Fear information and the development of fears during childhood: effects on implicit fear responses and behavioural avoidance

Field, Argyris and Knowles (Behav Res Ther 39 (2001) 1259), and Field, Hamilton, Knowles and Plews (Behav Res Thera 41 (2003) 113) have developed a prospective paradigm for testing Rachman's (Behav Res Ther 15 (1977) 375) proposition that fear information is important in the development of fears and phobias in children. Despite this paradigm being an advance on retrospective reports, the research so far has been restricted to self-reported fear beliefs measured after the information is given. This gives rise to two possible shortcomings: (1) the effects could simply reflect demand characteristics resulting from children conforming to the experimental demands, and (2) although fear information changes beliefs, this might not translate into the behavioural change that would be expected if this information has a powerful effect relevant to the development of pathological fear. This paper describes an experiment that attempts to address these concerns by improving Field et al.'s (2001, 2003) basic paradigm but with the addition of two measures: (1) a behavioural measure of avoidance, and (2) an implicit attitude task that should not be susceptible to deliberate attempts to conform to experimental demands. The result showed that negative and positive information have dramatic, and opposite, effects on self-reported fear beliefs, behavioural avoidance and implicit attitudes. There were no effects of gender on any of these results. This study fully supports Rachman's model and suggests that past work does not merely reflect demand characteristics and that fear information increases behavioural avoidance as well as fear beliefs.     

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.     

Fear of the beast: a prospective study on the effects of negative information on childhood fear

The current study examined the effects of negative information on the enhancement of childhood fear. A large group of normal primary school children aged between 4 and 12 years (N=285) received either negative or positive information about an unknown, doglike animal, called 'the beast'. Children's fears were assessed at three points in time: before, directly after, and one week after the information about the beast was provided (i.e., pre-, post- and follow-up assessment). Results showed that type of information changed children's fear of the beast in the predicted direction with negative information increasing fear levels and positive information decreasing fear levels. This was not only the case directly after the experimental manipulation but also at one week follow-up. Furthermore, fear of the beast appeared to generalize, that is, children who became more fearful of the beast after receiving negative information, also became more apprehensive of other dogs and predators.     

Distinctions between separation anxiety and social anxiety in children and adolescents

Separation anxiety and social phobia are intertwined to a considerable degree, and high comorbidity rates have been reported. The present study used latent class analysis (LCA) to investigate if classes of children and adolescents with-simultaneously-high rates of separation anxiety and low rates of social anxiety symptoms, or vice versa, could be identified. Eight- to 18-year-olds from a large general population (n=1000) and referred sample (n=735) were assessed with the Multidimensional Anxiety Scale for Children (MASC). With LCA, a separate class of referred 8-11-year-old children with high separation anxiety scores, and simultaneously lower social anxiety scores was identified, next to a class of children with high scores on separation anxiety and social anxiety. In the other groups (referred 12-18-year-olds and children and adolescents from the general population), a class with individuals who specifically scored high on separation anxiety could not be revealed. The results indicated that separation anxiety represents a different construct than social anxiety in referred children (but not in referred adolescents or in the general population). It can be concluded that, in referred children, research regarding etiology and treatment outcome of anxiety symptoms should be aimed specifically at separation anxiety and social anxiety, instead of just investigating a broader anxiety dimension.     

The effects of verbal information on children's fear beliefs about social situations

Two experiments explored the role of verbal information in changing children's fear-related beliefs about social situations. In Experiment 1, 118 6- to 8- and 12- to 13-year-olds heard positive, negative, or no information about individuals' experiences of three social situations. Fear beliefs regarding each situation were assessed before and after this manipulation. Verbal information had no significant influence on children's fear beliefs. In Experiment 2, the same paradigm was used with 80 12- to 13-year-olds, but the information took the form of multiple attitude statements about the situations expressed by groups of peers, older children, or adults. An affective priming task of implicit attitudes was used to complement the explicit questions about fear beliefs. Negative information influenced both explicit and implicit fear beliefs. The source of information and the child's own social anxiety did not moderate these effects. Implications for our understanding of the socialisation of childhood fears are discussed.     

The Koala Fear Questionnaire: a standardized self-report scale for assessing fears and fearfulness in pre-school and primary school children

The Koala Fear Questionnaire (KFQ) is a standardized self-report scale for assessing fears and fearfulness in children aged between 4 and 12 years. The current article presents six studies which examined the reliability and validity of the KFQ. Study 1 (N=108) demonstrated that the visual fear scales of Koala bears as employed in the KFQ are highly comparable to the standard 3-point scales that are used in other childhood fear measures. Study 2 (N=163) provided support for the convergent validity of the KFQ in a sample of 8- to 14-year-old children. That is, the scale correlated substantially with alternative measures of childhood fear and anxiety. Study 3 (N=189) showed that the KFQ possesses good internal consistency and test-retest stability in a group of 8- to 11-year-old children. The results of Studies 4 (N=129) and 5 (N=176) indicated that the KFQ is suitable for children aged 4 to 6 years and demonstrated that the psychometric properties of the scale in younger children are highly similar to those obtained in older children. Study 6 (N=926) showed that the factor structure of the KFQ was theoretically meaningful: although the data clearly pointed in the direction of one factor of general fearfulness, spurs of the commonly found five-factor solution of childhood fear were found in the KFQ. Altogether, the KFQ seems to be a valuable addition to the instrumentarium of clinicians and researchers who are working with fearful and anxious children.     

Fear generalization in humans: Impact of prior non-fearful experiences

Fear generalization lies at the heart of many anxiety problems, and is therefore an important target for prevention and/or treatment. Here, we investigated whether fear generalization towards a specific stimulus can be weakened by prior non-fearful experiences with that stimulus. Using the standard human fear conditioning procedure, all participants received paired presentations of a geometric figure and an electric shock. This was followed by a test phase in which a similar but different figure was presented. Electrodermal responding and ratings of shock-expectancy measured the level of fear generalization towards this test stimulus. Crucially, half of the participants had been preexposed to that stimulus (without shock). The results show significantly less generalization in this group, suggesting that prior non-fearful experiences can protect against fear generalization. These results may inspire novel ways to prevent the development of clinical anxiety.     

Cognitive predictors of posttraumatic stress disorder in children: results of a prospective longitudinal study

The present study explored whether cognitive factors specified in the Ehlers and Clark model (Behav. Res. Ther. 38 (2000) 319) of posttraumatic stress disorder (PTSD) predict chronic PTSD in children who had experienced a road traffic accident. Children were assessed at 2 weeks, 3 months, and 6 months after the accident. Data-driven processing during the accident, negative interpretation of intrusive memories, alienation from other people, anger, rumination, thought suppression and persistent dissociation at initial assessment predicted PTSD symptom severity at 3 and 6 months. On the basis of sex and stressor severity variables, 14% of the variance of PTSD symptoms at 6 months could be explained. The accuracy of the prediction increased to 49% or 53% when the cognitive variables measured at initial assessment or 3 months, respectively, were taken into account.     

Social phobic interoception: effects of bodily information on anxiety, beliefs and self-processing

It has been suggested that body-state information influences self-perception and negative thinking in social phobia [Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope & F. R. Schneier (Eds.), Social phobia: diagnosis, assessment and treatment (pp. 69-93). New York: Guilford Press.]. This study explored the effects of body-state information on anxiety and cognition in patients with generalised social phobia during a feared social interaction. It was hypothesised that information concerning an increase in pulse rate would lead to increments in anxiety, negative beliefs and self-processing whilst information concerning a decrease in pulse rate would have the opposite effect. The results of this study were generally consistent with the hypotheses. These findings are important as they may help to account for fluctuations in anxiety, negative beliefs and self-processing in social situations that do not present objective social threat. In particular, social anxiety appears to be modulated by body-state information. The implications of the present findings for cognitive therapy of social phobia are briefly discussed.     

Nighttime fears of children and adolescents: frequency, content, severity, harm expectations, disclosure, and coping behaviours

The present school-based study investigated the nighttime fears of 511 children and adolescents, aged 8-16 years. Participants were assessed using a structured interview about the frequency, content, severity, harm expectations, coping strategies, and disclosure of nighttime fears. Results indicated that nighttime fears are a common experience, with nearly two-thirds (64.2%) of children and adolescents reporting nighttime fears. Fear of intruders/home invasion was the most frequently reported nighttime fear. Females more frequently reported nighttime fears than males (72.9% and 54.6%, respectively) and a greater number of children reported nighttime fears compared to adolescents (79.4% and 48.8%, respectively). Nighttime fears were given moderate severity ratings, and harm expectations were most strongly associated with 'personal security' fears. Respondents reported a variety of coping strategies to manage their nighttime fears with self-control/distraction techniques being the most common. Most respondents reported disclosing their nighttime fear(s) to another person. The clinical implications of these findings and the methodological limitations are discussed.     

Workaholism in organizations: The role of personal beliefs and fears

Abstract

This research examined potential individual difference correlates of workaholism in organizational settings. Data were collected from 530 women and men in managerial and professional roles using anonymous questionnaires. Workaholism types were determined using measures developed by Spence and Robbins (1992) Journal of Personality Assessment 58, 160–178. Three personal beliefs and fears identified by Price (1982) Journal of Occupational Behavior, 3, 109–130 in her cognitive social learning model of Type A behavior were assessed as well, some suggesting a possible overlap between particular Type A components and workaholism. Two of the three beliefs and fears were positively and significantly related with workaholism type.     

Fear of storms and hurricanes in Antillean and Belgian children

The present study assessed fear of hurricanes in children who had been confronted with this natural event (i.e., Antillean children, n=161). Their fear levels were compared to those of children who are unfamiliar with such an event (i.e., Belgian children, n=185). Antillean children reported significantly higher levels of fear of storms than Belgian children did, thus providing support for the notion that exposure to dangerous events promotes children's fears of those events. Surprisingly, however, Antillean children had lower scores on the 'Hurricanes' item than Belgian children. Plausibly, differences in how children interpreted this item may have accounted for this unexpected finding. That is, ratings of Antillean children were probably based on actual experiences with hurricanes, whereas scores of Belgian children presumably reflected appraisal of threat in case they would be confronted with such an event. Implications of this finding for the assessment of childhood fears are briefly discussed.     

A dirty animal is a scary animal! Effects of disgust-related information on fear beliefs in children

The present study investigated whether disgust-valenced information has an impact on children's fear beliefs about animals. Non-clinical children aged between 9 and 13 years (n=159) were presented with disgust-related and cleanliness-related information about unknown animals (Australian marsupials). Before and after information, beliefs of disgust and fear regarding the animals were assessed. Results showed that disgust-related information not only induced higher levels of disgust but also increased children's fear beliefs in relation to these animals. The other way around, cleanliness-related information decreased levels of disgust and resulted in lower levels of fear. The implications for the role of disgust in the development of animal fear are briefly discussed.     

The sleep patterns and problems of clinically anxious children

Childhood sleep problems have been associated with a range of adverse cognitive and academic outcomes, as well as increased impulsivity and emotional disorders such as anxiety and depression. The aim of the study was to examine subjective reports of sleep-related problems in children with anxiety disorders during school and weekend nights. Thirty-seven children with clinically-diagnosed anxiety disorders and 26 non-clinical children aged 7-12 years completed an on-line sleep diary to track sleep patterns across school nights and weekend nights. Anxious children reported going to bed significantly later (p = 0.03) and had significantly less sleep (p = 0.006) on school nights compared to non-anxious children. No significant differences in sleep onset latency, number of awakenings or time awake during the night, daytime sleepiness, or fatigue were found between the two groups. On the weekends, anxious children fell asleep quicker and were less awake during the night than on weeknights. School-aged anxiety disordered children showed a sleep pattern that differs from their non-anxious peers. Although the mean 30 min less sleep experienced by anxious children may initially seem small, the potential consequences on daytime performance from an accumulation of such a sleep deficit may be significant, and further investigation is warranted.     

Threat interpretation in anxious children and their mothers: comparison with nonclinical children and the effects of treatment

Interpretation biases towards threat play a prominent role in cognitive theories of anxiety, and have been identified amongst highly anxious adults and children. Little is known, however, about the development of these cognitive biases although family processes have been implicated. The current study investigated the nature of threat interpretation of anxious children and their mothers through (i) comparison of a clinic and non-clinic population, (ii) analysis of individual differences; and (iii) pre- and post-treatment comparisons. Participants were 27 children with a primary anxiety disorder and 33 children from a non-clinic population and their mothers. Children and mothers completed self-report measures of anxiety and indicated their most likely interpretation of ambiguous scenarios. Clinic and non-clinical groups differed significantly on measures of threat interpretation. Furthermore, mothers' and children's threat interpretation correlated significantly. Following treatment for child anxiety, both children and their mothers reported a reduction in threat interpretation.     

Emotion Regulation in Youth with Emotional Disorders: Implications for a Unified Treatment Approach

Given the relationship between internalizing disorders and deficits in emotion regulation in youth, the emotion science literature has suggested several avenues for increasing the efficacy of interventions for youth presenting with anxiety and depression. These possibilities include the identification and addition of emotion-regulation skills to existing treatment packages and broadening the scope of those emotions addressed in cognitive-behavioral treatments. Current emotion-focused interventions designed to meet one or both of these goals are discussed, and the developmental influences relevant to the selection of emotion-focused treatment goals are explored using the framework of a modal model of emotion regulation. These various lines of evidence are woven together to support the utility of a novel emotion-focused, cognitive-behavioral intervention, the Unified Protocol for the Treatment of Emotional Disorders in Youth, a transdiagnostic treatment protocol that aims to treat the range of emotional disorders (i.e., anxiety and depression) simultaneously. Avenues for future directions in treatment outcome and assessment of emotion regulation are also discussed.     

Experimental modification of interpretation bias in socially anxious children: Changes in interpretation, anticipated interpersonal anxiety, and social anxiety symptoms

We report on an experimental manipulation of interpretation bias in socially anxious youths. A non-clinical sample of 10–11-year-olds selected for high social anxiety was trained over three sessions to endorse benign rather than negative interpretations of potentially threatening social scenarios. This group was subsequently less likely to endorse negative interpretations of new ambiguous social situations than children in a test–retest condition. Children who received interpretation training also showed reduced trait social anxiety and reported significantly less anxiety about an anticipated interpersonal encounter, compared with the control group.     

Relationships between metacognitive beliefs,social evaluative threat and worry

A worry state is assumed to emerge from the interaction between metacognitive beliefs, and the appraisal of environmental demands (Wells & Matthews, 1994). The aim of this study was to show that metacognitive beliefs moderate the effect of sources of social evaluative threat on worry. Our sample (N = 174) completed a working memory task in two contexts (threatful vs. neutral), while both pre- and post-task measures subjective stress states were recorded. Our results confirmed significant effects of sources of social evaluative threat and metacognitive beliefs on worry. The interaction metacognition * threat context effect on worry was not significant. Our findings support the hypothesis that worry is a form of subjective stress explained by a combination of outcome uncontrollability and social evaluative threat. Social evaluative threat and metacognitive beliefs appeared as two, independent predictors of a worry state. Our results are discussed in reference to the Self Regulative model of stress.     

Mom told me scary things about this animal: Parents installing fear beliefs in their children via the verbal information pathway

This study investigated whether fear beliefs can be installed in children after parents had received negatively tinted information about a novel stimulus. Parents of children aged 8-13 years (N = 88) were presented with negative, positive, or ambiguous information about an unknown animal and then given a number of open-ended vignettes describing confrontations with the animal with the instruction to tell their children what would happen in these situations. Results indicated that children's fear beliefs were influenced by the information that was provided to the parent. That is, parents who had received negative information provided more threatening narratives about the animal and hence installed higher levels of fear beliefs in their children than parents who had received positive information. In the case of ambiguous information, the transmission of fear was dependent on parents' trait anxiety levels. More precisely, high trait anxious parents told more negative stories about the unknown animal, which produced higher fear levels in children.