A psychometric comparison of anxiety-relevant attention measures

Background and Objectives: Preferential attention to threat, emotional response inhibition, and attentional control each purportedly play a key role in anxiety disorders. Divergent psychometric properties among attention measures may produce differential detection of anxiety-related associations and treatment-related changes. However, no studies have directly compared the psychometric properties of these attention measures in the same sample.

Design: Eighty-five young adults (M?=?19.41 years, SD?=?1.47, 48 Females) completed a cognitive task battery and a subset of 60 participants (M?=?19.42 years, SD?=?1.48, 33 Females) completed the task battery again approximately two weeks later.

Method: To assess preferential attention to threat, emotional response inhibition, and attentional control, the cognitive task battery included a dot-probe task, emotion and gender Stroop tasks, and a flanker task. Tasks varied in how attention was directed and if emotional stimuli were included. Internal consistency and test-retest reliability were compared across measures.

Results: Within the same sample, internal consistency and reliability differed across attention measures. Explicit attention measures (emotional Stroop and flanker) exhibited stronger internal consistency and greater test-retest reliability compared to implicit measures (dot-probe and gender Stroop).

Conclusions: These results inform clinical research using attention measures to assess anxiety-related differences and treatment response.     

Relations between empathy and anxiety dimensions in inpatient adolescents

Background and objectives: A better understanding of the relationships between empathy and internalizing disorders is needed to plan therapeutic interventions for children and adolescents. Several studies have revealed positive relations of internalizing symptoms to personal distress and affective empathy. However, there is a lack of studies that take into account the multidimensional nature of anxiety in its relation to empathy.

Design: Structural equation modeling was used to test the moderated mediation model of the relations between empathy, depression and anxiety dimensions and the moderating role of gender on these associations in inpatient adolescents.

Method: A total of 403 inpatient adolescents aged 12–17 years completed the Basic Empathy Scale, the Multidimensional Anxiety Scale for Children, and the Beck Depression Inventory-II.

Results: Affective empathy was positively related to all the anxiety dimensions – most strongly to separation/panic and humiliation/rejection anxiety, whereas cognitive empathy was negatively related to social and separation/panic anxiety. Relations between affective and cognitive empathy and anxiety were partly mediated by depressive symptoms. No evidence of a moderating role of gender has been found.

Conclusions: Our results suggest that processes associated with empathy may play a role in the development or maintenance of anxiety symptoms.     

Serotonin transporter 5-HTTLPR genotype is associated with intrusion and avoidance symptoms of DSM-5 posttraumatic stress disorder (PTSD) in Chinese earthquake survivors

Background and Objectives: Prior studies have found that the serotonin transporter gene-linked polymorphic region (5-HTTLPR) interacts with trauma exposure to increase general risk for Posttraumatic Stress Disorder (PTSD). However, there is little knowledge about the effects of the interaction on distinct symptom clusters of PTSD. This study aimed to investigate the relation between the interaction of 5-HTTLPR and earthquake-related exposures and a contemporary phenotypic model of DSM-5 PTSD symptoms in a traumatised adult sample from China.

Design: A cross-sectional design with gene-environment interaction (G?×?E) approach was adopted. Methods: Participants were 1131 survivors who experienced 2008 Wenchuan earthquake. PTSD symptoms were assessed with the PTSD Checklist for DSM-5 (PCL-5). The 5-HTTLPR polymorphism was genotyped with capillary electrophoresis (CE) in ABI 3730xl genetic Analyzer.

Results: Although there was no significant interaction between 5-HTTLPR and traumatic exposure on total PTSD symptoms, respondents with the LL genotype of 5-HTTLPR who were highly exposed to the earthquake experienced lower intrusion and avoidance symptoms than those with the S-allele carriers.

Conclusions: The findings suggest that the 5-HTTLPR may have an important impact on the development of PTSD and add to the extant knowledge on understanding and treating of posttraumatic psychopathology.     

Cognitive development in children of adolescent mothers: The impact of socioeconomic risk and maternal sensitivity

BackgroundAdolescent motherhood is accompanied by a constellation of risk factors that translate into developmental risk for the off-spring. Socioeconomic risk that is associated with adolescent motherhood as well as maternal interactive behaviors may contribute to the impact of adolescent motherhood on children’s developmental outcome.ObjectiveTherefore, the aim of the current study was to investigate differences in children’s cognitive development between children of adolescent and adult mothers in their first two years of life and to examine whether socioeconomic risk (e.g. such as educational and financial problems) and/or maternal sensitivity mediate developmental differences between children of adolescent and adult mothers.MethodsAdolescent mothers (<21 years; N = 64) and adult mothers (>25 years; N = 34) and their infants were included in the current study. Child cognitive development and maternal sensitivity were assessed at three different time points (T1: mean child age 5.26 months; T2: mean child age 14.69 months; T3: mean child age 21.16 months).ResultsChildren of adult mothers showed better cognitive performance at T3 compared to children of adolescent mothers but not at T1 and T2. A multiple mediation model including socioeconomic risk and maternal sensitivity as serial mediators demonstrated that the effect of adolescent motherhood on cognitive development was mediated in a causal effect chain with socioeconomic risk negatively affecting maternal sensitivity and maternal sensitivity affecting children’s cognitive development.DiscussionThe present findings demonstrate that maternal interactive behaviors are not only a simple predictor of cognitive development but may also act as a mediator of the association between more distal variables such as socioeconomic risk and cognitive development in adolescent mothers. This supports the need to promote prevention and intervention programs for adolescent mothers during the early postpartum period to reduce socioeconomic problems and enhance maternal interactive behaviors.     

Language-mediated object categorization: A longitudinal study with 16- to 20-month-old Serbian-speaking children

This study addressed the development of language-mediated categorization longitudinally, on a sample of Serbian-speaking children aged 16–20 months. Twenty four children were tested 3 consecutive times on: categorization of unknown objects with a shared label and a similar shape; and categorization of unknown objects with a shared label, but no visual similarity. The task was embedded in a game-like activity which included real object manipulation, categorization of novel objects labeled with made-up names, and socio-pragmatic cues provided by the experimenter. Our results indicate that an average child develops the ability to categorize novel objects with a similar shape and a shared label around 16 months of age, whereas for novel objects with a shared label, but no visual similarity, this ability is acquired sometime between 18 and 20 months of age. Our results partly confirm research findings obtained in other languages, thus emphasizing the need for cross-linguistic and cross-cultural validation of all language-related developmental studies.     

Exploring the relationship between executive functions and self-reported media-multitasking in young adults

Media-multitasking involves simultaneous engagement with information streams from multiple media sources, and is most prevalent in young adults. Heavy media-multitasking has been associated with differential performance on tasks involving attentional control and working memory relative to light media-multitasking. The aim of the present study was to systematically investigate relationships between executive functions and self-reported media-multitasking. Healthy participants (N?=?112, aged 18–25, male N?=?36) completed a battery of 10 traditional executive function tasks, that included assessments of attentional inhibition, response inhibition, working memory, and cognitive flexibility. Scores on the individual executive function tasks were correlated against frequency of self-reported media-multitasking, but no significant relationships were found. Trait anxiety, however, was found to be significantly associated with greater frequency of self-reported media-multitasking. The present study found no evidence of a relationship between the frequency of self-reported media-multitasking and executive functioning. The possible reasons for this are discussed.     

Efficacy of Guided iCBT for Depression and Mediation of Change by Cognitive Skill Acquisition

Guided internet CBT (iCBT) is a promising treatment for depression; however, it is less well known through what mechanisms iCBT works. Two possible mediators of change are the acquisition of cognitive skills and increases in behavioral activation. We report results of an 8-week waitlist controlled trial of guided iCBT, and test whether early change in cognitive skills or behavioral activation mediated subsequent change in depression. The sample was 89 individuals randomized to guided iCBT (n = 59) or waitlist (n = 30). Participants were 75% female, 72% Caucasian, and 33 years old on average. The PHQ9 was the primary outcome measure. Mediators were the Competencies of Cognitive Therapy Scale–Self Report and the Behavioral Activation Scale for Depression–Short Form. Treatment was Beating the Blues plus manualized coaching. Outcomes were analyzed using linear mixed models, and mediation with a bootstrap resampling approach. The iCBT group was superior to waitlist, with large effect sizes at posttreatment (Hedges’ g = 1.45). Dropout of iCBT was 29% versus 10% for waitlist. In the mediation analyses, the acquisition of cognitive skills mediated subsequent depression change (indirect effect = -.61, 95% bootstrapped biased corrected CI: -1.47, -0.09), but increases in behavioral activation did not. iCBT is an effective treatment for depression, but dropout rates remain high. Change in iCBT appears to be mediated by improvements in the use of cognitive skills, such as critically evaluating and restructuring negative thoughts.     

Treating Procrastination Using Cognitive Behavior Therapy: A Pragmatic Randomized Controlled Trial Comparing Treatment Delivered via the Internet or in Groups

Procrastination is a common problem among university students, with at least half of the population reporting great difficulties initiating or completing tasks and assignments. Procrastination can have a negative impact on course grades and the ability to achieve a university degree, but can also lead to psychological distress. Cognitive behavior therapy (CBT) is believed to reduce procrastination, but few studies have investigated its effectiveness in a regular clinical setting. The current study explored its effects using a pragmatic randomized controlled trial comparing treatment delivered during 8 weeks as self-guided CBT via the Internet (ICBT) or as group CBT. In total, 92 university students with severe procrastination were included in the study (registered as a clinical trial on Clinicaltrials.gov: NCT02112383). Outcome measures on procrastination, depression, anxiety, and well-being were distributed at pre- and posttreatment as well as 6-month follow-up. An outcome measure of procrastination was administered weekly. Linear mixed and fixed effects models were calculated, along with improvement and deterioration rates. The results showed large within-group effect sizes on procrastination, Cohen’s d of 1.29 for ICBT, 95% Confidence Interval (CI) [0.81, 1.74], and d of 1.24 for group CBT, 95% CI [0.76, 1.70], and small to moderate benefits for depression, anxiety, and well-being. In total, 33.7% were regarded as improved at posttreatment and 46.7% at follow-up. No differences between conditions were observed after the treatment period, however, participants in group CBT continued or maintained their improvement at follow-up, while participants in self-guided ICBT showed some signs of deterioration. The findings from the current study suggest that CBT might be an effective treatment for those struggling with severe procrastination, but that a group format may be better for some to sustain their benefits over time and that the clinical significance of the results need to be investigated further.     

Improved Parent Cognitions Relate to Immediate and Follow-Up Treatment Outcomes for Children With ADHD-Predominantly Inattentive Presentation

We investigated treatment effects on parenting self-efficacy and parent cognitive errors, and whether these parent cognitions are related to short- and long-term outcomes in parenting behaviors in psychosocial treatment for youth with attention-deficit/hyperactivity disorder, predominantly inattentive presentation (ADHD-I). In a randomized controlled trial across two sites (University of California, San Francisco, and University of California, Berkeley), 199 children between the ages of 7 and 11 were randomized to the Child Life and Attention Skills (CLAS; n = 74) program, parent-focused treatment (PFT; n = 74), or treatment as usual (TAU; n = 51). Parents reported on self-efficacy, cognitive errors, positive parenting, and negative parenting prior to treatment, immediately after treatment, and in the next school year at follow-up. Compared to TAU, CLAS and PFT had higher posttreatment parenting self-efficacy, and CLAS alone had lower posttreatment parent cognitive errors. At follow-up, only CLAS had improved parent cognitive errors compared to TAU. No other between-group differences were found in parenting self-efficacy or cognitive errors. Improved parenting self-efficacy was associated with improved posttreatment negative parenting outcomes for PFT and CLAS, and improved parent cognitive errors were also related to improvements in positive and negative posttreatment parenting outcomes for CLAS. Posttreatment parenting self-efficacy mediated follow-up negative parenting outcomes for CLAS and posttreatment parent cognitive errors mediated improved follow-up positive and negative parenting outcomes for CLAS. PFT and CLAS led to enhanced parenting self-efficacy, and CLAS appears especially robust in improving parent cognitive errors both in the short and long term. Pathways provide support for the possibility of parent cognitions as mediators of treatment effects on parenting; clinical focus on such cognitions may be useful.