Emotional Control Mediates the Association Between Dimensions of Perfectionism and Worry in Children.

Previous research has shown that perfectionism predicts for increased worry in children. Theoretically, children with high levels of perfectionism may show a decreased ability to control their emotions during times of perceived failure. Children may then worry as a maladaptive attempt to cope with intense emotions. The current study sought to test the mediating role of emotional control on the relation between perfectionism dimensions and worry in children. Participants were 66 parent-child dyads. Children were 7-13 years (50 % male; 77.3 % Caucasian, 9.1 % African American). Overall the model fit the data well. Results indicated that perfectionism domains predicted for emotional control deficits and increased worry. Emotional control also partially mediated the relation between perfectionism dimensions and worry. These results suggest that emotional control may be one mechanism through which perfectionism exerts its effect on worry and perfectionistic children may worry due to difficulty controlling their emotional responses.

Negative Affect and Child Internalizing Symptoms: The Mediating Role of Perfectionism.

Separate lines of research have linked the temperament factor negative affect and perfectionism with internalizing disorders. Despite theory, no previous studies have connected these lines of research to examine internalizing pathology. The current study tested a path model to investigate the mediating effect of perfectionism domains on the relation between negative affect and child anxiety, worry, and depression symptoms. Participants were 61 parent-child dyads recruited from the community. Children were 7-13 years old (54.1 % male; 88.2 % Caucasian). Overall the model fit the data well. Analyses indicated that separate domains of perfectionism mediated separate relations between negative affect and child anxiety, worry, and depression symptoms. The findings suggest that domains of perfectionism may be implicated in specific paths between negative affect and child anxiety, depression, and worry. Implications and future directions are discussed.

Relating Worry and Executive Functioning During Childhood: The Moderating Role of Age.

The associations between worry and executive functioning across development have not been previously explored. Examining the interrelationships between these variables in childhood may further elucidate the cognitive nature of worry as well as its developmental course. Hypotheses predicted that difficulties with executive functioning would correlate with child worry; based on extant literature, age-related hypotheses were proposed for particular aspects of executive functioning. Children (N = 130) participated in the present study. Difficulties with executive functioning and child worry were assessed. Results demonstrated that each executive functioning subscale correlated with worry. The relations between worry and several facets of executive functioning were no longer significant at older ages, while the relations between worry and the facets of inhibition, shifting, and emotional control did not demonstrate age-related interaction effects. Overall, the findings suggest that worry is associated with executive functioning at young ages and that this association takes distinct forms during different childhood stages.

Duplication of GTF2I results in separation anxiety in mice and humans.

Duplication (dup7q11.23) and deletion (Williams syndrome) of chromosomal region 7q11.23 cause neurodevelopmental disorders with contrasting anxiety phenotypes. We found that 30% of 4- to 12-year-olds with dup7q11.23 but fewer than 5% of children with WS or in the general population met diagnostic criteria for a separation-anxiety disorder. To address the role of one commonly duplicated or deleted gene in separation anxiety, we compared mice that had varying numbers of Gtf2i copies. Relative to mouse pups with one or two Gtf2i copies, pups with additional Gtf2i copies showed significantly increased maternal separation-induced anxiety as measured by ultrasonic vocalizations. This study links the copy number of a single gene from 7q11.23 to separation anxiety in both mice and humans, highlighting the utility of mouse models in dissecting specific gene functions for genomic disorders that span many genes. This study also offers insight into molecular separation-anxiety pathways that might enable the development of targeted therapeutics.

Children with 7q11.23 duplication syndrome: psychological characteristics.

To begin to delineate the psychological characteristics associated with classic 7q11.23 duplication syndrome (duplication of the classic Williams syndrome region; hereafter classic Dup7), we tested 63 children with classic Dup7 aged 4-17 years. Sixteen toddlers aged 18-45 months with classic Dup7 and 12 adults identified by cascade testing also were assessed. For the child group, median General Conceptual Ability (similar to IQ) on the Differential Ability Scales-II was 85.0 (low average), with a range from severe disability to high average ability. Median reading and mathematics achievement standard scores were at the low average to average level, with a range from severe impairment to high average or superior ability. Adaptive behavior was considerably more limited; median Scales of Independent Behavior-Revised Broad Independence standard score was 62.0 (mild impairment), with a range from severe adaptive impairment to average adaptive ability. Anxiety disorders were common, with 50.0% of children diagnosed with Social Phobia, 29.0% with Selective Mutism, 12.9% with Separation Anxiety Disorder, and 53.2% with Specific Phobia. In addition, 35.5% were diagnosed with Attention Deficit/Hyperactivity Disorder and 24.2% with Oppositional Defiant Disorder or Disruptive Behavior Disorder-Not Otherwise Specified. 33.3% of the children screened positive for a possible Autism Spectrum Disorder and 82.3% were diagnosed with Speech Sound Disorder. We compare these findings to previously reported results for children with Williams syndrome and argue that genotype/phenotype studies involving the Williams syndrome region offer important opportunities to understand the contribution of genes in this region to common disorders affecting the general population.

The language of worry: examining linguistic elements of worry models.

Despite strong evidence that worry is a verbal process, studies examining linguistic features in individuals with generalised anxiety disorder (GAD) are lacking. The aim of the present study is to investigate language use in individuals with GAD and controls based on GAD and worry theoretical models. More specifically, the degree to which linguistic elements of the avoidance and intolerance of uncertainty worry models can predict diagnostic status was analysed. Participants were 19 women diagnosed with GAD and 22 control women and their children. After participating in a diagnostic semi-structured interview, dyads engaged in a free-play interaction where mothers' language sample was collected. Overall, the findings provided evidence for distinctive linguistic features of individuals with GAD. That is, after controlling for the effect of demographic variables, present tense, future tense, prepositions and number of questions correctly classified those with GAD and controls such that a considerable amount of the variance in diagnostic status was explained uniquely by language use. Linguistic confirmation of worry models is discussed.

Parent Emotion Socialization Practices and Child Self-regulation as Predictors of Child Anxiety: The Mediating Role of Cardiac Variability.

The importance of the parent-child relationship in emotional development is well supported. The parental role of facilitating a child's self-regulation may provide a more focused approach for examining the role of parenting in child anxiety. The current study hypothesized that parent emotion socialization practices would predict a child's abilities in self-regulation. Given that physiological arousal has been implicated in emotional development, this was hypothesized to mediate the relationship between parental emotion socialization and child emotion regulation to predict child anxiety. Eighty-five parent and child dyads participated in the study. Parents reporting higher degrees of unsupportive emotion socialization were more likely to have children with fewer abilities in emotion regulation. Cardiac responsiveness mediated the relationship between unsupportive emotion socialization and child emotion regulation. The model of cardiac responsiveness mediating the relationship between unsupportive emotion socialization and child emotion regulation failed to reach statistical significance in predicting child anxiety symptoms.

Temperament, peer victimization, and nurturing parenting in child anxiety: a moderated mediation model.

Research has linked fearful temperament and childhood anxiety. Yet there remain numerous factors that moderate and mediate this relation. Two specific factors, identified in separate lines of research, are peer victimization and parenting. The current study tested a moderated mediational model to investigate the respective effects of peer victimization and nurturing parenting on the relation between fearful temperament and child anxiety. Participants were 124 parent-child dyads recruited from the community. Children were between the ages of 7 and 12 (56.5% male, 93.5% Caucasian) and most parents were mothers. Overall the data fit the model well. Analyses indicated that peer victimization was a mediator of the temperament to child anxiety relation, while nurturing parenting moderated this mediated effect. Nurturing parenting did not mediate the temperament to child anxiety relation directly. The findings suggest that nurturing parenting may be a specific, rather than global, protective factor for peer victimization in child anxiety.

The role of metacognition, intolerance of uncertainty, and negative problem orientation in children's worry.

BACKGROUND: Although worry is common in children, empirical models of worry remain largely untested in youth. A small number of studies have established preliminary links between cognitive variables and worry in children younger than 12 years old. These cognitive variables include positive and negative beliefs about worry, intolerance of uncertainty, and problem orientation. AIMS: The current study examined these variables concurrently and their association with worry. We also examined the extent to which intolerance of uncertainty mediated the association between worry and beliefs about worry. METHOD: Eighty elementary school children aged 8 to 12 years completed a battery of self-report measures. RESULTS: As a group, the cognitive variables significantly predicted worry scores; negative beliefs about worry was the only significant individual predictor. As a group, the four cognitive variables discriminated clinical from nonclinical levels of worry; positive beliefs about worry and intolerance of uncertainty were the only significant individual predictors. Finally, intolerance of uncertainty mediated the association between worry and both positive and negative beliefs about worry. CONCLUSIONS: Components of a cognitive model of worry are largely applicable to children. Negative beliefs about worry were associated with worry across the continuum, while intolerance of uncertainty and positive beliefs about worry were more strongly associated with clinical levels of worry. Intolerance of uncertainty accounted for a significant portion of the association between metacognition and worry and may be a particularly effective target for treatment. Further implications for conceptual models and treatment interventions are discussed.

A sequential analysis of parent-child interactions in anxious and nonanxious families.

Although theoretical work has suggested that reciprocal behavior patterns between parent and child may be important in the development of childhood anxiety, most empirical work has failed to consider the bidirectional nature of interactions. The current study sought to address this limitation by utilizing a sequential approach to exploring parent-child interactions. Participants included 161 children (ages 3-12 years) and their parents. Parent and child dyads were classified into four categories: anxious parent-anxious child (n = 45), anxious parent-nonanxious child (n = 45), nonanxious parent-anxious child (n = 21), and nonanxious parent-nonanxious child (n = 50). Parent and child behaviors were coded from two 10-min interactions. Results indicated that anxious parents of children with anxiety disorders were more likely to respond with negative behaviors, which their child then mirrored. Nonanxious parents of nonanxious children responded with more warmth, which was then mirrored by their child. These results provide evidence for differential patterns of behaviors between anxious and nonanxious parents and children following critical moments in their interactions.

Child internalizing symptoms: contributions of child temperament, maternal negative affect, and family functioning.

Research has traditionally focused on the role of genetic and environmental variables in the development and maintenance of childhood internalizing disorders. Temperament variables, such as negative affect and effortful control have gained considerable interest within the field of developmental psychopathology. Environmental factors such as mother-child interactions and family cohesion have also been linked with internalizing disorders. The current study examines the relationship between child negative affect, effortful control, maternal negative affect, family functioning, and internalizing symptoms in a sample of preschool-aged children using a path analysis approach. Sixty-five children, aged 3-5 years and their mothers completed measures on child temperament, family environment, maternal personality, and child internalizing symptoms. Results support a complex model for the influence of both direct and indirect factors on internalizing symptoms in preschool-aged children.

Human and economic burden of GAD, subthreshold GAD, and worry in a primary care sample.

Generalized anxiety disorder (GAD) has been associated with significant impairment and estimates of human and economic burden associated with the disorder are substantial. Little has been done, however, to examine impairment associated with subthreshold presentations of the disorder in medically underserved populations. This study compared primary care patients with GAD (n = 30), subthreshold GAD (n = 21), worry (n = 79), and no worry (n = 199) on measures of human and economic burden. On measures of human burden, all three symptomatic groups reported poorer perceived physical health, greater stress, and sleep difficulty. Worried and subthreshold groups also reported lower social support. For economic burden, GAD and worry groups reported a greater number of prescription medications. However, when co-morbid depression was accounted for the effect was no longer significant. Groups did not differ on employment status, number of visits to the clinic in the last 90 days, or physical health. Results are discussed in terms of identification, prevention, and intervention for GAD in primary care settings.

Longitudinal course of anxiety in children and adolescents with Williams syndrome.

The longitudinal course of anxiety disorders in 45 children and adolescents with Williams syndrome (WS) was examined. Children were ages 4-13 years at the initial assessment. To assess their child's DSM-IV diagnoses, parents completed a structured diagnostic interview 3-9 times at intervals of at least 1 year. At the first assessment, 60% of the sample presented with at least one anxiety diagnosis; 82.2% received an anxiety diagnosis at some time during the study. Chronic, persistent anxiety within the period 5 years after their initial diagnosis was shown by 62.2% of those with an anxiety diagnosis (51.1% of the entire sample). The most common diagnoses were specific phobias and generalized anxiety disorder. Multilevel logistic regression models were estimated for the presence of any anxiety disorder, specific phobia, and specific phobia of loud noises. Developmental trajectories, expressed as the probability of a positive diagnosis, suggested that the odds of a positive diagnosis did not change with age. IQ was not significantly related to the presence of an anxiety disorder. However, there was a significant relation between executive functioning and anxiety such that the presence of an anxiety diagnosis was associated with increased scores on behavioral regulation, indicative of increased difficulty with inhibitory control of affect and behavior. These findings are discussed in terms of persistence of anxiety over time and the need to develop and test interventions to address the high levels of anxiety experienced by children and adolescents with WS.

Relating mindfulness and executive function in children.

Despite the important role of cognitions in mindful awareness, research on the cognitive processes underlying mindfulness in young populations is scarce. This study explores the association between the core executive functions (i.e. inhibition, working memory, and shifting) and mindfulness within the same model in a sample of children. Seventy-two parent-child dyads participated in the study. Difficulties with executive functioning and child mindfulness level were assessed. Inhibition, working memory, and shifting were significantly correlated with mindfulness. Furthermore, moderate to good fit was found in a model testing the association between mindfulness and the latent executive function variable composed by the three executive functions, and individual executive functions demonstrated significant loadings in relation to the latent variable. In a model relating mindfulness to each individual executive function, mindfulness was uniquely associated with inhibition, working memory, and shifting. The application of current theoretical models of mindfulness to child populations and clinical implications are discussed.

Neonatal auditory evoked responses are related to perinatal maternal anxiety.

Maternal stress and anxiety during pregnancy are related to negative developmental outcomes for offspring, both physiological and psychological, from the fetal period through early adolescence. This robust relationship is likely to be partly explained by alterations in fetal neurodevelopmental programming, calling for further examination of neurophysiologically-based cognitive markers that may be related to the altered structure-function relationships that contribute to these negative developmental outcomes. The current investigation examined the relationship between perinatal maternal anxiety and neonatal auditory evoked responses (AERs) to mother and stranger voices. Results indicated that neonates of low-anxiety mothers displayed more negative frontal slow wave amplitudes in response to their mother's voice compared to a female stranger's voice, while neonates of high-anxiety mothers showed the opposite pattern. These findings suggest that neonates of perinatally anxious mothers may demonstrate neurophysiologically-based differences in attentional allocation. This could represent one pathway to the negative psychological outcomes seen throughout development in offspring of anxious mothers.

A structural equation model analysis of perceived control and psychological distress on worry among African American and European American young adults.

Perceived control has been identified as an important factor in the development and maintenance of mood disorders, and worry has been shown to have a unique relationship with psychological distress associated with mood disorders. The relationships between these variables have received little attention in the literature, and even less in terms of the role racial status may serve. The current study investigated the structural relationship between psychological distress and perceived control in predicting self-reported worry as well as potential differences in paths to worry in African American and European American young adults using a structural equation model. One hundred twenty-one European American and 100 African American undergraduate students completed the Beck Depression Inventory (BDI), the State Trait Anxiety Inventory (STAI), the Anxiety Control Questionnaire (ACQ), and the Penn State Worry Questionnaire (PSWQ). Results suggest that psychological distress and perceived control predict worry in both the African American and European American samples, however there were significant differences in terms of which construct contributed most. For African Americans, psychological distress contributed significantly more to worry than perceived control, whereas low perceived control contributed more to worry for European Americans. Implications and suggestions for future research are discussed.

A confirmatory factor analysis of specific phobia domains in African American and Caucasian American young adults.

The current study investigated factors related to specific phobia domains and differences in patterns among African American and Caucasian American adults. Subjects were 100 African Americans and 121 Caucasian Americans who completed the Fear Survey Schedule--Second Edition (FSS-II). Fears related to specific phobia domains were first examined, with frequencies differing between African American and Caucasian American samples on three of the six specific phobia domains. A confirmatory factor analysis was conducted to determine the patterns of specific phobias among the African American sample. The trimmed model for the African American sample included natural environment, animal and social anxiety specific phobia factors as latent, exogenous variables. Data from the Caucasian American sample provided a poor fit to this model. Instead, the trimmed model for the Caucasian American sample included the situational, animal and social anxiety factors. The natural environment-type specific phobia factor did not have adequate fit for the Caucasian American sample as in the African American sample. Results indicated that different factor loading patterns of fear-related stimuli may exist among African American and Caucasian American young adults. Potential explanations and future directions are discussed.

Parental reactions to children's negative affect: The moderating role of parental GAD.

The impact of parental anxiety disorders has been explored in broad categories of parenting behaviors; however, less is known about the impact of parental anxiety on emotion socialization behaviors. The current study tested the conditional effect of parental Generalized Anxiety Disorder (GAD) on one aspect of emotion socialization, parents' reactions to their child's negative affect. Participants were 89 children between ages 3 and 12 and their parents, from a community sample. Parents completed the Anxiety Disorders Interview Schedule-IV (ADIS-IV), an interaction task with their child, and the Beck Anxiety Inventory-II (BAI-II). Overall, the data supported study hypotheses. Parental GAD moderated the relationship between child's negative affect and parental over control and emotional discouragement. Specifically, children's negative affect was positively related to parental emotional discouragement for parents with GAD, but not for parents without a diagnosis. Conversely, children's negative affect was not predictive of parental overcontrol for parents with GAD, but increases in children's negative affect did predict increases in parental overcontrol for parents without a diagnosis. The present findings suggest parents diagnosed with GAD are discouraging of their children's emotional experiences and fail to adjust their level of guidance throughout situations which induce negative affect, leaving children to cope with negative emotions on their own.

Intolerance of uncertainty in children with attention-deficit/hyperactivity disorder.

Intolerance of uncertainty (IU) has often been studied in the context of internalizing disorders, but no studies to our knowledge have explored the relation between IU and externalizing disorders. Given the proposed link between IU and emotion regulation, the current study sought to examine levels of IU in an externalizing clinical population with known emotion regulation difficulties-attention-deficit/hyperactivity disorder (ADHD). IU levels in this population were compared to a clinical population known to experience elevated levels of IU. Participants in present study were ninety-three children (36 anxiety disorder, 28 ADHD, 29 unaffected children) ages 7-13, who completed the Intolerance of Uncertainty Scale-Short Version (IUS). Responses on the IUS were converted to total IU, prospective IU, and inhibitory IU. A linear mixed model analysis of covariance was conducted while controlling for age, sex, and ADHD medications. A significant interaction was observed between diagnostic status and IU scale. Planned contrasts indicated that children with anxiety disorders and ADHD reported significantly higher levels of IU relative to unaffected children, and children with ADHD reported comparable levels of inhibitory IU relative to children with anxiety disorders. The current results contribute to a growing literature on the link between IU and psychopathology. IU appears to be a transdiagnostic construct present among children with internalizing and externalizing disorders, and may be broadly associated with emotion regulation deficits rather than specific disorder symptoms.

Examination of the utility of the Beck Anxiety Inventory and its factors as a screener for anxiety disorders.

The Beck Anxiety Inventory (BAI) and the Anxiety Disorders Interview Schedule (ADIS-IV) were administered to 193 adults at a major Midwestern university recruited from an anxiety research and treatment center. The BAI and its four factor scores were compared from individuals with a primary diagnosis of generalized anxiety disorder (GAD), specific or social phobia, panic disorder with or without agoraphobia, obsessive-compulsive disorder (OCD), and no psychiatric diagnosis. The cut scores on the BAI and its factors, their sensitivity, specificity, as well as positive and negative predictive values were calculated for each group. The results of this study support previous findings that the strongest quality of the BAI is its ability to assess panic symptomatology. The present study also expands on this notion by establishing that the BAI can be used as an efficient screening tool for distinguishing between individuals with and without panic disorder.