Parental Psychopathology Levels as a Moderator of Temperament and Oppositional Defiant Disorder Symptoms in Preschoolers

Oppositional Defiant Disorder (ODD) is among the most prevalent disorders in preschoolers. It has been linked to temperament, since characteristics such as elevated surgency and negative affect, as well as low levels of effortful control, contribute to the development of this disorder. Evidence also indicates that parental psychopathology can accentuate temperamental traits. Our aim was to assess whether the levels of psychopathology of mothers and fathers acts as a moderator of the relationship between temperament and ODD symptoms in preschoolers, both cross-sectionally at ages 3, 4 and 5, and longitudinally between ages 3 and 5. The sample included 550 children evaluated at ages 3, 4 and 5 through questionnaires and a semi-structured diagnostic interview with parents. Parents also answered a questionnaire about their own psychopathology. The results indicated that negative affect and effortful control are associated with higher levels of ODD symptoms in preschoolers. At child age 5, higher levels of paternal depression and anxiety increased the effect of low effortful control on ODD. High levels of negative affect and low levels of effortful control at age 3 were statistical predictors of ODD levels at age 5, and this relationship was also moderated by paternal anxiety and depression. The results have important clinical implications for the proper orientation of interventions, suggesting that interventions should integrate the paternal caregiver in the treatment.     

Early manifestations of childhood depression: influences of infant temperament and parental depressive symptoms

In this longitudinal study, 83 parents of infants between 3 and 12 months completed questionnaires assessing demographic information, infant temperament, and maternal depression. When these children were at least 18 months of age, parents completed follow‐up questionnaires assessing toddler temperament and depression‐like symptoms. We were primarily interested in the contributions of infant temperament and maternal depression to toddler depressive problems, and the analytic strategy involved controlling for toddler temperament in order to isolate the influence of infancy characteristics. The findings indicated that lower levels of infant regulatory capacity and greater severity of maternal depression were predictive of toddler depression‐like symptoms. Moderator effects of infant temperament were also examined, with the negative affectivity * maternal depression interaction emerging as significant. Follow‐up analyses indicated that the risk for early manifestations of depression was attenuated for children with lower negative affectivity in infancy and parents who reported lower levels of their own depressive symptoms; conversely, children exhibiting higher infant negative emotionality had higher levels of depression‐like symptoms as toddlers, regardless of their parents' level of depression. The present findings further suggest that parental depressive symptoms need not be ‘clinically significant’ to predict toddler affective problems. Copyright © 2008 John Wiley & Sons, Ltd.     

Reactive and self-regulatory dimensions of temperament: Interactive relations with symptoms of general distress and anhedonia

Converging evidence indicates that shared temperamental diatheses partly underlie the covariance between anxiety and depression. Although developmental psychopathology research suggests that self-regulatory temperament (e.g., effortful control or EC) mitigates reactive risks associated with negative affectivity (NA) and positive affectivity (PA), and their respective counterparts, behavioral inhibition- and activation sensitivity (BIS and BAS), no studies have established EC’s protective effects in adulthood. This study examined concurrent relations between temperament and distress symptoms shared by anxiety and depression, and anhedonic symptoms unique to depression, in young adults. Anticipated two- and three-way interactions emerged supporting EC’s moderating effect between reactive temperament (i.e., high BIS and low BAS) and both symptom dimensions. However, no interactive relations emerged between symptoms and NA, PA, and EC.     

Separation anxiety disorder in a sample of children of divorce

Anxiety in children through separation from parents is one of the most frequent psychological problems in the infantile population. Children of divorce are more vulnerable to suffer this disorder due to the abrupt separation from one of the parents after the break-up, which they may experience as a traumatic event that predisposes them to react anxiously in daily separations. The purpose of this study is to examine the presence of symptoms of separation anxiety and general anxiety in a Spanish sample of 95 students of ages between 8 and 12 years. They were compared to a group of children of similar ages and sex whose parents are not divorced. The results show that children of divorce present higher levels of separation anxiety than the children whose parents remain together. Moreover, they show significant levels of generalized anxiety, but similar to that of the other group of children (undivorced parents). The clinical implications of these findings are discussed, emphasizing the importance of cooperation and frequent contact of the children with both parents to promote their security and autonomy.     

Examining Alternative Explanations of the Covariation of ADHD and Anxiety Symptoms in Children: A Community Study

Attention-deficit hyperactivity disorder (ADHD) is comorbid with a range of other disorders, including anxiety disorders. The aim was to examine different explanations for the covariation of these symptom domains in children according to the framework provided by (Lilienfeld, S. O. Comorbidity between and within childhood externalizing and internalizing disorders: Reflections and directions. Journal of Abnormal Child Psychology, 2003). The covariation of ADHD symptoms and anxiety symptoms were examined over a 12-month period in a community sample of 499 children aged 8-13; 91% were retained at 12-month follow-up. Dimensional assessments were conducted using questionnaires given to children, parents and teachers, with results analyzed via structural equation modeling. Positive associations between ADHD and anxiety symptoms were linked with inattention symptoms, were particularly pronounced for girls, and were linked via temperament and behavioral problems. No support for the hypothesis that ADHD symptoms predicted the development of anxiety symptoms over time or vice versa. ADHD symptoms (particularly inattention) and anxiety symptoms are covarying phenomena that are linked with an irritable temperament and disruptive behavior.     

Temperament as Risk and Protective Factors in Obesogenic Eating: Relations Among Parent Temperament,Child Temperament,and Child Food Preference and Eating

Children’s food preferences and eating behaviors have implications for their health and weight status, serving as risk or protective factors for obesity. Although parent and child factors influence children’s eating, few studies have examined parent and child temperament simultaneously in relation to child food preference and eating behaviors. The authors addressed this research gap. Participants were 115 ethnically diverse children between 4 and 6?years old and their parents. Measures included parental temperament traits, parental anxiety, child temperament traits, and child food preference and eating behaviors observed using a laboratory procedure. Results show that children preferred candies over grapes, and that aspects of both child and adult temperament were related to child eating behaviors. Child surgency was linked to eating more candies, while child effortful control was linked to eating more grapes. Parent effortful control was related to children’s preference toward grapes. No relations were found between child eating behaviors and child or parent negative affectivity and parental anxiety. Overall, findings suggest that highly impulsive and poorly self-regulated children may be at risk for obesogenic eating habits.     

Parent-directed cognitive behavioral therapy for young anxious children: a pilot study

Anxiety in children age 8 years and above has been successfully treated with cognitive behavioral therapy (CBT). However, the efficacy of CBT for anxious children ages 4-7 years has not, to date, been fully investigated. This paper piloted a CBT intervention targeting child anxiety that was delivered exclusively to parents of 26 children with anxiety symptoms ages 4-7 years. The intervention consisted of four 2-hour group sessions of four to six parents (couples). These group sessions were followed by four individual telephone sessions, once per week across a 4-week period. The pre- and postintervention assessment involved measures of multiple constructs of child anxiety (anxiety symptoms, children's fears, behavioral inhibition, and internalizing symptoms) from multiple informants (parents, children, and teachers). Parents also reported parenting strategies they were likely to use to manage their children's anxiety pre- and postintervention. Results indicated a significant decrease in child anxiety and behavioral inhibition as reported by parents and teachers. Furthermore, mothers reported significant increases in their use of positive reinforcement, and modeling and reassurance, and a significant decrease in their use of reinforcement of dependency directly after treatment. Taken together, parent-directed CBT appears to be an effective approach for treating children ages 4-7 years with anxiety symptoms. Limitations of the current research are discussed.     

Multi-domain Models of Risk Factors for Depression and Anxiety Symptoms in Preschoolers: Evidence for Common and Specific Factors

Relatively few studies have examined multiple pathways by which risk factors from different domains are related to symptoms of anxiety and depression in young children; even fewer have assessed risks for these symptoms specifically, rather than for internalizing symptoms in general. We examined a theoretically- and empirically-based model of variables associated with these symptom types in a diverse community sample of 796 4-year-olds (391 boys, 405 girls) that included factors from the following domains: contextual (SES, stress and family conflict); parent characteristics (parental depression); parenting (support/engagement, hostility and scaffolding); and child characteristics including negative affect (NA) effortful control (EC) sensory regulation (SR), inhibitory control (IC) and attachment. We also compared the models to determine which variables contribute to a common correlates of symptoms of anxiety or depression, and which correlates differentiate between those symptom types. In the best-fitting model for these symptom types (a) SES, stress and conflict had indirect effects on both symptom types via long-chain paths; (b) caregiver depression had direct effects and indirect ones (mediated through parenting and child effortful control) on both symptom types; (c) parenting had direct and indirect effects (via temperament and SR); and temperament had direct effects on both symptom types. These data provide evidence of common risk factors, as well as indicate some specific pathways/mediators for the different symptom types. EC was related to anxiety, but not depression symptoms, suggesting that strategies to improve child EC may be particularly effective for treatment of anxiety symptoms in young children.     

气质与童年早期的师生关系:家庭情感环境的作用

通过对118名幼儿的父母和教师间隔两年的追踪研究,考察了气质对童年早期师生关系的直接预测作用,以及气质与家庭情感环境在预测师生关系中的交互作用。结果发现:(1)控制先前的师生关系、性别、月龄、母子关系及家庭情感环境后,气质活动水平、节律性、趋避性对两年后的师生关系有显著的直接预测作用;(2)三种气质与家庭情感环境的交互作用对两次测量的师生关系也有显著的预测作用。这些发现同时支持了气质影响儿童发展的直接作用模型和交互作用模型。     

The Contribution of Temperamental and Cognitive Factors to Childhood Anxiety Disorder Symptoms: A Closer Look at Negative Affect,Behavioral Inhibition,and Anxiety Sensitivity

This study examined the role of anxiety sensitivity as an explanatory variable in the link between two temperamental dimensions (i.e., behavioral inhibition and negative affect) and anxiety disorder symptom severity in a sample of children with anxiety disorders. Forty-four children (52?% African American) between 8 and 12 years of age and their mothers participated in this study. An assessment battery consisting of diagnostic interviews, questionnaires, and behavioral assessment of behavioral inhibition was administered. Findings revealed that anxiety sensitivity was a significant explanatory variable linking child self-reports of behavioral inhibition and negative affect to anxiety disorder symptom severity. For parent-completed measures, only direct effects of behavioral inhibition on anxiety disorder symptom severity were found. The clinical implications of our findings, including the importance and feasibility of anxiety sensitivity and behavioral inhibition assessments as part of routine clinical care of children with anxiety disorders are discussed, along with the limitations of our study.     

Parents’ Attachment Styles and Adolescents’ Regulatory Emotional Self-efficacy: The Mediating Role of Adolescents’ Attachment to Parents in China

Guided by attachment theory, this longitudinal study examined the mediating role of parent-adolescent attachment on the relation between parents’ attachment styles and adolescents’ regulatory emotional self-efficacy (RESE, including managing negative affect and expressing positive affect). Five hundred seventy-three Chinese junior high school students (46% male; aged 11–14 years, M = 12.76 years, SD = 0.74) completed measures of RESE at T1, parent-adolescent attachment at T2 (six months later), and RESE at T3 (another six months later), while 573 students’ parents (one student only has a parent, 241 fathers and 332 mothers) completed measures of adult attachment styles (anxiety and avoidance) at T1. Results from structural equation modeling indicated that father-adolescent attachment mediated the association between fathers’ attachment anxiety and adolescents’ self-efficacy beliefs in managing negative affect, while mother-adolescent attachment marginally mediated the relation between mothers’ attachment anxiety and adolescents’ self-efficacy beliefs in managing negative affect and expressing positive affect. These findings suggest that parents’ attachment anxiety could predict their children’s attachment to parents, in turn, impacting their children’s regulatory emotional self-efficacy.

     

“Anxious Suicidality”: A New Subtype of Childhood Suicide Ideation?

The current study examined the presence of anxiety in children with suicide ideation. From a sample of 100 inpatients, children who displayed suicide ideation (n = 27) were selected and divided into two groups, high and low anxiety. Findings indicated that children with suicide ideation and anxiety were less happy and satisfied, experienced more negative life events, and were more distractible and intense than children with suicide ideation only. Additionally, according to their self-reports, parents of children with high anxiety reported more obsessive-compulsive and anxiety symptoms as well as greater hostility than parents of children with low anxiety. The authors have identified a subgroup of children with suicide ideation who are highly anxious and can be termed as experiencing “anxious suicidality.”     

Predicting toddler anxiety/depressive symptoms: Effects of caregiver sensitivity on temperamentally vulnerable children

This research examines whether maternal sensitivity in early childhood reduces later anxiety/depressive symptoms for children with more temperamental vulnerability, and whether these effects are different for boys and girls. Data from the National Institute of Child Health and Human Development Early Child Care study with 1,226 subjects (631 boys, 595 girls) were analyzed. Mothers and other caregivers rated children's difficult temperament at 1 and 6 months. Trained observers scored maternal sensitivity when children were 6 and 15 months. Child anxiety/depressive symptoms were rated by mothers and other caregivers when children were 2 and 3 years of age. Maternal sensitivity in early childhood significantly predicted decreased 2‐ and 3‐year‐old anxiety/depressive symptoms. Children with more difficult temperament were significantly more likely to show decreased anxiety/depressive symptoms at 2 years of age if their mothers had been more sensitive. Maternal sensitivity also was a significant predictor of decreased anxiety/depressive symptoms for more temperamentally difficult boys, and temperamentally difficult boys with more sensitive mothers were found to be significantly more likely than girls to show decreased anxiety/depressive symptoms at 3 years of age. The findings of this pilot research suggest that facilitating and supporting increased sensitivity for mothers with more temperamentally difficult children could be beneficial. ©2005 Michigan Association for Infant Mental Health.     

Early—but modest—gender differences in focal aspects of childhood temperament

The best evidence for gender differences in child temperament is in the broad areas of effortful control and surgency, and to an extent negative affectivity, domains that encompass temperament dimensions of inhibitory control, activity level, and shyness. We examined the influence of child gender in a methodologically comprehensively assessed twin sample. We used mother, father, and Laboratory Temperament Assessment Battery (Lab-TAB) ratings to assess temperament in 3 year-olds. Boys had higher levels of activity level and lower levels of shyness and inhibitory control than girls across all methods of assessment. Then, more rigorous testing showed that patterns of mean gender differences for opposite-sex twin pairs in our sample were very consistent with overall sample gender differences and the magnitude of these gender differences was consistent across assessment methodology. We then asked: are these more gendered dimensions of temperament associated with one another, and are associations different across gender? The answer to both questions is, yes. Shyer children have lower activity level and higher inhibitory control, and those with higher inhibitory control are less active. Gender differences did appear in the intercorrelations between parent ratings of shyness and inhibitory control with only girls showing significant associations within and across these dimensions.     

Behavioral Inhibition and Anxiety: The Moderating Roles of Inhibitory Control and Attention Shifting

Behavioral inhibition (BI), a temperament identified in early childhood, is associated with social reticence in childhood and an increased risk for anxiety problems in adolescence and adulthood. However, not all behaviorally inhibited children remain reticent or develop an anxiety disorder. One possible mechanism accounting for the variability in the developmental trajectories of BI is a child’s ability to successfully recruit cognitive processes involved in the regulation of negative reactivity. However, separate cognitive processes may differentially moderate the association between BI and later anxiety problems. The goal of the current study was to examine how two cognitive processes—attention shifting and inhibitory control—laboratory assessed at 48 months of age moderated the association between 24-month BI and anxiety symptoms in the preschool years. Results revealed that high levels of attention shifting decreased the risk for anxiety problems in children with high levels of BI, whereas high levels of inhibitory control increased this risk for anxiety symptoms. These findings suggest that different cognitive processes may influence relative levels of risk or adaptation depending upon a child’s temperamental reactivity.     

Tripartite model of depression and anxiety in youth psychiatric inpatients: relations with diagnostic status and future symptoms

Examined the relation of the depression aspect of the tripartite model of depression and anxiety to the diagnostic status and future symptoms of two samples that included 74 child and adolescent psychiatric inpatients, ages 7 to 17 years (M = 13.57, SD = 2.39), some with either internalizing or externalizing diagnoses. The tripartite model suggests that anhedonia (low positive affect, or PA) differentiates depression from other conditions, whereas generalized negative affect (NA) also characterizes depression but is not specific to it. In this study, differences among children in PA and NA were associated with depressive versus externalizing diagnostic status and with future symptoms of depression. Depressive disorder diagnoses were associated with the combination of low levels of PA and high levels of NA. Changes over time in depression, but not in anxiety, also were associated with the combination of low PA and high NA. Results provide support for the applicability, clinical utility, and extension of the tripartite model with children.     

Early Negative Affect Predicts Anxiety, not Autism, in Preschool Boys with Fragile X Syndrome

Children with fragile X syndrome (FXS) face high risk for anxiety disorders, yet no studies have explored FXS as a high-risk sample for investigating early manifestations of anxiety outcomes. Negative affect is one of the most salient predictors of problem behaviors and has been associated with both anxiety and autistic outcomes in clinical and non-clinical pediatric samples. In light of the high comorbidity between autism and anxiety within FXS, the present study investigates the relationship between longitudinal trajectories of negative affect (between 8 and 71 months) and severity of anxiety and autistic outcomes in young males with FXS (n?=?25). Multilevel models indicated associations between elevated anxiety and higher fear and sadness, lower soothability, and steeper longitudinal increases in approach. Autistic outcomes were unrelated to negative affect. These findings suggest early negative affect differentially predicts anxiety, not autistic symptoms, within FXS. Future research is warranted to determine the specificity of the relationship between negative affect and anxiety, as well as to explore potential moderators. Characterizing the relationship between early negative affect and anxiety within FXS may inform etiology and treatment considerations specific to children with FXS, as well as lend insight into precursors of anxiety disorders in other clinical groups and community samples.     

Locus of Control as a Stress Moderator and Mediator in Children of Divorce

This paper examined the stress moderator and mediator effects of four dimensions of perceived control in children of divorce. The dimensions of locus of control included internal control for positive events, internal control for negative events, unknown control for positive events, and unknown control for negative events. The sample consisted of 222 children between the ages of 8 and 12 whose parents had divorced in the previous 2 years. Moderational analyses showed that unknown control for positive events interacted with negative events to predict total symptoms. Plots of the simple slopes indicated a stress buffering effect whereby the slope of negative events on symptoms was higher for high than for low levels of unknown control for positive events. Mediational analysis showed that the relations between negative events and symptoms were mediated by both unknown control for positive events and unknown control for negative events. In contrast, evidence was not found for either a stress mediational or a moderational model for perceived internal control for positive or negative events. These results suggest that unknown control beliefs may be a particularly important dimension of control for children of divorce.     

Etiology of preschool behavior problems: Contributions of temperament attributes in early childhood

The present study was conducted to examine the contributions of early appearing temperament attributes to toddler and preschool‐age behavior problems. High levels of negative emotionality and low levels of effortful control were linked to both externalizing and internalizing difficulties. All fine‐grained dimensions of negative affect were concurrently associated with internalizing problems whereas relations between components of negative affect and externalizing were observed only for frustration, sadness, and low falling reactivity. Higher surgency was associated with increased risk for externalizing behaviors whereas low surgency increased the likelihood of internalizing problems. Trait‐by‐trait moderation occurred, such that negative emotionality was most closely related to behavior problems when orienting/regulatory capacity or effortful control was low or when infant surgency was high. Results of this study have implications for theory linking temperament and psychopathology, and clinical applications utilizing temperament assessment to prevent behavior problems.     

Prenatal maternal anxiety and early childhood temperament

The consequences of exposure to prenatal maternal anxiety for the development of child temperament were examined in a sample of 120 healthy, 2-year-old children. Prenatal maternal state and pregnancy-specific anxiety (PSA) were measured five times during pregnancy, and maternal state anxiety was measured again at 2 years post partum. Child temperament was measured at 2 years using the Early Childhood Behavior Questionnaire. The relationship between the trajectory of maternal anxiety across gestation and negative affectivity was evaluated using hierarchical linear growth curve modeling. Higher maternal PSA between 13 and 17 weeks of gestation was associated with increased negative temperament in the children. This association could not be explained by postnatal maternal anxiety, demographic, or obstetric factors. Prenatal maternal state anxiety was not associated with child temperament. These findings demonstrate that PSA early in gestation has a distinctive influence on the developing fetus.