comparable to those in children directly experiencing disasters, with 77% of children reporting being worried, 68% being upset by reminders, and 39% having upsetting thoughts. The most common PTS symptom cluster was re-experiencing, and 8% of children met criteria consistent with PTSD. African-American children reported more avoidant PTS symptoms and being more upset by the attacks than European-American children. Girls reported being more upset than boys. Prior internalizing, externalizing, social competence and self-esteem were related to post-attack PTS; and child inhibitory control, assessed prior to the 9/11 attacks, demonstrated a trend towards an association with post-attack PTS symptoms controlling for prior levels of symptomatology. PTS predicted child-report anxiety and conduct problem symptoms at follow-up, approximately 6 months after 9/11.

CONCLUSIONS

Children experiencing a major disaster at a distance or indirectly through media exposure demonstrated worries and PTS symptoms suggesting that communities need to attend to children's mental health needs in response to national or regional disasters. Pre-disaster symptomatology or low self-regulation may render children more vulnerable in response to a disaster, and immediate post-disaster responses predict subsequent symptomatology. These variables might be used in the identification of children in need of intervention.

The role of the orbitofrontal cortex in normally developing compulsive-like behaviors and obsessive-compulsive disorder

Mounting evidence concerning obsessive-compulsive disorders points to abnormal functioning of the orbitofrontal cortices. First, patients with obsessive-compulsive disorder (OCD) perform poorly on tasks that rely on response suppression/motor inhibition functions mediated by the orbitofrontal cortex relative to both normal and clinical controls. Second, patients with OCD exhibit functional hyperactivity in lateral orbitofrontal and related structures corresponding with symptom severity. In this article, we compare these neurocognitive correlates of OCD with the executive and neural underpinnings of "compulsive-like" behaviors that are common in normal childhood. We discuss the phenomenology and natural history of normative compulsive-like behaviors as well as the behavioral, emotional, and cognitive continuities between typical and pathological obsessive-compulsive behaviors. We then examine associations between children's executive performance deficits and their observed compulsive-like characteristics. We relate these patterns to executive deficits shown by adults with OCD. Finally, we speculate on the developmental neurobiology of children's compulsive-like behaviors, with particular attention to orbitofrontal functions including behavioral and emotional regulation, and we suggest similarities and differences with the neurobiology of OCD. In making these comparisons, we hope to open a dialogue between researchers who study underlying brain pathologies associated with OCD and those who explore the neurocognitive bases of normal development.

Temperament and attention deficit hyperactivity disorder: the development of a multiple pathway model

This article outlines the parallels between major theories of attention deficit hyperactivity disorder (ADHD) and relevant temperament domains, summarizing recent research from our laboratories on (a) child temperament and (b) adult personality traits related to ADHD symptoms. These data are convergent in suggesting a role of effortful control and regulation in the core symptoms of ADHD. Negative approach and anger is also associated with ADHD, but this may be due to the overlap of ADHD and antisocial behavior. Positive approach may be involved in an alternate pathway to ADHD. The involvement of effortful control is congruent with experimental findings of executive functioning deficits in children with ADHD. We hypothesize that, whereas regulation problems may occur in most children with ADHD, a subgroup also may be characterized by positive approach problems and another subgroup by negative approach problems. We conclude with a theorized multiple process developmental model outlining alternate pathways to ADHD that warrant empirical investigation to better resolve etiological heterogeneity in ADHD.

Coping responses of adolescent suicide attempters and their relation to suicidal ideation across a 2-year follow-up: a preliminary study

The coping responses of 23 hospitalized adolescent suicide attempters were compared to those of 19 hospitalized non-attempters matched on diagnosis and demographics. Relative to the comparison group, suicide attempters made fewer effortful-approach and more automatic-approach coping responses, and were judged by trained raters to have coped less effectively. Coders' ratings of greater coping effectiveness among suicide attempters were associated with a greater decline in suicidal symptoms assessed at 6-month follow-up intervals across a 2-year period. The findings are discussed in light of a model of coping that incorporates both individual differences and situational characteristics.

Temperament, Anxiety, and the Processing of Threat-Relevant Stimuli

This article discusses converging evidence from developmental, clinical, and cognitive psychology suggesting that there is significant overlap between research findings on affect, temperament, and attentional processes associated with pathological anxiety. We offer a proposal for the integration of these 3 areas aimed at developing a more clear understanding of the developmental sequence and operative mechanisms in the dysregulation of negative affect and the development of symptoms of anxiety pathology. We review evidence for a model indicating that reactive and effortful temperamental processes, possibly mediated by an attentional bias toward threat-relevant information, interact to produce problems of dysregulated negative affect and elevated levels of pathological anxiety. This model may assist in understanding the development of anxiety disorders, identifying children at risk for such disorders, and selecting points of entry for both preventative and curative interventions.

Cognitive outcomes in school-age children born prematurely

The purpose of this article is to discuss findings in the literature regarding long-term developmental outcomes of infants born prematurely, to examine potential causes of individual differences in these outcomes, and to explore directions for future research. An extensive table summarizes recent (1996-2002) international studies of developmental outcomes among children of school age and older who were born with low birth weight, especially as the studies relate to cognitive development and academic performance. The discussion then examines how characteristics of the child and the environment may interact to produce individual differences in outcomes. Processes of attention regulation within the context of the psychosocial environment are examined as an important possible direction for future research. When designing and implementing interventions aimed at improving outcomes in this and other groups of children at risk for delays and deficits, it is important to consider how various factors affect development.

Factors associated with young children's long-term recall of an invasive medical procedure: a preliminary investigation

This exploratory study investigated children's recall of the voiding cysto-urethrogram (VCUG, x-ray of the kidneys) after a 6-month delay and the associations between children's memory reports and specific behaviors coded during the procedure (distraction, crying, procedure-related talk). Thirty-two children, aged 2 to 7 years, were interviewed 6 months after undergoing the VCUG. Twenty-nine of the 32 children reported information about the VCUG after 6 months. Free recall was skeletal but highly accurate; more information was reported in prompted recall, but accuracy was reduced. Older children provided more complete and accurate reports than did younger children. Independently of age, specific child behaviors were associated with children's memory reports: crying during the VCUG was negatively associated with the correct information reported and accuracy in prompted recall; procedure-related talk was positively associated with the correct information reported in free recall; and distraction was negatively associated with the accuracy of free recall. The implications for intervention in pediatric contexts are discussed.

Anxiety-related attentional biases and their regulation by attentional control

This study examined the role of self-reported attentional control in regulating attentional biases related to trait anxiety. Simple detection targets were preceded by cues labeling potential target locations as threatening (likely to result in negative feedback) or safe (likely to result in positive feedback). Trait anxious participants showed an early attentional bias favoring the threatening location 250 ms after the cue and a late bias favoring the safe location 500 ms after the cue. The anxiety-related threat bias was moderated by attentional control at the 500-ms delay: Anxious participants with poor attentional control still showed the threat bias, whereas those with good control were better able to shift from the threatening location. Thus, skilled control of voluntary attention may allow anxious persons to limit the impact of threatening information.

School readiness. Integrating cognition and emotion in a neurobiological conceptualization of children's functioning at school entry

The author examines the construct of emotionality, developmental relations between cognition and emotion, and neural plasticity and frontal cortical functioning and proposes a developmental neurobiological model of children's school readiness. Direct links are proposed among emotionality, use-dependent synaptic stabilization related to the prefrontal cortex, the development of executive function abilities, and academic and social competence in school settings. The author considers research on the efficacy of preschool compensatory education in promoting school readiness and recommends that programs expand to include curricula directly addressing social and emotional competence. Research should focus on the ontogeny of self-regulation and successful adaptation to the socially defined role of student, the development of prevention research programs to reflect this orientation, and interdisciplinary collaborations that integrate scientific methods and questions in the pursuit of comprehensive knowledge of human developmental processes.

Is ADHD a disinhibitory disorder?

Attention deficit hyperactivity disorder (ADHD) is widely theorized to stem from dysfunctional inhibitory processes. However, the definition of inhibition is imprecisely distinguished across theories. To clarify the evidence for this conception, the author relies on a heuristic distinction between inhibition that is under executive control and inhibition that is under motivational control (anxiety or fear). It is argued that ADHD is unlikely to be due to a motivational inhibitory control deficit, although suggestions are made for additional studies that could overturn that conclusion. Evidence for a deficit in an executive motor inhibition process for the ADHD combined type is more compelling but is not equally strong for all forms of executive inhibitory control. Remaining issues include specificity to ADHD, whether inhibitory problems are primary or secondary in causing ADHD, role of comorbid anxiety and conduct disorder, and functional deficits in the inattentive ADHD subtype.

On inhibition/disinhibition in developmental psychopathology: views from cognitive and personality psychology and a working inhibition taxonomy

Disinhibition is a common focus in psychopathology research. However, use of inhibition models often is piecemeal, lacking an overarching taxonomy of inhibitory processes. The author organizes key concepts and models pertaining to different kinds of inhibitory control from the cognitive and temperament/personality literatures. Within the rubrics of executive inhibitory processes, motivational inhibitory processes, and automatic attentional inhibition processes, 8 kinds of inhibition are distinguished. Three basic temperament traits may address key executive and motivational inhibitory processes. Future developmental psychopathology research should be based on a systematic conceptual taxonomy of the kinds of inhibitory function relevant to a given disorder. Such an approach can clarify which inhibition distinctions are correct and which inhibition deficits go with which disorders.