Cost-Effectiveness of the Mindfulness-Based Childbirth and Parenting Program for Pregnant Women With Fear of Childbirth.

OBJECTIVE: To examine the cost-effectiveness of the Mindfulness-Based Childbirth and Parenting (MBCP) program compared with enhanced care as usual (ECAU). DESIGN: Randomized controlled trial. SETTING: Midwifery settings in the Netherlands, April 2014 to July 2017. PARTICIPANTS: Subset of pregnant women with high levels of fear of childbirth (N = 54: randomized to MBCP, n = 32, or to ECAU, n = 22) who were selected from the parent study because they completed all four cost questionnaires. METHODS: We measured self-reported health care and non-health care costs. A subset of participants from the parent study completed the questionnaires at all four assessment points. We used the Wijma Delivery Expectancy Questionnaire to measure fear of childbirth and used the EuroQol-5D to measure quality of life. We used these measures of effect together with societal costs in the primary cost-effectiveness analyses. In the secondary cost-effectiveness analyses, we used different estimates of effects and costs to test the robustness of the primary analyses. RESULTS: In all but one scenario, MBCP was more effective and cost less than ECAU. As indicated by the acceptability curves, the likelihood of MBCP being cost-effective varied within a range of 70% to 98%. CONCLUSION: Our findings indicate that MBCP is a cost-effective intervention to reduce fear of childbirth in pregnant women. Important next steps are to replicate the study in countries with different health care systems and to explore the potential for further integration of MBCP into midwifery care.

The Effects of Mindfulness for Youth (MYmind) versus Group Cognitive Behavioral Therapy in Improving Attention and Reducing Behavioral Problems among Children with Attention-Deficit Hyperactivity Disorder and Their Parents: A Randomized Controlled Trial.

INTRODUCTION: There is a lack of studies evaluating mindfulness-based interventions for children with attention-deficit hyperactivity disorder (ADHD) compared with an evidence-based control. This randomized controlled trial (RCT) evaluated the effects of mindfulness for youth (MYmind) in improving children's attention, behavior, and parent-related outcomes versus cognitive behavioral therapy (CBT). METHODS: A total of 138 families of children with ADHD aged 8-12 years were recruited from the community with 69 randomized to MYmind and 69 to CBT. Participants were assessed at baseline, immediately after intervention, at 3 months and 6 months. The primary outcome was the attention score of the Sky Search subtest of the Test of Everyday Attention for Children (TEA-Ch). Secondary outcomes were child behavior and parent-related assessments. Linear mixed models were used to assess the efficacy of MYmind compared with CBT. RESULTS: Both MYmind and CBT significantly improved children's attention score at 6 months (MYmind: ß = 1.48, p = 0.013, Cohen's d = 0.32; CBT: ß = 1.46, p = 0.008, d = 0.27). There were significant within-group improvements in most secondary outcomes. No significant difference was shown for both primary or secondary outcomes between the two arms at any time point. CONCLUSIONS: Both MYmind and CBT appeared to improve children's attention and behavior outcomes, although no difference was found between these two interventions. This is the largest RCT so far comparing MYmind and CBT although there was loss of follow-up assessments during the pandemic. Further RCTs adopting a non-inferiority design are needed to validate the results.

Intergenerational relations in childhood anxiety: A network approach.

OBJECTIVE: Family factors are assumed to play a central role in the development of childhood anxiety disorders. How child and parental anxiety symptoms are intertwined on a symptom and family level has not yet been examined. Such knowledge may lead to a more detailed understanding of the intergenerational relation in anxiety problems. The current study investigated the relation between anxiety in children and their parents at a symptom level using a network approach. METHOD: Parents of 1,452 clinically referred children in the Netherlands completed questionnaires on anxiety about their children and themselves. We examined relations on a symptom level both within persons and between parents and children. In addition, we also compared the relations between parental and child anxiety symptoms in families with children with an anxiety disorder (n = 350) versus families with children who displayed other psychiatric diagnoses (n = 1,102). RESULTS: Anxiety symptom relations within persons were more intertwined than the symptom relations between family members. Between-person relations were found among similar anxiety symptoms, suggesting specific intergenerational relations. The feeling of being fearful was found to be a central and connecting symptom in all family members (fathers, mothers, and children). The relations between parental and child anxiety symptoms were more specific (i.e., among similar symptoms) in families with children with an anxiety disorder than in families with children with other types of psychopathologies. CONCLUSIONS: This study found that anxiety symptom associations are present within the family on a detailed (symptom) level. This stresses the importance of future studies to examine factors responsible for this family-anxiety transmission.

The Development and Validation of a Subscale for the School-Age Child Behavior CheckList to Screen for Autism Spectrum Disorder.

The first aim of this study was to construct/validate a subscale-with cut-offs considering gender/age differences-for the school-age Child Behavior CheckList (CBCL) to screen for Autism Spectrum Disorder (ASD) applying both data-driven (N = 1666) and clinician-expert (N = 15) approaches. Further, we compared these to previously established CBCL ASD profiles/subscales and DSM-oriented subscales. The second aim was to cross-validate results in two truly independent samples (N = 2445 and 886). Despite relatively low discriminative power of all subscales in the cross-validation samples, results indicated that the data-driven subscale had the best potential to screen for ASD and a similar screening potential as the DSM-oriented subscales. Given beneficial implications for pediatric/clinical practice, we encourage colleagues to continue the validation of this CBCL ASD subscale.

BOAM: A Visual, Explanatory Diagnostic and Psychoeducation System Used in Collaboration with Families-Feasibility and Acceptability for Children Who Are Non-Responsive to Treatment as Usual.

Many children referred to mental health services have neurodevelopmental problems, which are not always recognized because the resulting emotional and behavioral problems dominate diagnosis and treatment. BOAM (Basic needs, Order, Autonomy and Meaning) is a new diagnostic system consisting of imaginative models that explain the complexity of symptoms and underlying neuropsychological problems in a simple way. It is designed to be used in a transparent, collaborative process with families, so that family members can better understand the nature of mental health problems, thus increasing self-knowledge and mutual understanding. In this study, the feasibility of the BOAM diagnostic trajectory and subsequent treatment informed by this trajectory are evaluated clinically in 34 children who have not responded to or relapsed after treatment as usual (TAU). Parents completed questionnaires pre-test, post-test and at a 3-month follow-up. The treatment drop-out rate was 2.9%. Post-test, parents rated the BOAM trajectory positively. The questionnaires (measuring child psychopathology, attention, executive functioning, family functioning, partner relationships and parenting stress) demonstrated sensitivity to change, and therefore, seems appropriate for a future effectiveness study. A limitation was the high percentage of missing measurements both post-test (41%) and at the follow-up (41%). The BOAM diagnostic trajectory and subsequent treatment may be a feasible alternative for children who do not respond to or relapse after TAU.

Just as they expected: How parents' expectations about their unborn child's characteristics provide a context for early transactions between parenting and child temperament.

Prenatal expectations about what children will be like after birth may provide a context for how parents perceive their infant's actual temperament. We examined how these expectations and perceptions are associated and together predict early parenting behavior, with parenting behavior in turn predicting changes in temperament. Reports of 125 families (N = 122 fathers; N = 123 mothers; sample 1) about their expectations of their unborn child's temperament (negative affectivity, surgency, regulation, T1), their infant's temperament at 4 and 12 months post-partum (T2 and T3), and their hostile, responsive, warm, and overprotective parenting (T2) were included. We also included data from an independent sample of 168 mothers (sample 2), with the same measures, except that mothers reported on Big Five personality traits at T1. Results indicated that in both samples, parents' expectations were positively associated with perceptions of infant temperament. Prenatal expectations and newborn temperament independently predicted parenting behavior, and maternal and paternal parenting in turn predicted infant temperament at T3, controlling for infant temperament at T2. Although overall findings indicated associations between (expectations of) a more difficult temperament and more negative/less positive parenting, significant combinations of specific traits and parenting behaviors were sample-specific-indicating that more research is necessary to draw a conclusion about specific links. Both maternal and paternal expectations about their unborn child's temperament appear to carry over into the postpartum reality and provide a context for shaping early interactions between caregivers and their children, which may further shape the developing temperament of the child.

Modular CBT for Childhood Anxiety Disorders: Evaluating Clinical Outcomes and its Predictors.

This study examined clinical outcomes of a modular individual CBT for children with anxiety disorders (AD), and predictors of outcomes, in usual clinical practice. Participants were 106 children with ADs (7-17 years), and parents. Assessments were pre-, mid-, post-test, and 10 weeks after CBT (follow-up). Predictors (measured pre-treatment) were child characteristics (gender, age, type of AD, comorbid disorders), fathers' and mothers' anxious/depressive symptoms, and parental involvement (based on parents' presence during treatment sessions and the use of a parent module in treatment). At follow-up, 59% (intent-to-treat analyses) to 70% (completer analysis) of the children were free from their primary anxiety disorder. A significant decrease in anxiety symptoms was found. Higher parental involvement was related to lower child anxiety at follow-up, but only for children with comorbid disorders. Findings suggest that it is beneficial to treat anxiety with modular CBT. Future steps involve comparisons of modularized CBT with control conditions.

Mothers' and fathers' mind-mindedness in infancy and toddlerhood predict their children's self-regulation at preschool age.

The ability to regulate one's emotions and behaviors is essential for adaptive functioning in society. We investigated whether parental mind-mindedness-parents' tendency to treat their children as mental agents-in infancy and toddlerhood predicts school-age children's self-regulation. The sample consisted of 125 mostly Dutch and White families. We assessed mothers' and fathers' appropriate and nonattuned mind-related comments during free play with their 12- and 30-month-old child (70 girls and 55 boys). We measured children's physiological, temperamental, and behavioral self-regulation when children were 4 1/2 years old. Fathers' appropriate mind-related comments predicted children's higher temperamental and behavioral self-regulation and mothers' and fathers' nonattuned mind-related comments predicted children's lower physiological and temperamental self-regulation. Our findings emphasize the importance of both parents' mind-mindedness in children's socioemotional development. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Do Improvements in Maternal Mental Health Predict Improvements in Parenting? Mechanisms of the Mindful with Your Baby Training.

Postpartum mental health symptoms are associated with parenting difficulties, which have negative consequences for child development. Interventions for young mothers should target their mental health problems and parenting difficulties. Mindful with Your Baby (MwyB) is an intervention for parents, with a baby, who experience (mental) health problems and/or stress or insecurity in parenting. This study seeks to replicate previous effects of MwyB regarding mindfulness, mindful parenting, maternal (mental) health (psychological distress, depressive mood, physical health complaints) and parenting outcomes (parenting stress, parental self-efficacy, bonding), and gain insight into the working mechanisms of the training. Mothers with babies aged 1-18 months (n = 61) completed questionnaires at waitlist, pretest, posttest, and 8-week follow-up. No significant differences were seen between the waitlist and pretest. Significant improvements in all outcomes were shown in the posttest (except for physical health complaints) and follow-up, compared to the pretest. Improvements in depressive symptoms and physical health complaints were dependent on improvements in mindfulness. Improvements in parental self-efficacy were dependent on improvements in mindful parenting. Improvements in some (mental) health and parenting outcomes seemed to be bidirectional. The results suggest that both mindfulness and mindful parenting are important for mothers who experience psychological distress and/or stress or insecurity in parenting their babies.

Early physiological indicators of narcissism and self-esteem in children.

A common belief is that narcissism is a manifestation of high self-esteem. Here, we argue that self-esteem and narcissism are fundamentally distinct and have unique early physiological indicators. We hypothesized that children predisposed to narcissism would show elevated, whereas children predisposed to high self-esteem would show lowered, physiological arousal in social-evaluative contexts. We tested this in a prospective study including 113 children, who were first assessed at age 4.5, a critical age when children begin evaluating themselves through others' eyes. At age 4.5, children sang a song in front of an audience while being videotaped. Children's physiological arousal (skin conductance, heart rate, and heart rate variability) was assessed while children anticipated, performed, and recovered from the singing task. At age 7.5, children's narcissism and self-esteem levels were assessed. Consistent with our predictions, children predisposed to higher narcissism levels showed elevated skin conductance levels during anticipation. Their skin conductance levels further rose during performance (but less so than for other children) and failed to return to baseline during recovery. By contrast, children predisposed to higher self-esteem levels showed lowered skin conductance levels throughout the procedure. The effects emerged for skin conductance but not heart rate or heart rate variability, suggesting that arousal was sympathetically driven. Effects were larger and more robust for self-esteem than for narcissism. Together, these findings uncover distinct physiological indicators of narcissism and self-esteem: Narcissism is predicted by indicators reflecting early social-evaluative concerns, whereas self-esteem is predicted by indicators reflecting an early sense of comfort in social-evaluative contexts.

Mindful parenting intervention for parents of children with skin conditions: a single group experimental cases series.

BACKGROUND: Parents of children with eczema or psoriasis experience high levels of parenting stress, which can negatively impact their child's mental and physical health. AIMS: We aimed to investigate the effectiveness, feasibility and acceptability of a mindful parenting intervention for parents of children with eczema or psoriasis. METHOD: Seven parents of children (4-12 years old) with eczema or psoriasis took part in an 8-week mindful parenting group intervention. A single-case experimental design was adopted, whereby parents completed daily idiographic measures of parenting stress related to their child's skin condition. Parents also completed standardised questionnaires measuring their parenting stress, depression, anxiety and quality of life, and children completed a quality of life measure, at four time points: baseline, pre-intervention, post-intervention and 6-week follow-up. Parents provided qualitative feedback after the intervention. RESULTS: All parents completed the intervention and showed improvements in idiographic measures of parenting stress from baseline to follow-up. Improvements in parenting stress were larger at follow-up than post-intervention, suggesting the benefits of intervention continue beyond the intervention. Six of seven parent-child dyads showed improvement in at least one of the wellbeing measures, from pre-intervention to post-intervention or follow-up. Feasibility was demonstrated through good participant retention, adherence to home practice, and treatment fidelity. Acceptability was demonstrated through positive parent evaluations of the intervention. CONCLUSIONS: Mindful parenting can be an effective, feasible and acceptable intervention for parents of children with eczema or psoriasis. Future studies should attempt to replicate the findings through randomised controlled trials.

Mindful with your baby for mothers of infants with (parental) stress in a non-clinical setting: a wait-list controlled pilot trial.

BACKGROUND: Because of the far-reaching negative consequences of high levels of (parental) stress for the mother, infant, the mother-infant relationship, and family functioning, psychological support for young mothers is important. Mindful with Your Baby is a mindfulness-based intervention, originally developed and evaluated in a clinical population of mothers with mental health issues and/or babies with regulation problems. The current pilot examines whether Mindful with Your Baby for mothers with symptoms of (parental) stress offered in a non-clinical setting is also effective and acceptable. METHODS: In this pilot waitlist-controlled trial, 17 mothers with infants (2-15 months) admitted themselves for a Mindful with Your Baby training in a non-clinical setting because of (parental) stress. Mindful with Your Baby was offered in groups of three to six mother-infant dyads and consisted of eight weekly 2-h sessions. Participants completed questionnaires on symptoms of parental stress, general stress, depression, anxiety, mindfulness and self-compassion at 8-week waitlist, pretest, posttest and 8-week follow-up. RESULTS: There were no training drop-outs, attendance rate was 92.5%, and the training was evaluated positively: all mothers (100%) felt they got something of lasting importance as a result of taking the training, and reported becoming more conscious as a parent, and 93% reported changing their lifestyle or parenting as a result of the training. Multilevel analyses showed no significant changes between waitlist and pretest. At posttest, a significant improvement occurred in all outcome measures compared to pretest, of moderate to large effect sizes. At follow-up, a significant improvement was seen compared to pretest in all outcomes except anxiety compared to pretest, of small to moderate effect sizes. CONCLUSIONS: Mindful with Your Baby appears an acceptable and effective intervention for mothers with a baby who experience (parental) stress but who have not been referred to specialized mental health care. A low threshold access to Mindful with Your Baby in non-clinical settings could provide a timely and positive interference in (parental) stress.

Mindful awareness as a mechanism of change for natural childbirth in pregnant women with high fear of childbirth: a randomised controlled trial.

BACKGROUND: Mindfulness-Based Childbirth and Parenting (MBCP) is effective in increasing natural childbirth in pregnant women with high fear of childbirth (FOC) as compared to enhanced care as usual (ECAU). We aimed to examine through which pathway of action MBCP reaches this effect, based on a model of approaching or avoiding the challenges related to childbirth. METHODS: One hundred eleven pregnant women with high FOC were measured pre- and post-intervention on FOC (emotion pathway), catastrophic beliefs about labour pain (cognition pathway) and mindful awareness (attention pathway). A multiple mediation model was used to examine through which pathway the mechanism of change operated in relation to approach (i.e., natural childbirth) versus avoidance (i.e., self-requested caesarean section). RESULTS: It was found that greater mindful awareness (18% R2 = 0.18, F[1107] = 22.77, p < 0.0001) was the only significant mechanism of change operating through the attentional pathway leading to natural childbirth. More specifically, nonreactivity to inner experience (a facet of mindful awareness) showed to be the strongest mechanism of change. More extensive meditation practice was positively associated with natural childbirth; however, the number of completed MBCP sessions was not associated with the outcome. CONCLUSIONS: An increase in mindful awareness was the strongest mechanism of change for better adaptation to the challenges of childbirth. Decreases in neither FOC nor catastrophic beliefs about labour pain were identified as mechanisms of change. Additionally, the more one meditated, the more one was inclined towards a natural childbirth. MBCP enhances adaptation to the challenges of childbirth and less use of obstetric interventions in the presence of high FOC. TRIAL REGISTRATION: The Netherlands Trial Register (NTR; 4302 ).

A randomised controlled trial (MindChamp) of a mindfulness-based intervention for children with ADHD and their parents.

BACKGROUND: Family mindfulness-based intervention (MBI) for child attention-deficit/hyperactivity disorder (ADHD) targets child self-control, parenting and parental mental health, but its effectiveness is still unclear. METHODS: MindChamp is a pre-registered randomised controlled trial comparing an 8-week family MBI (called 'MYmind') in addition to care-as-usual (CAU) (n = 55) with CAU-only (n = 48). Children aged 8-16 years with remaining ADHD symptoms after CAU were enrolled together with a parent. Primary outcome was post-treatment parent-rated child self-control deficits (BRIEF); post hoc, Reliable Change Indexes were explored. Secondary child outcomes included ADHD symptoms (parent/teacher-rated Conners' and SWAN; teacher-rated BRIEF), other psychological symptoms (parent/teacher-rated), well-being (parent-rated) and mindfulness (self-rated). Secondary parent outcomes included self-ratings of ADHD symptoms, other psychological symptoms, well-being, self-compassion and mindful parenting. Assessments were conducted at post-treatment, 2- and 6-month follow-up. RESULTS: Relative to CAU-only, MBI+CAU resulted in a small, statistically non-significant post-treatment improvement on the BRIEF (intention-to-treat: d = 0.27, p = .18; per protocol: d = 0.33, p = .11). Significantly more children showed reliable post-treatment improvement following MBI+CAU versus CAU-only (32% versus 11%, p < .05, Number-Needed-to-Treat = 4.7). ADHD symptoms significantly reduced post-treatment according to parent (Conners' and SWAN) and teacher ratings (BRIEF) per protocol. Only parent-rated hyperactivity impulsivity (SWAN) remained significantly reduced at 6-month follow-up. Post-treatment group differences on other secondary child outcomes were consistently favour of MBI+CAU, but mostly non-significant; no significant differences were found at follow-ups. Regarding parent outcomes, significant post-treatment improvements were found for their own ADHD symptoms, well-being and mindful parenting. At follow-ups, some significant effects remained (ADHD symptoms, mindful parenting), some additional significant effects appeared (other psychological symptoms, self-compassion) and others disappeared/remained non-significant. CONCLUSIONS: Family MBI+CAU did not outperform CAU-only in reducing child self-control deficits on a group level but more children reliably improved. Effects on parents were larger and more durable. When CAU for ADHD is insufficient, family MBI could be a valuable addition.

Fear of childbirth, nonurgent obstetric interventions, and newborn outcomes: A randomized controlled trial comparing mindfulness-based childbirth and parenting with enhanced care as usual.

OBJECTIVE: To investigate whether mindfulness-based childbirth and parenting (MBCP) or enhanced care as usual (ECAU) for expectant couples decreases fear of childbirth (FOC) and nonurgent obstetric interventions during labor and improves newborn outcomes. DESIGN: Randomized controlled trial. SETTING: Midwifery settings, the Netherlands, April 2014-July 2017. POPULATION: Pregnant women with high FOC (n = 141) and partners. METHODS: Allocation to MBCP or ECAU. Hierarchical multilevel and intention-to-treat (ITT) and per-protocol (PP) analyses. MAIN OUTCOME MEASURES: Primary: pre-/postintervention FOC, labor anxiety disorder, labor pain (catastrophizing and acceptance), and preferences for nonurgent obstetric interventions. Secondary: rates of epidural analgesia (EA), self-requested cesarean birth (sCB), unmedicated childbirth, and 1- and 5-minute newborn's Apgar scores. RESULTS: MBCP was significantly superior to ECAU in decreasing FOC, catastrophizing of labor pain, preference for nonurgent obstetric interventions, and increasing acceptance of labor pain. MBCP participants were 36% less likely to undergo EA (RR 0.64, 95% CI [0.43-0.96]), 51% less likely to undergo sCB (RR 0.49, 95% CI [0.36-0.67]), and twice as likely to have unmedicated childbirth relative to ECAU (RR 2.00, 95% CI [1.23-3.20]). Newborn's 1-minute Apgar scores were higher in MBCP (DM -0.39, 95% CI [-0.74 to -0.03]). After correction for multiple testing, results remained significant in ITT and PP analyses, except EA in ITT analyses and 1-minute Apgar. CONCLUSIONS: MBCP for pregnant couples reduces mothers' fear of childbirth, nonurgent obstetric interventions during childbirth and may improve childbirth outcomes. MBCP adapted for pregnant women with high FOC and their partners appears an acceptable and effective intervention for midwifery care.

Attention Biases to Threat in Infants and Parents: Links to Parental and Infant Anxiety Dispositions.

Parent-to-child transmission of information processing biases to threat is a potential causal mechanism in the family aggregation of anxiety symptoms and traits. This study is the first to investigate the link between infants' and parents' attention bias to dynamic threat-relevant (versus happy) emotional expressions. Moreover, the associations between infant attention and anxiety dispositions in infants and parents were explored. Using a cross-sectional design, we tested 211 infants in three age groups: 5-to-7-month-olds (n = 71), 11-to-13-month-olds (n = 73), and 17-to-19-month-olds (n = 67), and 216 parents (153 mothers). Infant and parental dwell times to angry and fearful versus happy facial expressions were measured via eye-tracking. The parents also reported on their anxiety and stress. Ratings of infant temperamental fear and distress were averaged across both parents. Parents and infants tended to show an attention bias for fearful faces with marginally longer dwell times to fearful versus happy faces. Parents dwelled longer on angry versus happy faces, whereas infants showed an avoidant pattern with longer dwell times to happy versus angry expressions. There was a significant positive association between infant and parent attention to emotional expressions. Parental anxiety dispositions were not related to their own or their infant's attention bias. No significant link emerged between infants' temperament and attention bias. We conclude that an association between parental and infant attention may already be evident in the early years of life, whereas a link between anxiety dispositions and attention biases may not hold in community samples.

Pupil responses to dynamic negative facial expressions of emotion in infants and parents.

Observing others' emotions triggers physiological arousal in infants as well as in adults, reflected in dilated pupil sizes. This study is the first to examine parents' and infants' pupil responses to dynamic negative emotional facial expressions. Moreover, the links between pupil responses and negative emotional dispositions were explored among infants and parents. Infants' and one of their parent's pupil responses to negative versus neutral faces were measured via eye tracking in 222 infants (5- to 7-month-olds, n = 77, 11- to 13-month-olds, n = 78, and 17- to 19-month-olds, n = 67) and 229 parents. One parent contributed to the pupil data, whereas both parents were invited to fill in questionnaires on their own and their infant's negative emotional dispositions. Infants did not differentially respond to negative expressions, while parents showed stronger pupil responses to negative versus neutral expressions. There was a positive association between infants' and their parent's mean pupil responses and significant links between mothers' and fathers' stress levels and their infants' pupil responses. We conclude that a direct association between pupil responses in parents and offspring is observable already in infancy in typical development. Stress in parents is related to their infants' pupillary arousal to negative emotions.

The relation between early behavioural inhibition and later social anxiety, independent of attentional biases to threat.

Early behavioural inhibition, a temperamental characteristic defined by fearful, overly-sensitive, avoidant, or withdrawn reactions to the unknown, is a predictor of later social anxiety. However, not all behaviourally inhibited children develop anxiety problems, and attentional bias to threat has been proposed to moderate the relation between behavioural inhibition and anxiety. The current study aimed to further specify the relation between early behavioural inhibition and later social anxiety by testing this potentially moderating role of childhood attentional bias to threat. Behavioural inhibition was assessed during toddlerhood (age 2.5 years) using laboratory observations of children's behaviours in response to unknown objects and situations. When children were 7.5 years old, attentional bias was measured in 86 children (46 girls) using both a visual probe task and a visual search task with angry and happy faces. Child social anxiety was measured using questionnaires completed by the child and both parents, and clinical interviews conducted with both parents. Our results showed that while early behavioural inhibition was related to later social anxiety, there was no evidence for a moderation of this relation by attentional bias, suggesting that the relation between early fearful temperament and later social anxiety holds across children, independent of their attentional biases.

The Japanese self-focused attention scale: Factor structure, internal consistency, convergent, and discriminant validity.

OBJECTIVE: Self-focused attention is a maintaining factor for social anxiety disorder. It was shown that self-focused attention correlates with trait mindfulness, but not with attention control. This study examined the reliability and validity of the Japanese version of the self-focused attention (J-SFA) scale. METHOD: Students (N = 502) completed a set of questionnaires, measuring self-focused attention, social anxiety symptoms, trait mindfulness, and attention control. RESULTS: A confirmatory factor analysis indicated that the J-SFA scale has a bi-factor structure. The Cronbach's α coefficient was high. Correlation analysis showed that each factor of the J-SFA scale was significantly weakly to moderately correlated with social anxiety symptoms and trait mindfulness, and the J-SFA scale's factors were significantly or non-significantly very weakly correlated with attentional control functions. CONCLUSION: The findings indicate that the J-SFA demonstrated satisfactory reliability and validity for our sample and provide impetus for future research into the measure for clinical and nonclinical samples in Japan.