The Role of Emotion Regulation in the Treatment of Child Anxiety Disorders

In this review, we examine the role of emotion regulation in the treatment of children with anxiety disorders. Cognitive-behavioral therapy (CBT) has been shown to “work” for children with anxiety disorders and it has been categorized as an evidence-based treatment. However, most studies have shown that the treatment is effective for about 60–70% of children, leaving the remaining children symptomatic and oftentimes with persisting psychological disorders. Of importance, it has also been shown that many children with anxiety disorders demonstrate poor emotion regulation skills. Despite these findings, little attention has been directed toward incorporating emotion regulation strategies into these relatively effective cognitive-behavioral treatments. It is possible that CBT programs do not work as well for a portion of children because their emotion regulation deficits, if present, are not being targeted sufficiently. In this review, it is suggested that adding an emotion regulation component could increase treatment efficacy. In addition, strategies aimed at improving emotion regulation at the individual level and at the family level are introduced. Details of how improved emotion regulation skills could be beneficial in bringing about change are discussed. Finally, issues of measurement and the clinical implications for research and practice are considered.     

Disorder-specific Effects of CBT for Anxious and Depressed Youth: A Meta-analysis of Candidate Mediators of Change

The commonalities between anxiety and depression have been discussed before, but few have delineated the potentially different mechanisms through which treatments work for these populations. The current study conducted a comprehensive review of child and adolescent randomized clinical trials that tested cognitive-behavioral therapy (CBT) for anxiety or depression. All studies were required to have assessed both treatment outcomes and at least one theory-specific process target, including behavioral, physiological, cognitive, and coping variables. Using a meta-analytic approach, CBT demonstrated positive treatment gains across anxiety, depression, and general functioning outcomes. CBT for anxiety also produced moderate to large effects across behavioral, physiological, cognitive, and coping processes, with behavioral targets demonstrating potentially the greatest change. CBT for depression produced small effects for cognitive processes but nonsignificant effects for behavioral and coping variables. Findings were generally consistent with CB theory but suggest potentially different mediators in the treatment of anxiety and depression. Results are discussed in terms of implications for mechanisms research, theories of change, and treatment development.     

Perceived organizational structure for teacher liking: the role of peers’ perceptions of teacher liking in teacher–student relationship quality,motivation, and achievement

Previous research has identified the role of perceived peer hierarchies, or organizational structures, in affecting students’ adjustment to school (Lease et al. 2003, Journal of Early Adolescence, 23, 194–217). The purpose of this study was to examine whether middle school classrooms can be described in terms of the perceived status individual students hold for who will and will not be ‘liked’ by the teacher. Specifically we examined: (1) Do students share a mutually agreed on representation, a perceived organizational structure, for describing relative status with their teacher? (2) Are teachers perceived as systematically favoring girls or boys? (3) Are peers’ perceptions of teacher liking associated with individual students’ social and academic motivation and relationship quality with teachers? (4) Are students identified by peers as ‘not liked’ at risk for long-term teacher rejection and underachievement? And, (5) What are the underlying criteria students use to judge teacher likeability? Data for this study were drawn from peer ratings from 516 (262 boys, 254 girls) middle school students in 20 classrooms. Findings indicate multidimensional scaling techniques can be used to map the ‘teacher-liking space,’ accounting for  > 90% of the variability in peers’ ratings of teacher likeability. Additionally, findings indicate perceived status in the teacher-liking space has consequences for students’ achievement and teacher relationship quality.     

Stacking of blocks by chimpanzees: developmental processes and physical understanding

The stacking-block task has been used to assess cognitive development in both humans and chimpanzees. The present study reports three aspects of stacking behavior in chimpanzees: spontaneous development, acquisition process following training, and physical understanding assessed through a cylindrical-block task. Over 3 years of longitudinal observation of block manipulation, one of three infant chimpanzees spontaneously started to stack up cubic blocks at the age of 2 years and 7 months. The other two infants began stacking up blocks at 3 years and 1 month, although only after the introduction of training by a human tester who rewarded stacking behavior. Cylindrical blocks were then introduced to assess physical understanding in object-object combinations in three infant (aged 3-4) and three adult chimpanzees. The flat surfaces of cylinders are suitable for stacking, while the rounded surface is not. Block manipulation was described using sequential codes and analyzed focusing on failure, cause, and solution in the task. Three of the six subjects (one infant and two adults) stacked up cylindrical blocks efficiently: frequently changing the cylinders' orientation without contacting the round side to other blocks. Rich experience in stacking cubes may facilitate subjects' stacking of novel, cylindrical shapes from the beginning. The other three subjects were less efficient in stacking cylinders and used variable strategies to achieve the goal. Nevertheless, they began to learn the effective way of stacking over the course of testing, after about 15 sessions (75 trials).     

Artificial organisms as tools for the development of psychological theory: Tolman’s lesson

In the 1930s and 1940s, Edward Tolman developed a psychological theory of spatial orientation in rats and humans. He expressed his theory as an automaton (the "schematic sowbug") or what today we would call an "artificial organism." With the technology of the day, he could not implement his model. Nonetheless, he used it to develop empirical predictions which tested with animals in the laboratory. This way of proceeding was in line with scientific practice dating back to Galileo. The way psychologists use artificial organisms in their work today breaks with this tradition. Modern "artificial organisms" are constructed a posteriori, working from experimental or ethological observations. As a result, researchers can use them to confirm a theoretical model or to simulate its operation. But they make no contribution to the actual building of models. In this paper, we try to return to Tolman's original strategy: implementing his theory of "vicarious trial and error" in a simulated robot, forecasting the robot's behavior and conducting experiments that verify or falsify these predictions.     

Cognition as coordinated non-cognition

We propose that cognition is more than a collection of independent processes operating in a modular cognitive system. Instead, we propose that cognition emerges from dependencies between all of the basic systems in the brain, including goal management, perception, action, memory, reward, affect, and learning. Furthermore, human cognition reflects its social evolution and context, as well as contributions from a developmental process. After presenting these themes, we illustrate their application to the process of anticipation. Specifically, we propose that anticipations occur extensively across domains (i.e., goal management, perception, action, reward, affect, and learning) in coordinated manners. We also propose that anticipation is central to situated action and to social interaction, and that many of its key features reflect the process of development.     

Initial Development and Validation of the Multidimensional Students’ Life Satisfaction Scale–Adolescent Version

The factor structure of a new self-report scale, the Multidimensional Students’ Life Satisfaction Scale–Adolescent version, was examined. Reliability and 2-week stability estimates of the domain scores and total score were calculated. Relationships of the domain and total scores with other well-being measures were examined as well as the impact of social desirability responding. Although additional development is necessary, results provided preliminary psychometric support for the MSLSS–A for research purposes.The usefulness of life satisfaction measures vis-à-vis the positive psychology movement (Seligman and Csikzentmihalyi, American Psychologist, 55(1): 5-14, 2000) is highlighted.     

A comparison of the effects of thought suppression, distraction and concentration

This study compared the effects of suppression, focused-distraction, and concentration on controlling unwanted distressing thoughts, and examined how anxiety levels were associated with the use of each thought-control technique. In the study, college students were told to suppress thoughts about a distressing story, to suppress the same thoughts by focusing on an alternative distraction task, to simply concentrate on that alternative task, or to think about anything without restrictions for 6 minutes. This initial period was followed by a “free-thinking” period to assess the delayed effect of thought-control techniques. The results indicated that focused-distraction and concentration led to fewer intrusions of target thoughts than suppression, and concentration in turn resulted in fewer target intrusions than focused-distraction during the initial period. Participants in the focused-distraction and concentration condition also tended to report lower anxiety during the initial period than those who were told to suppress thoughts.     

Acting on persecutory delusions: the importance of safety seeking

OBJECTIVE: Acting on delusions is a significant clinical issue. The concept of safety behaviours--actions carried out with the intention of reducing perceived threat--provides a new way of understanding acting on delusions. A study was conducted with the aim of examining the prevalence and correlates of safety behaviours related to persecutory delusions. METHOD: One hundred patients with persecutory delusions were assessed for safety behaviours, acting on delusions, anxiety, depression, and psychotic symptoms. Case note data were collected on instances of serious violence or suicide attempts. RESULTS: Ninety-six patients had used safety behaviours in the last month. Greater use of safety behaviours was associated with higher levels of distress. A history of violence or suicide attempts was associated with greater use of safety behaviours. Safety behaviours were significantly associated with acting on delusions, but not with the negative symptoms of psychosis. CONCLUSION: Safety behaviours are a common form of acting on persecutory delusions. These behaviours have the consequence that they are likely to prevent the processing of disconfirmatory evidence and will therefore contribute to delusion persistence.     

Short-term predictive effects of the looming cognitive style on anxiety disorder symptoms under restrictive methodological conditions

The looming cognitive style (LCS), an overarching cognitive vulnerability for anxiety syndromes, pertains to a tendency to construct dynamic expectations (mental scenarios, images) of negative events as progressively increasing in danger and rapidly escalating in risk. This study tested the hypothesis that the LCS has functions as a cognitive antecedent and moderator for even short-term changes over a brief time interval in anxiety syndromes (worry, obsessive-compulsive disorder (OCD) symptoms, social anxiety, general anxiety) under restrictive methodological conditions. These included: (a) a one-week interval during which very little changes in anxiety were observed, and (b) controlling for participants' depression and intolerance of uncertainty. As hypothesized by our model, the looming cognitive style predicted short-term changes in worry and OCD symptoms over the week interval, and tended to predict changes in social (audience) anxiety. This style also functioned as a moderator and predicted changes in OCD symptoms among participants already high on this anxiety outcome. Intolerance of uncertainty predicted changes in social (audience) anxiety but not changes in OCD symptoms or worry. These findings support the looming vulnerability theory of anxiety, and encourage further attention into the possible role of the LCS as a cognitive antecedent and moderator of changes in a spectrum of anxiety syndromes.