Relationships Between Anxiety, Attention, and Reading Performance in Children.

Many studies link anxiety in children with reading difficulties, but some facets of anxiety have been found to be positively associated with reading achievement. Attentional Control Theory offers a potential explanation for these seemingly contradictory findings, positing that anxiety can both interfere in attentional processes and enhance effort and use of compensatory processing strategies. The current study examines the relationships between anxiety, attentional control, and reading performance (word reading/decoding and passage comprehension) in a racially-diverse sample of 251 s-grade students, 152 of whom had not met reading benchmarks using screening measures. Results showed that harm avoidance was positively associated with reading performance and physical symptoms of anxiety were negatively associated with reading performance. These links were attenuated when including attentional control in the model, suggesting mediation and lending support to Attentional Control Theory. Further research is needed to confirm causal mediation effects between anxiety, attentional control, and reading performance.

Understanding the relation between reading and anxiety among upper elementary students with reading difficulties.

This study examined the relations between reading anxiety, general anxiety, and test anxiety in a sample of students with reading difficulties (n = 536). It also tested if dimensions of anxiety were differentially related to word reading accuracy and fluency, text reading fluency, or reading comprehension. The results indicated that the three anxiety measures were significantly related (r = 0.51 to 0.56, p < .001). Additionally, higher reading anxiety was related to poorer word reading fluency, text reading fluency, and comprehension outcomes. Further analyses indicated that these relations existed in students who fell in the middle and upper quantiles for reading, but not the lowest quantile. This pattern of findings suggests that the relation is complex and varies depending on severity of reading difficulty. Results may help to inform future efforts to support students with reading difficulties, including students with dyslexia.

Relationships between Anxiety, Attention, and Reading Comprehension in Children.

Many studies link anxiety in children with reading difficulties, but some facets of anxiety have been found to be positively associated with reading achievement. Attentional Control Theory offers a potential explanation for these seemingly contradictory findings, positing that anxiety can both interfere in attentional processes and enhance effort and use of compensatory processing strategies. The current study examines the relationships between anxiety, attentional control, and reading comprehension in a racially-diverse sample of 251 second-grade students, most of whom were struggling readers. Results showed that harm avoidance was positively associated with reading comprehension and physical symptoms of anxiety were negatively associated with reading comprehension. These links were attenuated when including attentional control in the model, suggesting mediation and lending support to Attentional Control Theory. Further research is needed to confirm causal mediation effects between anxiety, attentional control, and reading performance.

Internalizing Symptoms and Reading Difficulties Among Early Elementary School Students.

While the field of learning disabilities has grown substantially over the past several decades (Grigorenko et al. in Am Psychol 75:37, 2020) little work has explored the role of internalizing symptoms among struggling students. The present study compared struggling and typical readers on several child reported internalizing measures at both the beginning and end of a school year during which time they received either classroom-as-usual or research-team provided intensive intervention. Struggling readers who did and did not meet reading benchmarks were also compared at year-end. While minimal differences were present at the beginning of the year, numerous differences were observed at the end, with students exhibiting persistent reading struggles reporting significantly greater distress. Bi-directional associations emerged with beginning of year group status predicting internalizing symptoms and beginning of year internalizing symptoms predicting end of year intervention response group status. Findings are discussed in terms of future directions for enhancing intervention studies of struggling readers.

Examining the Effects of Integrating Anxiety Management Instruction Within a Reading Intervention for Upper Elementary Students With Reading Difficulties.

We present findings from the first cohort of third- and fourth-grade students with reading difficulties (128 students from 31 classrooms) who participated in a 2-year intervention examining the effects of a reading intervention with and without anxiety management. Using a randomized controlled trial, students were assigned to one of three conditions: (a) small-group reading intervention with anxiety management instruction (RANX), (b) small-group reading intervention with math fact practice (RMATH), and (c) business-as-usual (BAU) comparison condition (no researcher provided treatment). Personnel from the research team provided participants in the RANX and RMATH the same reading intervention with the variation in the two treatments being whether the same amount of time per lesson was allocated to anxiety management (RANX) or practicing math facts (RMATH). Students in the RANX significantly outperformed students in the BAU on reading comprehension (effect size [ES] = 1.22) and students in the RMATH outperformed BAU on reading comprehension (ES = 0.77). Groups did not differ significantly on other reading outcomes. Reading anxiety moderated the main effect of the RANX intervention on the Test of Word Reading Efficiency (TOWRE) word reading when contrasted against the BAU group, indicating a significant difference favoring RANX where treatment's effect decreased by 0.94 units (about 1 point on the outcome) on word reading for each additional point increase in reading anxiety.

The Role of Reading Anxiety among Struggling Readers in Fourth and Fifth Grade.

Cognitive predictors of reading are well known, but less is understood about the roles of "noncognitive" factors, including emotional variables such as anxiety. While math anxiety has been a focus of study, its analogue in the reading literature is understudied. We assessed struggling fourth and fifth graders (n = 272) on reading anxiety in the context of general anxiety, cognitive predictors (working memory, verbal knowledge), and demographics. Regressions tested for unique contributions to three reading outcomes: word reading accuracy, oral reading fluency, and reading comprehension. Reading anxiety and general anxiety correlated moderately (r = .63) but were differentially related to reading. Reading anxiety predicted comprehension when all other predictors were considered, and predicted oral reading fluency until word reading accuracy was added to the model. Results offer a more nuanced understanding of the nature of reading anxiety, and its implications for struggling readers.

Using Research-Informed Pedagogical Practices to Maximize Learning in Youth Cognitive Behavioral Therapy.

Cognitive-behavioral therapy (CBT) for youth is an evidence-based treatment that typically starts with some form of psychoeducation, during which the patient is taught in a didactic manner about their presenting problems and strategies to ameliorate their symptoms. The learning process continues over the course of treatment as patients consolidate and attempt to utilize their aqcuired knowledge in their daily life. Manuals provide helpful structure and strategies to facilitate this learning process (e.g., using metaphors, personalized coping cards); however, there is variability across patients in terms of what presented content they will be able to access and understand, how they can most effectively transfer what they learn into their everyday life, and why they will become engaged in this learning process. The purpose of this paper is to connect CBT and pedagogy by outlining the research-informed pedagogical framework known as Universal Design for Learning (UDL) as it relates to the teaching and learning that takes place in CBT. First, we describe UDL as a lens through which clinicians can conceptualize evidence-based pedagogical principles that undergird common CBT teaching practices. Second, we recommend that clinicians use UDL as a guiding framework when they are faced with barriers to learning due to the variability that exists in how patients engage in, access and understand, and utilize the material. We posit that UDL can help clinicians ensure that more patients are able to successfully access and benefit from CBT.

Perceived Control, Family Environment, and the Etiology of Child Anxiety-Revisited.

In 1998, Chorpita, Brown, and Barlow published a now seminal study in Behavior Therapy examining the development of anxiety in children and adolescents using Barlow's 1988 model of the development of anxiety in adults. Mindful of developmental considerations, parental control and children's perceptions of control were considered key factors in this revised model. Since that study, mixed support has accumulated for the role of control, both parental control and children's perceptions of that control, in the development of childhood anxiety. As a result, the measurement of these constructs has been critically examined and refined in recent years and encouraging findings have been obtained. Unfortunately, however, the Chorpita and colleagues study as well as the studies that have followed have used cross-sectional designs and the directionality of effects has not been clearly established. Longitudinal studies are required. Here, we present a qualitative review of these developments and provide directions for future research.

The From Survivor to Thriver program: RCT of an online therapist-facilitated program for rape-related PTSD.

This study evaluated the efficacy of the From Survivor to Thriver program, an interactive, online therapist-facilitated cognitive-behavioral program for rape-related PTSD. Eighty-seven college women with rape-related PTSD were randomized to complete the interactive program (n=46) or a psycho-educational self-help website (n=41). Both programs led to large reductions in interview-assessed PTSD at post-treatment (interactive d=2.22, psycho-educational d=1.10), which were maintained at three month follow-up. Both also led to medium- to large-sized reductions in self-reported depressive and general anxiety symptoms. Follow-up analyses supported that the therapist-facilitated interactive program led to superior outcomes among those with higher pre-treatment PTSD whereas the psycho-educational self-help website led to superior outcomes for individuals with lower pre-treatment PTSD. Future research should examine the efficacy and effectiveness of online interventions for rape-related PTSD including whether treatment intensity matching could be utilized to maximize outcomes and therapist resource efficiency.

Primary Versus Secondary Diagnosis of Generalized Anxiety Disorder in Youth: Is the Distinction an Important One?

Examine whether children with a primary diagnosis of generalized anxiety disorder (GAD) differ from children with a secondary diagnosis of GAD on clinician, parent, teacher, and youth-report measures. Based on consensus diagnoses, 64 youth referred to a general outpatient assessment clinic were categorized as having either a primary or secondary diagnosis of GAD. A semi-structured diagnostic interview was used to guide diagnostic decisions and assign primary versus secondary diagnostic status. We predicted that youth with a primary GAD diagnosis would present with greater anxiety symptomatology and symptom impairment on a variety of anxiety-related measures than youth with a secondary GAD diagnosis. Contrary to our hypotheses, no differences were found between those with primary versus secondary GAD diagnoses on measures of symptom severity and clinical impairment, comorbid diagnoses, or youth and teacher-report measures. Our findings have potential implications for the current practice of requiring primary anxiety diagnostic status as an inclusion criterion in clinical research and treatment outcome studies. Assuming our findings are confirmed in larger samples and with other anxiety disorders, future clinical trials and basic psychopathology research might not exclude youth based on absence of a particular anxiety disorder as the primary disorder but rather include individuals for whom that anxiety disorder is secondary as well.

Anxiety and Response to Reading Intervention among First Grade Students.

BACKGROUND: For school-aged children with reading difficulties, an emerging and important area of investigation concerns determining predictors of intervention response. Previous studies have focused exclusively on cognitive and broadly defined behavioral variables. What has been missing, however, are studies examining anxiety, which is among the most commonly experienced difficulty for youth. OBJECTIVE: The present study examined anxiety among children classified as typically achieving or showing inadequate/adequate response following an intervention for reading problems. METHODS: Participants were 153 ethnically-diverse children (84 male, 69 female) evaluated in the winter and spring of their first-grade academic year. Children completed several standardized measures of reading achievement involving decoding and fluency along with a multidimensional anxiety rating scale. RESULTS: Repeated measures ANOVA revealed significant main effects for time and scale and significant interactions for time*scale and group*scale. Logistic regression examined whether anxiety predicted response to intervention (Y/N) at the end of the school-year. CONCLUSIONS: Results showed overall decreases in anxiety over time, with the exception of the harm avoidance area which increased and also interacted with group (children with decoding/fluency difficulties reported less harm avoidance than typically achieving children). The harm avoidance area was most pertinent across analyses highlighting the potential importance of targeting this area; however, none of the anxiety scales predicted response group at the end of the intervention. Ongoing research is needed in this area in order to identify characteristics of inadequate responders to reading intervention programs and/or inform interventions that incorporate these socioemotional factors.

Predicting risky sexual behavior in emerging adulthood: examination of a moderated mediation model among child sexual abuse and adult sexual assault victims.

Although having a sexual victimization history is associated with engaging in sexual risk behavior, the mechanisms whereby sexual victimization increases risk behavior are unclear. This study examined use of sex as an affect regulation strategy as a mediator of the relationship between depressive symptoms and sexual risk behavior among 1,616 sexually active college women as well as examined having a history of child sexual abuse (CSA), adolescent/adult sexual assault (ASA), or both (CSA/ASA) as moderators. Results supported the mediated model as well as moderated mediation, where depressive symptoms were more strongly associated with use of sex as an affect regulation strategy among ASA victims, and sex as an affect regulation strategy was more strongly related to sexual risk behavior for CSA/ASA victims.

Who is best at predicting children's anxiety in response to a social evaluative task? A comparison of child, parent, and teacher reports.

The purpose of this preliminary study was to examine the validity of child, parent, and teacher reports of child social anxiety in predicting the child's responses to a social evaluative task. Children, parents, and teachers each completed a measure of social anxiety, as well as a measure that asked them to predict the child's anxiety during a behavioral approach task (BAT) of reading aloud in front of a video camera. Consistent with previous literature, analyses revealed poor agreement across informants. Importantly, children's reports predicted their own anxious feelings and, to some degree, their behaviors during the task, whereas other informants' reports did not. We recommend that further research examine the relative validity of multiple informants' reports in predicting children's real-life behavior.

Multiple informant agreement and the anxiety disorders interview schedule for parents and children.

OBJECTIVE: To examine concordance of child, parent, and consensus agreement on the Anxiety Disorders Interview Schedule, Child and Parent versions (ADIS-C/P), for an outpatient sample of children and adolescents and to explore moderators of those relations. Child characteristics (age, gender, social desirability), a family environment variable (conflict), and type of diagnoses (internalizing, externalizing) were systematically examined. METHOD: These relations were examined in 165 children and adolescents referred to a psychological clinic by family practitioners, pediatricians, schools, and mental health professionals. Participants were individually administered the ADIS-C or ADIS-P by separate clinicians, and consensus diagnoses were determined in a clinical conference. Agreements between child-parent, child-consensus, and parent-consensus were determined. RESULTS: Poor levels of agreement were found among our informants, especially between child and parent and to some extent between child and consensus. Agreement was higher between parent and consensus, suggesting that our clinicians tended to favor parent input over child input. Although the effects were complex, characteristics of the child, family, and type of diagnosis moderated or qualified these findings. CONCLUSIONS: Although discrepancies exist among our informants, our overall findings suggest important information is obtained from each informant and, when combined with certain modifying characteristics, may lead to diagnostic and treatment decisions.

Peer victimization, global self-worth, and anxiety in middle school children.

Examined relations among peer victimization, global self-worth, and anxiety, with particular interest in the potential mediating and moderating effects of global self-worth in the anticipated relations between peer victimization and anxiety. Sixth-grade children (N = 279) from a public middle school in southwestern Virginia participated. Reported levels of peer victimization were similar to those reported in previous studies, as were levels of anxiety. Sex differences were noted on measures of peer victimization and anxiety with boys reporting more victimization but less anxiety than girls. All subsequent analyses were conducted separately by sex. Significant relations were found among all variables of interest. For girls, global self-worth was found to mediate the peer victimization-anxiety relation, suggesting that victimization experiences negatively influenced girls' views of themselves and helped explain elevated levels of anxiety reported by them. For boys, global self-worth moderated the peer victimization-anxiety relation. Boys with higher global self-worth reported fewer anxiety symptoms than boys with lower global self-worth. Implications of these findings are discussed.