Startle to neutral, not negative stimuli: A neurophysiological correlate of behavioral inhibition in young children.

A putative biomarker of anxiety risk, the startle response is typically enhanced by negative compared to neutral emotion modulation in adults, but remains understudied in children. To determine the extent to which neutral, negative, and positively valenced emotional conditions modulate startle response in early life, a child-friendly film paradigm was used to vary emotion across these conditions during startle induction in sixty-four 4- to 7-year-old children. Association of emotion-modulated startle with parent-reported anxiety symptom severity and child behavioral inhibition, a risk factor for anxiety problems, were assessed. Analyses revealed no difference in startle magnitude during negative compared to neutral film clips. By contrast, startle during both negative and neutral conditions was greater than startle during the positive condition. Larger startle magnitude during the neutral condition associated with higher levels of child behavioral inhibition (BI). These results are consistent with possible immaturity of startle response in young children, and suggest that startle amplitude in more emotionally ambiguous, neutral conditions could serve as an early biomarker for anxiety risk.

Grant Report on Anxiety-CBT: Dimensional Brain Behavior Predictors of CBT Outcomes in Pediatric Anxiety.

In the following grant report, we describe initial and planned work supported by our National Institute of Mental Health R01-funded, Research Domain Criteria (RDoc) informed project, "Dimensional Brain Behavior Predictors of CBT Outcomes in Pediatric Anxiety". This project examines response to cognitive behavioral therapy (CBT) in a large sample of anxiety-affected and low-anxious youth ages 7 to 18 years using multiple levels of analysis, including brain imaging, behavioral performance, and clinical measures. The primary goal of the project is to understand how brain-behavioral markers of anxiety-relevant constructs, namely acute threat, cognitive control, and their interaction, associate with CBT response in youth with clinically significant anxiety. A secondary goal is to determine whether child age influences how these markers predict, and/or change, across varying degrees of CBT response. Now in its fourth year, data from this project has informed the examination of (1) baseline (i.e., pre-CBT) anxiety severity as a function of brain-behavioral measures of cognitive control, and (2) clinical characteristics of youth and parents that associate with anxiety severity and/or predict response to CBT. Analysis of brain-behavioral markers before and after CBT will assess mechanisms of CBT effect, and will be conducted once the data collection in the full sample has been completed. This knowledge will help guide the treatment of clinically anxious youth by informing for whom and how does CBT work.

Maternal comforting behavior, toddlers' dysregulated fear, and toddlers' emotion regulatory behaviors.

Developmental theories of emotion regulation suggest that influences from both extrinsic (e.g., from caregivers) and intrinsic (i.e., temperament) sources contribute to children's displays of emotion regulatory behaviors. Very few studies have examined specific caregiver behaviors in relation to specific regulatory behaviors. Further, few empirical investigations have tested theoretical notions that temperament may be an important context in which to understand the nature of the relation between caregiver behavior and toddlers' regulatory behaviors. The current study examined the specific maternal behavior of physical comfort in relation to three regulatory strategies exhibited by toddlers (attention-shifting, caregiver-focused behavior, and self-focused behavior) in 117 pairs of mothers and their 24-month-old toddlers. Further, we tested the temperament dimension of dysregulated fear, a more recent derivation of behavioral inhibition, both in relation to regulatory efforts and as a moderator of relations between maternal comforting and toddler regulatory behaviors. Dysregulated fear related directly and positively to attention-shifting, and it moderated the relation between maternal comforting and both caregiver-focused and self-focused behaviors. This study provides new evidence of the importance of both extrinsic and intrinsic correlates of emotion regulation in early childhood. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Attention to Threat as a Predictor of Shyness in the Context of Internalizing and Externalizing Problems.

The duration of children's attention to putative threat has been documented as a consistent predictor of later anxiety in inhibited children across childhood (Fox, 2010; Perez-Edgar & Fox, 2005). However, attention to threat has not been broadly examined within existing behavioral contexts, and has seldom been studied in very early childhood. Whereas toddlers with high levels of internalizing behavior may view fear-inducing stimuli as a threat, toddlers with high levels of externalizing behavior may demonstrate attention out of interest or sensation seeking. Thus, attention to threat was expected to predict increased toddler shyness in the context of either high internalizing problems or low externalizing behavior. We examined 117 24-month-old toddlers to determine whether attention to threat interacted with internalizing and externalizing behavior at 24 months of age to predict toddler shyness one year later. Results indicated that attention to threat predicted toddlers' lower shyness at 36 months when toddlers' externalizing behavior at age 24 months were high, but there was no significant interaction between toddlers' internalizing behavior and their attention to threat in predicting later shyness. These results expand our understanding of the contexts in which attention to threat in early childhood is a viable predictor of later shyness.

Gender Moderates the Progression from Fearful Temperament to Social Withdrawal through Protective Parenting.

Child gender may exert its influence on development, not as a main effect, but as a moderator among predictors and outcomes. We examined this notion in relations among toddler fearful temperament, maternal protective parenting, maternal accuracy in predicting toddler distress to novelty, and child social withdrawal. In two multi-method, longitudinal studies of toddlers (24 months at Time 1; ns = 93 and 117, respectively) and their mothers, few main effect gender differences occurred. Moderation existed in both studies: only for highly accurate mothers of boys, fearful temperament related to protective parenting, which then predicted later social withdrawal. Thus, studying only main-effect gender differences may obscure important differences in how boys and girls develop from fearful temperament to later social withdrawal.

Maternal depressive symptoms, toddler emotion regulation, and subsequent emotion socialization.

Although many studies have examined how maternal depressive symptoms relate to parenting outcomes, less work has examined how symptoms affect emotion socialization, a parenting construct linked to a myriad of socioemotional outcomes in early childhood. In line with a transactional perspective on the family, it is also important to understand how children contribute to these emotional processes. The current study examined how toddler emotion regulation strategies moderated the relation between maternal depressive symptoms and emotion socialization responses, including nonsupportive responses (e.g., minimizing, responding punitively to children's negative emotions) and wish-granting, or the degree to which mothers give in to their children's demands in order to decrease their children's and their own distress. Mothers (n = 91) and their 24-month-old toddlers participated in laboratory tasks from which toddler emotion regulation behaviors were observed. Mothers reported depressive symptoms and use of maladaptive emotion socialization strategies concurrently and at a 1-year follow-up. The predictive relation between maternal depressive symptoms and emotion socialization was then examined in the context of toddlers' emotion regulation. Toddlers' increased use of caregiver-focused regulation interacted with depressive symptoms in predicting increased wish-granting socialization responses at 36 months. At high levels of toddlers' caregiver-focused regulation, depressive symptoms related to increased wish-granting socialization at 36 months. There was no relation for nonsupportive socialization responses. Results suggest that toddler emotional characteristics influence how depressive symptoms may put mothers at risk for maladaptive parenting. Family psychologists must strive to understand the role of both parent and toddler characteristics within problematic emotional interactions.

Maternal Encouragement to Approach Novelty: A Curvilinear Relation to Change in Anxiety for Inhibited Toddlers.

Various parenting behaviors (e.g., protection, intrusiveness, sensitivity) have been shown to impact young children's anxiety development, particularly for temperamentally inhibited children. These behaviors have sometimes predicted both increases and decreases in anxiety in inhibited children, suggesting that linear relations may not adequately model their influence. In the current study, we proposed the dimension of encouragement to approach novelty to characterize parenting behavior ranging from very little encouragement (i.e., protective behavior) to very strong encouragement (i.e., intrusiveness), with gentle encouragement residing in the middle. In a sample of 110 toddlers (48 female, 62 male) and their mothers, the linear and curvilinear effects of this parenting dimension were investigated in relation to change in child separation anxiety and shyness from age 2 to age 3. Inhibited temperament was also investigated as a moderator. Encouragement to approach novelty displayed the hypothesized curvilinear relation to change in separation anxiety, but not shyness, at extreme levels of inhibited temperament. Toddlers increased in separation anxiety when mothers' encouragement resided at either extreme end of the continuum, with lower child anxiety occurring when mothers displayed behavior closer to the middle of the continuum. Implications for the study of parenting outcomes for inhibited toddlers are discussed.

Training interpretation biases among individuals with body dysmorphic disorder symptoms.

The current study provided an initial test of a Cognitive Bias Modification for Interpretations (CBM-I) training paradigm among a sample with elevated BDD symptoms (N=86). As expected, BDD-relevant interpretations were reduced among participants who completed a positive (vs. comparison) training program. Results also pointed to the intriguing possibility that modifying biased appearance-relevant interpretations is causally related to changes in biased, socially relevant interpretations. Further, providing support for cognitive behavioral models, residual change in interpretations was associated with some aspects of in vivo stressor responding. However, contrary to expectations there were no significant effects of condition on emotional vulnerability to a BDD stressor, potentially because participants in both training conditions experienced reductions in biased socially-threatening interpretations following training (suggesting that the "comparison" condition was not inert). These findings have meaningful theoretical and clinical implications, and fit with transdiagnostic conceptualizations of psychopathology.

The effect of toddler emotion regulation on maternal emotion socialization: Moderation by toddler gender.

Although developmental research continues to connect parenting behaviors with child outcomes, it is critical to examine how child behaviors influence parenting behaviors. Given the emotional, cognitive, and social costs of maladaptive parenting, it is vital to understand the factors that influence maternal socialization behaviors. The current study examined children's observed emotion regulatory behaviors in two contexts (low-threat and high-threat novelty) as one influence. Mother-child dyads (n = 106) with toddlers of 24 months of age participated in novelty episodes from which toddler emotion regulation behaviors (i.e., caregiver-focused, attention, and self-soothing) were coded, and mothers reported their use of emotion socialization strategies when children were 24 and 36 months. We hypothesized that gender-specific predictive relations would occur, particularly from regulatory behaviors in the low-threat contexts. Gender moderated the relation between caregiver-focused emotion regulation in low-threat contexts and nonsupportive emotion socialization. Results from the current study inform the literature on the salience of child-elicited effects on the parent-child relationship. (PsycINFO Database Record (c) 2014 APA, all rights reserved).