Emotion-Focused Cognitive-Behavioral Therapy for Youth with Anxiety Disorders: A Randomized Trial

Difficulties with emotion regulation are a core feature of anxiety disorders (ADs) in children and adults. Interventions with a specific focus on emotion regulation are gaining empirical support. Yet, no studies to date have compared the relative efficacy of such interventions to existing evidence-based treatments. Such comparisons are necessary to determine whether emotion-focused treatments might be more effective for youth exhibiting broad emotion-regulation difficulties at pretreatment. This study examined an emotion-focused cognitive-behavioral therapy (ECBT) protocol in comparison to traditional cognitive-behavioral therapy (CBT) in a sample of children with a primary anxiety disorder diagnosis. Moderation analyses examined whether children with higher levels of emotion dysregulation at pretreatment would show greater levels of improvement in ECBT than CBT. Ninety-two youth ages 7 to 12 years (58% male) with a primary diagnosis of separation anxiety disorder, generalized anxiety disorder, or social phobia were included. Participants were randomly assigned to ECBT or CBT. Results showed that youth in both conditions demonstrated similar improvements in emotion regulation and that pretreatment levels of emotion dysregulation did not moderate treatment outcomes. Additional analyses showed that ECBT and CBT were similarly effective on diagnostic, severity, and improvement measures. Future work is needed to further explore the ways that emotion regulation is related to treatment outcome for anxious youth.     

Associations between Race and Eating Disorder Symptom Trajectories in Black and White Girls

Epidemiological research suggests racial differences in the presentation of eating disorder symptoms. However, no studies have examined associations between race and eating disorder symptom trajectories across youth and adolescence, which is necessary to inform culturally sensitive prevention programs. The purpose of the current study was to examine the trajectories of eating disorder symptoms from childhood to young adulthood and to examine whether race was associated with trajectory group membership. Data were drawn from 2,305 Black and White girls who participated in a community-based longitudinal cohort study (Pittsburgh Girls Study) examining the development of psychopathology. The child and adult versions of the Eating Attitudes Test assessed self-reported eating disorder symptoms at six time points between ages 9 and 21 years. Growth mixture modeling was used to examine developmental trajectories of dieting, bulimia/food preoccupation, and total eating disorder symptom scores. Given potential confounds with race and disordered eating, financial strain (i.e., receiving public assistance) and weight were included as covariates. Four to six distinct developmental patterns were found across eating disorder symptoms, including none, increasing, decreasing, or increasing-decreasing trajectories. Black girls had a greater likelihood of being in the decreasing trajectories for dieting, bulimia/food preoccupation, and total eating disorder symptom scores. White girls were more likely to follow increasing trajectories of dieting and total eating disorder symptom scores compared to Black girls. These results highlight the importance of examining the influence of racial background on eating disorder symptoms and the potential need for differences in the timing and focus of prevention interventions in these groups.     

Fearful Inhibition,Inhibitory Control,and Maternal Negative Behaviors During Toddlerhood Predict Internalizing Problems at Age 6

Many, but not all, young children with high levels of fearful inhibition will develop internalizing problems. Individual studies have examined either child regulatory or environmental factors that might influence the level of risk. We focused on the interaction of regulation and environment by assessing how early fearful inhibition at age 2, along with inhibitory control and maternal negative behaviors at age 3, interactively predicted internalizing problems at age 6. A total of 218 children (105 boys, 113 girls) and their mothers participated in the study. Results indicated a three-way interaction among fearful inhibition, inhibitory control, and maternal negative behaviors. The correlation between fearful inhibition and internalizing was significant only when children had low inhibitory control and experienced high levels of maternal negative behaviors. Either having high inhibitory control or experiencing low maternal negative behaviors buffered against the adverse effect caused by the absence of the other. These findings highlight the importance of considering associations among both within-child factors and environmental factors in studying children’s socioemotional outcomes.     

An Imbalance of Approach and Effortful Control Predicts Externalizing Problems: Support for Extending the Dual-Systems Model into Early Childhood

Although the association between deficits in effortful control and later externalizing behavior is well established, many researchers (Nigg Journal of Child Psychology and Psychiatry, 47(3-4), 395–422, 2006; Steinberg Developmental Review, 28(1), 78–106, 2008) have hypothesized this association is actually the product of the imbalance of dual systems, or two underlying traits: approach and self-regulation. Very little research, however, has deployed a statistically robust strategy to examine that compelling model; further, no research has done so using behavioral measures, particularly in longitudinal studies. We examined the imbalance of approach and self-regulation (effortful control, EC) as predicting externalizing problems. Latent trait models of approach and EC were derived from behavioral measures collected from 102 children in a community sample at 25, 38, 52, and 67 months (2 to 5 ½ years), and used to predict externalizing behaviors, modeled as a latent trait derived from parent-reported measures at 80, 100, 123, and 147 months (6 ½ to 12 years). The imbalance hypothesis was supported: Children with an imbalance of approach and EC had more externalizing behavior problems in middle childhood and early preadolescence, relative to children with equal levels of the two traits.     

Testosterone and Proactive-Reactive Aggression in Youth: the Moderating Role of Harsh Discipline

This study tests a biosocial model of the link between testosterone and proactive-reactive aggression in youth at varying levels of harsh discipline. Given that proactive aggression is used to gain power and status and the importance of social learning in its formation, we hypothesized that testosterone would be associated with proactive aggression at higher levels of harsh discipline, and that this relationship would be more pronounced in boys than girls. Participants (n?=?445; 50% male; M age?=?11.92 years; 80% African-American) and their caregivers completed questionnaires including demographics, conflict tactics, and proactive-reactive aggression. Youth also provided a saliva sample for testosterone. Analyses revealed an interaction between testosterone and harsh discipline on proactive aggression in both boys and girls, and an interaction between testosterone and harsh discipline on reactive aggression in boys only. For those experiencing high levels of harsh discipline, testosterone was positively associated with proactive aggression, with the magnitude of the association increasing as harsh discipline increased. For below average levels of harsh discipline, there were protective effects of high testosterone for boy’s reactive aggression and for girl’s proactive aggression. The findings support basic tenets of the biosocial model which suggest that links between testosterone and aggressive behavior are dependent on contextual forces, highlighting the complex relationship between hormones, social context, and aggression. Novel findings include protective effects of high testosterone for those exposed to low levels of harsh discipline. Findings are discussed in light of the context-contingency effect and also within the differential susceptibility framework.     

Dynamic measures of anxiety-related threat bias: Links to stress reactivity

Exaggerated attention to threatening information, or the threat bias, has been implicated in the development and maintenance of anxiety disorders. Recent research has highlighted methodological limitations in threat bias measures, such as temporal insensitivity, leading to the development of novel metrics that capture change and variability in threat bias over time. These metrics, however, have rarely been examined in non-clinical samples. The present study aimed to explore the utility of these trial-level metrics in predicting anxiety-related stress reactivity (stress-induced negative mood state) in trait anxious adults (N?=?52). Following a stressor, participants completed the dot probe task to generate threat bias scores. Stress reactivity was measured via stress-induced changes in subjective mood state. More variability in trial-level bias scores (TL-BSs) and greater bias away from threat (both mean and peak negative TL-BSs) predicted increased stress reactivity. The temporal characteristics of threat bias and implications for clinically-relevant measurement are discussed.     

Parent and teacher effects on academic coping and classroom engagement: Testing a motivational model

Little is known about the contextual antecedents and consequences of children’s academic coping. One hundred and eighty-three-sixth grade students participated in a study that examined a process model whereby children’s perceptions of parent and teacher behaviors were associated with children’s coping strategies through children’s appraisals of failure. It also examined whether these coping strategies were then associated with students’ classroom engagement. Results revealed that parent autonomy support was indirectly associated with defensive coping through its effects on children’s appraisals of failure. There was also some support that cognitive appraisals, particularly threat appraisals were indirectly associated with child reported engagement through coping, suggesting that coping appraisals impact children’s engagement and participation in the classroom through their effects on coping behavior/strategy use. The findings underscore the importance of parent autonomy support for children’s appraisals of failure, coping, and engagement.     

The impact of implicitly and explicitly primed ingroup–outgroup categorization on the evaluation of others pain: The case of the Jewish–Arab conflict

Despite the automaticity of affective sharing, many studies have documented the role of top-down effects, such as social categorization, on people’s empathic responses. An important question, largely ignored in previous research, concerns empathy to ingroup and outgroup members’ pain in the contexts of ongoing intergroup conflict. In the present study we examined how implicit and explicit ethnic social categorization of others affects empathy to pain in the context of the Israeli–Palestinian conflict. To meet this aim, we assessed the evaluation of pain by Jewish and Arab participants who viewed a series of visual stimuli depicting painful and non-painful familiar situations. The stimuli were associated with explicitly or implicitly primed typical names depicting ingroup, neutral outgroup, and adversary outgroup members. Results demonstrate that pain ratings in the explicit priming condition provide support for the ingroup empathy hypothesis, positing that empathy is higher for ingroup than for outgroup members for both Jews and Palestinian Arabs. Conversely, when the targets’ categories are primed implicitly, results revealed difference in empathy by the two ethnic groups where an ingroup bias was detected only for Palestinian Arabs. This suggests that the activation of ingroup bias on the subliminal implicit level among Palestinian Arab participants might be mediated by the amount of conflict permeating in their daily lives and by deeply rooted cultural values and behavioural patterns.     

Schools can improve motivational quality: Profile transitions across early foreign language learning experiences

Elementary school is as much about developing attitudes as competence. With this fact in mind, the Japanese national government established a plan to enhance elementary school students’ motivation for learning English. The success of this program has, however, not been empirically tested. This study aimed to assess the longitudinal, discrete development of Japanese elementary school students’ motivation for learning English as a foreign language. A cohort of 513 Japanese elementary students participated in the study across 2 years of school. Students responded to surveys regarding the quality of their motivation at three time points, and their engagement at two time points. Latent profile analysis followed by latent profile transition analysis was used to assess the sample for latent subgroups. With subgroups established at three time points, a Mover–Stayer model was tested to estimate the movement of students among the subgroups across three time points and 2 years of elementary school education. Three theoretically consistent latent subgroups were observed at each of the time points. Based on theory and past empirical research, the subgroups (presented from least to most adaptive) were labeled: Poor Quality, High Quantity, and Good Quality. Across the three measurements, an overall shift of students to higher quantity and quality motivational subgroups was observed. This study provides evidence that the low-stakes, high-interest approach currently undertaken may have the desired effect of improving students’ motivation to learn across 2 years of schooling. Implications for both practice and national policy are discussed.