Cognitive Errors, Anxiety Sensitivity, and Anxiety Control Beliefs

Measuring State and Trait Anxiety: An Application of Multidimensional Item Response Theory

The State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) is a widely used measure of state and trait anxiety. Within the Classical Testing Theory model, consistent findings provide support for its multidimensional factor structure, discriminant, convergent, and nomological validity, as well as age and gender invariance, across healthy and clinical samples. Nevertheless, some issues regarding STICSA dimensionality and item-scale composition remain unresolved (e.g., both bifactor and two-factor models were found to fit data equally well). The goal of this study was to investigate the STICSA's dimensionality within the Item Response Theory, and to assess the tenability of the bifactor model as a plausible model over the multidimensional model. The sample consisted of 3338 Italian participants (58.21% females; 41.79% males) with an average age of 35.65 years (range: 18-99; SD = 20.25). Both bifactor and two-correlated dimensions of the STICSA scales were confirmed to fit data by applying the multidimensional Item Response Theory (mIRT). While the bifactor model showed better fit indices, the multidimensional model was more accurate and precise (0.86-0.88) in estimating state and trait latent anxiety. A further comparison between multidimensional item parameters revealed that the multidimensional and bifactor models were equivalent. Findings showed that the STICSA is an accurate and precise instrument for measuring somatic and cognitive symptomatology dimensions within state and trait anxiety. The use of the state/trait total score requires special attention from the clinicians and researchers to avoid bias in the psychodiagnostic assessment.

Youth stress generation: an examination of the role of anxiety, anxiety symptoms and cognitive distortions

INTRODUCTION

Stress generation suggests a reciprocal relationship between depression and prospective stressful life events. However, the applicability of stress generation to anxiety disorders has been understudied, particularly among youth. We address this gap by examining stress generation in youth at high-risk of developing anxiety disorders.

METHODS

Participants were one-hundred thirty-six at-risk youth (M age = 8.69, 84.6% Caucasian; 55.9% female), each of whom had a parent with an anxiety disorder. We examined the role of an anxiety disorder diagnosis, anxiety symptoms, and cognitive distortions in youth's prospective one and six-year stressful life events (i.e., stress generation).

RESULTS

Anxiety symptoms and cognitive distortions were significant predictors of one-year total dependent stress. Anxiety diagnosis and anxiety symptoms were significant predictors of one-year dependent interpersonal stress. Anxiety diagnosis and anxiety symptoms were significant predictors of six-year independent stress.

CONCLUSION

Support for the stress generation model was found in high-risk youth, but only over a one-year period. This suggests important effects of anxiety and cognitive distortions on stress generation, though their implications might be time-capped.

The efficacy of transdiagnostic cognitive behavioural therapy on reducing negative affect, anxiety sensitivity and improving perceived control in children with emotional disorders - a randomized controlled trial

In response to the high rate of comorbidity among different types of emotional disorders in children, Transdiagnostic Unified Protocol of Emotional disorder in children (UP-C) was developed to address common underlying mechanisms in the development and maintenance of emotional disorders using empirically supported cognitive and behavioural strategies. Although, studies supported the effectiveness of this protocol in the treatment of wide range of emotional disorders, further studies are needed to examine its effect on transdiagnostic factors. The present study aimed to investigate the efficacy of the UP-C on negative affect, anxiety sensitivity and perceived control in children with emotional disorders. During this randomized controlled trial, 34 children aged 7 to 13 with emotional disorders were randomly assigned to treatment (n=18) and control (n=16) groups. The treatment group and their parents received 15 sessions of UP-C. Negative Affect Schedule for Children (PANASNA- C), Children’s Anxiety Sensitivity Index (CASI), Anxiety Control Questionnaire-Children (ACQ-C) were carried out in all phases (pre-treatment, post-treatment, 3 and 8 months follow- up). The results showed that following UP-C, negative affect (hedges’g=2.01) and anxiety sensitivity (hedges’g=1.05) were significantly reduced, and perceived control (hedges’g= –2.36) was significantly improved. The results remained relatively constant during the follow-ups. Findings provide evidence that the UP-C has significant effect on negative affect, anxiety sensitivity and perceived control as roots of emotional disorders.

Changes in Anxiety Control Beliefs Following a Brief CBT Treatment and Their Association With Anxiety Symptom Reduction

Anxiety control beliefs (i.e., beliefs regarding one's ability to cope with external, fear-inducing threats and internal reactions to those perceived threats) have been found to negatively predict anxiety symptoms in children and adults and to be modifiable by cognitive-behavioral therapy for anxiety disorders. The current study examines whether changes in anxiety control beliefs were seen following a brief, intensive treatment for specific phobias, and whether those changes were associated with improvements in the targeted phobia and comorbid anxiety disorder symptoms. Participants were 135 children and adolescents (M age = 9.01 years, 49% male) who received one-session treatment (OST) with or without parental involvement for their primary specific phobia. Results indicated that self-reported anxiety control beliefs significantly increased following treatment and that these increases significantly predicted reductions in specific phobia severity and symptoms of comorbid anxiety disorders 6 months and 1 year following treatment. Findings illustrate that involvement in a single 3-hour OST was associated with changes in anxiety control beliefs and demonstrate the potential importance of targeting control beliefs in pediatric anxiety treatment.

Identifying effective cognitive biases in information retrieval

The purpose of this study is to identify the types of cognitive biases in the process of information retrieval. This research used a mixed-method approach for data collection. The research population consisted of 25 information retrieval specialists and 30 post-graduate students. We employed three tools for collecting data, including a checklist, log files and semi-structured interviews. The findings showed that from the perspective of information retrieval specialists, the cognitive biases such as ‘Familiarity’, ‘Anchoring’, ‘Rush to solve’ and ‘Curse of knowledge’ could be of the greatest importance in the field of information retrieval. Also, in terms of users’ searching, the ‘Rush to solve problems’ and ‘Mere exposure effects’ biases have the highest frequency, and the ‘Outcome’ and ‘Curse of knowledge’ biases have the lowest frequency in the process of user retrieval information. It can be concluded that, because cognitive biases occurring in information retrieval, designers of information retrieval systems and librarians should pay attention to this issue in designing and evaluating information systems.

Interpretation biases and depressive symptoms among anxiety-disordered children: The role of individual differences in respiratory sinus arrhythmia

Individual differences in interpretation biases-the tendency to interpret ambiguous stimuli as threatening-partially explain the presence of comorbid depressive symptoms among anxious youth. Increasing efforts have examined physiological processes that influence the association between interpretation biases and depressive symptoms in this population, and potential gender differences in this relationship. This study examined the moderating role of respiratory sinus arrhythmia (RSA) suppression (i.e., decrease from baseline)-an index of parasympathetic nervous system reactivity-in the association between interpretation biases and depressive symptoms in clinically anxious youth. One-hundred-and-five clinically anxious children (Mage  = 10.09 years, SD = 1.22; 56.7% female; 61.9% racial/ethnic minority) completed measures of self-reported and behaviorally indexed interpretation biases, reported anxiety/depression symptom severity, and participated in a speech task. RSA suppression during the task moderated the association between interpretation biases and depressive symptom severity in the total sample. Separate exploratory moderation analyses were conducted among girls and boys. Among girls, RSA suppression moderated the association between behaviorally indexed interpretation biases and depressive symptoms, and marginally moderated (p = .067) the association between self-reported interpretation biases and depressive symptoms. Among boys, RSA suppression was not a significant moderator. These findings may help identify clinically anxious youth most at-risk for comorbid depressive symptoms.

Parental Emotion-Focused Behaviors Moderate the Relationship Between Perceptual Sensitivity and Fear Reactivity in Anxious Children

This investigation examined the synergistic role of parental emotion-focused socialization behaviors and children's perceptual sensitivity on children's fear reactivity. A sample of 105 children with anxiety disorders (8-12 years; M = 10.07 years, SD = 1.22; 57% female) and their clinically anxious mothers (M = 39.35 years, SD = 7.05) completed an assessment battery that included a diagnostic interview and questionnaires regarding anxiety symptoms, perceptual sensitivity, and emotion socialization behaviors; children also completed a 5-min, videotaped speech task, and rated their fear levels before and after the task. Analyses revealed a significant interaction between perceptual sensitivity and emotion-focused strategies predicting fear change scores from pre- to post-speech. Higher perceptual sensitivity was related to greater reductions in fear from pre- to post- speech (adjusting for pre-speech fear scores), yet only among anxious children whose mothers reported high use of emotion-focused strategies. Maternal emotion-focused socialization strategies may increase anxious children's ability to modulate their affective responses during stressful situations.

Mediators of youth anxiety outcomes 3 to 12 years after treatment

OBJECTIVE

Test changes in perceived coping efficacy, negative self-statements, and interpretive biases to threat during treatment as potential mediators of the relationship between randomly assigned treatment conditions and long-term anxiety follow-ups. Age at randomization was also tested as a moderator of mediational relationships.

METHOD

Participants included 319 youth (ages 7-17) from the Child/Adolescent Multimodal Study (CAMS) who participated in a naturalistic follow-up beginning an average of 6.5 years after the end of the CAMS intervention. The intervention conditions included cognitive behavioral therapy (CBT; Coping Cat), pharmacotherapy (sertraline), combined CBT and sertraline, and pill placebo. Putative mediators were measured four times during the intervention phase. Follow-up consisted of four annual assessments of current anxiety.

RESULTS

Reductions on a measure of interpretive bias to threat over the course of the combined condition intervention, as compared to the placebo condition, mediated anxiety outcomes at the first follow-up visit. This mediated effect was not significant for the CBT-only or sertraline-only conditions when compared to the placebo condition. No other significant mediated effects were found for putative mediators. Age did not significantly moderate any mediated effects.

CONCLUSION

Changes in youth-reported interpretive biases to threat over the course of combined youth anxiety interventions, as compared to a placebo intervention, may be associated with lower anxiety an average of 6.5 years following treatment.

Associations between cognitive errors and mental health status in New Zealand adolescents

BACKGROUND

Cognitive models of psychopathology suggest that negatively biased thinking styles are involved in the development and maintenance of emotional disturbances.

AIMS

The present study examined the relationships between negative cognitive errors and indices of mental health status (i.e. anxiety and depression) in New Zealand adolescents.

METHOD

A community sample of 490 youth aged 16-18 years completed an anonymous online survey consisting of the Children's Negative Cognitive Error Questionnaire (CNCEQ), the Trait subscale of the State-Trait Anxiety Inventory (STAI-T) and the Center for Epidemiologic Studies Depression Scale (CES-D).

RESULTS

Negative cognitive errors correlated positively with greater levels of anxious and depressive symptoms. Hierarchical regression analyses indicated that overall cognitive error score was a strong predictor of adolescents' self-reported anxious symptoms and, to a lesser extent, depressive symptoms. Moreover, cognitive errors significantly differentiated between adolescents with high scores from adolescents with low scores on both the anxiety (STAI-T) and the depression (CES-D) scales.

CONCLUSIONS

These findings lend support to the generalizability of Beck's cognitive theory to a New Zealand adolescent population and highlight the importance of focusing on prevention and early intervention programmes that directly target these faulty or biased ways of thinking in adolescents with anxious and/or depressive symptoms before meeting diagnostic criteria.

Examining the Hierarchical Influences of the Big-Five Dimensions and Anxiety Sensitivity on Anxiety Symptoms in Children

Anxiety sensitivity (AS), namely the fear of anxiety symptoms, has been described as a precursor of sub-threshold anxiety levels. Sexton et al. (2003) posited that increased AS would arise from an elevated neuroticism and that both would act as vulnerability factors for panic disorder (PD), obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD) symptoms. Accordingly, this study aimed to (1) evaluate the applicability of this model to a pediatric population and (2) examine the influences of the other Big-Five personality dimensions on the four lower-order dimensions of AS (cognitive, physical, control, and physical) and on social phobia (SP), separation anxiety disorder (SAD) and depression symptoms. 200 children (104 girls) aged between 8 and 12 years old (mean age = 132.52 months, SD = 14.5) completed the Childhood Anxiety Sensitivity Index (Silverman et al., 1991), the Big Five Questionnaire for Children (Barbaranelli et al., 2003), and the Revised’s Children Anxiety and Depression Scale (Chorpita et al., 2000). Regression analyses confirmed that AS and neuroticism together significantly predicted the presence of PD, OCD, and GAD symptoms but also SP, SAD, and depression symptoms. Moreover, neuroticism interacted with extraversion, conscientiousness and agreeableness to significantly predict SP, GAD, and depression. Surprisingly, the global AS score was only predicted by agreeableness, while AS dimensions also specifically related to openness. Finally, AS dimensions did not predict the presence of specific anxiety symptoms. To conclude, the predicting model of anxiety symptoms in children sets neuroticism and AS on the same level, with an unexpected influence of agreeableness on AS, raising the importance of other trait-like factors in the definition of such models. Moreover, AS should be considered as a unitary construct when predicting the presence of anxiety symptoms in children. Future interventions must consider these associations to help children detect and recognize the symptoms of their anxiety and help them to interpret them correctly.

Impairment in planning tasks of children and adolescents with anxiety disorders

Anxiety disorders are associated with poor neuropsychological performance in attention and memory. However, little is known about the impact of these difficulties on other cognitive functions, such as planning. The ability to plan, including attention, working memory and set-shifting components, can be assessed by the Tower of Hanoi task (ToH). This study evaluated seventy-one participants, aged from 7-17 years. Thirty-seven subjects met DSM-IV diagnostic criteria for at least one anxiety disorder and 34 individuals comprised the controls. The neuropsychological tests used were: the ToH, a problem-solving task, involves planning ability and other executive functions (working memory, attentional control and cognitive flexibility); for the assessment of processing speed and problem-solving, the Vocabulary/Matrix Reasoning subtests of the Wechsler Abbreviated Scale of Intelligence was used to measure for estimated-IQ in both groups. The groups were compared with a generalized linear model controlling for age, IQ and ADHD comorbidity. Compared with controls, anxiety disorders subjects made more errors and required more time to complete the ToH. Children and adolescents with anxiety disorders have poorer planning ability compared to subjects without anxiety disorders, and the difficulty in planning is affected by interference from other cognitive functions, such as attention, working memory, cognitive flexibility and problems-solutions.

Parental coping socialization is associated with healthy and anxious early-adolescents' neural and real-world response to threat

The ways parents socialize their adolescents to cope with anxiety (i.e., coping socialization) may be instrumental in the development of threat processing and coping responses. Coping socialization may be important for anxious adolescents, as they show altered neural threat processing and over reliance on disengaged coping (e.g., avoidance and distraction), which can maintain anxiety. We investigated whether coping socialization was associated with anxious and healthy adolescents' neural response to threat, and whether neural activation was associated with disengaged coping. Healthy and clinically anxious early adolescents (N = 120; M = 11.46 years; 71 girls) and a parent engaged in interactions designed to elicit adolescents' anxiety and parents' response to adolescents' anxiety. Parents' use of reframing and problem solving statements was coded to measure coping socialization. In a subsequent visit, we assessed adolescents' neural response to threat words during a neuroimaging task. Adolescents' disengaged coping was measured using ecological momentary assessment. Greater coping socialization was associated with lower anterior insula and perigenual cingulate activation in healthy adolescents and higher activation in anxious adolescents. Coping socialization was indirectly associated with less disengaged coping for anxious adolescents through neural activation. Findings suggest that associations between coping socialization and early adolescents' neural response to threat differ depending on clinical status and have implications for anxious adolescents' coping.

Anxiety Sensitivity Moderates the Relation Between Family Accommodation and Anxiety Symptom Severity in Clinically Anxious Children

High levels of family accommodation (FA), or parental involvement in child symptoms, are associated with child anxiety symptom severity. The strength of associations has varied across studies, however, highlighting the need to identify moderating variables. We investigated whether anxiety sensitivity (AS) moderated the FA-anxiety symptom severity association in clinically anxious children (N = 103, ages 6-17; mean age 11.07 years). We collected child and mother ratings of FA, child anxiety symptom severity, and child AS ratings. AS significantly moderated the FA-child anxiety severity link. Specifically, this link was significant for low-AS but not high-AS children. Findings suggest that FA may operate in the typically observed fashion for low-AS children-alleviating immediate distress while inadvertently exacerbating longer-term anxiety-whereas high-AS children may experience distress following anxiety-provoking stimuli regardless of FA. Assessing AS in research and clinical settings may help identify subsets of children for whom FA is more closely tied to anxiety severity.

Examining the Mechanisms of Therapeutic Change in a Cognitive-Behavioral Intervention for Anxious Children: The Role of Interpretation Bias, Perceived Control, and Coping Strategies

This study examined the role of theoretically meaningful mediators of therapeutic change-interpretation bias, perceived control, and coping strategies-in a cognitive-behavioral intervention for anxious youth. This is one of the few studies that examined the change in potential mediator and outcome variables by means of a longitudinal design that included four assessment points: pretreatment, in-treatment, post-treatment, and at 4-months follow-up. Forty-seven 8- to 12-year-old children with a principal DSM-IV diagnosis of anxiety disorder participated in the study. On each assessment point, questionnaires assessing the mediator variables and a standardized anxiety scale were administered to the children. The results showed that perceived control and interpretation bias (but not coping strategies) accounted for a significant proportion in the variability of various types of anxiety symptoms, providing a preliminary support for the notion that these cognitive dimensions' act as mechanisms of therapeutic change in cognitive-behavioral therapy for anxious children.

Reluctance to express emotion explains relation between cognitive distortions and social competence in anxious children

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 (M_age  = 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.

Do cognitive distortions explain the longitudinal relationship between life adversity and emotional and behavioural problems in secondary school children?

Research has shown that children exposed to life adversity are at higher risk of negative developmental outcomes than those enduring lower stress levels. Life adversity can lead, among other things, to emotional and behavioural problems. Several factors have been studied to explain this relationship, with several investigators underlining the role of thought structures such as cognitive distortions, which refer to negatively biased information-processing of external events. This can help explain why some individuals characterised by adverse personal life stories interpret ambiguous events in a negatively biased way. This study was aimed at assessing the mediating role of cognitive distortions in the longitudinal relationship between life adversity and two dimensions of psychopathology, namely, emotional and behavioural problems in 247 secondary school children attending three state secondary schools in one county in the South East of England. An increase in life adversity was associated with an increase in cognitive distortions, which was in turn related to a higher number of symptoms reflecting behavioural issues. In terms of practical applications, an effort to protect children from further exposure to adverse life events could represent a step forward to prevent the development of future behavioural problems in at-risk children.

Social Interpretation Bias in Children and Adolescents with Anxiety Disorders: Psychometric Examination of the Self-report of Ambiguous Social Situations for Youth (SASSY) Scale

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.

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

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

Biases in attention, interpretation, memory, and associations in children with varying levels of spider fear: Inter-relations and prediction of behavior

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.

Perceived Control, Family Environment, and the Etiology of Child Anxiety-Revisited

In 1998, Chorpita, Brown, and Barlow published a now seminal study in Behavior Therapy examining the development of anxiety in children and adolescents using Barlow's 1988 model of the development of anxiety in adults. Mindful of developmental considerations, parental control and children's perceptions of control were considered key factors in this revised model. Since that study, mixed support has accumulated for the role of control, both parental control and children's perceptions of that control, in the development of childhood anxiety. As a result, the measurement of these constructs has been critically examined and refined in recent years and encouraging findings have been obtained. Unfortunately, however, the Chorpita and colleagues study as well as the studies that have followed have used cross-sectional designs and the directionality of effects has not been clearly established. Longitudinal studies are required. Here, we present a qualitative review of these developments and provide directions for future research.

The Loneliness Questionnaire: Establishing Measurement Invariance Across Ethnic Groups

A state of loneliness describes an individual's perception of having dissatisfying social connections to others. Though it is notable across the life span, it may have particularly deleterious effects in childhood and adolescence, leading to increased risk of emotional impairment. The current study evaluates a widely used test of loneliness, the Loneliness Questionnaire, for measurement invariance across ethnic groups in a large, representative sample of youth in the 2nd to 12th grades ( N = 12,344; 41% African American) in Mississippi. Analyses were conducted using multigroup confirmatory factor analysis following a published, sequential method to examine invariance in form, factor loadings, and item intercepts. Overall, our results indicated that the instrument was invariant across ethnicities, suggesting that youth with equivalent manifest scores can be discerned as having comparable levels of latent loneliness. The loneliness scores also corresponded significantly with depression and anxiety scores for most subsamples, with one exception. These findings are discussed in the context of previous results comparing levels of loneliness across ethnicities. Additionally, the broader context of the need to expand invariance studies in instrumentation work is highlighted.

Relations of Anxiety Sensitivity, Control Beliefs, and Maternal Over-Control to Fears in Clinic-Referred Children with Specific Phobia

The relations of fear to anxiety sensitivity, control beliefs, and maternal overprotection were examined in 126 7- to 13-year-old clinically referred children with specific phobias. Results indicated that anxiety sensitivity and control beliefs were significant predictors of children's fear levels, accounting for approximately 48% of the total variance. Unexpectedly, age, gender, and maternal overprotection did not emerge as significant predictors of fear in the overall sample. In subsequent analyses, anxiety sensitivity was found to be a consistent, significant predictor for both girls and boys, for both younger and older children, and for children with and without an additional anxiety disorder diagnosis. Control beliefs were only a significant predictor for girls, younger children, and children with an additional anxiety diagnosis. Maternal overprotection was not a significant predictor for any group. Children with an additional anxiety disorder diagnosis had higher levels of fear, anxiety sensitivity, and maternal overprotection, as well as lower levels of control beliefs than the non-additional anxiety disorder subgroup. Future directions and clinical implications are explored.

Identifying Moderators of the Link Between Parent and Child Anxiety Sensitivity: The Roles of Gender, Positive Parenting, and Corporal Punishment

A substantial body of literature suggests that anxiety sensitivity is a risk factor for the development of anxiety problems and research has now begun to examine the links between parenting, parent anxiety sensitivity and their child's anxiety sensitivity. However, the extant literature has provided mixed findings as to whether parent anxiety sensitivity is associated with child anxiety sensitivity, with some evidence suggesting that other factors may influence the association. Theoretically, specific parenting behaviors may be important to the development of child anxiety sensitivity and also in understanding the association between parent and child anxiety sensitivity. In this study, 191 families (n = 255 children and adolescents aged 6-17 and their parents) completed measures of child anxiety sensitivity (CASI) and parenting (APQ-C), and parents completed measures of their own anxiety sensitivity (ASI) and their parenting (APQ-P). Corporal punishment was associated with child anxiety sensitivity and the child's report of their parent's positive parenting behaviors moderated the association between parent and child anxiety sensitivity. The child's gender was also found to moderate the association between parent and child anxiety sensitivity, such that there was a positive association between girls' and their parents anxiety sensitivity and a negative association in boys. The findings advance the understanding of child anxiety sensitivity by establishing a link with corporal punishment and by showing that the association between parent and child anxiety sensitivity may depend upon the parenting context and child's gender.

Developmental differences in the linkages between anxiety control beliefs and posttraumatic stress in youth

BACKGROUND

Anxiety control beliefs have emerged as a trans-diagnostic risk factor for anxiety disorders and a potential mechanism of change in cognitive and behavioral therapies. The purpose of this study was to examine the association between anxiety control beliefs and anxiety disorder symptoms following exposure to hurricanes in youth and test a developmental hypothesis about those associations.

METHODS

A large school-based sample of (N = 1048) children and adolescents with a history of exposure to natural disaster were assessed with the short form of the Anxiety Control Questionnaire for Children (ACQ-C), symptom measures (PTSD and generalized anxiety disorder symptoms) and level of disaster exposure. Developmental differences in the association between ACQ-C scores and symptoms were tested, as well as the ACQ-C's ability to assess symptoms beyond level of exposure.

RESULTS

ACQ-C scores were associated with symptoms beyond level of exposure, but age moderated the strength of the association. Modeling the interaction suggested that the ACQ-C short had incremental validity beyond hurricane exposure in youth over 12 years.

CONCLUSIONS

Findings extend previous work to a novel population of youth and add to the developmental understanding of the role of anxiety control beliefs in anxiety regulation. Age differences in the linkages between anxiety control and symptoms is consistent with a developmental model where low perceived control exhibited by younger children may be less indicative of problems with anxiety but may instead be related to normal cognitive development.

Anxiety Disorders and Sleep in Children and Adolescents

Sleep problems are common in children and adolescents. A growing body of research has explored the relationship between sleep problems and anxiety in youth. When reviewing the literature, methodologic inconsistencies need to be considered, such as variation in conceptualization of sleep problems, measurement of sleep, and the classification of anxiety. Despite this, there seems to be good evidence of concurrent and longitudinal associations between sleep difficulties and anxiety in community and clinical samples of young people. Potential mechanisms are proposed. There is a need for further exploration of these relationships, with the hope of aiding preventive capability and developing useful treatments.

Ruminative and catastrophizing cognitive styles mediate the association between daily hassles and high anxiety in Hong Kong adolescents

This study assessed rumination, catastrophizing and daily hassles as predictors of anxiety when controlling for depressive symptoms in a community sample of adolescents reporting high anxiety. Adolescents aged 12-18 (N = 2,802, mean age of 14.9) completed the Screen For Child Anxiety-Related Emotional Disorders. With a total score of 30 as the cutoff, a group of high anxiety adolescents was identified (a prevalence rate of 28.02%). Path analyses results showed that amongst the high anxiety boys, catastrophizing but not rumination was a positive predictor of anxiety and it mediated the effects of daily hassles on anxiety. In the high anxiety girls, both rumination and catastrophizing predicted anxiety but only catastrophizing was the mediator between daily hassles and anxiety. It is suggested that such gender differences in cognitive responses styles should be considered in cognitive-behavioral therapeutic approaches designed to help adolescents showing high anxiety.

Developmental trajectories of anxiety symptoms in early adolescence: the influence of anxiety sensitivity

Children and adolescents seem to suffer from anxiety disorders at rates similar to adults. Interestingly, anxiety symptoms appear to generally decline over time within children as evidenced by lower rates in early and middle adolescence. There is some evidence that there may be heterogeneous subpopulations of adolescent children with different trajectories of anxiety symptoms, including a class of adolescents with elevated levels of anxiety that do not dissipate over time. Anxiety sensitivity has been identified as an important risk factor in the development of anxiety psychopathology. This study prospectively examined the development of anxiety symptoms in a sample of 277 adolescents (M age = 11.52; 44 % female, 56 % male) over a 3 year period including the influence of anxiety sensitivity on this development. Further, this study investigated whether there were distinct classes of adolescents based on their anxiety symptom trajectories and including anxiety sensitivity as a predictor. Consistent with other reports, findings indicated an overall decline in anxiety symptoms over time in the sample. However, three classes of adolescents were found with distinct anxiety symptom trajectories and anxiety sensitivity was an important predictor of class membership. Adolescents with elevated anxiety sensitivity scores were more likely to be classified as having high and increasing anxiety symptoms over time versus having moderate to low and decreasing anxiety symptoms over time. There are important implications for identification of adolescents and children who are at risk for the development of an anxiety disorder.

Obsessive-Compulsive Symptoms and Beliefs in Adolescents: A Cross-Sectional Examination of Cognitive Models

Cognitive models of obsessive-compulsive disorder (OCD) posit that particular beliefs transform normal intrusions into disturbing obsessions. A wealth of data shows that such beliefs and obsessive-compulsive (OC) symptoms are related in adults. However, there is markedly less information regarding OCD-related beliefs in youth. The purpose of this study was to assess the relation between OCD-related beliefs and OC symptoms in unselected adolescents (ages 13-18 years; N = 159). Findings from questionnaires completed on the Internet were consistent with previous findings in adults. Increased levels of OCD-related beliefs were related to increased levels of OC symptoms. Perfectionism and certainty beliefs had a specific relation with symmetry and ordering symptoms. Contrary to expectation, levels of OCD-related beliefs in this unselected sample were similar to those found in prior studies of youth diagnosed with OCD. Implications, limitations, and future directions for the study of OCD-related beliefs in youth are discussed.

Cognitive vulnerability profiles of highly anxious and non-anxious children

Current theoretical notions emphasise the role of cognitive variables in the development and maintenance of childhood anxiety. The purpose of this study was to explore whether there are different types of cognitive vulnerability to anxiety among children. The participants were 118 children between the ages of 7 and 13 who completed a set of questionnaires to measure cognitive errors, threat-related interpretation bias, and anxiety-related control. Cluster analysis identified three relevant clusters: (1) a High Cognitive Vulnerability cluster, characterised by high levels of cognitive errors and threat interpretation and low levels of control; (2) a Low Cognitive Vulnerability cluster, characterised by low levels of cognitive errors and threat interpretation and high levels of control; and (3) an Inconsistent Cognitive Vulnerability cluster, characterised by low levels of cognitive errors and threat interpretation and low levels of control. Differences between the clusters were found in terms of anxiety symptoms, coping strategies, and gender. The theoretical and clinical implications of these findings are discussed.

Neural mechanisms of emotion regulation in childhood anxiety

BACKGROUND

The present study was designed to examine the cortical processes that mediate cognitive regulation in response to emotion-eliciting stimuli in anxious children.

METHODS

Electroencephalographic (EEG) activity was recorded from clinically anxious children (n = 29) and typically developing children (n = 34). Event-related potential components were recorded while children performed a go/no-go task using facial stimuli depicting angry, calm, and happy expressions.

RESULTS

Anxious children had significantly greater posterior P1 and frontal N2 amplitudes, components associated with attention/arousal and cognitive control, respectively, than typically developing children. Anxious children also had significantly greater error-related negativities and correct-response negativities relative to typically developing children. For the anxious group only, there were no differences in neural activation between face (emotion) types or trial (Go vs. No-go) types. A regression analysis revealed that No-go N2 amplitudes for calm faces predicted self-reported anxiety levels.

CONCLUSIONS

Anxious children appeared to show increased cortical activation regardless of the emotional content of the stimuli. Anxious children also showed greater medial-frontal activity regardless of task demands and response accuracy. Taken together, these findings suggest indiscriminate cortical processes that may underlie the hypervigilant regulatory style seen in clinically anxious individuals.

Perceived control in clinically anxious and non-anxious children indirectly measured with the Implicit Association Procedure (IAP)

BACKGROUND

Perceived control is thought to play an important role in the development and maintenance of anxiety disorders in children. The objective of the present study was to further investigate the Perceived Control Implicit Association Procedure (IAP, Hogendoorn et al., 2008) as an indirect measure of perceived control in children.

METHODS

The IAP was completed by 136 anxiety disordered children (aged 8-18 years old, M = 12.51) and 31 non-selected children (8-15 years old, M = 11.65). A second control group of 38 non-selected children (aged 8-18 years old, M = 12.08) was used to validate the pictorial stimuli in the computer task.

RESULTS

First, children were able to correctly classify the pictures into Control and No control categories. Second, as predicted, anxious children reported less perceived control than the control group on both the direct measure (the ACQ-C) and the indirect measure (IAP). For the No Control score however, this was only the case for children younger than twelve years old. Third, test-retest correlation in the anxious group was fair to good (ICCs .57-.58).

CONCLUSIONS

These results suggest that the perceived control IAP is still quite experimental, but could be an interesting departure point for future research on perceived control in children.

A measurement invariance examination of the Revised Child Anxiety and Depression Scale in a Southern sample: differential item functioning between African American and Caucasian youth

This study examined the psychometric properties of the Revised Child Anxiety and Depression Scale in a large sample of youth from the Southern United States. The authors aimed to determine (a) if the established six-factor Revised Child Anxiety and Depression Scale structure could be replicated in this Southern sample and (b) if scores were associated with measurement invariance across African American and Caucasian youth representative of youth from this region of the United States. The established six-factor model evidenced the best fit in comparison to one-, two-, and five-factor models in the total sample (N = 12,695), as well as in the African American (n = 4,906) and Caucasian (n = 6,667) subsamples. Multigroup confirmatory factor analysis also supported measurement invariance across African American and Caucasian youth at the levels of equal factor structure and equal factor loadings. Noninvariant item intercepts were identified, however, indicating differential functioning for a subset of items. Clinical and measurement implications of these findings are discussed and new norms are presented.

The role of anxiety sensitivity, behavioral inhibition, and cognitive biases in anxiety symptoms: structural equation modeling of direct and indirect pathways

OBJECTIVE(S)

Limited research has examined how temperamental (i.e., behavioral inhibition, anxiety sensitivity) and cognitive (i.e., interpretive and judgment biases) risks for the development anxiety covary to influence anxiety symptoms. Thus, the present study aimed to advance understanding of the direct and indirect links between anxiety sensitivity, behavioral inhibition, and interpretive biases, and judgment biases (in the form of perceived control) to anxiety outcomes (i.e., worry and trait anxiety symptoms).

METHOD

842 emerging adults (mean = 18.75 years, standard deviation = 1.05; age range = 18-24; 70% women) recruited from a university in the northeast participated in this study. Participants completed a battery of self-report measures assessing risk factors and anxiety outcomes of interest.

RESULTS

Structural equation modeling revealed anxiety sensitivity and behavioral inhibition were directly linked with anxiety outcomes. Anxiety sensitivity and behavioral inhibition were also indirectly linked with anxiety outcomes through interpretive and judgment biases. The hypothesized model was partially invariant across high-risk and low-risk groups for anxiety disorders.

CONCLUSIONS

Results of this study provide preliminary support for theoretical models hypothesizing a developmental progression from temperamental to cognitive risks and culminating in the expression of anxiety symptoms. Limitations and clinical implications of this research are discussed.

Clustering of temperamental and cognitive risk factors for anxiety in a college sample of late adolescents

Temperamental vulnerabilities (e.g., behavioral inhibition, anxiety sensitivity) and cognitive biases (e.g., interpretive and judgment biases) may exacerbate feelings of stress and anxiety, particularly among late adolescents during the early years of college. The goal of the present study was to apply person-centered analyses to explore possible heterogeneity in the patterns of these four risk factors in late adolescence, and to examine associations with several anxiety outcomes (i.e., worry, anxiety symptoms, and trait anxiety). Cluster analyses in a college sample of 855 late adolescents revealed a Low-Risk group, along with four reliable clusters with distinct profiles of risk factors and anxiety outcomes (Inhibited, Sensitive, Cognitively-Biased, and Multi-Risk). Of the risk profiles, Multi-Risk youth experienced the highest levels of anxiety outcomes, whereas Inhibited youth experienced the lowest levels of anxiety outcomes. Sensitive and Cognitively-Biased youth experienced comparable levels of anxiety-related outcomes, despite different constellations of risk factors. Implications for interventions and future research are discussed.