Attention Biases to Threat Link Behavioral Inhibition to Social Withdrawal over Time in Very Young Children

Behaviorally inhibited children display a temperamental profile characterized by social withdrawal and anxious behaviors. Previous research, focused largely on adolescents, suggests that attention biases to threat may sustain high levels of behavioral inhibition (BI) over time, helping link early temperament to social outcomes. However, no prior studies examine the association between attention bias and BI before adolescence. The current study examined the interrelations among BI, attention biases to threat, and social withdrawal already manifest in early childhood. Children (N = 187, 83 Male, M _age  = 61.96 months) were characterized for BI in toddlerhood (24 & 36 months). At 5 years, they completed an attention bias task and concurrent social withdrawal was measured. As expected, BI in toddlerhood predicted high levels of social withdrawal in early childhood. However, this relation was moderated by attention bias. The BI-withdrawal association was only evident for children who displayed an attention bias toward threat. The data provide further support for models associating attention with socioemotional development and the later emergence of clinical anxiety.     

Maternal Over-Control Moderates the Association Between Early Childhood Behavioral Inhibition and Adolescent Social Anxiety Symptoms

Behavioral inhibition (BI) and maternal over-control are early risk factors for later childhood internalizing problems, particularly social anxiety disorder (SAD). Consistently high BI across childhood appears to confer risk for the onset of SAD by adolescence. However, no prior studies have prospectively examined observed maternal over-control as a risk factor for adolescent social anxiety (SA) among children initially selected for BI. The present prospective longitudinal study examines the direct and indirect relations between these early risk factors and adolescent SA symptoms and SAD, using a multi-method approach. The sample consisted of 176 participants initially recruited as infants and assessed for temperamental reactivity to novel stimuli at age 4?months. BI was measured via observations and parent-report across multiple assessments between the ages of 14?months and 7?years. Maternal over-control was assessed observationally during parent–child interaction tasks at 7?years. Adolescents (ages 14–17?years) and parents provided independent reports of adolescent SA symptoms. Results indicated that higher maternal over-control at 7?years predicted higher SA symptoms and lifetime rates of SAD during adolescence. Additionally, there was a significant interaction between consistently high BI and maternal over-control, such that patterns of consistently high BI predicted higher adolescent SA symptoms in the presence of high maternal over-control. High BI across childhood was not significantly associated with adolescent SA symptoms when children experienced low maternal over-control. These findings have the potential to inform prevention and early intervention programs by indentifying particularly at-risk youth and specific targets of treatment.     

Inhibitory control and set shifting describe different pathways from behavioral inhibition to socially anxious behavior

Individuals with a behaviorally inhibited (BI) temperament are more likely to develop social anxiety. However, the mechanisms by which socially anxious behavior emerges from BI are unclear. Variation in different forms of top‐down control, specifically executive functions (EF), may play distinct roles and characterize differential pathways to social anxiety. Here 291 children were assessed for BI in toddlerhood (ages 2 and 3), parent‐reported inhibitory control and set shifting during middle childhood (age 7), and multidimensional assessment of socially anxious behavior completed during late childhood and early adolescence (ages 9 and 12). Structural equation modeling revealed that early variation in BI predicted the development of socially anxious behavior through either higher levels of parent‐reported inhibitory control or lower levels of parent‐reported set shifting. These data reinforce the notion that top‐down control does not uniformly influence relations between temperament and socially anxious behavior. These data suggest novel approaches to thinking about the role of EFs and social anxiety outcomes as children approach adolescence.     

Internalizing Symptoms and Affective Reactivity in Relation to the Severity of Aggression in Clinically Referred,Behavior-Disordered Children

We examined the affective correlates of aggression in children referred to a partial hospitalization program for the treatment of behavior disorders who did not have a mood or anxiety disorder. Parent and teacher ratings of the children’s impulsivity, internalizing symptoms, affective reactivity, and aggression were examined for their interrelationships and then entered into regression analyses to predict the child’s level of aggression in the home, at school, and in the treatment program. Intercorrelations among three affective reactivity factors were modest. Both internalizing symptoms and affective reactivity contributed to aggression severity beyond impulsivity and demographics. Only child irritability predicted treatment program aggression. Because of their potential role in understanding children’s behavioral disturbances, internalizing symptoms and negative emotionality merit careful assessment and treatment in treatment programs serving hard-to-manage children with behavior disorders.     

Childhood Peer Status and Adult Susceptibility to Anxiety and Depression. A 30-Year Hospital Follow-up

This study examined the extent to which sixth grade peer status could predict anxiety and/or depression in 5,242 women and 5,004 men who were born in 1953 and whose hospital records were followed up from 1973–2003. The data used was the Stockholm Birth Cohort Study. While no association could be established for men, results indicated that women who held low peer status positions in childhood were at a considerably higher risk of anxiety and/or depression later in life compared to women in average status positions. Women who held popular positions during childhood did not differ significantly from their average counterparts. These findings persisted after adjusting for family- and child-related problem-load, perceived security at school, family constellation, socioeconomic status as well as the child’s cognitive ability, ninth grade school marks and continuance to upper secondary school.     

Maternal Depressive Symptoms and Child Social Preference During the Early School Years: Mediation by Maternal Warmth and Child Emotion Regulation

This longitudinal study examined processes that mediate the association between maternal depressive symptoms and peer social preference during the early school years. Three hundred and fifty six kindergarten children (182 boys) and their mothers participated in the study. During kindergarten, mothers reported their level of depressive symptomatology. In first grade, teachers rated children’s emotion regulation at school and observers rated the affective quality of mother-child interactions. During second grade, children’s social preference was assessed by peer nomination. Results indicated that mothers’ level of depressive symptomatology negatively predicted their child’s social preference 2 years later, controlling for the family SES and teacher-rated social preference during kindergarten. Among European American families, the association between maternal depressive symptoms and social preference was partially mediated by maternal warmth and the child’s emotion regulation. Although the relation between maternal depressive symptoms and children peer preference was stronger among African American families than Europrean American families, its mediation by the maternal warmth and child’s emotion regulation was not found in African American families.     

The Course of Childhood Anxiety Symptoms: Developmental Trajectories and Child-Related Factors in Normal Children

This three-wave longitudinal study explored developmental trajectories for various types of childhood anxiety symptoms (i.e., specific fears, social anxiety, generalized anxiety, and separation anxiety) and examined how these trajectories were associated with several factors thought to be involved in the pathogenesis of anxiety. Parents of a community sample of 224 children aged 4 to 11 years repeatedly completed a standardized questionnaire of anxiety symptoms during a 2-year period. At Time 1, parents also filled out scales for measuring children’s level of behavioral inhibition (BI), internalizing and externalizing symptoms, and prosocial behaviors, while an interview was conducted with children to assess Theory-of-Mind (TOM) ability. Growth Mixture Modeling identified multiple developmental trajectories in childhood anxiety symptoms of which the ‘stable-low’ or ‘stable-medium’ reflected the normative trajectories. Further, multinomial regression analyses indicated that the higher developmental trajectories of anxiety were associated with higher levels of BI and internalizing symptoms at Time 1. In sum, results show heterogeneity in the development of anxiety symptoms and underline the importance of early prevention programs for children at high risk for developing an anxiety disorder.     

Children and Violence: The Role of Children’s Regulation in the Marital Aggression–Child Adjustment Link

Exposure to marital psychological and physical abuse has been established as a risk factor for children’s socio-emotional, behavioral, and cognitive problems. Understanding the processes by which children develop symptoms of psychopathology and deficits in cognitive functioning in the context of marital aggression is imperative for developing efficient and effective treatment programs for children and families, and has far-reaching mental health implications. The present paper outlines our research program, Child Regulation and Exposure to Marital Aggression, which focuses on children’s emotional and physiological reactivity and regulation as pathways in the marital aggression–child development link. Findings from our research program, which highlight the importance of children’s regulatory processes for understanding children’s adjustment in contexts of intimate partner violence, are presented, and future directions in this line of inquiry are outlined.     

Behavioral Inhibition and Attentional Control in Adolescents: Robust Relationships with Anxiety and Depression

Behavioral inhibition (BI) has been associated with the development of internalizing disorders in children and adolescents. It has further been shown that attentional control (AC) is negatively associated with internalizing problems. The combination of high BI and low AC may particularly lead to elevated symptomatology of internalizing behavior. This study broadens existing knowledge by investigating the additive and interacting effects of BI and AC on the various DSM-IV based internalizing dimensions. A sample of non-clinical adolescents (N = 1806, age M = 13.6 years), completed the Behavioral Inhibition System/Behavioral Activation System Scales (BIS/BAS), the attentional control subscale of the Adult Temperament Questionnaire (ATQ) and the Revised Child Anxiety and Depression Scale (RCADS). As expected, BI was positively, and AC was negatively related to internalizing dimensions, with stronger associations of BI than of AC with anxiety symptoms, and a stronger association of AC than of BI with depressive symptoms. AC moderated the association between BI and all measured internalizing dimensions (i.e., symptoms of generalized anxiety disorder, social phobia, separation anxiety disorder, panic disorder, obsessive–compulsive disorder, and major depressive disorder). Since high AC may reduce the impact of high BI on the generation of internalizing symptoms, an intervention focused on changing AC may have potential for prevention and treatment of internalizing disorders.     

Does Father Know Best? A Formal Model of the Paternal Influence on Childhood Social Anxiety

We explore paternal social anxiety as a specific risk factor for childhood social anxiety in a rational optimization model. In the course of human evolution, fathers specialized in external protection (e.g., confronting the external world) while mothers specialized in internal protection (e.g., providing comfort and food). Thus, children may instinctively be more influenced by the information signaled by paternal versus maternal behavior with respect to potential external threats. As a result, if fathers exhibit social anxiety, children interpret it as a strong negative signal about the external social world and rationally adjust their beliefs, thus becoming stressed. Under the assumption that paternal signals on social threats are more influential, a rational cognitive inference leads children of socially anxious fathers to develop social anxiety, unlike children of socially anxious mothers. We show in the model that mothers cannot easily compensate for anxious paternal behavior, but choose to increase maternal care to maintain the child’s wellbeing. We discuss research directions to test the proposed model as well as implications for the prevention and treatment of child social anxiety.     

Parental Experiences of Having a Child with Obsessive-Compulsive Disorder: Associations with Clinical Characteristics and Caregiver Adjustment

We examined parental experience of having a child with obsessive-compulsive disorder (OCD) in 62 parent–child dyads. Youth with a primary diagnosis of OCD and their parent(s) were administered the CY-BOCS jointly by a trained clinician. Parents completed several measures about their child’s OCD-related impairment and accommodation, emotional and behavioral functioning, parental distress, caregiver stress, and parental experiences of having a child with OCD. Results indicated that parents of children with OCD are considerably distressed about their child’s condition. As expected, negative parental experiences (e.g., anxiety about child’s condition, uncertainty about their future) were directly related to OCD symptom severity and impairment, as well as child internalizing and externalizing problems, family accommodation of symptoms, and caregiver strain. The presence of emotional resources was negatively related to most outcomes, although some of these relationships did not achieve statistical significance. The presence of internalizing symptoms mediated the relationship between parental experiences and parental distress. Given these findings, addressing parental experiences as part of a family based cognitive-behavioral treatment program for pediatric OCD may help reduce parental distress and improve patient prognosis.     

Symptoms of Attention-Deficit/Hyperactivity Disorder and Social and School Adjustment: The Moderating Roles of Age and Parenting

This study examined the associations between symptoms of attention-deficit/hyperactivity disorder (ADHD) and social and school adjustment (academic performance, peer relationships, school social problems) and the moderating roles of children’s age and maternal parenting (affection and overprotection) in these associations. The sample consisted of 2,463 students who were in the first to ninth grade in northern Taiwan. Results from the linear mixed models demonstrated that ADHD symptoms were inversely associated with academic performance and positively associated with social adjustment problems. Further, children’s age and maternal parenting moderated the associations between ADHD symptoms and school and social adjustment. For example, maternal overprotection moderated the relation between hyperactivity and negative peer relationships (i.e., difficulty forming and maintaining friendships), such that this relation was stronger for children who experienced higher levels of overprotection than children who did not. Moreover, children’s age moderated the association between attention problems and decreased academic performance, such that this association was stronger for older children and adolescents than for younger children. Furthermore, children’s age and maternal affection interacted to influence the association between attention problems and school social problems (i.e., bullying, aggression, and peer rejection) with maternal affection acting as a buffer for older children (grades 4–6) only. These findings are discussed from a developmental psychopathology perspective.     

Cognitive control moderates early childhood temperament in predicting social behavior in 7‐year‐old children: an ERP study

Behavioral inhibition (BI) is a temperament associated with heightened vigilance and fear of novelty in early childhood, and social reticence and increased risk for anxiety problems later in development. However, not all behaviorally inhibited children develop signs of anxiety. One mechanism that might contribute to the variability in developmental trajectories is the recruitment of cognitive‐control resources. The current study measured N2 activation, an ERP (event‐related potential) associated with cognitive control, and modeled source‐space activation (LORETA; Low Resolution Brain Electromagnetic Tomography) at 7 years of age while children performed a go/no‐go task. Activation was estimated for the entire cortex and then exported for four regions of interest: ventromedial prefrontal cortex (VMPFC), ventrolateral prefrontal cortex (VLPFC), dorsal anterior cingulate cortex (dorsal ACC), and dorsal lateral prefrontal cortex (DLPFC). BI was measured in early childhood (ages 2 and 3 years). Anxiety problems and social reticence were measured at 7 years of age to ascertain stability of temperamental style. Results revealed that BI was associated with increased performance accuracy, longer reaction times, greater (more negative) N2 activation, and higher estimated dorsal ACC and DLPFC activation. Furthermore, early BI was only associated with social reticence at age 7 at higher (more negative) levels of N2 activation or higher estimated dorsal ACC or DLPFC activation. Results are discussed in the context of overcontrolled behavior contributing to social reticence and signs of anxiety in middle childhood.     

Reward-related brain function as a predictor of treatment response in adolescents with major depressive disorder

The present study provides preliminary evidence that pretreatment reward-related brain function in the striatum and medial prefrontal cortex (PFC) could have relevance for predicting both final level and rate of change of clinical characteristics in adolescents with major depressive disorder. Adolescents with depression underwent a functional MRI scan during a monetary reward task, participated in an 8-week open trial of cognitive behavioral therapy (CBT) or CBT plus selective serotonin reuptake inhibitor, and completed reports of anxiety and depressive symptoms before, during, and after treatment. Clinicians rated adolescents’ improvement and severity at the same time points. Growth models were used to examine change in clinical characteristics and its association with brain function. Severity, anxiety symptoms, and depressive symptoms decreased over treatment. Final levels of severity and anxiety symptoms were associated with pretreatment striatal reactivity, and rate of anxiety symptom reduction was associated with greater striatal reactivity and lower medial PFC reactivity.     

Cognitive Theories of Depression in Children and Adolescents: A Conceptual and Quantitative Review

This paper quantitatively reviews longitudinal studies examining three central cognitive theories of depression—Beck’s theory, Hopelessness theory, and the Response Styles theory—among children (age 8–12) and adolescents (age 13–19). We examine the effect sizes in 20 longitudinal studies, which investigated the relation between the cognitive vulnerability–stress interaction and its association with prospective elevations in depression after controlling for initial levels of depressive symptoms. The results of this review suggest that across theories there is a small relation between the vulnerability–stress interaction and elevations in depression among children (pr = 0.15) and a moderately larger effect (pr = 0.22) among adolescents. Despite these important findings, understanding their implications has been obscured by critical methodological, statistical, and theoretical limitations that bear on cognitive theories of depression. The evidence base has been limited by poor measurement of cognitive vulnerabilities and over reliance on null hypothesis significance testing; these have contributed to a field with many gaps and inconsistencies. The relative paucity of research on developmental applications of such theories reveals that surprisingly little is known about their hypothesized etiologic mechanisms in children and adolescents. Ways to advance knowledge in the area of cognitive theories of depression among youth are discussed.     

Professional Ambivalence: Accounts of Ethical Practice in Childhood Genetic Testing

Childhood genetic testing raises complex ethical and moral dilemmas for both families and professionals. In the family sphere, the role of communication is a key aspect in the transmission of ‘genetic responsibility’ between adults and children. In the professional sphere, genetic responsibility is an interactional accomplishment emerging from the sometimes competing views over what constitutes the ‘best interests’ of the child in relation to parental preferences on the one hand, and professional judgements on the other. In the present paper we extend our previous research into parental accounts of childhood genetic testing and explore the ethical accounts of professionals in research interviews. Interviews (n = 20) were conducted with professional practitioners involved in the genetic diagnosis and management of children and their families. We first identify four inter-related themes—juxtaposition of parental rights vis-à-vis child’s autonomy, elicitation of the child’s autonomy, avoidance of parental responsibility and recognition of professional uncertainty. Then, using Rhetorical Discourse Analysis, we examine the range of discourse devices through which ethical accounts are situationally illustrated: contrast, reported speech, constructed dialogue, character and event work. An overarching device in these ethical accounts is the use of extreme case scenarios, which reconstruct dilemmas as justifications of professional conduct. While acknowledging ambivalence, our analysis suggests that professional judgement is not a simple matter of implementing ethical principles but rather of managing the practical conditions and consequences of interactions with parents and children. We conclude that more attention is needed to understand the way professional practitioners formulate judgements about ethical practice.     

Associations Among Selective Attention, Memory Bias, Cognitive Errors and Symptoms of Anxiety in Youth

The purpose of this study was to examine the linkages among selective attention, memory bias, cognitive errors, and anxiety problems by testing a model of the interrelations among these cognitive variables and childhood anxiety disorder symptoms. A community sample of 81 youth (38 females and 43 males) aged 9-17 years and their parents completed measures of the child's anxiety disorder symptoms. Youth completed assessments measuring selective attention, memory bias, and cognitive errors. Results indicated that selective attention, memory bias, and cognitive errors were each correlated with childhood anxiety problems and provide support for a cognitive model of anxiety which posits that these three biases are associated with childhood anxiety problems. Only limited support for significant interrelations among selective attention, memory bias, and cognitive errors was found. Finally, results point towards an effective strategy for moving the assessment of selective attention to younger and community samples of youth.     

Moral Emotions,Emotion Self-Regulation,Callous-Unemotional Traits,and Problem Behavior in Children of Incarcerated Mothers

Children with incarcerated mothers are at high risk for developing problem behaviors. Fifty children (6–12 years; 62% girls) participated in summer camps, along with adult mentors. Regression analyses of child and adult measures of child’s emotion self-regulation and callous-unemotional traits, and a child measure of moral emotions, showed that poor emotion regulation, along with low levels of guilt and high levels of shame, predicted children’s externalizing behaviors, while only low levels of guilt predicted a unique subset of child characteristics called callous-unemotional traits. Children who experienced healthy guilt for misdeeds were better able to control their behavior. Adults noted the ability of children with callous/unemotional traits to manage and regulate their emotions, while poor emotion regulation was more predictive of the cluster of externalizing problems. Discussion focuses on prevention efforts aimed at teaching emotion self-regulation and the implications of the high levels of callous-unemotional traits in this population of children.     

Childhood behavioral inhibition and the experience of social anxiety in American Indian adolescents

American Indian youth may be at increased risk for anxiety-related problems. Social anxiety is the most common form of anxiety experienced by adolescents, yet little research specific to American Indians has been conducted. Childhood temperament, especially behavioral inhibition (BI), has been identified as an important risk factor for social anxiety in other racial and ethnic groups. This study examined BI in relation to social anxiety in a cross-sectional community-based sample of 86 rural southeastern American Indian adolescents. Patterns of childhood BI suggested cultural variations in the way temperament relates to adolescent social anxiety. Specifically, nonsocially based fears in childhood were associated with social anxiety symptoms in adolescence, which is in contrast to previous findings in non American Indian samples that have suggested continuity between social inhibition in childhood and social anxiety in adolescence. It is recommended that major psychological risk factors, including temperament, be evaluated within the specific social and cultural context of the adolescent population of interest.     

Early-occurring Maternal Depression and Maternal Negativity in Predicting Young Children’s Emotion Regulation and Socioemotional Difficulties

This longitudinal investigation examined the effects of maternal depression and concomitant negative parenting behaviors on children’s emotion regulation patterns and socioemotional functioning. One hundred fifty-one mothers and their children were assessed when children were approximately 1 1/2-, 3-, 4-, and 5-years of age. Ninety-three of the children had mothers with a history of Major Depressive Disorder (MDD) that had occurred within the first 21 months of the child’s birth, and 58 of the children had mothers without any history of MDD. Early-occurring Initial maternal depression predicted children’s dysregulated emotion patterns at age 4 and decreased perceived competence ratings at age 5. Initial maternal depression also indirectly predicted decreased child social acceptance ratings at age 5 through its association with dysregulated emotion patterns. Furthermore, the relation between maternal depression and children’s decreased social acceptance was more pronounced in those offspring with a history of high versus low maternal negativity exposure. Findings increase understanding of the processes by which maternal depression confers risk on children’s socioemotional adjustment.