Temporal Patterns of Infant Regulatory Behaviors in Relation to Maternal Mood and Soothing Strategies.

This study investigates the temporal patterning of infant self-regulatory behaviors (crying/fussing, sleeping) in relation to both infant (age, sex, regulatory problems) and maternal variables (soothing behaviors, mood). Self-regulatory and soothing behaviors were assessed in 121 mother-infant dyads (4-44 weeks) by the Baby's Day Diary at 5 min intervals over 3 days. Further infant characteristics and maternal mood were assessed by questionnaires (DASS, CES-D, STAI) and the Diagnostic Interview for the Assessment of Regulatory Problems in Infancy and Toddlerhood. Data were analyzed using generalized additive mixed models. Negative maternal mood was associated with a deviant course of crying/fussing during the day. Body contact was associated with reduced variability in the 24 h course of sleep. Mother-infant transactional processes-above and beyond known relationships with overall levels of crying/fussing and sleeping-might play out on the temporal dimension of infant regulatory behaviors.

Anxiety disorders.

With the adoption of a developmental psychopathology perspective, the DSM-5 translates empirical evidence on the continuity of childhood anxiety disorders into diagnostic practice, thereby completing a process that started with the exclusion of the former childhood anxiety disorders overanxious disorder and avoidant disorder from DSM-III to DSM-IV. This change in perspective, however, leads to a low level of concordance between the DSM-5 and ICD-10. To reliably identify anxiety disorders at different points in development, and to take into account their developmental pathways, assessment instruments need to be sensitive to age-related manifestations and age-related subtypes of a disorder. This may best be achieved by a multi-informant, multi-method assessment approach. With regard to treatment, only cognitive-behavioral therapy (CBT) fulfills the criteria of an evidence-based treatment approach in youth. Disorder-specific treatments can lead to larger treatment effects and slightly higher remission rates as compared to more general treatment programs for childhood anxiety disorders (e.g., Coping Cat). Parental involvement seems not to add to treatment success. In conclusion, the evidence-based diagnostic approach of the DSM-5 needs to be complemented by the development and evaluation of child-friendly, developmentally sensitive assessment tools and evidence-based treatments for anxiety disorders in children. With regard to diagnostic concordance, the gap between the DSM-5 and ICD-10 needs to be bridged by more closely aligning the two nosological systems.

The role of exposure in the treatment of anxiety in children and adolescents: protocol of a systematic review and meta-analysis.

BACKGROUND: In children and adolescents, anxiety disorders (ADs) are among the most prevalent mental disorders. While there is a solid empirical foundation to support CBT as an evidence-based treatment for childhood ADs, the mechanisms underlying the efficacy of CBT are not well explored. Exposure is assumed to be vital to the efficacy of CBT in ADs, but empirical evidence (e.g., dismantling studies) showing that exposure is indeed a vital element of effective treatments is relatively scarce. The proposed meta-analysis aims to investigate the role of exposure in reducing symptoms of anxiety among children and adolescents. METHODS: A systematic search of several electronic databases including PubMed/MEDLINE, PsycINFO, Psyndex plus, Web of Science, Scopus, and EMBASE will be conducted (from inception onwards). We will include randomized and non-randomized clinical trials examining exposure and anxiety among children and adolescents. If feasible, we will also include experimental, quasi-experimental, and observational studies. The primary outcome will be improvement in anxiety levels (recovery or change in anxiety rating scale) after exposure. Three reviewers will independently screen all citations, abstract data, and full-text articles. The methodological quality (or risk of bias) of individual studies will be appraised using an appropriate tool. If feasible, we will conduct mixed effects meta-analysis. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., dose of exposure, age group, methodological quality). DISCUSSION: This systematic review and meta-analysis will examine the role of exposure in reducing symptoms of anxiety among youth. The review will provide information on the working mechanisms underlying the efficacy of CBT. Our findings will be of interest to mental health professionals, researchers, and policy makers who wish to support children and adolescents with anxiety disorders by guiding well-informed treatment decisions. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (CRD42019128667).

A New 3-Day Standardized Eyeblink Conditioning Protocol to Assess Extinction Learning From Infancy to Adulthood.

Associative learning can be observed from the neonatal period onward, providing opportunities to examine changes in basic learning and memory abilities. One method that is suitable to study associative learning is classical eyeblink conditioning (EBC) which is dependent on the cerebellum. Extinction learning can be systematically investigated in this paradigm by varying the context during learning and extinction. Because of methodological difficulties and ethical challenges, no studies have compared extinction learning using EBC across human development. Our goal was to test feasibility of a 3-day delay EBC paradigm that can be used from infancy to adulthood. Acceptance/safety was tested especially for infancy by investigating attrition rates and parental report on infant wellbeing. On a paradigm side, we tested if the paradigm leads to successful acquisition and extinction. An air puff served as unconditional stimulus (US) and a tone as conditional stimulus (CS). On day 1 during acquisition, participants received 36 US-CS pairings in context A. On day 2, participants received 12 acquisition trials in context A to consolidate association learning, followed by 48 extinction trials (tone alone presentations) in context B. Renewal was assessed on day 3 and incorporated 12 CS alone trials presented in both the acquisition context and the extinction context. Eyeblink responses were videotaped and coded offline. The protocol was tested with 12-36-months-old infants (N = 72), adolescents (N = 8), and adults (N = 8). Concerning the acceptance/safety side, attrition ranged from 21 to 58% in infant samples due to the complex preparation of the children for the paradigm. However, attrition is equal to or lower than other infant learning paradigms. Parents of infant samples were very interested in the paradigm and reported low levels of infant stress, exhaustion, and negative feelings during the sessions. Data quality was very high, and no participant had to be excluded because of insufficient data. Concerning the paradigm side, participants showed successful acquisition and extinction as a group. The procedure is ethically sound, feasible, tolerated by many infants, and acceptable among parents. The data show successful acquisition and extinction rates, making the paradigm a valuable tool for investigating developmental changes in extinction learning over the lifespan.

Genetic and attachment influences on adolescents' regulation of autonomy and aggressiveness.

BACKGROUND: Adolescence is a time when intense emotions are elicited within the parent-adolescent relationship, often when autonomy subjectively is endangered. As emotion dysregulation is one of the risk processes for the development of psychopathology, adolescence may be perceived as a highly sensitive period for maladjustment. Inter-individual differences in emotionality and emotion regulation have been shown to be influenced or moderated by molecular genetic differences in the serotonin transporter gene (5-HTT) and by attachment patterns. We investigated whether both the 5-HTT and attachment are associated with emotionality and emotion regulation in an observed adolescent-mother interaction and the personality traits aggressiveness and anxiety in adolescence. METHODS: Ninety-one adolescents at age 12 were observed in interaction with their mothers during a standardized emotion-eliciting social task to assess emotionality and emotion regulation in relation to autonomy. Adolescents' aggressiveness and anxiety were assessed by mother report. Concurrent attachment quality was determined by an attachment interview. DNA samples were collected in order to assess the 5-HTTLPR, a repeat polymorphism in the promoter region of the serotonin transporter gene. RESULTS: While the short allele of the serotonin transporter gene was associated with a higher overall rate of autonomy behaviors, attachment security was related to more agreeable and less hostile autonomy. A significant interaction revealed a moderating effect of attachment security. Carriers of the short version of the 5-HTTLPR showed more agreeable autonomy when they had a secure attachment behavior strategy but showed more hostile autonomy when they were insecurely attached. Carriers of the short version of the 5-HTTLPR and insecurely attached adolescents were rated as more aggressive. CONCLUSIONS: The study suggests a gene-attachment interaction in adolescents where the adolescent's attachment status moderates a genetically based higher negative reactivity in response to threats to autonomy in social interactions.

Enhanced discriminative fear learning of phobia-irrelevant stimuli in spider-fearful individuals.

Avoidance is considered as a central hallmark of all anxiety disorders. The acquisition and expression of avoidance, which leads to the maintenance and exacerbation of pathological fear is closely linked to Pavlovian and operant conditioning processes. Changes in conditionability might represent a key feature of all anxiety disorders but the exact nature of these alterations might vary across different disorders. To date, no information is available on specific changes in conditionability for disorder-irrelevant stimuli in specific phobia (SP). The first aim of this study was to investigate changes in fear acquisition and extinction in spider-fearful individuals as compared to non-fearful participants by using the de novo fear conditioning paradigm. Secondly, we aimed to determine whether differences in the magnitude of context-dependent fear retrieval exist between spider-fearful and non-fearful individuals. Our findings point to an enhanced fear discrimination in spider-fearful individuals as compared to non-fearful individuals at both the physiological and subjective level. The enhanced fear discrimination in spider-fearful individuals was neither mediated by increased state anxiety, depression, nor stress tension. Spider-fearful individuals displayed no changes in extinction learning and/or fear retrieval. Surprisingly, we found no evidence for context-dependent modulation of fear retrieval in either group. Here, we provide first evidence that spider-fearful individuals show an enhanced discriminative fear learning of phobia-irrelevant (de novo) stimuli. Our findings provide novel insights into the role of fear acquisition and expression for the development and maintenance of maladaptive responses in the course of SP.