Anxiety Sensitivity and Negative Interpretation Biases: Their Shared and Unique Associations with Anxiety Symptoms

Anxiety sensitivity (AS) is a psychological risk factor for anxiety disorders. Negative interpretation biases are a maladaptive form of information-processing also associated with anxiety disorders. The present study explored whether AS and negative interpretation biases make independent contributions to variance in panic and generalized anxiety symptoms and whether particular interpretation bias domains (e.g., of ambiguous arousal sensations) have specific associations with panic and/or generalized anxiety symptoms. Eighty-nine female undergraduates (44 low AS; 45 high AS) completed measures of AS, interpretation biases, and panic and generalized anxiety symptoms. Findings showed that AS and negative interpretation biases both significantly added to the prediction of anxiety symptoms. Negative interpretations of ambiguous arousal sensations were uniquely associated with panic symptoms, while negative interpretations of ambiguous general and social events were uniquely associated with generalized anxiety symptoms. Findings support the conceptual validity of AS and negative interpretation biases and their unique and shared contributions to anxiety symptoms.     

Social Anxiety and Content Specificity of Interpretation and Judgemental Bias in Children

Previous research with adult samples has demonstrated that social anxiety disorder is associated with content‐specific interpretation and judgemental biases. The present study extends our understanding of the specificity of cognitive biases in childhood social anxiety. A sample of non‐clinical children aged 11–12 years completed social anxiety and depression scales and was presented with scenarios depicting hypothetical events varying along two dimensions: relevance to self (event occurs to self or to other) and domain of activity (event is social or non‐social). Partial support for the content‐specificity hypothesis was found. Children's social anxiety symptoms were positively associated with negative interpretation ratings for ambiguous self‐referent and other‐referent events, but only when these events were in the social domain. Further, children's social anxiety symptoms were positively associated with emotional cost judgements for ambiguous social and non‐social events, but only when these events referred to the self. Both patterns of results remained significant even after controlling for concurrent depressive symptoms. Implications of the results for our understanding of maintaining factors in childhood social anxiety are discussed. Copyright © 2011 John Wiley & Sons, Ltd.     

A Pilot Feasibility Open Trial of an Interpretation Bias Intervention for Parents of Anxious Children

Interpretation bias is a transdiagnostic mechanism underlying anxiety. Theoretical models highlight the role of parental interpretation bias in predicting and maintaining child anxiety. However, very few studies have examined parent interpretation bias as a treatment target. The current pilot study tested the feasibility and acceptability of an interpretation bias intervention delivered by a smartphone app, called HabitWorks, in parents of anxious children who self-reported at least mild symptoms of anxiety and negative interpretation bias.Parents of anxious youth (ages 8 to 16) were recruited from the waitlists of three child anxiety clinics. They were asked to complete interpretation modification exercises via the HabitWorks app 3 times per week for 1 month. Participants completed assessments at pre- and post-intervention and 1-month follow-up to assess changes in interpretation bias, anxiety symptoms, and overall perceptions of HabitWorks.Participants (N = 14) (M_age = 44.36; 14.29% men, 85.71% women) completed an average of 13.29 exercises out of the 12 prescribed. Acceptability ratings were high. Interpretation bias, as measured by an assessment version of the intervention exercise, significantly improved from pre- to posttreatment, and these improvements were maintained at the 1-month follow-up. Anxiety symptoms significantly improved from the “mild” severity range to the “none to minimal” range.In this pilot feasibility study in parents of anxious youth, HabitWorks was a feasible and acceptable low-intensity intervention. These preliminary results support a future controlled trial of HabitWorks for parents. Future studies are also needed to test whether targeting interpretation bias in parents has downstream effects on maladaptive parent behaviors and ultimately, child interpretation bias and anxiety.     

Temperament,Family Environment and Anxiety in Preschool Children

This research examines the relationship between behavioural inhibition (BI), family environment (overinvolved and negative parenting, parental anxiety and parent-child attachment) and anxiety in a sample of 202 preschool children. Participants were aged between 3 years 2 months and 4 years 5 months, 101 were male. A thorough methodology was used that incorporated data from multiple observations of behaviour, diagnostic interviews and questionnaire measures. The results showed that children categorised as behaviourally inhibited were significantly more likely to meet criteria for a range of anxiety diagnoses. Furthermore, a wide range of family environment factors, including maternal anxiety, parenting and attachment were significantly associated with BI, with inhibited children more likely to experience adverse family environment factors. No interactions between temperament and family environment were found for child anxiety. However, a significant relationship between current maternal anxiety and child anxiety was found consistently even after controlling for BI. Additionally, there was some evidence of a relationship between maternal negativity and child anxiety, after controlling for BI. The results may suggest that temperament and family environment operate as additive, rather than interactive risk factors for child anxiety. This is discussed in the context of theoretical models of child anxiety and directions for future research.     

Targeted Prevention of Childhood Anxiety: Engaging Parents in an Underserved Community

Selective prevention programs hold the promise of alleviating child anxiety symptoms, decreasing the risk for emotional problems across the lifespan. Such programs have particular public health import for young children of poor, underserved communities. Identifying factors related to parent engagement, and methods to improve engagement, are paramount in the effort to develop anxiety‐focused, community prevention programs. This feasibility study investigated the effect of an enhanced recruitment strategy to maximize parent engagement, as well as factors related to attendance in a single session focused on anxiety prevention. Participants were poor, ethnic minority parents of children aged 11–71 months (n = 256) who completed a survey that assessed anxiety risk according to trauma exposure, child anxiety, or parent anxiety, as well as preferences for preventive services (phase 1). Those meeting risk criteria (n = 101) were invited to a preventive group session (phase 2). Half of parents received enhanced recruitment (ER), which included personalized outreach, matching parent preferences, and community endorsement. Other parents were invited by mail. Chi square analyses indicated that ER was associated with planning to attend (49 vs. 6 % of control). Parents receiving ER were 3.5 times more likely to attend. Higher sociodemographic risk was correlated with higher child anxiety symptoms but not attendance. Results highlight the need for improved strategies for engaging parents in preventive, community‐based interventions.     

Positive Interpretation Bias Predicts Longitudinal Decreases in Social Anxiety

Theoretical models of social anxiety suggest that distorted interpretation processes contribute to its development and maintenance, although the pathways through which this occurs are not well understood. Therefore, the present longitudinal study sought to determine whether negative interpretation bias, positive interpretation bias, and interpretation inflexibility (the degree to which participants correctly revise initial interpretations) predict changes in social anxiety over time. In an important advance over prior studies, individual differences in working memory capacity (WMC) were accounted for, as WMC is thought to play a crucial role in the generation and maintenance of interpretation biases. Following a baseline assessment of social anxiety, interpretation biases, and WMC, participants completed follow-up assessments of social anxiety both 2 weeks (n = 106) and 4 weeks (n = 96) later. After controlling for baseline social anxiety and WMC, greater positive interpretation bias was found to predict lower social anxiety at both follow-ups. Neither negative interpretation bias nor interpretation inflexibility was significantly associated with follow-up social anxiety. These results provide support for greater positive interpretation bias as a facilitator of decreases in social anxiety and a potential target for clinical intervention.     

Attachment,Behavioral Inhibition,and Anxiety in Preschool Children

This study examined the association between insecure attachment, behavioral inhibition, and anxiety in an at risk sample of preschool children. The relationship between maternal anxiety and child anxiety was also assessed. Participants were 104 children aged 3–4 years who were assessed for behavioral inhibition and mother–child attachment (using the Strange Situation procedure). DSM-IV criteria were used to assess childhood anxiety disorders. Insecure attachment and behavioral inhibition were both independently associated with child anxiety, even after controlling for the effect of maternal anxiety. Maternal anxiety was also associated with child anxiety. This study identified both constitutional and environmental factors associated with the expression of anxiety in young children. Furthermore, the highest levels of anxiety were shown by children who were behaviorally inhibited and insecurely attached and whose mothers were also anxious.     

Interpretation and Expectation in Childhood Anxiety Disorders: Age Effects and Social Specificity

Theory and treatment for childhood anxiety disorders typically implicates children’s negative cognitions, yet little is known about the characteristics of thinking styles of clinically anxious children. In particular, it is unclear whether differences in thinking styles between children with anxiety disorders and non-anxious children vary as a function of child age, whether particular cognitive distortions are associated with childhood anxiety disorders at different child ages, and whether cognitive content is disorder-specific. The current study addressed these questions among 120 7–12 year old children (53% female) who met diagnostic criteria for social anxiety disorder, other anxiety disorder, or who were not currently anxious. Contrary to expectations, threat interpretation was not inflated amongst anxious compared to non-anxious children at any age, although older (10–12 year old) anxious children did differ from non-anxious children on measures of perceived coping. The notion of cognitive-content specificity was not supported across the age-range. The findings challenge current treatment models of childhood anxiety, and suggest that a focus on changing anxious children’s cognitions is not warranted in mid-childhood, and in late childhood cognitive approaches may be better focussed on promoting children’s perceptions of control rather than challenging threat interpretations.     

Interventions for Suicidal Children and Their Parents

ABSTRACT: Five features of the family organization of suicidal children include family inhibition of change, lack of defined generational boundaries, severity of spouse conflict, projection of inappropriate parental feelings onto the child, and a symbiotic parent-child interaction. The treatment of suicidal children must encompass a holistic family technique. The acute phases of treatment include protecting the child from harm, promoting family recognition of the seriousness of the child's suicidal behavior, promoting appropriate parental role responsibilities, and effecting an immediate significant family change. During the long-term process of treatment, attention must be focused on the child's unique psychopathology, the conflicts that preclude appropriate parental response to the child's needs, and the characterological difficulties of each parent.     

Instructing Parents to Use Dialogic Reading Strategies with Preschool Children

Abstract

Caregiver use of dialogic reading (DR) strategies in home, preschool, and daycare settings has been shown to facilitate development of oral language and emergent literacy skills in toddlers and preschool age children. Training in the use of DR strategies may be provided ‘live’ or via videotape. Using a randomized, control group, repeated measures design with 18 caregiver-child dyads, we investigated (a) caregivers' ability to learn to use DR strategies with their young children through videotape training in community health centers, and (b) children's verbalizations during shared book reading. Caregivers learned to use DR strategies through the videotape training and maintained their use of DR strategies 12 weeks later. In addition, an intervention effect was observed related to levels of child on-task verbalizations such that children of parents who learned DR strategies talked more about books during shared book reading relative to their baseline and to the control group children, whose parents did not view the DR training video.     

Theory of Mind,Anxiety, and Interpretive Bias During Middle Childhood

Journal of Child and Family Studies - The developmental trajectory of the anxiety-related interpretive bias (a tendency to inappropriately interpret ambiguous stimuli as threatening) and its...     

Dyadic Anxiety in Youth Sport: The Relationship of Achievement Goals With Anxiety in Young Athletes and Their Parents

The role of achievement motivation on precompetitive anxiety was examined in 73 dyads comprising youth athletes and a parent of each athlete. Participants completed questionnaires assessing achievement goals and anxiety. Actor–partner interdependence models were estimated using Mplus 7.11. Parents’ adoption of performance-approach and performance-avoidance goals predicted athletes’ worry (β_{performance-approach} =.30, p <.01; β_{performance-avoidance} =.25, p <.05). Athletes’ adoption of any goal predicted parents’ concentration disruption (β_{mastery-approach} =.41; β_{mastery-avoidance} =.30, p <.01; β_{performance-approach} =.27; β_{performance-avoidance} =.22, p <.05). Thus, parental definitions of competence held for the child was related to their young athlete's emotional state and vice versa.     

Assessment of Discipline Styles Among Parents of Preschool Through School-Age Children

The Parenting Scale (D.S. Arnold, S.G. O'Leary, L.S. Wolff, & M.M. Acker, 1993) is a self-report measure of parenting practices that has demonstrated sound psychometric properties when used with the parents of young children. However, less is known about the use of this measure with parents of older children. This study was conducted to examine the psychometric properties and factor structure of the Parenting Scale in a normative sample of parents with children 2–12 years old. Findings reveal that the psychometric properties remain strong among the parents of elementary school children, with minimal differences in scores as a function of children's age. However, the data suggest that the factor structure may differ from that proposed by the authors. Although statistically significant correlations with ADHD symptoms were revealed, the magnitude of these correlations was relatively small. Suggestions for future research and clinical use of this scale are discussed.     

Changing the Speech of Autistic Children and Their Parents

The parents of nine autistic preschool children were trained in behavior modification and operant techniques of teaching speech. The study used a multiple baseline design with Group 1 completing behavior modification training while Group 2 remained on the waiting list. Then, Group 1 entered speech training while Group 2 began behavior modification. Finally, Group 2 received speech training. Videotape assessments of parents and child were made pretreatment and after each stage of training. The tapes were coded reliably for the parents' speech oriented and non-speech oriented language and the childrens' speech and non-speech behaviors. There was no change in parental speech oriented language following behavior modification but a substantial rise in such language was noted after speech training. Both mothers and fathers changed after training, although mothers were consistently more active than fathers. Both before and after training, the parents of the more verbal children emitted more speech oriented language than the parents of the mute children. The children showed changes which paralleled those of the parents. There was no significant change in child speech after behavior modification, but a rise in children's speech was obvious when their parents completed the speech training. The verbal children accounted for the changes in the two groups since the mute children showed Iittle evidence of change. The results suggest that parents of nonverbal chiIdren can learn to modify their language behavior and that this parent training can be done in an economical group setting.     

Brief report: Attentional Control Moderates the Relationship Between Attentional Bias and Anxiety in Children

This current study tested whether attentional control moderates the relationship between attentional bias to threat and anxiety in children. Children completed a self-report measure of attentional control and anxiety and an attentional bias task. Attentional control was examined as a moderator in the relationship between attentional bias and different dimensions of anxiety. The interaction between attentional control and attentional bias was significant for total and generalized anxiety. Although attentional control significantly moderated the relationship between attentional bias and anxiety, the direction of the interaction was not consistent with existing literature. Study implications and explanations for the study results are discussed.