Elevated amygdala response to faces following early deprivation

A functional neuroimaging study examined the long-term neural correlates of early adverse rearing conditions in humans as they relate to socio-emotional development. Previously institutionalized (PI) children and a same-aged comparison group were scanned using functional magnetic resonance imaging (fMRI) while performing an Emotional Face Go/Nogo task. PI children showed heightened activity of the amygdala, a region that supports emotional learning and reactivity to emotional stimuli, and corresponding decreases in cortical regions that support perceptual and cognitive functions. Amygdala activity was associated with decreased eye-contact as measured by eye-tracking methods and during a live dyadic interaction. The association between early rearing environment and subsequent eye-contact was mediated by amygdala activity. These data support the hypothesis that early adversity alters human brain development in a way that can persist into childhood, and they offer insight into the socio-emotional disturbances in human behavior following early adversity.     

Improvements in early care in Russian orphanages and their relationship to observed behaviors

This article describes a unique study that attempts to promote positive social‐emotional relationships and attachment between caregivers and children in orphanages in St. Petersburg, Russia. The children who reside in these orphanages are typically between birth and 48 months of age; approximately 50% are diagnosed with disabilities, and approximately 60% leave through foreign adoption. Initially, their orphanage caregivers showed a high level of current anxiety and depression and were detached from and communicated little with the children. Likewise, during baseline observations, the children demonstrated poor attachment behaviors such as indiscriminant friendliness, lack of eye contact with adults, aggression, and impulsive behavior. Two interventions were used in a quasiexperimental design: (a) training of caregivers to promote warm, responsive caregiving and (b) staffing and structural alterations to support relationship building, especially increasing the consistency of caregivers. The methodology required that both the training and staffing interventions be provided to one orphanage, only the training to a second, and neither to a third. (At any one time, ns = 80–120 in each condition.) Initial informal observations reveal positive behaviors for both the caregivers and the children, such as increased two‐way conversations, animated and enthusiastic emotional responses, and positive social and language interactions. Early data analyses show an increase in the consistency and stability of caregivers and increased scores for caregivers on every subscale of the HOME Scales. Children showed improvements in physical growth, cognition, language, motor, personal‐social, and affect, with children having severe disabilities improving the most. The implications of these findings suggest that training staff with modest educational backgrounds and structural changes are effective, can increase socially responsive caregiving behaviors, and improves social interactions of children, at least temporarily. ©2005 Michigan Association for Infant Mental Health.     

Severity of anxiety moderates the association between neural circuits and maternal behaviors in the postpartum period

Neuroimaging research has suggested that activity in the amygdala, center of the socioemotional network, and functional connectivity between the amygdala and cortical regions are associated with caregiving behaviors in postpartum mothers. Anxiety is common in the early postpartum period, with severity ranging from healthy maternal preoccupation to clinical disorder. However, little is known about the influence of anxiety on the neural correlates of early caregiving. We examined these relationships in a community cohort of 75 postpartum women (ages 18–22; predominantly low-SES, minority race) who listened to infant cry sounds while undergoing an fMRI assessment. Maternal self-reported symptoms of anxiety were mostly within the subclinical range. Positive and negative caregiving behaviors during filmed face-to-face mother–infant interactions were coded by independent observers. The results from whole-brain analyses showed that anxiety severity moderated the brain–maternal behavior relationships. Specifically, our results showed that the higher a mother’s anxiety, the stronger the association between positive caregiving (i.e., maternal warmth and involvement) and amygdala–right posterior superior temporal sulcus (amygdala–RpSTS) functional connectivity. These results remained significant when we controlled for symptoms of depression and contextual variables. These findings suggest that functional connectivity between the amygdala and a social perception region (RpSTS) plays a particularly important role for anxious mothers in facilitating their positive parenting. These findings extend our understanding of the specific neural circuits that support positive maternal caregiving in the context of maternal anxiety, and they may help inform the future design of personalized and effective interventions.     

Infant–mother attachment security and children's anxiety and aggression at first grade

With a large and diverse sample of children from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, the role of infant–mother attachment security as a protective factor against the development of children's anxious and aggressive behaviors at first grade was examined. When child's sex, family income, maternal sensitivity, and prior levels of anxiety and aggression were controlled for, attachment security at 15 months of age was found to moderate the effects of negative life events families experienced, thereby protecting children from experiencing symptoms of anxiety, but not aggression, at 4.5 years of age. Children classified as insecurely attached at 15 months of age who experienced many stressful life events exhibited more anxiety symptoms in first grade than children classified as securely attached who similarly experienced many negative life events. These findings are interpreted within attachment theory, which predicts that early attachment security has a unique role in children's anxiety experiences later in childhood.     

Perceived parental rearing behaviour and anxiety disorders symptoms in normal children

The present study examined the relationship between perceptions of parental rearing behaviours and anxiety disorders symptomatology in a sample of normal school children. 45 children, aged 8 to 12 years, completed the EMBU for children, a questionnaire that measures perceptions of parental rearing practices. Additionally, they filled in the Screen of Child Anxiety Related Emotional Disorders (SCARED), an index of DSM-defined anxiety disorders symptoms. Significant and positive relationships were found between anxious rearing behaviours and parental control, on the one hand, and anxiety disorders symptomatology, in particular symptoms of generalized anxiety disorder, separation anxiety disorder and environmental–situational phobia, on the other hand.     

Cognitive Control in the Face of Fear: Reduced Cognitive-Emotional Flexibility in Women with a History of Child Abuse

Child abuse can negatively affect neurobiological systems involved in regulating emotions. Adults who were maltreated as children show diminished capacity to flexibly integrate the prefrontal and limbic circuits underlying emotion regulation. Using a facial identification Stroop task with nonemotional and emotional stimuli, we found that women who reported more childhood abuse (N = 44) were no different from women reporting less childhood abuse (N = 45) on nonemotional conflict adaptation, but were significantly less able to adapt to emotional conflict. Women who reported more abuse were especially impaired in adapting to emotional conflict when incongruent stimuli involved a fearful face. These results help characterize the relation between cognitive control and emotion regulation and highlight the far-reaching effects of childhood abuse on cognitive-emotional flexibility.     

Emotional reactivity and cognitive regulation in anxious children

Recent models of anxiety disorders emphasize abnormalities in emotional reactivity and regulation. However, the empirical basis for this view is limited, particularly in children and adolescents. The present study examined whether anxious children suffer both negative emotional hyper-reactivity and deficits in cognitive emotion regulation. Participants were 49 children aged 10-17 with generalized anxiety disorder, social anxiety, or separation anxiety disorder as their primary diagnosis, as well as 42 age- and gender-matched non-anxious controls. After completing a diagnostic interview and self-report questionnaires, participants were presented with pictures of threatening scenes with the instructions either to simply view them or to use reappraisal, a cognitive emotion regulation strategy, to decrease their negative emotional response. Emotion ratings, content analysis of reappraisal responses, and reports of everyday use of reappraisal were used to assess negative emotional reactivity, reappraisal ability, efficacy and frequency. Relative to controls, children with anxiety disorders (1) experienced greater negative emotional responses to the images, (2) were less successful at applying reappraisals, but (3) showed intact ability to reduce their negative emotions following reappraisal. They also (4) reported less frequent use of reappraisal in everyday life. Implications for the assessment and treatment of childhood anxiety disorders are discussed.     

Maternal sensitivity moderates the impact of prenatal anxiety disorder on infant responses to the still-face procedure

Animal studies have demonstrated the interactive effects of prenatal stress exposure and postnatal rearing style on offspring capacity to manage stress. However, little is known about how parenting quality impacts the association between maternal prenatal anxiety and stress reactivity in human infants. This prospective study examined the impact of prenatal anxiety disorder and maternal caregiving sensitivity on infants’ responses to a standardised interactive stressor (still-face procedure). Eighty-four women completed a clinical interview during pregnancy to assess anxiety symptoms meeting DSM-IV diagnostic criteria. At infant age 7 months, maternal sensitivity to infant distress and infant negative affect were observed and coded during the still-face procedure. Maternal postnatal (concurrent) anxiety and depression were also assessed at this time. Results indicated a negative association between maternal sensitivity to infant distress and infant negative affect responses to the still-face procedure. An unexpected finding was a positive association between parity and infant reactivity. The main effect for sensitivity was qualified by a significant interaction, p < .05, suggesting that the impact of sensitivity was particularly marked among infants of women who experienced an anxiety disorder during pregnancy. This finding is consistent with a cumulative risk model suggesting that maternal prenatal anxiety and quality of maternal care act in concert to shape infant outcomes.     

Stress Sensitization and Adolescent Depressive Severity as a Function of Childhood Adversity: A Link to Anxiety Disorders

The goal of the present study was to determine whether exposure to adversity in childhood contributes to a differential threshold at which stressful life events provoke depressive reactions in adolescence. In addition, to address empirical and conceptual questions about stress effects, the moderating effect of anxiety disorder history was also explored. This examination was conducted in a sample of 816 children of depressed and nondepressed mothers, who were followed from birth to age 15. Information on adversities experienced in childhood was collected both from mothers during the first five years of their youth's life and from the youths themselves at age 15, and included information on the mother's relationship with her partner, maternal psychopathology, as well as youth-reported abuse. Results indicated that youths with both greater exposure to adversity in childhood and a history of an anxiety disorder displayed increased depressive severity following low levels of episodic stress compared to youths with only one or neither of these risk factors. The results are speculated to reflect the possibility that early anxiety disorders associated with exposure to adversity in childhood may be a marker of dysregulated stress responses, and may help to account for the comorbidity of depression and anxiety in some individuals.     

Developmental and mental health characteristics of children exposed to psychosocial adversity and stressors at the age of 18-months: Findings from a population-based cohort study

BackgroundPrior research on adverse experiences in early childhood has mainly focused on at-risk populations while studies of unselected populations are scarce. This topic therefore remains to be elucidated in broader child populations. Accordingly, the aim of this study was to examine if and to what extent children from a general population sample are exposed to psychosocial adversity and stressors in early childhood and whether the development and mental health of children with and without such exposure differ at the age of 18-months.MethodsA random sample of the Copenhagen Child Cohort (CCC2000) comprising 210 children and their parents participated in the study when the children were approximately 18-months. Information on exposures was obtained from a semi-structured interview including the Mannheim Parent Interview (MPI) and classified in agreement with the Multiaxial Classification of Child and Adolescent Psychiatric Disorders (ICD-10), and the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0-3). Child development was assessed with the Bayley Scales of Infant and Toddler Development – Second Edition (BSID-II), while mental health was measured using the Child Behavior Check List (CBCL 1½-5).ResultsAmong the 210 children, 91 (43%) had been exposed to psychosocial adversity and persistent stressors. The exposed children differed from the non-exposed children by poorer cognitive development and behavioral regulation, as well as more attention problems and anxious/depressed symptoms. The children exposed to adverse caregiving environments were specifically more likely to have delayed cognitive development than the rest of the sample.ConclusionsIn a general population sample of children aged 18-months, exposure to psychosocial adversity and stressors was associated with poorer development and mental health in cognitive and affective domains. These findings highlight an avenue for further research with potential implications for early preventative practices.     

The effect of prenatal adversity on externalizing behaviors at 24 months of age in a high-risk sample: Maternal sensitivity as a moderator

The purpose of this study was to examine the moderating role of maternal sensitivity on the association between prenatal adversity and externalizing behaviors at 24 months of age in a diverse, high-risk sample. We hypothesized that among children with higher prenatal adversity, high maternal sensitivity would serve as a protective factor. Participants were 247 primarily low-income, diverse dyads. Results indicated a significant interaction effect of maternal sensitivity and prenatal adversity on externalizing problems. The association between prenatal adversity and externalizing behaviors was significant only among children who experienced low prenatal adversity, with higher maternal sensitivity associated with lower externalizing behaviors. These findings indicate that, in the absence of high prenatal risk, responsive and sensitive parenting can buffer children in an otherwise high-risk sample from the development of externalizing behaviors.     

When parents have a history of conduct disorder: how is the caregiving environment affected?

Individuals with early-emerging conduct problems are likely to become parents who expose their children to considerable adversity. The current study tested the specificity of and alternative explanations for this trajectory. The sample included 246 members of a prospective, 30-year cohort study and their 3-year-old children. Parents who had a history of conduct disorder were specifically at elevated risk for socioeconomic disadvantage and relationship violence, but suboptimal parenting and offspring temperament problems were common to parents with any history of disorder. Recurrent disorder, comorbidity, and adversity in the family of origin did not fully account for these findings. The cumulative consequences of early-onset conduct disorder and assortative mating for antisocial behavior may explain the long-term effects of conduct disorder on young adult functioning.     

The neurodevelopmental basis of math anxiety

Math anxiety is a negative emotional reaction to situations involving mathematical problem solving. Math anxiety has a detrimental impact on an individual's long-term professional success, but its neurodevelopmental origins are unknown. In a functional MRI study on 7- to 9-year-old children, we showed that math anxiety was associated with hyperactivity in right amygdala regions that are important for processing negative emotions. In addition, we found that math anxiety was associated with reduced activity in posterior parietal and dorsolateral prefrontal cortex regions involved in mathematical reasoning. Multivariate classification analysis revealed distinct multivoxel activity patterns, which were independent of overall activation levels in the right amygdala. Furthermore, effective connectivity between the amygdala and ventromedial prefrontal cortex regions that regulate negative emotions was elevated in children with math anxiety. These effects were specific to math anxiety and unrelated to general anxiety, intelligence, working memory, or reading ability. Our study identified the neural correlates of math anxiety for the first time, and our findings have significant implications for its early identification and treatment.     

Patterns of Emotional Reactivity and Regulation in Children with Anxiety Disorders

Emotion dysregulation is believed to be a key factor in anxiety disorders. However, the empirical basis for this view is limited, particularly in children and adolescents. This study aimed to examine whether anxious children display negative emotional hyper-reactivity and deficits in emotion regulation, using a new task that presents ambiguous situations with potentially threatening meanings. Forty-nine children diagnosed with either generalized anxiety disorder, social anxiety, or separation anxiety disorder, were compared with 42 non-anxious controls. Relative to controls, anxious children demonstrated (a) greater intensity and frequency of negative emotional responses, (b) deficits in using reappraisal in negative emotional situations and corresponding deficits in reappraisal self-efficacy, and (c) greater reliance on emotion regulation strategies that increase the risk of functional impairment, intense negative emotion, and low emotion regulation self-efficacy. Implications for the assessment and treatment of childhood anxiety are discussed.     

Trajectories of emotional well-being in mothers of adolescents and adults with autism

Raising an adolescent or adult child with a developmental disability confers exceptional caregiving challenges on parents. We examined trajectories of 2 indicators of emotional well-being (depressive symptoms and anxiety) in a sample of primarily Caucasian mothers (N = 379; M age = 51.22 years at Time 1) of adolescent and adult children with an autism spectrum disorder (ASD; M age = 21.91 years at Time 1, 73.2% male). We also investigated within-person associations of child context time-varying covariates (autism symptoms, behavior problems, residential status) and maternal context time-varying covariates (social support network size and stressful family events) with the trajectories of emotional well-being. Data were collected on 5 occasions across a 10-year period. Average patterns of stable (depressive symptoms) and improved (anxiety) emotional well-being were evident, and well-being trajectories were sensitive to fluctuations in both child and maternal context variables. On occasions when behavior problems were higher, depressive symptoms and anxiety were higher. On occasions after which the grown child moved out of the family home, anxiety was lower. Anxiety was higher on occasions when social support networks were smaller and when more stressful life events were experienced. These results have implications for midlife and aging families of children with an ASD and those who provide services to these families.     

Emotion-focused cognitive-behavioral therapy for anxious youth: A multiple-baseline evaluation

Examined the efficacy of an Emotion-focused Cognitive-Behavioral Therapy (ECBT) for six anxious youths ages 7–13 years. All participants had a principal anxiety disorder (generalized anxiety disorder, separation anxiety disorder, or social phobia) based on the Anxiety Disorder Interview Schedule for Children—Child and Parent versions. Children and parents reported on anxious symptomatology using the Multidimensional Anxiety Scale for Children (MASC). To assess emotion-related competencies, children were administered the Kusche Affective Interview—Revised and children and parents completed the Emotion Expression Scale for Children (EESC) and Emotion Regulation Checklist (ERC), respectively. Cases began treatment after baselines of 0, 2, or 3 weeks. At posttreatment, the majority of children demonstrated improvements in anxious symptomatology, emotion understanding and regulation skills, and overall functioning. Such improvements in emotion-related skills, in addition to anxiety, are significant given that emotional competence is a crucial component in children's adaptive social functioning and psychological adjustment. These findings provide initial support for ECBT.     

The two sides of adversity: the effect of distant versus recent adversity on updating emotional content in working memory

Previous research suggests that adversity can have both adaptive and maladaptive effects, yet the emotional and working memory processes that contribute to more or less adaptive outcomes are unclear. The present study sought to investigate how updating emotional content differs in adolescents who have experienced past, recent, or no adversity. Participants who had experienced distant adversity (N?=?53), no adversity (N?=?58), or recent adversity only (N?=?20) performed an emotion n-back task with emotional facial expressions. Results revealed that the distant adversity group exhibited significantly faster reaction times (RTs) than the no adversity and recent adversity only groups. In contrast, the recent adversity only group exhibited significantly slower RTs and more errors than the distant adversity and no adversity groups. These results suggest an emotion and executive control pathway by which both the benefits and negative effects of adversity may be conferred. Results also highlight the importance of time in assessing the impact of adversity.     

Familial correlates of social anxiety in children and adolescents

Retrospective studies suggest a relationship between parental rearing practices and social phobia. The present study investigated whether socially anxious children perceive their current parental rearing as rejecting, overprotective, and lacking emotional warmth, and as emphasizing the importance of other's opinion, and de-emphasizing social initiatives and family sociability. Furthermore, we examined whether parents of socially anxious children report to rely on such rearing practices, and suffer themselves from social fears. A regression analysis as well as extreme group comparisons were applied. Little support was found for the presumed role of the assessed family rearing aspects in the development of social anxiety in children. Solely family sociability (children's and mothers' report) and children's perception of overprotection of the mother predicted social anxiety in the regression analysis. Given the influence of the mentioned rearing practices, social anxiety of the mother still significantly predicted social anxiety of the child. In the extreme group comparisons, differences in the expected direction were found between socially anxious and normal children on parental rejection, emotional warmth, and family sociability. However, the lack of differences between socially anxious and clinical control children suggests that these variables do not form a specific pathway to social fears.     

Parenting Behaviors and Childhood Anxiety: A Psychometric Investigation of the EMBU-C

Parent rearing behaviors, including both behavioral modeling and parent–child interactions, are associated with anxiety in children. Patterns of overprotection or rejecting behavior from parents may lead children to develop behavioral avoidance, lower self-confidence, and higher symptoms of anxiety. Additional research is needed to further elucidate the role that parenting behavior plays in the development of childhood anxiety. Unfortunately, few measures of parenting behavior exist. The EMBU-C is a 40-item child-report measure of these behaviors, but empirical data supporting the psychometric properties of the EMBU-C are limited. The current investigation examined the psychometric properties of the EMBU-C in the context of childhood anxiety. Participants were 213 children with an anxiety disorder and 150 recruited from the community (all aged 8–13 years). Overall, the EMBU-C demonstrated promising psychometrics. In terms of convergent validity, parent rearing behaviors described on the EMBU-C were significantly related to children’s anxiety symptoms, anxiety-related disability, parenting stress, family functioning and children’s externalizing behaviors. Further, the overprotection and anxious-rearing subscales discriminated between clinical and community participants. Finally, parental overprotection significantly predicted increases in child anxiety and anxiety-related disability 1 year later. Thus, the EMBU-C appears to have value as a clinical tool for assessing parental factors that may contribute to anxiety in children. Recommendations for further item development and measure improvement are offered.