Evaluating the sensitivity to threat and affiliative reward (STAR) model in relation to the development of conduct problems and callous-unemotional traits across early adolescence.

BACKGROUND: The Sensitivity to Threat and Affiliative Reward (STAR) model proposes low threat sensitivity and low affiliation as risk factors for callous-unemotional (CU) traits. Preliminary evidence for the STAR model comes from work in early childhood. However, studies are needed that explore the STAR dimensions in late childhood and adolescence when severe conduct problems (CP) emerge. Moreover, it is unclear how variability across the full spectrum of threat sensitivity and affiliation gives rise to different forms of psychopathology beyond CU traits. METHODS: The current study addressed these gaps using parent- and child-reported data from three waves and a sub-study of the Adolescent Brain Cognitive Development Study® of 11,878 youth (48% female; ages 9-12). RESULTS: Consistent with the STAR model, low threat sensitivity and low affiliation were independently related to CU traits across informants and time. Moreover, there was significant interaction between the STAR dimensions, such that children with lower sensitivity to threat and lower affiliation had higher parent-reported CU traits. Unlike CU traits, children with higher threat sensitivity had higher parent-reported CP and anxiety. Finally, children with lower affiliation had higher parent-reported CP, anxiety, and depression. Results largely replicated across informants and time, and sensitivity analysis revealed similar findings in children with and without DSM-5 defined CP. CONCLUSIONS: Results support the STAR model hypotheses as they pertain to CU traits and delineate threat sensitivity and affiliation as independent transdiagnostic risk factors for different types of psychopathology. Future research is needed to develop fuller and more reliable and valid measures of affiliation and threat sensitivity across multiple assessment modalities.

Social threat processing in adults and children: Faster orienting to, but shorter dwell time on, angry faces during visual search.

Attention to emotional signals conveyed by others is critical for gleaning information about potential social partners and the larger social context. Children appear to detect social threats (e.g., angry faces) faster than non-threatening social signals (e.g., neutral faces). However, methods that rely on behavioral responses alone are limited in identifying different attentional processes involved in threat detection or responding. To address this question, we used a visual search paradigm to assess behavioral (i.e., reaction time to select a target image) and attentional (i.e., eye-tracking fixations, saccadic shifts, and dwell time) responses in children (ages 7-10 years old, N = 42) and adults (ages 18-23 years old, N = 46). In doing so, we compared behavioral responding and attentional detection and engagement with threatening (i.e., angry and fearful faces) and non-threatening (i.e., happy faces) social signals. Overall, children and adults were faster to detect social threats (i.e., angry faces), but spent a smaller proportion of time dwelling on them and had slower behavioral responses. Findings underscore the importance of combining different measures to parse differences between processing versus responding to social signals across development. RESEARCH HIGHLIGHTS: Children and adults are slower to select angry faces when measured by time to mouse-click but faster to detect angry faces when measured by time to first eye fixation. The use of eye-tracking addresses some limitations of prior visual search tasks with children that rely on behavioral responses alone. Results suggest shorter time to first fixation, but subsequently, shorter duration of dwell on social threat in children and adults.

An Examination of the Relations Between Effortful Control in Early Childhood and Risk for Later Externalizing Psychopathology: A Bi-factor Structural Equation Modeling Approach.

Deficits in effortful control (EC) contribute to patterns of maladaptation across development; however, little is known about how specific subfactors of EC differentially predict children's externalizing psychopathology. Using a longitudinal sample of 206 children (47.8% female, 42.6% Caucasian), the current study employed a bi-factor structural equation modeling approach to examine the concurrent and longitudinal associations between EC and its subfactors (i.e., attentional focusing, low-intensity pleasure, perceptual sensitivity, inhibitory control) and conduct problems, attention deficit disordered behaviors (ADD), and callous-unemotional (CU) traits at 36 and 84 months, respectively. Results indicated that increased general EC at 36 months predicted reduced CU traits and ADD at 84 months. Attentional focusing was the only subfactor to uniquely predict later CU traits, suggesting that strong attentional abilities attenuate risk for CU trait development. The implications for research and practice are discussed.

Testing reciprocal associations between child anxiety and parenting across early interventions for inhibited preschoolers.

BACKGROUND: Given the robust evidence base for the efficacy of evidence-based treatments targeting youth anxiety, researchers have advanced beyond efficacy outcome analysis to identify mechanisms of change and treatment directionality. Grounded in developmental transactional models, interventions for young children at risk for anxiety by virtue of behaviorally inhibited temperament often target parenting and child factors implicated in the early emergence and maintenance of anxiety. In particular, overcontrolling parenting moderates risk for anxiety among highly inhibited children, just as child inhibition has been shown to elicit overcontrolling parenting. Although longitudinal research has elucidated the temporal unfolding of factors that interact to place inhibited children at risk for anxiety, reciprocal transactions between these child and parent factors in the context of early interventions remain unknown. METHOD: This study addresses these gaps by examining mechanisms of change and treatment directionality (i.e., parent-to-child vs. child-to-parent influences) within a randomized controlled trial comparing two interventions for inhibited preschoolers (N = 151): the multicomponent Turtle Program ('Turtle') and the parent-only Cool Little Kids program ('CLK'). Reciprocal relations between parent-reported child anxiety, observed parenting, and parent-reported accommodation of child anxiety were examined across four timepoints: pre-, mid-, and post-treatment, and one-year follow-up (NCT02308826). RESULTS: Hypotheses were tested via latent curve models with structured residuals (LCM-SR) and latent change score (LCS) models. LCM-SR results were consistent with the child-to-parent influences found in previous research on cognitive behavioral therapy (CBT) for older anxious youth, but only emerged in Turtle. LCS analyses revealed bidirectional effects of changes in parent accommodation and child anxiety during and after intervention, but only in Turtle. CONCLUSION: Our findings coincide with developmental transactional models, suggesting that the development of child anxiety may result from child-to-parent influences rather than the reverse, and highlight the importance of targeting parent and child factors simultaneously in early interventions for young, inhibited children.

Mother-infant emotional availability through the COVID-19 pandemic: Examining continuity, stability, and bidirectional associations.

The COVID-19 pandemic may impact the development of infants' social communication patterns with their caregivers. The current study examined continuity, stability, and bidirectional associations in maternal and infant dyadic Emotional Availability (EA) before and during the COVID-19 pandemic. Participants were 110 Israeli mother-infant dyads (51% girls) that were assessed prior to (Mage = 3.5 months) and during (Mage = 12.4 months) the pandemic. At both time points, mother-infant interactions were observed during play (nonstressful context) and tasks designed to elicit infant frustration (stressful context). Maternal and child EA were coded offline. Maternal EA demonstrated no significant mean-level changes from before to during the COVID-19 pandemic, whereas infant responsiveness and involvement increased over time. Stability and bidirectional associations in EA differed by context and were evident only in the stressful context. Mothers' perceived levels of social support further moderated these associations. Specifically, infants' pre-pandemic responsiveness and involvement predicted maternal EA during the pandemic only when mothers reported low levels of social support. Our findings suggest that maternal and child EA were not adversely impacted by the COVID-19 pandemic. However, patterns of EA demonstrated moderate-to-no stability over time, suggesting considerable individual differences in trajectories of EA.

The Impact of Callous-Unemotional Traits on Achievement, Behaviors, and Relationships in School: A Systematic Review.

Disruptive behavior disorders (DBDs) are associated with significant academic, behavioral, and relationship challenges in the school setting. Children with co-occurring DBDs and callous-unemotional (CU) traits show a distinct pattern of early starting, chronic, and aggressive disruptive behavior and are resistant to traditional DBD interventions. There is growing evidence that CU traits have important consequences for children's school functioning. The purpose of this systematic review is to synthesize research on CU traits in school with a focus on academics, relationships, and behavior. We searched PsycINFO, PubMed, and Education Full-Text to identify 37 empirical studies that met inclusionary criteria. Findings suggest that CU traits are associated with poor academic performance, high levels of aggression and conduct problems, and difficulty forming relationships at school, often above and beyond the impact of DBDs alone. Findings and future directions are discussed including how the current study can support key stakeholders in promoting the success of students with elevated CU traits.

Callous-unemotional Traits and Emotion Recognition Difficulties: Do Stimulus Characteristics Play a role?

Emotion recognition difficulties are linked to callous-unemotional (CU) traits, which predict risk for severe antisocial behavior. However, few studies have investigated how stimulus characteristics influence emotion recognition performance, which could give insight into the mechanisms underpinning CU traits. To address this knowledge gap, children aged 7-10 years old (N = 45; 53% female, 47% male; 46.3% Black/African-American, 25.9% White, 16.7% Mixed race or Other, 9.3% Asian) completed an emotion recognition task featuring static facial stimuli from child and adult models and facial and full-body dynamic stimuli from adult models. Parents reported on CU traits of children in the sample. Children showed better emotion recognition for dynamic than static faces. Higher CU traits were associated with worse emotion recognition, particularly for sad and neutral expressions. Stimulus characteristics did not impact associations between CU traits and emotion recognition.

Low social affiliation predicts increases in callous-unemotional behaviors in early childhood.

BACKGROUND: Callous-unemotional (CU) behaviors predict risk for aggression and rule-breaking. Low social affiliation (i.e. reduced motivation for and enjoyment of social closeness) is hypothesized to be a phenotypic marker for CU behaviors in early childhood. However, studies need to establish observational methods to objectively assess social affiliation as well as to establish parenting practices that can buffer pathways from low social affiliation to CU behaviors. METHODS: Using data from a longitudinal twin study of 628 children (age 2, 47% females; age 3, 44.9% females), we examined reciprocal associations between observed social affiliation, CU behaviors, and oppositional-defiant behaviors. We tested whether positive parenting moderated associations over time. RESULTS: We established that an observed measure of social affiliation derived from the Bayley's Behavior Rating Scale and Infant Behavior Record showed high inter-rater reliability and expected convergence with parent-reported temperament measures. Lower social affiliation at age 2 uniquely predicted CU behaviors, but not oppositional-defiant behaviors, at age 3. Finally, low social affiliation at age 2 predicted CU behaviors at age 3 specifically among children who experienced low, but not high, levels of parental positivity. CONCLUSIONS: An objective rating scale that is already widely used in pediatric settings reliably indexes low social affiliation and risk for CU behaviors. The dynamic interplay between parenting and low child social affiliation represents an important future target for novel individual- and dyadic-targeted treatments to reduce risk for CU behaviors.

Early intervention for inhibited young children: a randomized controlled trial comparing the Turtle Program and Cool Little Kids.

BACKGROUND: Children classified as behaviorally inhibited (BI) are at risk for social anxiety. Risk for anxiety is moderated by both parental behavior and social-emotional competence. Grounded in developmental-transactional theory, the Turtle Program involves both parent and child treatment components delivered within the peer context. Our pilot work demonstrated beneficial effects of the Turtle Program ('Turtle') over a waitlist control group. Herein, we report results of a rigorous randomized controlled trial (RCT) comparing Turtle to the best available treatment for young children high in BI, Cool Little Kids (CLK). METHODS: One hundred and fifty-one parents and their 3.5- to 5-year-old children selected on the basis of BI were randomly assigned to Turtle or CLK, delivered in group format over 8 weeks. Effects on child anxiety, life interference, BI, and observed parenting were examined at post-treatment and 1-year follow-up. ClinicalTrials.gov registration: NCT02308826. RESULTS: No significant main effect differences were found between Turtle and CLK on child anxiety; children in both programs evidenced significant improvements in BI, anxiety severity, family accommodation, and child impairment. However, Turtle yielded increased observed warm/engaged parenting and decreased observed negative control, compared with CLK. Parental social anxiety moderated effects; parents with higher anxiety demonstrated diminished improvements in child impairment, and parent accommodation in CLK, but not in Turtle. Children of parents with higher anxiety demonstrated more improvements in child BI in Turtle, but not in CLK. CONCLUSIONS: Turtle and CLK are both effective early interventions for young children with BI. Turtle is more effective in improving parenting behaviors associated with the development and maintenance of child anxiety. Turtle also proved to be more effective than CLK for parents with social anxiety. Results suggest that Turtle should be recommended when parents have social anxiety; however, in the absence of parent anxiety, CLK may offer a more efficient treatment model.

Context is key: Parasympathetic regulation in the classroom differentially predicts preschoolers' socially competent behaviors.

Research shows that children's early social competence predicts their later academic and interpersonal success. Accordingly, early childhood education programs increasingly aim to evaluate and support children's social skill development. Despite ample theoretical and empirical work demonstrating the role of the parasympathetic nervous system (PNS) in supporting neurophysiological processes that underlie social behaviors, no study has explicitly tested whether the assessment of PNS activity in childhood educational settings provides insight into children's social functioning. The current study addresses this gap by examining the influence of context-specific PNS regulation, assessed via respiratory sinus arrhythmia (RSA), in predicting preschool children's socially competent behavior toward peers in the classroom. Results showed that: (1) RSA withdrawal (e.g., decreases relative to a baseline task) during unstructured classroom activities predicted children's socially competent behaviors during these unstructured activities but not during structured activities, whereas (2) withdrawal during structured classroom activities predicted children's socially competent behaviors during structured activities. These results indicate that PNS activity makes context-specific contributions to children's social behaviors and highlight the importance of assessing neurophysiological regulation in context.

Fearlessness and low social affiliation as unique developmental precursors of callous-unemotional behaviors in preschoolers.

BACKGROUND: Early callous-unemotional (CU) behaviors identify children at risk for severe and persistent aggression and antisocial behavior. Recent work suggests that fearlessness and low social affiliation are implicated in the etiology of CU behaviors, although more research is needed to clarify these etiological pathways, as well as the role of parenting. METHOD: Using a sample of preschoolers (N = 620), we examined pathways between observed fear in response to social and non-social stimuli and observed social affiliation during social interactions at age 3 and increases child CU behaviors and oppositional-defiant behaviors from ages 3 to 5. To elucidate the role of parenting in exacerbating or buffering the relationships between low fear and social affiliation and CU behaviors, we tested whether parental harshness or low warmth moderated these pathways. RESULTS: Fearlessness and low social affiliation uniquely predicted increases in CU behaviors, but not oppositional-defiant behaviors, from ages 3 to 5. Moreover, there was evidence for differential moderation of the fear pathway by harsh parenting, such that harsh parenting predicted increases in CU behaviors in fearless children but increases in oppositional-defiant behaviors in fearful children. CONCLUSIONS: Fearlessness and low social affiliation contribute to the development of CU behaviors. Harsh parenting can exacerbate the risky fearlessness pathway. Preventative interventions aimed at reducing risk for CU behaviors and persistent aggression and antisocial behavior should target socioaffiliative processes and provide parents with strategies and training to manage and scaffold rule-compliant behavior when children show low fearful arousal.

Attachment quality assessed from children's family drawings links to child conduct problems and callous-unemotional behaviors.

OBJECTIVE: Recently, there has been considerable research on the origins of childhood conduct problems (CP) and callous-unemotional (CU) behaviors. This study examined associations between children's attachment representations and CP and CU behaviors during middle childhood. METHOD: At 1st grade, 1,292 children (57% European American, 42.5% African American, 0.5% other race; 50.9% girls) completed a drawing of their family, which was coded by trained raters to assess attachment representations. Primary caregivers reported on children's CP and CU behaviors. RESULTS: Children with disorganized representations showed more CP and CU behaviors than children with secure and resistant representations. They were also more likely than those with secure representations to show elevated CP without CU behaviors, CU behaviors only, and co-occurring CP and CU behaviors. CONCLUSION: These findings provide support for attachment disorganization as a correlate of CP and CU behaviors and suggest that attachment representations are likely important proximal influences on children's behavior.

The Impact of the COVID-19 Pandemic on Children's Conduct Problems and Callous-Unemotional Traits.

The COVID-19 pandemic has dramatically altered family life, but whether family exposures to and worries about the COVID-19 pandemic has impacted child conduct problems (CP) and callous-unemotional (CU) traits is unknown. Thus, we evaluated 303 parents (Mage = 38.04; SD = 5.21; 92.4% biological mothers) and children (Mage = 6.43; SD = 2.13; 51.8% female) during a four-month period early in the pandemic. We examined associations between parental exposures to COVID-19, parental worries about the pandemic, harsh and warm parenting practices, and child CP and CU traits. Although more parental worries were not directly related to parenting practices, more worry about COVID-19 was specifically related to higher levels of child CP, particularly parental worries about themselves or family members contracting the virus. Our findings add to a growing literature demonstrating the burden that the pandemic has placed on families and its implications for children's mental health.

Observed Peer Competence Moderates Links between Children's Self-Regulation Skills and Academic Performance.

The current study focuses on the relations between observed measures of children's self-regulation and academic achievement, as well as the extent to which observations of children's peer competence in preschool moderates these links. Data were drawn from 102 students (male = 48; M age = 4.82 years, SD age = 0.46 years) enrolled in pre-kindergarten classrooms. A series of linear path models was used to test study hypotheses, and the nature of significant interactions was elucidated by examining simple slopes and regions of significance. Children's self-regulation, but not peer competence, significantly predicted both reading and math performance assessed using the Woodcock Johnson III, ß = .43, p < .001 and ß = .39, p < .001, respectively. Tests of moderation effects revealed that the association between children's poor self-regulation and poor math performance, but not reading performance, ß = -.28, p = .022 and ß = -.11, p = .23, was negated for children with average to high peer competence. These results demonstrate the protective quality of peer competence for academic performance using observational methods collected in preschools.

Less imitation of arbitrary actions is a specific developmental precursor to callous-unemotional traits in early childhood.

OBJECTIVE: Callous-unemotional (CU) traits in early childhood explain heterogeneity within conduct problems and are associated with higher risk for later diagnoses of childhood disruptive behavior disorders and antisocial behavior in adulthood. Emerging research implicates impairments in affiliative processes in the etiology of CU traits. The current study tests whether the imitation of intentional actions with no functional significance -a behavior that supports the acquisition of social conventions and affiliative bonds, is a specific developmental precursor to CU traits in early childhood. METHODS: Data came from a longitudinal twin study of 628 children (Age 2: 47% females; Age 3: 44.9% females) with observations of arbitrary (i.e., nonfunctional actions) and instrumental (i.e., functional actions) imitation and parent reports of CU traits and oppositional defiant (ODD) behaviors at ages 2 and 3. RESULTS: Lower arbitrary imitation at age 2, but not instrumental imitation, was related to increases in CU traits from ages 2 to 3 (ß = -.10, p = .02). CONCLUSIONS: These findings establish early social and affiliative processes in the etiology of CU traits, highlighting that novel personalized treatment and intervention strategies for CU traits may benefit from targeting these processes to help reduce CU traits and risk for persistent conduct problems in children.

Parenting and Cortisol in Infancy Interactively Predict Conduct Problems and Callous-Unemotional Behaviors in Childhood.

This study examines observed maternal sensitivity, harsh-intrusion, and mental-state talk in infancy as predictors of conduct problems (CP) and callous-unemotional (CU) behaviors in middle childhood, as well as the extent to which infants' resting cortisol and cortisol reactivity moderate these associations. Using data from the Family Life Project (n = 1,292), results indicate that maternal sensitivity at 6 months predicts fewer CP at first grade, but only for infants who demonstrate high levels of cortisol reactivity. Maternal harsh intrusion predicts fewer empathic-prosocial behaviors, a component of CU behaviors, but only for infants who demonstrate high resting cortisol. Findings are discussed in the context of diathesis-stress and differential susceptibility models.

Children's Executive Function Attenuate the Link Between Maternal Intrusiveness and Internalizing Behaviors at School Entry.

The goal of this study was to examine the independent and interactive roles of harsh-intrusive maternal behaviors and children's executive function in the development of internalizing behaviors across the first years of school. A diverse sample (58% African American, 42% European American) of 137 children (48% female) was followed from kindergarten (age 5 years) through school entry (ages 6-7 years). At age 5, maternal harsh-intrusive parenting behaviors were rated from a mother-child structured play task, and children completed 3 executive function tasks that measured inhibitory control, working memory, and attention set-shifting. Teachers reported on children's internalizing behaviors at ages 5, 6, and 7. Harsh-intrusive parenting behaviors at age 5 years were positively related to internalizing behaviors in the first years of school, whereas high executive function abilities at age 5 years were related to lower internalizing behaviors in the first years of school. In addition, executive function buffered the association between parenting behaviors and internalizing behaviors such that the link between harsh-intrusive parenting and child internalizing behaviors was evident only among children with low executive function and not among children with high executive function. Interventions that focus on reducing negative parenting behaviors and improving children's executive function may prevent internalizing behaviors from increasing during times of social and academic challenge.

Maternal Attributions of Infant Behavior and Parenting in Toddlerhood Predict Teacher-Rated Internalizing Problems in Childhood.

Social-information-processing theories of parenting posit that parents' beliefs and attributions about their children's behaviors contribute to how parents interact with their children. The purpose of this study was to examine the associations between negative parenting attributions in infancy, harsh-intrusive parenting in toddlerhood, and children's internalizing problems (IPs) in early childhood. Using data from a diverse longitudinal study (n = 206), the current study used a structural equation modeling approach to test if mothers' negative attributions measured at 6 months predicted teacher ratings of children's IPs in 1st grade, as well as the extent to which observed harsh-intrusive parenting behaviors measured at ages 1, 2, and 3 years mediated this link. Maternal negative attributions in infancy predict more IPs in 1st grade, but this link becomes nonsignificant when observed harsh-intrusive parenting is included as a mediator. A significant indirect effect suggests that harsh-intrusive parenting mediates the association between early negative attributions and eventual IPs. Findings from this study identify harsh-intrusive parenting behaviors as one potential mechanism through which the effects of early attributions are carried forward to influence children's IPs. The developmental and clinical implications of these findings are discussed.

Children's autonomic functioning moderates links between maternal rejecting attitudes and preschool aggressive behaviors.

Substantial theoretical and empirical literature suggests that the extent to which children's early experiences contribute to the development of aggressive behaviors may depend on the psychophysiological regulatory capacities of the child. This study adds to this literature by examining the relations between mothers' rejecting child-rearing attitudes and children's aggressive behaviors, as well as whether children's parasympathetic regulation, both at rest and in response to anger-inducing films, moderate these links. Using the data collected from 88 preschoolers (mage  = 51 months), the results revealed that the positive association between mothers' rejecting child-rearing attitudes and children's aggressive behaviors was moderated by respiratory sinus arrhythmia (RSA) reactivity to anger. More rejecting child-rearing attitudes predicted more aggressive behaviors only for children who showed mild RSA suppression to RSA augmentation. Conversely, and consistent with the differential-susceptibility model, children who showed mild RSA suppression to RSA augmentation had the fewest aggressive behaviors when mothers reported less rejecting child-rearing attitudes.

Prevalence and Perceptions of Electronic Cigarette Use during Pregnancy.

Objectives The current study is the first to assess pregnant women's perceptions of e-cigarettes and the prevalence of e-cigarette use during pregnancy, using a national sample of pregnant women (N = 445) recruited online. Methods An online survey was used to assess the prevalence and perceptions of e-cigarette use among pregnant women, including perceptions of e-cigarette safety. Results In our sample, 5.62% (n = 25) of women solely used tobacco cigarettes, 6.52% (n = 29) solely used e-cigarettes, 8.54% (n = 38) used both tobacco cigarettes and e-cigarettes, and 79.33% (n = 353) used neither tobacco cigarettes nor e-cigarettes during their current pregnancy. Overall, 64.27% (n = 286) of participants viewed e-cigarettes as being safer than tobacco cigarettes. Having seen advertisements for e-cigarettes increased likelihood of viewing them as safer than tobacco cigarettes (OR [Odds Ratio] = 2.5, p < .01). Conclusions for Practice Taken together, findings from this study suggest that at least as many women use e-cigarettes during pregnancy as tobacco cigarettes, that pregnant women view e-cigarettes as being safer than tobacco cigarettes, and that these views may be influenced by exposure to e-cigarette advertisements.