Is autonomic functioning distinctly associated with anxiety and unsociability in preschoolers?

There are many benefits of peer interactions for children's social, emotional, and cognitive development, and isolation from peers may have negative consequences for children. Although biological processes may underlie social withdrawal broadly, distinct patterns may be associated with withdrawal behaviors depending on their underlying motivation (e.g., shy versus disinterested). This study investigated the role of autonomic nervous system activity, as assessed via skin conductance level (SCL) and respiratory sinus arrhythmia (RSA) in predicting changes in unsociability (e.g., lack of interest in peers) and anxious-fearfulness (e.g., discomfort among peers). Data were collected using a community sample of 92 US preschool children (45.7% female; Mage = 45.51 months, SDage = 3.81 months) at two time points one year apart. Gender differences were also explored. Baseline physiology was assessed while viewing a neutral video clip, and reactivity was assessed while viewing social exclusion and post-aggression discussion videos. For all children, coinhibition (i.e., SCL inhibition accompanied by RSA inhibition) to the post-aggression discussion video and blunted SCL activation to the exclusion video were prospectively associated with higher levels of anxious-fearfulness one year later. For boys only, baseline reciprocal sympathetic activation (i.e., SCL activation and RSA inhibition) was prospectively related to higher levels of unsociability one year later. For girls only, RSA inhibition in response to the post-aggression discussion video was prospectively related to higher levels of unsociability one year later. Findings contribute to a growing literature on autonomic reactivity in preschoolers' adjustment and suggest possible differences in the physiological processes underlying unsociability and anxious-fearfulness.

Reinforcement sensitivity theory and externalizing problems across early adolescence: Testing within-person reciprocal associations.

Temperament and externalizing problems are closely linked, but research on how they codevelop across adolescence remains sparse and equivocal. Reinforcement sensitivity theory (RST) provides a useful framework for understanding temperament and externalizing problems associations. During adolescence, oppositional problems are posited to be linked to an overactive behavioral approach system (BAS) while conduct problems are linked to an underactive behavioral inhibition system (BIS). However, this research mostly uses adult samples and cross-sectional designs and tests only between-person associations. Moreover, most studies typically test only one direction of effects (i.e., temperament predicts externalizing problems) and do not consider alternative models of associations, such as reciprocal associations. To address these limitations, we use three annual waves of a longitudinal, community-based sample of 387 early adolescents (mean Wave 1 age = 11.61 years, 55% female, 83% non-Hispanic White) to test reciprocal associations between BIS and BAS and oppositional and conduct problems. Latent curve models with structured residuals are used to test hypotheses and disaggregate between- and within-person associations. Evidence supports within-person reciprocal associations between BAS and oppositional problems and between BIS and combined conduct and oppositional problems. Results potentially inform developmental theories of temperament and externalizing problems linkages and interventions with adolescents who are engaging in oppositional problems and more severe conduct problems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A social-ecological model of preschoolers' aggressive behavior: An exploratory analysis.

Understanding classroom-level correlates of preschool children's aggressive behavior is critical to identifying multiple avenues for intervention within schools. The present school-based study evaluated the reliability and validity of a classroom-level measure of physical and relational aggression and examined a social-ecological model to test whether individual variables (i.e., temperament), dyadic peer factors (i.e., peer victimization, the number of a child's play partners), and classroom-level aggression were associated with individual aggression. Observations of play partners and teacher reports of temperament (i.e., daring, prosociality, and negative emotionality), peer victimization (i.e., physical and relational victimization), and classroom aggression were collected in a sample of preschoolers (N = 307; Mage = 48.99 months, SD = 7.51). Observer reports of aggression were used to create aggression severity and directionality scores, reflecting the overall level of aggression a child displays and their propensity to use physical relative to relational aggression, respectively. There was evidence to support the reliability and validity of the classroom-level aggression measure providing initial support that this measure could be used by school psychologists. A multilevel regression model indicated that higher levels of negative emotionality, daring, and a greater number of play partners were associated with higher levels of aggression severity. Children in classrooms with more relational aggression were more likely to use relational instead of physical aggression. These findings demonstrate the importance for school psychologists to account for multiple levels of influence when examining preschoolers' aggression. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Aggression and Irritability in Middle Childhood: Between- and Within-Person Associations.

OBJECTIVE: This study tested predicted bidirectional associations between irritability and physical and relational forms of aggression, disentangling theorized within- and between-person effects using latent curve models with structured residuals (LCM-SR) over one year in middle childhood. Gender differences and robustness of results when controlling for other externalizing problems (i.e., attention problems, delinquency) were also considered. METHOD: Children in third, fourth, and fifth grade (N = 704, 49.9% female) were recruited from schools in a large midwestern city. The sample was diverse in regard to race/ethnicity (31% Black, 29% White, 13% Hmong, 14% Latinx, 4% Native American, 4% Asian, 5% other races/ethnicities). Irritability, attention problems, and delinquency were measured using teacher-report, and physical and relational aggression were measured using self-report at three time points over one calendar year. RESULTS: At the between-person level, higher mean levels of irritability predicted higher initial levels of physical and relational aggression. Irritability continued to predict higher levels of physical aggression across the course of the study, whereas the effect of irritability on relational aggression diminished. Boys showed higher starting levels of physical aggression, but no other significant gender differences emerged. No significant within-person associations were found. CONCLUSIONS: The present study suggests that irritability may represent a between-person risk factor for high levels of physical and relational aggression in middle childhood, although effects on physical aggression may be more persistent. This highlights the importance of considering affective processes to understand the development of aggression trajectories.

The COVID-19 pandemic and measurement of preschoolers' executive functions.

Given the far-reaching effects of the COVID-19 pandemic, it is important to investigate how executive function (EF) assessments were impacted by changes in measurement protocols, context, and timing due to the pandemic. The present study used data from two projects. The first project occurred prior to the pandemic (N = 244, 44.67% female; Mage = 44.27 months) with teacher ratings and objective EF measures collected in the spring of preschool, fall of prekindergarten (pre-K), and spring of pre-K. The second study was comprised of two cohorts, a transition cohort (i.e., Fall 2019 to Fall/Winter 2020) and a post-COVID lockdown cohort (i.e., Fall 2020 to Fall/Winter 2021). For both cohorts, data were collected in the fall of pre-K, spring of pre-K, and fall/winter of kindergarten (N = 130, 46.2% female, Mage = 44.84 months). Aims included: (1) evaluating the measurement characteristics of a virtual assessment of EF, (2) examining cohort differences in teacher and objective EF measures, (3) testing longitudinal mean-level change in EF, and (4) evaluating associations between COVID impact and change in EF. Teachers reported a marginal decrease in EF for the transition cohort and no change in the post-COVID cohort, whereas objective measurements demonstrated the expected increase in EF. Child and family COVID-19 impact emerged as risk factors for reduced EF for the transition cohort but not the post-COVID cohort. Overall, this study provides novel evidence that the timing and type of EF assessment differentially impacted estimates of children's EF. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The development of forms and functions of aggression during early childhood: A temperament-based approach.

This study used a short-term longitudinal design with theoretically derived preregistered hypotheses and analyses to examine the role of temperament in the development of forms (i.e., physical and relational) and functions (i.e., proactive and reactive) of aggressive behavior in early childhood (N = 300, M age = 44.70 months, SD = 4.38, 44% girls). Temperament was measured via behavioral reports of emotional dysregulation, fearlessness/daring, and rule internalization/empathy and, in a subsample that completed a physiological assessment, via skin conductance and respiratory sinus arrhythmia. Emotion dysregulation generally served as a risk factor for all subtypes of aggression, with evidence of stronger associations with reactive as compared to proactive functions of relational aggression for girls. Daring predicted increases in physical aggression, especially among boys, and rule internalization predicted decreases in relational aggression, especially among girls. Rule internalization mediated longitudinal associations between daring and proactive relational aggression for girls. Some evidence also emerged supporting associations between adaptive functioning (i.e., high empathy, high respiratory sinus arrhythmia) and proactive functions of aggression. Findings highlight distinct temperamental risk factors for physical versus relational aggression and provide partial support for gender-linked theories of the development of aggression.

Parenting and Adjustment Problems among Preschoolers during COVID-19.

A critical area of developmental science explores factors that confer risk or protection as young children and their families experience stressful circumstances related to sociohistorical events. This study contributes to this important area by assessing relations between family context and child adjustment as children transitioned from preschool to home learning during COVID-19, and whether children higher in stress levels, indexed by morning basal cortisol, were more strongly affected. Parents of 74 children (M age = 53.56 months, SD age = 3.68 months) completed reports spanning the home learning transition; children's pre-COVID-19 transition salivary cortisol levels were assessed. Path analyses were used to test the preregistered study aims. Significant interactions were decomposed using simple slopes and Preacher's Regions of Significance (ROS) method. Across the COVID-19 transition to home-based school, children with higher morning basal cortisol experienced the sharpest increase in anger when exposed to harsh/inconsistent parenting contexts. Importantly, these effects held when controlling for household chaos, socioeconomic resources, and supportive parenting. Parallel models with supportive parenting were also tested and are discussed. This study is one of the first to test and provide support for biological sensitivity to context theory within the context of a natural experiment like COVID-19.

Inhibitory Control in Early Childhood Aggression Subtypes: Mediation by Irritability.

The present study tested irritability as a mediator of inhibitory control's (IC) associations with crossed form and function aggression subtypes over one year in early childhood (N = 300, Mage = 44.70 months, SD = 4.38 months). We hypothesized lower IC would predict increases in irritability, which would in turn predict increases in aggression overall (severity) and a predominance of reactive over proactive subtypes (directionality), and considered moderation by gender. Irritability mediated IC's relations in the predicted direction for physical severity for girls only and relational severity for both genders. Lower IC predicted increases in irritability, which in turn predicted increasing predominance of reactive over proactive physical and relational aggression. The predicted indirect effect was significant for physical but not relational directionality. Findings highlight the viability of directionality scores for disentangling these effects, and that developmental associations between IC, irritability, and reactive functions of aggression are evident in early childhood.

Stress reactivity and social cognition in pure and co-occurring early childhood relational bullying and victimization.

This study tested the independent effects and interactions of sympathetic nervous system reactivity and hostile attribution biases (HAB) in predicting change in pure and co-occurring relational bullying and victimization experiences over one year. Co-occurring and pure relational bullying and victimization experiences were measured using a dimensional bifactor model, aiming to address methodological limitations of categorical approaches, using data from 300 preschoolers (Mage = 44.70 months, SD = 4.38). Factor scores were then saved and used in nested path analyses with a subset of participants (n = 81) to test main study hypotheses regarding effects of HAB and skin conductance level reactivity (SCL-R). Bifactor models provided good fit to the data at two independent time points. HAB and SCL-R interacted to predict increases in co-occurring relational bullying/victimization with evidence for over- and underarousal pathways.

A Randomized Controlled Trial of Computerized Interpretation Bias Training for Disruptive Mood Dysregulation Disorder: A Fast-Fail Study.

OBJECTIVE: To examine targeted, mechanism-based interventions is the next generation of treatment innovation. Biased threat labeling of ambiguous face emotions (interpretation bias) is a potential behavioral treatment target for anger, aggression, and irritability. Changing biases in face-emotion labeling may improve irritability-related outcomes. Here, we report the first randomized, double-blind, placebo-controlled targeted trial of interpretation bias training (IBT) in youths with chronic, severe irritability. METHOD: Patients with current disruptive mood dysregulation disorder (DMDD; N = 44) were randomly assigned to complete 4 sessions of active (n = 22) or sham (n = 22) computerized IBT training within a 1-week period. The first and last trainings were completed onsite, and 2 trainings were completed at home. We examined the effects of active IBT on labeling bias, primary outcome measures of irritability, and secondary outcome measures of anxiety, depression, and functional impairment. Follow-up assessments were completed immediately after the intervention as well as 1 and 2 weeks later. RESULTS: We found that active IBT engaged the behavioral target in the active relative to the sham condition, as shown by a significant shift toward labeling ambiguous faces as happy. However, there was no consistent clinical improvement in active IBT relative to the sham condition either immediately after or 2 weeks after training in either the primary or secondary outcome measures. CONCLUSION: Although this randomized controlled trial of IBT in youths with DMDD engaged the proposed behavioral target, there was no statistically significant improvement on clinical outcome. Identifying and changing behavioral targets is a first step in novel treatment development; these results have broader implications for target-based intervention development. CLINICAL TRIAL REGISTRATION INFORMATION: Psychological Treatments for Youth With Severe Irritability; https://clinicaltrials.gov/; NCT02531893.

Emotions and Cognitions in Early Childhood Aggression: the Role of Irritability and Hostile Attribution Biases.

The present study examines the role of irritability in form and function subtypes of aggression over 1 year in early childhood (N = 300, Mage = 44.70 months, SD = 4.38 months). This study prospectively tests hostile attribution biases (HAB) as a mediator in irritability's relations with aggression, with hypothesized form-specific relations between HAB and aggression. Moderation by gender and a reversed alternative model (aggression to irritability, mediated by HAB), were also tested. Path analyses showed irritability predicted increases in all subtypes of aggression (ßs = 0.24-0.34), but with moderation by gender, such that irritability significantly predicted increases in reactive relational aggression for girls only (ß = 0.43). Reactive physical aggression also significantly predicted increases in irritability (ß = 0.15). HAB was not associated significantly with any forms or functions of aggression, although gender differences emerged between HAB for instrumental provocations and reactive physical aggression. No significant indirect effects were found. Results highlight the importance of considering both forms and functions of aggression when investigating irritability, and point to potential gender differences in the role of irritability in relational aggression in early childhood.

Exposure-Based Cognitive-Behavioral Therapy for Disruptive Mood Dysregulation Disorder: An Evidence-Based Case Study.

Severe, chronic irritability is one of the most frequently reported problems in youth referred for psychiatric care. Irritability predicts adult depressive and anxiety disorders, and long-term impairment. Reflecting this pressing public health need, severe, chronic, and impairing irritability is now codified by the DSM-5 diagnosis of disruptive mood dysregulation disorder (DMDD). Since DMDD has only recently been added as its own nosological class, efficacious treatments that specifically target severe irritability as it presents in DMDD are still being developed. In a recent pilot study, we described the general concept of exposure-based cognitive-behavioral therapy (CBT) for irritability. This mechanism-driven treatment is based on our pathophysiological model of irritability that postulates two underlying mechanisms, which potentiate each other: (1) heightened reactivity to frustrative nonreward, and (2) aberrant approach responses to threat. In this case report, we describe and illustrate the specific therapeutic techniques used to address severe irritability in an 11-year-old boy with a primary diagnosis of DMDD. Specific techniques within this CBT include motivational interviewing to build commitment and target oppositionality; creation of an anger hierarchy; in-session controlled, gradual exposure; and parent training focusing on contingency management to counteract the instrumental learning deficits in irritable youth. Parents learn to tolerate their own emotional responses to their youth's irritability (e.g., parents engage in their own exposure) and increase their adaptive contingencies for their youth's behavior (e.g., withdraw attention during unwanted behavior, praise desirable behavior). Future directions in the context of this CBT, such as leveraging technology, computational modeling, and pathophysiological targets, are discussed.

Brain Mechanisms of Attention Orienting Following Frustration: Associations With Irritability and Age in Youths.

OBJECTIVE: Childhood irritability is a common, impairing problem with changing age-related manifestations that predict long-term adverse outcomes. However, more investigation of overall and age-specific neural correlates is needed. Because youths with irritability exhibit exaggerated responses to frustrating stimuli, the authors used a frustration functional MRI (fMRI) paradigm to examine associations between irritability and neural activation and tested the moderating effect of age. METHOD: The authors studied a transdiagnostic sample of 195 youths with varying levels of irritability (disruptive mood dysregulation disorder, N=52; anxiety disorder, N=42; attention deficit hyperactivity disorder, N=40; and healthy volunteers, N=61). Irritability was measured by parent and child reports on the Affective Reactivity Index. The fMRI paradigm was a cued-attention task differentiating neural activity in response to frustration (rigged feedback) from activity during attention orienting in the trial following frustration. RESULTS: Whole-brain activation analyses revealed associations with irritability during attention orienting following frustration. Irritability was positively associated with frontal-striatal activation, specifically in the dorsolateral prefrontal cortex, inferior frontal gyrus, and caudate. Age moderated the association between irritability and activation in some frontal and posterior regions (the anterior cingulate cortex, medial frontal gyrus, cuneus, precuneus, and superior parietal lobule [F=19.04-28.51, df=1, 189, partial eta squared=0.09-0.13]). Specifically, higher irritability was more strongly related to increased activation in younger youths compared with older youths. CONCLUSIONS: Following frustration, levels of irritability correlated with activity in neural systems mediating attention orienting, top-down regulation of emotions, and motor execution. Although most associations were independent of age, dysfunction in the anterior cingulate cortex and posterior regions was more pronounced in young children with irritability.

A double-blind, randomized, placebo-controlled trial of a computer-based Interpretation Bias Training for youth with severe irritability: a study protocol.

BACKGROUND: Severe, chronic, and impairing irritability is a common presenting clinical problem in youth. Indeed, it was recently operationalized as disruptive mood dysregulation disorder (DMDD) in the DSM-5. However, to date, there are no evidence-based treatments that were specifically developed for DMDD. The current randomized controlled trial assesses the efficacy of a computer-based cognitive training intervention (Interpretation Bias Training; IBT) in youth with DMDD. IBT aims to reduce irritability by altering judgments of ambiguous face-emotions through computerized feedback. IBT is based on previous findings that youth with irritability-related psychopathology rate ambiguous faces as more hostile and fear producing. METHODS/DESIGN: This is a double-blind, randomized controlled trial of IBT in 40 youth with DMDD. Participants will be randomized to receive four IBT sessions (Active vs. Sham training) over 4 days. Active IBT provides computerized feedback to change ambiguous face-emotion interpretations towards happy interpretations. Face-emotion judgments are performed pre and post training, and for 2 weeks following training. Blinded clinicians will conduct weekly clinical ratings. Primary outcome measures assess changes in irritability using the clinician-rated Affective Reactivity Index (ARI) and Clinical Global Impressions-Improvement (CGI-I) scale for DMDD, as well as parent and child reports of irritability using the ARI. Secondary outcome measures include clinician ratings of depression, anxiety, and overall impairment. In addition, parent and child self-report measures of depression, anxiety, anger, social status, and aggression will be collected. DISCUSSION: The study described in this protocol will perform the first RCT testing the efficacy of IBT in reducing irritability in youth with DMDD. Developing non-pharmacological treatment options for youth suffering from severe, chronic irritability is important to potentially augment existing treatments. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT02531893 . Registered on 25 August 2015.