51
|
Interpersonal Cognitive Biases in Children and Young People with Neurodevelopmental Disorders: A Systematic Review. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2021. [DOI: 10.1007/s40474-021-00239-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Purpose of Review
Interpersonal cognitive biases have been linked to externalising and internalising problems. This systematic review investigates their role in children and young people with neurodevelopmental disorders (NDD), who have a high risk of experiencing such problems.
Recent Findings
With 16 identified studies, this is a widely under-recognised research area. The three studies conducted within the last 5 years focused on threat interpretation and its association with anxiety. No difference between children and young people with and without NDD was found in the eleven studies investigating hostile attribution of intent, of which the most recent is nearly a decade old. No studies addressed attention or memory bias towards ambiguous interpersonal information.
Summary
The scarcity and heterogeneity of research highlighted in this paper demonstrate the urgency to use standardised and accessible research methods to develop a strong evidence base regarding the potential content-specific interpretation bias in individuals with NDD.
Collapse
|
52
|
Hernández-Avalos I, Mota-Rojas D, Mendoza-Flores JE, Casas-Alvarado A, Flores-Padilla K, Miranda-Cortes AE, Torres-Bernal F, Gómez-Prado J, Mora-Medina P. Nociceptive pain and anxiety in equines: Physiological and behavioral alterations. Vet World 2021; 14:2984-2995. [PMID: 35017848 PMCID: PMC8743789 DOI: 10.14202/vetworld.2021.2984-2995] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/23/2021] [Indexed: 01/02/2023] Open
Abstract
Pain and anxiety are two of the most important concerns in clinical veterinary medicine because they arise as consequences of multiple factors that can severely affect animal welfare. The aim of the present review was to provide a description and interpretation of the physiological and behavioral alterations associated with pain and anxiety in equines. To this end, we conducted an extensive review of diverse sources on the topic. The article begins by describing the neurophysiological pathway of pain, followed by a discussion of the importance of the limbic system in responses to pain and anxiety, since prolonged exposure to situations that cause stress and pain generates such physiological changes as tachycardia, tachypnea, hypertension, hyperthermia, and heart rate variability (HRV), often accompanied by altered emotional states, deficient rest, and even aggressiveness. In the long term, animals may show deficiencies in their ability to deal with changes in the environment due to alterations in the functioning of their immune, nervous, and endocrinologic systems. In conclusion, pain and anxiety directly impact the homeostasis of organisms, so it is necessary to conduct objective evaluations of both sensations using behavioral scales, like the horse grimace scale, complemented by assessments of blood biomarkers to analyze their correlation with physiological parameters: Heart rate, respiratory rate, HRV, theparasympathetic tone activity index, lactate and glucose levels, and temperature. Additional tools - infrared thermography, for example - can also be used in these efforts to improve the quality of life and welfare of horses.
Collapse
Affiliation(s)
- I. Hernández-Avalos
- Department of Biological Sciences, Clinical Pharmacology and Veterinary Anesthesia, Faculty of Higher Studies Cuautitlán FESC, Universidad Nacional Autónoma de México, State of Mexico 54714, Mexico
| | - D. Mota-Rojas
- Neurophysiology of Pain, Behavior and Assessment of Welfare in Domestic Animals, DPAA, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico
| | - J. E. Mendoza-Flores
- Equine Hospital Faculty of Higher Studies Cuautitlán FESC, Universidad Nacional Autónoma de México, State of Mexico 54714, Mexico
| | - A. Casas-Alvarado
- Neurophysiology of Pain, Behavior and Assessment of Welfare in Domestic Animals, DPAA, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico
| | - K. Flores-Padilla
- Neurophysiology of Pain, Behavior and Assessment of Welfare in Domestic Animals, DPAA, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico
| | - A. E. Miranda-Cortes
- Department of Biological Sciences, Clinical Pharmacology and Veterinary Anesthesia, Faculty of Higher Studies Cuautitlán FESC, Universidad Nacional Autónoma de México, State of Mexico 54714, Mexico
| | - F. Torres-Bernal
- Neurophysiology of Pain, Behavior and Assessment of Welfare in Domestic Animals, DPAA, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico
| | - J. Gómez-Prado
- Neurophysiology of Pain, Behavior and Assessment of Welfare in Domestic Animals, DPAA, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico
| | - P. Mora-Medina
- Department of Livestock Sciences, Animal Welfare, FESC, Universidad Nacional Autónoma de México, State of Mexico 54714, Mexico
| |
Collapse
|
53
|
Lau JYF, Watkins-Muleba R, Lee I, Pile V, Hirsch CR. Promoting helpful attention and interpretation patterns to reduce anxiety and depression in young people: weaving scientific data with young peoples' lived experiences. BMC Psychiatry 2021; 21:403. [PMID: 34429091 PMCID: PMC8386061 DOI: 10.1186/s12888-021-03320-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/19/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Anxiety and depression are common, disabling and frequently start in youth, underscoring the need for effective, accessible early interventions. Empirical data and consultations with lived experience youth representatives suggest that maladaptive cognitive patterns contribute to and maintain anxiety and depression in daily life. Promoting adaptive cognitive patterns could therefore reflect "active ingredients" in the treatment and/or prevention of youth anxiety and depression. Here, we described and compared different therapeutic techniques that equipped young people with a more flexible capacity to use attention and/or promoted a tendency to positive/benign (over threatening/negative) interpretations of uncertain situations. METHODS We searched electronic databases (PubMed, PsycINFO, EMBASE, and PsycARTICLES) for studies containing words relating to: intervention; youth; anxiety and/or depression and attention and/or interpretation, and selected studies which sought to reduce self-reported anxiety/depression in youth by explicitly altering attention and/or interpretation patterns. Ten young people with lived experiences of anxiety and depression and from diverse backgrounds were consulted on the relevance of these strategies in managing emotions in their daily lives and also whether there were additional strategies that could be targeted to promote adaptive thinking styles. RESULTS Two sets of techniques, each targeting different levels of responding with different strengths and weaknesses were identified. Cognitive bias modification training (CBM) tasks were largely able to alter attention and interpretation biases but the effects of training on clinical symptoms was more mixed. In contrast, guided instructions that teach young people to regulate their attention or to evaluate alternative explanations of personally-salient events, reduced symptoms but there was little experimental data establishing the intervention mechanism. Lived experience representatives suggested that strategies such as deliberately recalling positive past experiences or positive aspects of oneself to counteract negative thinking. DISCUSSION CBM techniques target clear hypothesised mechanisms but require further co-design with young people to make them more engaging and augment their clinical effects. Guided instructions benefit from being embedded in clinical interventions, but lack empirical data to support their intervention mechanism, underscoring the need for more experimental work. Feedback from young people suggest that combining complimentary techniques within multi-pronged "toolboxes" to develop resilient thinking patterns in youth is empowering.
Collapse
Affiliation(s)
- Jennifer Y. F. Lau
- grid.13097.3c0000 0001 2322 6764Psychology Department, IOPPN, King’s College London, Denmark Hill, London, SE5 8AF UK ,grid.4868.20000 0001 2171 1133Youth Resilience Research Unit, Queen Mary University of London, London, UK
| | - Rebecca Watkins-Muleba
- grid.13097.3c0000 0001 2322 6764Psychology Department, IOPPN, King’s College London, Denmark Hill, London, SE5 8AF UK
| | - Isabelle Lee
- grid.13097.3c0000 0001 2322 6764Psychology Department, IOPPN, King’s College London, Denmark Hill, London, SE5 8AF UK
| | - Victoria Pile
- grid.13097.3c0000 0001 2322 6764Psychology Department, IOPPN, King’s College London, Denmark Hill, London, SE5 8AF UK ,grid.4970.a0000 0001 2188 881XRoyal Holloway University of London, London, UK
| | - Colette R. Hirsch
- grid.13097.3c0000 0001 2322 6764Psychology Department, IOPPN, King’s College London, Denmark Hill, London, SE5 8AF UK
| |
Collapse
|
54
|
Anderson MG, Campbell AM, Crump A, Arnott G, Jacobs L. Environmental complexity positively impacts affective states of broiler chickens. Sci Rep 2021; 11:16966. [PMID: 34417475 PMCID: PMC8379235 DOI: 10.1038/s41598-021-95280-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/16/2021] [Indexed: 02/07/2023] Open
Abstract
Affective state can bias an animal's judgement. Animals in positive affective states can interpret ambiguous cues more positively ("optimistically") than animals in negative affective states. Thus, judgement bias tests can determine an animal's affective state through their responses to ambiguous cues. We tested the effects of environmental complexity and stocking density on affective states of broiler chickens through a multimodal judgement bias test. Broilers were trained to approach reinforced locations signaled by one color and not to approach unreinforced locations signaled by a different color. Trained birds were tested for latencies to approach three ambiguous cues of intermediate color and location. Broilers discriminated between cues, with shorter latencies to approach ambiguous cues closest to the reinforced cue than cues closest to the unreinforced cue, validating the use of the test in this context. Broilers housed in high-complexity pens approached ambiguous cues faster than birds in low-complexity pens-an optimistic judgement bias, suggesting the former were in a more positive affective state. Broilers from high-density pens tended to approach all cues faster than birds from low-density pens, possibly because resource competition in their home pen increased food motivation. Overall, our study suggests that environmental complexity improves broilers' affective states, implying animal welfare benefits of environmental enrichment.
Collapse
Affiliation(s)
- M. G. Anderson
- grid.438526.e0000 0001 0694 4940Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA USA
| | - A. M. Campbell
- grid.438526.e0000 0001 0694 4940Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA USA
| | - A. Crump
- grid.13063.370000 0001 0789 5319Centre for Philosophy of Natural and Social Science, London School of Economics and Political Science, London, UK
| | - G. Arnott
- grid.4777.30000 0004 0374 7521School of Biological Sciences, Queen’s University Belfast, Belfast, UK
| | - L. Jacobs
- grid.438526.e0000 0001 0694 4940Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA USA
| |
Collapse
|
55
|
Subar AR, Rozenman M. Like parent, like child: Is parent interpretation bias associated with their child's interpretation bias and anxiety? A systematic review and meta-analysis. J Affect Disord 2021; 291:307-314. [PMID: 34077820 DOI: 10.1016/j.jad.2021.05.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/09/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Anxiety disorders are the most prevalent psychiatric problem across the lifespan, with typical onset during the pediatric period. Prior literature has examined cognitive mechanisms associated with youth anxiety and identified interpretation bias, the threatening appraisal of ambiguity, as a ubiquitous correlate and likely mechanism. A small set of studies have examined interpretation bias and anxiety in parent-child dyads, although results about this potential relationship are conflicted. This systematic review and meta-analysis investigates the association between parent interpretation bias with child interpretation bias and child anxiety. METHODS Eight studies met the rigorous inclusion criteria, which required direct assessment of interpretation bias in both youth and parent. RESULTS Meta-analysis with a random effects model indicated a small and significant correlation between parent and child interpretation biases (r = 0.14, p < .01), as well as a small and significant correlation between parent interpretation bias and child anxiety (r = = 0.20, p = .01). LIMITATIONS As only eight studies were included in this meta-analysis, reflecting the state of the extant literature, it is possible that, as data accumulate and this work continues in the future, results may or may not be replicated. CONCLUSIONS Despite variability in findings across the included empirical studies, the current meta-analysis suggests that a correlational relationship between parent interpretation bias and child bias/anxiety exists. This work has implications for conceptualizing parent interpretation bias as a possible explanatory mechanism underlying youth interpretation bias and anxiety.
Collapse
Affiliation(s)
- Anni R Subar
- University of Denver, Department of Psychology, United States.
| | | |
Collapse
|
56
|
Prior K, Salemink E, Wiers RW, Teachman BA, Piggott M, Newton NC, Teesson M, Baillie AJ, Manning V, McLellan LF, Mahoney A, Stapinski LA. A Web-Based Cognitive Bias Modification Intervention (Re-train Your Brain) for Emerging Adults With Co-occurring Social Anxiety and Hazardous Alcohol Use: Protocol for a Multiarm Randomized Controlled Pilot Trial. JMIR Res Protoc 2021; 10:e28667. [PMID: 34255726 PMCID: PMC8295835 DOI: 10.2196/28667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/26/2021] [Accepted: 05/26/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Alcohol use and anxiety disorders commonly co-occur, resulting in a more severe clinical presentation and poorer response to treatment. Research has shown that approach bias modification (ApBM) and interpretation bias modification (IBM) cognitive retraining interventions can be efficacious adjunctive treatments that improve outcomes for alcohol use and social anxiety, respectively. However, the acceptability, feasibility, and clinical utility of combining ApBM and IBM programs to optimize treatments among comorbid samples are unknown. It is also unclear whether integrating ApBM and IBM within each training session or alternating them between each session is more acceptable and efficacious. OBJECTIVE This paper describes the protocol for a randomized controlled pilot trial investigating the feasibility, acceptability, and preliminary efficacy of the Re-train Your Brain intervention-an adjunct web-based ApBM+IBM program-among a clinical sample of emerging adults with hazardous alcohol use and social anxiety. METHODS The study involves a three-arm randomized controlled pilot trial in which treatment-seeking emerging adults (18-30 years) with co-occurring hazardous alcohol use and social anxiety will be individually randomized to receive the Re-train Your Brain integrated program, delivered with 10 biweekly sessions focusing on both social anxiety and alcohol each week, plus treatment as usual (TAU; ie, the model of care provided in accordance with standard practice at their service; n=30); the Re-train Your Brain alternating program, delivered with 10 biweekly sessions focusing on social anxiety one week and alcohol the next week, plus TAU (n=30); or TAU only (n=30). Primary outcomes include feasibility (uptake, follow-up rates, treatment adherence, attrition, and adverse events) and acceptability (system usability, client satisfaction, user experience, and training format preference). Secondary efficacy outcomes include changes in alcohol approach and interpretation biases, social anxiety, and alcohol use (eg, drinks per day, binge drinking, drinking motives, severity of dependence, and cravings). The primary end point will be posttreatment (6 weeks postbaseline), with a secondary end point at 3 months postbaseline. Descriptive statistics will be conducted for primary outcomes, whereas intention-to-treat, multilevel mixed effects analysis for repeated measures will be performed for secondary outcomes. RESULTS This study is funded from 2019 to 2023 by Australian Rotary Health. Recruitment is expected to be completed by mid-2022 to late 2022, with follow-ups completed by early 2023. CONCLUSIONS This study will be the first to evaluate whether an ApBM+IBM program is acceptable to treatment-seeking, emerging adults and whether it can be feasibly delivered via the web, in settings where it will ultimately be used (eg, at home). The findings will broaden our understanding of the types of programs that emerging adults will engage with and whether the program may be an efficacious treatment option for this comorbidity. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12620001273976; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364131. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/28667.
Collapse
Affiliation(s)
- Katrina Prior
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Elske Salemink
- Experimental Psychopathology Lab, Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Amsterdam, Netherlands.,Center for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands
| | - Bethany A Teachman
- Department of Psychology, School of Arts and Sciences, University of Virginia, Virginia, VA, United States
| | - Monique Piggott
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Andrew J Baillie
- Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Victoria Manning
- Eastern Health Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
| | - Lauren F McLellan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Alison Mahoney
- Clinical Research Unit for Anxiety and Depression, St Vincent's Public Hospital, Sydney, Australia
| | - Lexine A Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| |
Collapse
|
57
|
O'Connor CE, Everaert J, Fitzgerald A. Interpreting ambiguous emotional information: Convergence among interpretation bias measures and unique relations with depression severity. J Clin Psychol 2021; 77:2529-2544. [PMID: 34101175 DOI: 10.1002/jclp.23186] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 04/07/2021] [Accepted: 05/08/2021] [Indexed: 12/30/2022]
Abstract
This study aimed to examine the convergence among interpretation bias measures and their associations with depressive symptom severity. Research into interpretation biases employs measures of interpretation bias interchangeably, however, little is known about the relationship between these measures. Participants (N = 82 unselected undergraduate students; 59 female) completed four computer-based interpretation bias tasks in a cross-sectional design study. Indirect measures, based on participants' reaction times, were not correlated with each other and had poor split-half reliability. Direct measures were more strongly correlated with depressive symptoms than indirect measures, but only the Scrambled Sentences Task explained a reliable unique portion of the variance in depressive symptoms. Interpretation bias tasks may not measure the same cognitive process and may differ in the extent to which they are a cognitive marker of depression-linked interpretation bias. These findings help to improve the measurement of and theory underlying interpretation bias and depressive symptoms.
Collapse
Affiliation(s)
| | - Jonas Everaert
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | | |
Collapse
|
58
|
Muris P, Ollendick TH. Selective Mutism and Its Relations to Social Anxiety Disorder and Autism Spectrum Disorder. Clin Child Fam Psychol Rev 2021; 24:294-325. [PMID: 33462750 PMCID: PMC8131304 DOI: 10.1007/s10567-020-00342-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 12/24/2022]
Abstract
In current classification systems, selective mutism (SM) is included in the broad anxiety disorders category. Indeed, there is abundant evidence showing that anxiety, and social anxiety in particular, is a prominent feature of SM. In this article, we point out that autism spectrum problems in addition to anxiety problems are sometimes also implicated in SM. To build our case, we summarize evidence showing that SM, social anxiety disorder (SAD), and autism spectrum disorder (ASD) are allied clinical conditions and share communalities in the realm of social difficulties. Following this, we address the role of a prototypical class of ASD symptoms, restricted and repetitive behaviors and interests (RRBIs), which are hypothesized to play a special role in the preservation and exacerbation of social difficulties. We then substantiate our point that SM is sometimes more than an anxiety disorder by addressing its special link with ASD in more detail. Finally, we close by noting that the possible involvement of ASD in SM has a number of consequences for clinical practice with regard to its classification, assessment, and treatment of children with SM and highlight a number of directions for future research.
Collapse
Affiliation(s)
- Peter Muris
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
- Stellenbosch University, Stellenbosch, South Africa.
| | - Thomas H Ollendick
- Virginia Polytechnic Institute and State University, Blacksburg, USA
- Roehampton University, London, England
| |
Collapse
|
59
|
Murphy LK, de la Vega R, Kohut SA, Kawamura JS, Levy RL, Palermo TM. Systematic Review: Psychosocial Correlates of Pain in Pediatric Inflammatory Bowel Disease. Inflamm Bowel Dis 2021; 27:697-710. [PMID: 32458966 DOI: 10.1093/ibd/izaa115] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pain is a common symptom in pediatric inflammatory bowel disease (IBD) and is associated with poor health outcomes, yet additional knowledge about the psychosocial correlates of pain is needed to optimize clinical care. The purpose of this study is to systematically review the psychosocial factors associated with pain and pain impact in youth diagnosed with IBD within a developmentally informed framework. METHODS Manual and electronic searches yielded 2641 references. Two authors conducted screening (98% agreement), and data extraction was performed in duplicate. Average study quality was rated using the National Institutes of Health Quality Assessment Tool. RESULTS Ten studies (N = 763 patients; N = 563 Crohn disease, N = 200 ulcerative/ indeterminate colitis) met the inclusion criteria. Findings showed consistent evidence that higher levels of child depression symptoms and child pain catastrophizing were associated with significantly greater pain and pain impact (magnitude of association ranged from small to large across studies). Greater pain and pain impact were also associated with higher levels of child anxiety symptoms, child pain threat, child pain worry, and parent pain catastrophizing. Within the included studies, female sex and disease severity were both significantly associated with pain and pain impact. Study quality was moderate on average. CONCLUSIONS There is evidence that child psychosocial factors are associated with pain and pain impact in pediatric IBD; more studies are needed to examine parent- and family-level psychosocial factors. Youth with IBD should be routinely screened for pain severity, pain impact, and psychosocial risk factors such as anxiety/depression.
Collapse
Affiliation(s)
- Lexa K Murphy
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Rocio de la Vega
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Sara Ahola Kohut
- Department of Psychology and Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Joy S Kawamura
- Department of Psychiatry and Behavioral Medicine, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Psychiatry, University of Washington, Seattle, Washington, USA
| | - Rona L Levy
- Department of Social Work, University of Washington, Seattle, Washington, USA
| | - Tonya M Palermo
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA.,Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, USA
| |
Collapse
|
60
|
Emerging Domain-Based Treatments for Pediatric Anxiety Disorders. Biol Psychiatry 2021; 89:716-725. [PMID: 33451677 DOI: 10.1016/j.biopsych.2020.08.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/19/2020] [Accepted: 08/19/2020] [Indexed: 12/25/2022]
Abstract
Domain-specific cognitive training treatments for pediatric anxiety disorders rely on accurate and reliable identification of specific underlying deficits and biases in neurocognitive functions. Once identified, such biases can serve as specific targets for therapeutic intervention. Clinical translations typically reflect mechanized training protocols designed to rectify the identified biases. Here, we review and synthesize research on key neurocognitive processes that emerge as potential targets for specialized cognitive training interventions in pediatric anxiety disorders in the domains of attention, interpretation, error monitoring, working memory, and fear learning. For each domain, we describe the current status of target establishment (i.e., an association between pediatric anxiety and a specific neurocognitive process), and then review extant translational efforts regarding these targets and the evidence supporting their clinical utility in youths. We then localize each of the domains within the path leading to efficacious, evidence-supported treatments for pediatric anxiety, providing a roadmap for future research. The review indicates that specific cognitive targets in pediatric anxiety have been established in all the reviewed domains except for fear learning, where a clear target is yet to be elucidated. In contrast, evidence for clinical efficacy emerged only in the threat-related attention domain, with some preliminary findings in the domains of interpretation and working memory. The path to clinical translation in the domain of error monitoring is yet unclear. Implications and potential avenues for future research and translation are discussed.
Collapse
|
61
|
Dodd HF, Lester KJ. Adventurous Play as a Mechanism for Reducing Risk for Childhood Anxiety: A Conceptual Model. Clin Child Fam Psychol Rev 2021; 24:164-181. [PMID: 33464448 PMCID: PMC7880968 DOI: 10.1007/s10567-020-00338-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 01/05/2023]
Abstract
In this conceptual article, we draw upon the literature regarding cognitive and behavioural factors that underpin childhood anxiety to outline how a range of these risk markers might be targeted through adventurous play. When children play in an adventurous way, climbing trees, riding their bikes fast downhill and jumping from rocks, they experience feelings of fear and excitement, thrill and adrenaline. We propose that the positive, thrilling and playful emotions associated with this type of child-led play facilitate exposure to fear-provoking situations and, in doing so, provide opportunities for children to learn about physiological arousal, uncertainty and coping. We hypothesise that these learning opportunities will, over time, reduce children's risk for elevated anxiety by increasing children's expectations and ability to cope with anxiety, decreasing intolerance of uncertainty and preventing catastrophic misinterpretations of physiological arousal. If our conceptual model is correct, then ensuring that children have the physical and psychological space required to play in an adventurous way may help to decrease their risk for elevated or clinical anxiety.
Collapse
Affiliation(s)
- Helen F Dodd
- School of Psychology and Clinical Language Sciences, University of Reading, Whiteknights, Reading, RG6 6AL, UK.
| | - Kathryn J Lester
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, UK
| |
Collapse
|
62
|
Abstract
Allowing dairy cattle to access pasture can promote natural behaviour and improve their health. However, the psychological benefits are poorly understood. We compared a cognitive indicator of emotion in cattle either with or without pasture access. In a crossover experiment, 29 Holstein-Friesian dairy cows had 18 days of overnight pasture access and 18 days of full-time indoor housing. To assess emotional wellbeing, we tested cows on a spatial judgement bias task. Subjects learnt to approach a rewarded bucket location, but not approach another, unrewarded bucket location. We then presented cows with three "probe" buckets intermediate between the trained locations. Approaching the probes reflected an expectation of reward under ambiguity-an "optimistic" judgement bias, suggesting positive emotional states. We analysed the data using linear mixed-effects models. There were no treatment differences in latency to approach the probe buckets, but cows approached the known rewarded bucket slower when they had pasture access than when they were indoors full-time. Our results indicate that, compared to cattle housed indoors, cattle with pasture access display less anticipatory behaviour towards a known reward. This reduced reward anticipation suggests that pasture is a more rewarding environment, which may induce more positive emotional states than full-time housing.
Collapse
|
63
|
Lau JF, Shariff R, Meehan A. Are biased interpretations of ambiguous social and non-social situations a precursor, consequence or maintenance factor of youth loneliness? Behav Res Ther 2021; 140:103829. [PMID: 33725566 DOI: 10.1016/j.brat.2021.103829] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 02/01/2021] [Accepted: 02/16/2021] [Indexed: 11/17/2022]
Abstract
Loneliness is common in youth, with suggestions that these negative emotions confer vulnerability for anxiety and depression. Here, we investigated for the first time whether, consistent with psychological models of loneliness, biased interpretations of social situations could prospectively predict loneliness in youth. 104 young people completed measures of loneliness and interpretations of ambiguous social and non-social (bodily or health-related) situations at three time-points with intervals of three months between each. As government-imposed social distancing measures (to control the COVID-19 outbreak) occurred between Times 2 and 3 (but not between Times 1 and 2), this enabled us to assess whether restricted social activity could provoke greater predictive power of biased interpretational styles on loneliness. Using cross-lagged panel models, we showed that after estimating paths representing within-time across-variable ("concurrent") paths and across-time within-variable ("stability") paths, there were no significant cross-lag 'causal' paths between earlier interpretational style and later loneliness. Between Time 2 and 3, we demonstrated a significant cross-lag 'consequential' path between earlier loneliness and later threatening interpretations of social situations, but this became non-significant after controlling for concurrent anxiety and depression. Biased interpretational style may reflect a concurrent maintenance factor of youth loneliness.
Collapse
Affiliation(s)
- JenniferY F Lau
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK.
| | - Rimsha Shariff
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK.
| | - AlanJ Meehan
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK.
| |
Collapse
|
64
|
Atkinson-Jones K, Jacobs K, Lau JYF. Associations between biased threat interpretations, fear and avoidance of pain and pain-linked disability in adolescent chronic pain patients. Eur J Pain 2021; 25:1031-1040. [PMID: 33400334 DOI: 10.1002/ejp.1724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 12/28/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Biased interpretations of ambiguous bodily threat situations characterize youth with chronic pain, and have been associated with functional disability for this population. Despite predictions by the fear-avoidance model of chronic pain, that fear and avoidance of pain explain the association between threat perceptions and disability, this has not yet been explored in youth with chronic pain. This study aimed to address this gap by investigating these proposed relationships, in addition to the association between bodily threat interpretations and daily aspects of disability (as well as social, and emotional impairments). METHOD Sixty-eight adolescents aged 11-18 years old with a clinical diagnosis of chronic pain completed an extended version of the Adolescent Interpretations of Bodily Threat task to assess interpretations of bodily and social threat situations, alongside measures of disability and fear and avoidance of pain. RESULTS Using mediation analysis, fear and avoidance of pain statistically accounted for the relationship between negative bodily threat interpretations and functional disability. Significant associations were also demonstrated between negative bodily threat interpretations and adolescent-reported impairments in daily, emotional and social impairments. Data revealed a significant relationship between negative social interpretations and daily functional disability. CONCLUSIONS Findings indicate the clinical relevance of bodily and social threat interpretations, and fear and avoidance of pain, for this population and raise further questions regarding the content-specificity of threat interpretations. SIGNIFICANCE Psychological theories of pain-associated impact and disability point to fear and avoidance of pain, as well as information-processing biases. Here, we present novel data showing the clinical relevance of bodily and social threat interpretations in explaining pain-related disability amongst youth with chronic pain, potentially by shaping fear and avoidance of pain. Longitudinal designs will be required to assess these temporally sensitive mediation pathways.
Collapse
Affiliation(s)
- K Atkinson-Jones
- Oxford Institute of Clinical Psychology, University of Oxford, Oxford, UK
| | - K Jacobs
- Oxford Centre for Children and Young People, Oxford University Hospitals, Oxford, UK
| | - J Y F Lau
- Psychology Department, King's College London, London, UK
| |
Collapse
|
65
|
Tan N, Shou Y. WITHDRAWN: Anxiety and responses towards ambiguity: A multidimensional framework. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
66
|
Vasileva M, Alisic E, De Young A. COVID-19 unmasked: preschool children's negative thoughts and worries during the COVID-19 pandemic in Australia. Eur J Psychotraumatol 2021; 12:1924442. [PMID: 34249241 PMCID: PMC8245093 DOI: 10.1080/20008198.2021.1924442] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: The COVID-19 pandemic and its consequences are stressful for many children and their families. Previous research with school-aged children has shown that negative thoughts and worries can predict mental health symptoms following stressful events. So far preschool children have been neglected in these investigations. Objective: The aim of this study was to explore negative thoughts and worries that preschool aged children are having during the COVID-19 pandemic. Method: As part of a larger mixed-method study, caregivers of N = 399 preschoolers aged between 3 and 5 years (M = 4.41) answered open-ended questions about their COVID-19 related thoughts and worries. Reflexive thematic analysis was used to identify relevant themes from the qualitative data. A theoretical model of child thoughts and worries was developed based on these qualitative findings and the existing empirical and theoretical literature. Results: Caregivers gave examples that indicated that preschoolers had difficulties understanding causality and overestimated the risk of COVID-19 infection. Caregivers reported that their children expressed worries about getting sick and infecting others as well as about changes in daily life becoming permanent. Caregivers observed their children's preoccupation with COVID-19 and worries in conversations, play and drawings as well as in behavioural changes - increased arousal, cautiousness, avoidance and attachment-seeking behaviour. Conclusion: Preschool children can and do express negative thoughts and worries and have also experienced threat and increased vulnerability during the COVID-19 pandemic. A theoretical model is proposed that could inform assessments, interventions and future research in the field.
Collapse
Affiliation(s)
- Mira Vasileva
- Child and Community Wellbeing Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Eva Alisic
- Child and Community Wellbeing Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Alex De Young
- Queensland Centre for Perinatal & Infant Mental Health, Children's Health Queensland Hospital and Health Service & Child Health Research Centre, Brisbane, Australia.,School of Psychology, University of Queensland, Brisbane, Australia
| |
Collapse
|
67
|
Crump A, Bethell EJ, Earley R, Lee VE, Mendl M, Oldham L, Turner SP, Arnott G. Emotion in animal contests. Proc Biol Sci 2020; 287:20201715. [PMID: 33203327 DOI: 10.1098/rspb.2020.1715] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Emotions encompass cognitive and behavioural responses to reward and punishment. Using contests as a case-study, we propose that short-term emotions underpin animals' assessments, decision-making and behaviour. Equating contest assessments to emotional 'appraisals', we describe how contestants appraise more than resource value and outcome probability. These appraisals elicit the cognition, drive and neurophysiology that governs aggressive behaviour. We discuss how recent contest outcomes induce long-term moods, which impact subsequent contest behaviour. Finally, we distinguish between integral (objectively relevant) and incidental (objectively irrelevant) emotions and moods (affective states). Unlike existing ecological models, our approach predicts that incidental events influence contest dynamics, and that contests become incidental influences themselves, potentially causing maladaptive decision-making. As affective states cross contexts, a more holistic ethology (incorporating emotions and moods) would illuminate animal cognition and behaviour.
Collapse
Affiliation(s)
- Andrew Crump
- Centre for Philosophy of Natural and Social Science, London School of Economics and Political Science, UK.,Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, UK
| | - Emily J Bethell
- School of Biological and Environmental Sciences, Liverpool John Moores University, UK
| | - Ryan Earley
- Department of Biological Sciences, University of Alabama, USA
| | - Victoria E Lee
- Animal Behaviour and Welfare, Scotland's Rural College, UK
| | - Michael Mendl
- Bristol Veterinary School, University of Bristol, UK
| | - Lucy Oldham
- Animal Behaviour and Welfare, Scotland's Rural College, UK
| | - Simon P Turner
- Animal Behaviour and Welfare, Scotland's Rural College, UK
| | - Gareth Arnott
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, UK
| |
Collapse
|
68
|
Training negative connectivity patterns between the dorsolateral prefrontal cortex and amygdala through fMRI-based neurofeedback to target adolescent socially-avoidant behaviour. Behav Res Ther 2020; 135:103760. [PMID: 33137695 DOI: 10.1016/j.brat.2020.103760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 08/06/2020] [Accepted: 10/23/2020] [Indexed: 12/28/2022]
Abstract
Social anxiety is prevalent in adolescence. Given its role in maintaining fears, reducing social avoidance through cognitive reappraisal may help attenuate social anxiety. We used fMRI-based neurofeedback (NF) to increase 'adaptive' patterns of negative connectivity between the dorsolateral prefrontal cortex (DLPFC) and the amygdala to change reappraisal ability, and alter social avoidance and approach behaviours in adolescents. Twenty-seven female participants aged 13-17 years with varying social anxiety levels completed a fMRI-based NF training task where they practiced cognitive reappraisal strategies, whilst receiving real-time feedback of DLPFC-amygdala connectivity. All participants completed measures of cognitive reappraisal and social approach-avoidance behaviour before and after NF training. Avoidance of happy faces was associated with greater social anxiety pre-training. Participants who were unable to acquire a more negative pattern of connectivity through NF training displayed significantly greater avoidance of happy faces at post-training compared to pre-training. These 'maladaptive' participants also reported significant decreases in re-appraisal ability from pre to post-training. In contrast, those who were able to acquire a more 'adaptive' connectivity pattern did not show these changes in social avoidance and re-appraisal. Future research could consider using strategies to improve the capacity of NF training to boost youth social-approach behaviour.
Collapse
|
69
|
Golombek K, Lidle L, Tuschen-Caffier B, Schmitz J, Vierrath V. The role of emotion regulation in socially anxious children and adolescents: a systematic review. Eur Child Adolesc Psychiatry 2020; 29:1479-1501. [PMID: 31201527 DOI: 10.1007/s00787-019-01359-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/27/2019] [Indexed: 01/04/2023]
Abstract
While numerous studies suggest that emotion dysregulation is important in maintaining social anxiety among adults, the role of emotion regulation in children and adolescents with social anxiety is not yet well understood. In this systematic review, we use the process model of emotion regulation as a framework for understanding emotion regulation in children and adolescents with social anxiety. We performed a systematic literature search in the electronic data bases Medline and PsycINFO. Additional studies were identified by hand search. We identified 683 studies, screened their titles and abstracts, viewed 142 studies, and included 55 of these. Study results indicate that children and adolescents with social anxiety disorder or high social anxiety show emotion dysregulation across all five domains of emotion regulation, such as enhanced social avoidance, more safety behaviors, repetitive negative thinking, biased attention and interpretation of social information, and reduced emotional expression. While enhanced social avoidance seems to be specific to childhood social anxiety, other maladaptive emotion regulation strategies, such as repetitive negative thinking, seem to occur transdiagnostically across different childhood anxiety disorders. Implications for current theory, interventions and future research are discussed.
Collapse
Affiliation(s)
- Kristin Golombek
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr 41, Freiburg, 79106, Germany
| | - Leonie Lidle
- Department of Psychology, Clinical Child and Adolescent Psychology, Leipzig University, Leipzig, Germany.,Leipzig Research Center for Early Child Development, Leipzig University, Leipzig, Germany
| | - Brunna Tuschen-Caffier
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr 41, Freiburg, 79106, Germany
| | - Julian Schmitz
- Department of Psychology, Clinical Child and Adolescent Psychology, Leipzig University, Leipzig, Germany.,Leipzig Research Center for Early Child Development, Leipzig University, Leipzig, Germany
| | - Verena Vierrath
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr 41, Freiburg, 79106, Germany.
| |
Collapse
|
70
|
Chen J, Short M, Kemps E. Interpretation bias in social anxiety: A systematic review and meta-analysis. J Affect Disord 2020; 276:1119-1130. [PMID: 32777650 DOI: 10.1016/j.jad.2020.07.121] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 07/12/2020] [Accepted: 07/28/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Interpretation bias, which involves interpreting ambiguous social events negatively and catastrophising even mildly negative social events, has been suggested as a key maintenance factor of Social Anxiety Disorder. Although some individual studies and narrative reviews have demonstrated a role for negative interpretation bias in social anxiety (disorder), findings have been mixed. Given the lack of a quantitative synthesis of the evidence, the current systematic review and meta-analysis examined the strength of the relationship between interpretation bias and social anxiety. It also investigated potential moderators of this relationship (i.e., types of measures and stimuli, samples, and study designs). METHODS Five databases (PsycINFO, PubMed, Medline, Scopus, and CINAHL) were searched. Of 46 studies identified, 44 were suitable for meta-analysis (N = 3859). RESULTS There was a large effect for the relationship between social anxiety and interpretation bias (g = 0.83). Types of measures (subjective versus objective) and stimuli (verbal versus visual) were identified as significant moderators, with subjective measures and verbal stimuli particularly adept at capturing interpretation bias in socially anxious individuals. LIMITATIONS The effect sizes displayed significant heterogeneity between studies, which likely reflects some publication bias, and thus, the overall effect size may be inflated. CONCLUSION Findings may help to refine clinical models and interventions for Social Anxiety Disorder, which in turn may maximise evidence-based interventions that target negative interpretation bias in this disorder.
Collapse
Affiliation(s)
- Junwen Chen
- Research School of Psychology, The Australian National University, 39 Science Road, Canberra, ACT 2601, Australia; School of Psychology, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
| | - Michelle Short
- School of Psychology, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
| | - Eva Kemps
- School of Psychology, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
| |
Collapse
|
71
|
Nikolić M. Disturbed Social Information Processing as a Mechanism in the Development of Social Anxiety Disorder. CHILD DEVELOPMENT PERSPECTIVES 2020. [DOI: 10.1111/cdep.12390] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
72
|
Sfärlea A, Buhl C, Loechner J, Neumüller J, Asperud Thomsen L, Starman K, Salemink E, Schulte-Körne G, Platt B. "I Am a Total…Loser" - The Role of Interpretation Biases in Youth Depression. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1337-1350. [PMID: 32654075 PMCID: PMC7445197 DOI: 10.1007/s10802-020-00670-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Negative interpretation biases have been found to characterize adults with depression and to be involved in the development and maintenance of the disorder. However, less is known about their role in youth depression. The present study investigated i) whether negative interpretation biases characterize children and adolescents with depression and ii) to what extent these biases are more pronounced in currently depressed youth compared to youth at risk for depression (as some negative interpretation biases have been found already in high-risk youth before disorder onset). After a negative mood induction interpretation biases were assessed with two experimental tasks: Ambiguous Scenarios Task (AST) and Scrambled Sentences Task (SST) in three groups of 9-14-year-olds: children and adolescents with a diagnosis of major depression (n = 32), children and adolescents with a high risk for depression (children of depressed parents; n = 48), as well as low-risk children and adolescents (n = 42). Depressed youth exhibited substantially more negative interpretation biases than both high-risk and low-risk groups (as assessed with both tasks), while the high-risk group showed more negative interpretation biases than the low-risk group only as assessed via the SST. The results indicate that the negative interpretation biases that are to some extent already present in high-risk populations before disorder onset are strongly amplified in currently depressed youth. The different findings for the two tasks suggest that more implicit interpretation biases (assessed with the SST) might represent cognitive vulnerabilities for depression whereas more explicit interpretation biases (assessed with the AST) may arise as a consequence of depressive symptomatology.
Collapse
Affiliation(s)
- Anca Sfärlea
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Nußbaumstr. 5a, 80336 Munich, Germany
| | - Christina Buhl
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Nußbaumstr. 5a, 80336 Munich, Germany
| | - Johanna Loechner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Nußbaumstr. 5a, 80336 Munich, Germany
- Department of Clinical Psychology and Psychotherapy, LMU Munich, Munich, Germany
| | - Jakob Neumüller
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Nußbaumstr. 5a, 80336 Munich, Germany
| | - Laura Asperud Thomsen
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Nußbaumstr. 5a, 80336 Munich, Germany
| | - Kornelija Starman
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Nußbaumstr. 5a, 80336 Munich, Germany
| | - Elske Salemink
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Gerd Schulte-Körne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Nußbaumstr. 5a, 80336 Munich, Germany
| | - Belinda Platt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Nußbaumstr. 5a, 80336 Munich, Germany
| |
Collapse
|
73
|
Songco A, Booth C, Spiegler O, Parsons S, Fox E. Anxiety and Depressive Symptom Trajectories in Adolescence and the Co-Occurring Development of Cognitive Biases: Evidence from the CogBIAS Longitudinal Study. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1617-1633. [PMID: 32926283 PMCID: PMC7554006 DOI: 10.1007/s10802-020-00694-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The development of negative cognitive biases, together with symptoms of anxiety and depression, has yet to be investigated longitudinally. Using a three-wave design, the present study examined developmental trajectories of anxiety and depressive symptoms and the co-occurrence of cognitive biases, in a large normative sample of adolescents (N = 504). Data was drawn from the CogBIAS Longitudinal Study (CogBIAS-L-S), which assessed a wide range of psychological variables, including cognitive biases and self-reported anxiety and depressive symptoms, when adolescents were approximately 13, 14.5, and 16 years of age. The results showed that overall levels of anxiety were low and stable, while levels of depression were low but increased slightly at each wave. Growth mixture modeling identified four distinct developmental classes with regard to anxiety and depressive symptoms. Multiple group analysis further showed that class membership was related to the development of cognitive biases. The majority of the sample (75%) was characterised by ‘Low symptoms’ of anxiety and depression and showed low interpretation and memory biases for negative stimuli at each wave. A second class (11%) displayed ‘Decreasing anxiety symptoms’ and showed decreasing interpretation bias, but increasing memory bias. A third class (8%) displayed ‘Comorbid increasing symptoms’ and showed increasing interpretation and memory biases. While the fourth class (6%) displayed ‘Comorbid decreasing symptoms’ and showed decreasing interpretation and memory biases. This longitudinal study sheds light on healthy and psychopathological emotional development in adolescence and highlights cognitive mechanisms that may be useful targets for prevention and early interventions.
Collapse
Affiliation(s)
- Annabel Songco
- Department of Experimental Psychology, University of Oxford, New Radcliffe House, Radcliffe Observatory Quarter, Oxford, OX26GG, UK.
| | - Charlotte Booth
- Department of Experimental Psychology, University of Oxford, New Radcliffe House, Radcliffe Observatory Quarter, Oxford, OX26GG, UK
| | - Olivia Spiegler
- Department of Experimental Psychology, University of Oxford, New Radcliffe House, Radcliffe Observatory Quarter, Oxford, OX26GG, UK
| | - Sam Parsons
- Department of Experimental Psychology, University of Oxford, New Radcliffe House, Radcliffe Observatory Quarter, Oxford, OX26GG, UK
| | - Elaine Fox
- Department of Experimental Psychology, University of Oxford, New Radcliffe House, Radcliffe Observatory Quarter, Oxford, OX26GG, UK
| |
Collapse
|
74
|
Evaluation of the Factor Structure and Content Specificity of the Interpretation Bias Task (IBT). COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10138-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Abstract
Background
Theories suggest that interpretation biases play a role in the aetiology of a range of psychopathology including depression, anxiety and psychosis. We evaluate the psychometric properties of an adapted version of an ambiguous scenario task (i.e., Interpretation Bias Task [IBT]) that assesses benign and negative interpretations in four domains: immediate bodily injury; long-term illness; social rejection; and, performance failure.
Methods
The factor structure of the IBT was evaluated in a student sample (N = 237) in Study 1, and subsequently confirmed in a community sample with a wider age range (N = 1103) in Study 2. Correlations between interpretation biases and health and social anxiety symptoms were tested in both studies.
Results
The four IBT domains were differentiable and each was represented by two factors (i.e., benign vs. negative). In Study 1, higher health anxiety was characterised by fewer benign interpretations for injury- and illness-related scenarios, whereas higher social anxiety was associated with more negative and fewer benign interpretations for social rejection and performance failure scenarios. Correlational results were replicated in Study 2 for social anxiety, but not health anxiety.
Conclusions
The IBT is suitable for measuring interpretation biases in Asian adults. The content specificity of interpretation biases was partially supported.
Collapse
|
75
|
Calleja RL, Rapee RM. Social threat sensitivity and its relationships with peer victimisation and internalising symptoms among adolescent girls. Behav Res Ther 2020; 133:103710. [PMID: 32836111 DOI: 10.1016/j.brat.2020.103710] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/12/2020] [Accepted: 08/08/2020] [Indexed: 10/23/2022]
Abstract
Consistent associations have been shown between self-reported peer victimisation and internalising symptoms. In distinct literature, anxious and depressed youth have been shown to interpret ambiguous social stimuli in a manner consistent with social threat and rejection. The aim of the current study was to determine whether this sensitivity to social threat among anxious/depressed youth explains significant variance in the relationship between self-reports of peer victimisation and internalising symptoms. Two hundred and sixty-seven students in grades seven and eight (M age = 12.62, SD = 0.65) completed measures of their own symptoms of anxiety and depression as well as their experiences of being physically or relationally victimised by their peers. They also read descriptions of 10 hypothetical ambiguous social interactions and provided responses indicating whether they interpreted each scenario as indicating social threat (rejection/negative evaluation) and the extent to which they perceived it as victimisation. As expected, anxiety and depression were positively correlated with self-reported peer victimisation and with interpretations consistent with social threat and victimisation (social threat sensitivity). In turn, social threat sensitivity was positively correlated with both self-reported relational and physical victimisation, but moreso with the former. However, the relationship between anxiety and depression and victimisation remained significant, even after controlling for social threat sensitivity. Results suggest that a sensitivity toward social threat can influence self-reports of peer victimisation among anxious and depressed youth, but that the relationship between internalising and victimisation goes beyond this sensitivity.
Collapse
Affiliation(s)
- Rachel L Calleja
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia.
| |
Collapse
|
76
|
Baartmans JMD, van Steensel FJA, Mobach L, Lansu TAM, Bijsterbosch G, Verpaalen I, Rapee RM, Magson N, Bögels SM, Rinck M, Klein AM. Social anxiety and perceptions of likeability by peers in children. BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2020; 38:319-336. [PMID: 32064647 PMCID: PMC7216937 DOI: 10.1111/bjdp.12324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/23/2020] [Indexed: 11/30/2022]
Abstract
The current study aimed to investigate the discrepancy between self-reported and peer-reported likeability among children, and the relation with social anxiety, depression, and social support. In total, 532 children between 7 and 12 years completed questionnaires about social anxiety symptoms, depressive symptoms, and social support, estimated their own likeability, and indicated how much they liked their classmates. Children with higher levels of social anxiety or depression overestimated their likeability less or even underestimated their likeability. Social anxiety symptoms, but not depressive symptoms, were significant predictors of the discrepancy. Social support was positively related to likeability and negatively related to social anxiety, but did not moderate the association between social anxiety symptoms and perception accuracy of likeability. These results are in line with cognitive theories of childhood social anxiety, and they stress the importance of using multi-informant measures when studying the relation between social anxiety and social functioning in children.
Collapse
Affiliation(s)
- Jeanine M. D. Baartmans
- Developmental PsychologyUniversity of AmsterdamThe Netherlands
- UvA Minds Academic Treatment CenterAmsterdamThe Netherlands
| | | | - Lynn Mobach
- Behavioural Science InstituteRadboud UniversityNijmegenThe Netherlands
- Centre for Emotional HealthMacquarie UniversitySydneyNew South WalesAustralia
| | - Tessa A. M. Lansu
- Behavioural Science InstituteRadboud UniversityNijmegenThe Netherlands
| | | | - Iris Verpaalen
- Behavioural Science InstituteRadboud UniversityNijmegenThe Netherlands
| | - Ronald M. Rapee
- Centre for Emotional HealthMacquarie UniversitySydneyNew South WalesAustralia
| | - Natasha Magson
- Centre for Emotional HealthMacquarie UniversitySydneyNew South WalesAustralia
| | - Susan M. Bögels
- Developmental PsychologyUniversity of AmsterdamThe Netherlands
| | - Mike Rinck
- Behavioural Science InstituteRadboud UniversityNijmegenThe Netherlands
| | - Anke M. Klein
- Developmental PsychologyUniversity of AmsterdamThe Netherlands
- Behavioural Science InstituteRadboud UniversityNijmegenThe Netherlands
| |
Collapse
|
77
|
Chan FHF, Suen H, Hsiao JH, Chan AB, Barry TJ. Interpretation biases and visual attention in the processing of ambiguous information in chronic pain. Eur J Pain 2020; 24:1242-1256. [PMID: 32223046 DOI: 10.1002/ejp.1565] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 03/12/2020] [Accepted: 03/16/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Theories propose that interpretation biases and attentional biases might account for the maintenance of chronic pain symptoms, but the interactions between these two forms of biases in the context of chronic pain are understudied. METHODS To fill this gap, 63 participants (40 females) with and without chronic pain completed an interpretation bias task that measures participants' interpretation styles in ambiguous scenarios and a novel eye-tracking task where participants freely viewed neutral faces that were given ambiguous pain/health-related labels (i.e. 'doctor', 'patient' and 'healthy people'). Eye movements were analysed with the Hidden Markov Models (EMHMM) approach, a machine-learning data-driven method that clusters people's eye movements into different strategy subgroups. RESULTS Adults with chronic pain endorsed more negative interpretations for scenarios related to immediate bodily injury and long-term illness than healthy controls, but they did not differ significantly in terms of their eye movements on ambiguous faces. Across groups, people who interpreted illness-related scenarios in a more negative way also focused more on the nose region and less on the eye region when looking at patients' and healthy people's faces and, to a lesser extent, doctors' faces. This association between interpretive and attentional processing was particularly apparent in participants with chronic pain. CONCLUSIONS In summary, the present study provided evidence for the interplay between multiple forms of cognitive biases. Future studies should investigate whether this interaction might influence subsequent functioning in people with chronic pain.
Collapse
Affiliation(s)
| | - Hin Suen
- Department of Psychology, The University of Hong Kong, Hong Kong
| | - Janet H Hsiao
- Department of Psychology, The University of Hong Kong, Hong Kong.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - Antoni B Chan
- Department of Computer Science, The City University of Hong Kong, Hong Kong
| | - Tom J Barry
- Department of Psychology, The University of Hong Kong, Hong Kong.,Institute of Psychiatry, King's College London, London, UK
| |
Collapse
|
78
|
Interpretation Bias in Online and Offline Social Environments and Associations with Social Anxiety, Peer Victimization, and Avoidance Behavior. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10097-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Abstract
Background
In face-to-face (offline) social situations a tendency, or bias, to negatively interpret ambiguous situations is consistently related to social anxiety. Although social interactions increasingly occur over the Internet (online), our understanding of cognitive processes in online social situations and how they relate to social anxiety, social experiences, and behavior, is limited.
Methods
In a sample of 324 young people (18–25 years), the current study addressed this gap in two ways: by simultaneously investigating online and offline interpretation bias in relation to social anxiety; and examining the extent to which online interpretation bias predicts peer victimization and avoidance.
Results
In line with hypotheses, online and offline interpretation bias each correlated positively with social anxiety; the offline interpretation bias-social anxiety association was stronger. Regression analyses revealed unique associations between online interpretation bias and online peer victimization and avoidance, after controlling for social anxiety and offline interpretation bias.
Discussion
Findings suggest that cognitive behavioral interventions for social anxiety could be optimized through eliciting and testing negative social beliefs related to online social settings.
Conclusions
The current study’s results indicate the importance of studying online interpretation bias to further understand social anxiety in online social environments.
Collapse
|
79
|
Abstract
Worry is common in children and adolescents, yet some youth experience excessive worries that persist over time and cause significant distress. Whilst the literature on worry and generalised anxiety disorder (GAD) in adults is well established, relatively less is known about the cognitive mechanisms underlying child and adolescent worry. An influential cognitive model of adult pathological worry (Hirsch and Matthews in Behav Res Therapy 50:636–646, 10.1016/j.brat.2012.06.007, 2012) proposes that negative information-processing biases, reduced executive functions, and verbal worry are critical in the aetiology of GAD in adults. The current systematic review investigated whether this cognitive model of worry could be extended to understand child and adolescent worry. Following a systematic search of the literature and screening for eligibility, 30 studies were identified. Evidence indicates that negative information-processing biases and reduced executive functions play an important role in worry and GAD in children and adolescents. However, evidence that children and adolescents experience verbal worry is inconclusive. Building upon Hirsch and Matthews' cognitive model (Behav Res Therapy 50:636–646, 10.1016/j.brat.2012.06.007, 2012), we propose a model of child and adolescent worry to provide a guiding framework for future research. We conclude that cognitive models of worry should incorporate a developmental framework in order to provide greater insight into the mechanisms uniquely associated with worry in children and adolescents and help to identify the cognitive processes to target for early interventions and treatments.
Collapse
|
80
|
Mobach L, Klein AM, Schniering CA, Hudson JL. Specificity of Dysfunctional Beliefs in Children with Social Anxiety Disorder: Effects of Comorbidity. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 51:389-396. [DOI: 10.1080/15374416.2019.1697930] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Lynn Mobach
- Centre for Emotional Health, Department of Psychology, Macquarie University
- Behavioural Science Institute, Radboud University
| | - Anke M. Klein
- Behavioural Science Institute, Radboud University
- Developmental Psychology, University of Amsterdam
| | | | - Jennifer L. Hudson
- Centre for Emotional Health, Department of Psychology, Macquarie University
| |
Collapse
|
81
|
Contributions of fixed mindsets and hopelessness to anxiety and depressive symptoms: A commonality analysis approach. J Affect Disord 2020; 261:245-252. [PMID: 31669923 DOI: 10.1016/j.jad.2019.10.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 09/09/2019] [Accepted: 10/14/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Fixed mindsets (beliefs that personal traits are unchangeable) show consistent associations with internalizing symptoms. However, the mindset-internalizing symptom link has previously been studied in isolation of other maladaptive cognitions that relate to internalizing symptoms. Thus, the unique contributions of mindsets to internalizing symptoms remains unclear. METHOD We used commonality analysis (CA), which yields unique and shared effects of independent variables on an outcome, to assess unique contributions of emotion and anxiety mindsets to anxiety and depression symptoms, relative to the contributions of hopelessness. Participants in two online studies (Ns=200, 430) self-reported depression and anxiety symptoms, hopelessness, and emotion and anxiety mindsets. RESULTS In Study 1, neither mindset type contributed unique variance to depression or anxiety beyond the contribution of hopelessness. In Study 2, emotion mindsets again explained no unique symptom variance. Anxiety mindsets uniquely contributed 2.0% and 6.5% of depression and anxiety variance, respectively-but far larger proportions of symptom variance (20.0%-60.9%) were contributed by hopelessness alone, variance shared by hopelessness and anxiety mindsets, and variance shared among hopelessness, anxiety mindsets, and emotion mindsets. LIMITATIONS The cross-sectional design precludes causal conclusions, and the non-referred adult samples may limit generalizability. DISCUSSION Mindsets contributed little unique variance to internalizing symptoms beyond hopelessness. Interventions teaching growth mindsets have been shown to reduce internalizing problem in past studies. However, these interventions might not necessarily operate by shaping mindsets; rather, they may affect symptom change by shaping closely-linked maladaptive cognitions-like hopelessness-with stronger ties to internalizing distress.
Collapse
|
82
|
Schwarz J, Schreiber F, Kühnemund M, Weber C, Stangier U, Melfsen S. [Cognition in children with social anxiety disorder experiencing stress]. ZEITSCHRIFT FUR KINDER- UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2020; 48:145-157. [PMID: 31920179 DOI: 10.1024/1422-4917/a000702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Cognition in children with social anxiety disorder experiencing stress Abstract. Empirical data on cognitions of children with social anxiety disorder (SAD) are inconclusive. Objective: The present study examines the significance of cognition in children with SAD. Method: Thirty children suffering from SAD and 30 control children free of diagnosis (HC) aged between 9 and 15 years took part in an experiment. Their cognition was assessed before, during, and after a stress-inducing social situation. The assessment method was a self-report measurement. Coping perception was also assessed. Results: Children with SAD did not report a higher level of negative or coping cognition than those in the HC group. An interaction was apparent on the positive cognition scale: Older children (11-12 or 13-15 years) with SAD reported less positive cognition than those in the HC group, and younger children with SAD (9-10 years) reported more than those in the HC group. No group differences were found for perceived coping. Conclusions: The findings are important to the cognitive model and for the psychological treatment of SAD in children.
Collapse
Affiliation(s)
- Judith Schwarz
- Abteilung für Klinische Psychologie und Psychotherapie, Goethe-Universität Frankfurt am Main, Deutschland
| | - Franziska Schreiber
- Abteilung für Klinische Psychologie und Psychotherapie, Goethe-Universität Frankfurt am Main, Deutschland
| | - Martina Kühnemund
- Abteilung für Klinische Psychologie und Psychotherapie, Goethe-Universität Frankfurt am Main, Deutschland
| | - Christoph Weber
- Institut für mathematische Stochastik, Otto-von-Guericke-Universität Magdeburg, Deutschland
| | - Ulrich Stangier
- Abteilung für Klinische Psychologie und Psychotherapie, Goethe-Universität Frankfurt am Main, Deutschland
| | - Siebke Melfsen
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Psychiatrische Universitätsklinik Zürich, Schweiz
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Zentrum für Psychische Gesundheit, Universitätsklinikum Würzburg, Deutschland
| |
Collapse
|
83
|
Murphy LK, Rights JD, Ricciuto A, Church PC, Ahola Kohut S. Biopsychosocial Correlates of Presence and Intensity of Pain in Adolescents With Inflammatory Bowel Disease. Front Pediatr 2020; 8:559. [PMID: 33014942 PMCID: PMC7506075 DOI: 10.3389/fped.2020.00559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 07/31/2020] [Indexed: 12/11/2022] Open
Abstract
Background: There is growing consensus that pain in pediatric inflammatory bowel disease (IBD) is not fully explained by disease-related processes. However, previous studies have largely measured individual biological, psychological, or social risk factors for pain in isolation. Further, not all youth with IBD presenting to clinic will report presence of pain, and those who do vary in their reports of pain intensity. This study therefore extends prior research by determining biopsychosocial correlates of both presence and intensity of pain in adolescents with IBD, in order to inform targeted pain management intervention approaches. Methods: Adolescents with IBD followed at SickKids, Toronto, and their parents were consecutively enrolled from outpatient clinic. IBD characteristics (diagnosis, time since diagnosis, patient-reported disease activity) were collected. Adolescents reported on current pain (NRS-10), internalizing symptoms (Strengths and Difficulties Questionnaire), and pain catastrophizing (Pain Catastrophizing Scale-Child). Parents reported on protective responses to child pain (Adult Responses to Child Pain) and pain catastrophizing (Pain Catastrophizing Scale-Child). Hurdle models were conducted to examine predictors of presence and intensity of pain in the same model. Biological (patient-reported disease activity, IBD diagnosis subtype, illness duration), psychological (internalizing symptoms, pain catastrophizing), and social (parent pain catastrophizing, parent protective responses) factors were entered as predictors, adjusting for age and sex. Results: Participants included 100 adolescents (12-18; Mean = 15 years) with IBD (60% Crohn's Disease, 40% Ulcerative Colitis or IBD-unclassified) and 76 parents. The majority of the sample was in clinical remission or reported minimal symptoms. Half of participants reported no current pain; for those reporting pain, intensity ranged 1-7 (M = 3.43, SD = 1.98). Disease activity (OR = 53.91, p < 0.001) and adolescent internalizing symptoms (OR = 7.62, p = 0.03) were significant predictors of presence of pain. Disease activity (RR = 1.37, p = 0.03) and parent protective responses (RR = 1.45, p = 0.02) were significant predictors of intensity of pain. Conclusions: Results suggest that the experience of pain in pediatric IBD is biopsychosocially determined. Patient-reported disease activity and internalizing symptoms predicted presence of pain, while disease activity and parent protective responses predicted intensity of pain. While medical intervention in pediatric IBD is focused on disease management, results suggest that depression/anxiety symptoms as well as parent protective responses may be important targets of pain management interventions in pediatric IBD.
Collapse
Affiliation(s)
- Lexa K Murphy
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Jason D Rights
- Department of Psychology, University of British Columbia, Vancouver, BC, United States
| | - Amanda Ricciuto
- Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada.,SickKids Research Institute, Toronto, ON, Canada.,Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Peter C Church
- Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Sara Ahola Kohut
- Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada.,SickKids Research Institute, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
84
|
Validating a mobile eye tracking measure of integrated attention bias and interpretation bias in youth. COGNITIVE THERAPY AND RESEARCH 2019; 44:668-677. [PMID: 33518843 DOI: 10.1007/s10608-019-10071-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Introduction This study sought to validate a real-world speech task designed to assess attention and interpretation bias in an integrated and ecologically valid manner. Methods Thirty adolescent girls gave a speech in front of an emotionally ambiguous judge and a positive judge while wearing mobile eye tracking glasses to assess how long they looked at each judge (i.e., attention bias). They also reported their interpretations of the ambiguous judge and distress associated with the task (i.e., interpretation bias). Results These task-based measures correlated with self-report of interpretation bias and mother-report of attentional control, demonstrating convergent validity. They did not correlate with frustration or high intensity pleasure, indicating discriminant validity. Task-based measures of interpretation bias also showed predictive and incremental validity in relation to child distress during the speech. Discussion This proof-of-concept study demonstrates the initial validity of a novel task designed to assess attention and interpretation bias as they manifest in real-world social interactions.
Collapse
|
85
|
Steinman SA, Portnow S, Billingsley AL, Zhang D, Teachman BA. Threat and benign interpretation bias might not be a unidimensional construct. Cogn Emot 2019; 34:783-792. [PMID: 31650889 DOI: 10.1080/02699931.2019.1682973] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The tendency for individuals to interpret ambiguous information in a threatening way is theorised to maintain anxiety disorders. Recent findings suggest that positive and negative interpretation biases may have unique effects. This study tested the relationships between threat and benign biases with state and trait anxiety and quality of life, and whether individual differences moderate these relationships. N = 699 individuals with elevated trait anxiety symptoms completed web-based measures of interpretation bias, trait anxiety, state anxiety, and quality of life. Results demonstrated that threat interpretations predicted state anxiety, trait anxiety, and quality of life. Benign interpretations also predicted quality of life. However, benign interpretations only weakly (or not at all) predicted state and trait anxiety. Individual differences (e.g. gender, race, ethnicity, age) did not moderate findings. Results emphasise the need to consider benign and threat biases separately, both in cognitive models of anxiety and experimental designs.
Collapse
Affiliation(s)
- Shari A Steinman
- Department of Psychology, West Virginia University, Morgantown, USA
| | - Sam Portnow
- Government Accountability Office, Alexandria, USA
| | | | - Diheng Zhang
- Department of Psychology, University of Arizona, Tucson, USA
| | | |
Collapse
|
86
|
Assessing the content specificity of interpretation biases in community adolescents with persistent and interfering pain. Pain 2019; 161:319-327. [DOI: 10.1097/j.pain.0000000000001723] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
87
|
Effortful control, interpretation biases, and child anxiety symptom severity in a sample of children with anxiety disorders. J Anxiety Disord 2019; 67:102136. [PMID: 31494512 PMCID: PMC6750729 DOI: 10.1016/j.janxdis.2019.102136] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 08/20/2019] [Accepted: 08/25/2019] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Effortful control-the ability to inhibit impulsive reactions in favor of more adaptive responses-is negatively related to child anxiety severity. One potential explanation is that greater effortful control may "slow down" automatic, threat-laden interpretations, thereby lowering children's anxiety. The present investigation tested this hypothesis by examining associations between effortful control (and its subcomponents) and anxiety symptom severity, mediated by interpretation biases, in a diverse sample of clinically anxious youth. METHOD Participants (N = 105; Mage = 10.09 years, SD = 1.22; 56.7% female; 49% ethnic minority) completed a diagnostic interview; self-report measures of temperament, anxiety, and interpretation biases; a performance-based measure of interpretation biases; and a parent-child interaction task for which an index of behavioral anxiety was computed. RESULTS Significant indirect effects were found for effortful control, attentional control, and inhibitory control on child self-reported anxiety severity by way of self-reported (but not behaviorally-indexed) interpretation biases. Models predicting behaviorally-indexed child anxiety severity were not significant. DISCUSSION Greater effortful control may result in enhanced attentional capacities that allow children to assess automatic cognitions more objectively, potentially lowering their anxiety. Future work should evaluate whether targeting malleable temperamental constructs, such as effortful control, leads to clinically meaningful reductions in interpretation biases and child anxiety symptoms.
Collapse
|
88
|
Mobach L, Rinck M, Becker ES, Hudson JL, Klein AM. Content-Specific Interpretation Bias in Children with Varying Levels of Anxiety: The Role of Gender and Age. Child Psychiatry Hum Dev 2019; 50:803-814. [PMID: 30879167 PMCID: PMC6737177 DOI: 10.1007/s10578-019-00883-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The current study examined whether children varying in their levels of social anxiety, separation anxiety and spider fear exhibit a negative interpretation bias specific for their fears. Furthermore, age and gender were assessed as moderators of this relation. Children (N = 603) of the age of 7-12 years were asked to solve ambiguous scenarios reflecting social threat, separation threat or spider threat. Children's levels of anxiety were assessed with self-report questionnaires. Results indicated that children scoring higher on self-reported social anxiety, separation anxiety or spider fear, displayed a negative interpretation bias for the threat-scenarios pertaining to their specific anxiety or fear, even after controlling for comorbidity with other anxiety subtypes. Contrary to our hypotheses, we did not find moderating effects of age or gender. These results indicate that even in a community sample, content-specificity of negative interpretation biases is present.
Collapse
Affiliation(s)
- Lynn Mobach
- Department of Psychology, Behavioural Science Institute, Radboud University, Montessorilaan, 6525 HR, Nijmegen, The Netherlands.
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia.
| | - Mike Rinck
- Department of Psychology, Behavioural Science Institute, Radboud University, Montessorilaan, 6525 HR, Nijmegen, The Netherlands
| | - Eni S Becker
- Department of Psychology, Behavioural Science Institute, Radboud University, Montessorilaan, 6525 HR, Nijmegen, The Netherlands
| | - Jennifer L Hudson
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Anke M Klein
- Department of Psychology, Behavioural Science Institute, Radboud University, Montessorilaan, 6525 HR, Nijmegen, The Netherlands
- Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
89
|
Content-specific interpretation biases in clinically anxious children. Behav Res Ther 2019; 121:103452. [DOI: 10.1016/j.brat.2019.103452] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 07/26/2019] [Accepted: 08/09/2019] [Indexed: 11/19/2022]
|
90
|
Van Bockstaele B, Notebaert L, Salemink E, Clarke PJF, MacLeod C, Wiers RW, Bögels SM. Effects of interpretation bias modification on unregulated and regulated emotional reactivity. J Behav Ther Exp Psychiatry 2019; 64:123-132. [PMID: 31002978 DOI: 10.1016/j.jbtep.2019.03.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/15/2019] [Accepted: 03/28/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Although induced changes in interpretation bias can lead to reduced levels of stress reactivity, results are often inconsistent. One possible cause of the inconsistencies in the effects of interpretation bias modification (IBM) on stress reactivity is the degree to which participants engaged in emotion regulation while being exposed to stressors. In this study, we distinguished between the effects of IBM on natural, unregulated stress reactivity and the effects of IBM on people's ability to up- or downregulate this stress reactivity. METHOD Both in the context of general anxiety (Experiment 1, N = 59) and social anxiety (Experiment 2, N = 54), we trained participants to interpret ambiguous scenarios in either a positive or a negative manner, and we assessed the effects on unregulated and regulated stress reactivity. RESULTS Although we found relatively consistent training-congruent changes in interpretation bias in both experiments, these changes had no effect on either unregulated or regulated stress reactivity. LIMITATIONS In both experiments, we used healthy student samples and relatively mild emotional stressors. CONCLUSIONS In line with previous research, our findings suggest that the effects of IBM on unregulated stress reactivity may be small and inconsistent. Differences in the extent to which participants engaged in emotion regulation during stressor exposure are unlikely to account for these inconsistencies.
Collapse
Affiliation(s)
- Bram Van Bockstaele
- ADAPT lab, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WT, Amsterdam, the Netherlands; Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WT, Amsterdam, the Netherlands.
| | - Lies Notebaert
- School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.
| | - Elske Salemink
- ADAPT lab, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WT, Amsterdam, the Netherlands; Department of Clinical Psychology, Utrecht University, Utrecht, P.O. Box 80140, 3508 TC, the Netherlands.
| | - Patrick J F Clarke
- School of Psychology and Speech Pathology, Curtin University, Kent St, WA, 6102, Bentley, Australia.
| | - Colin MacLeod
- School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.
| | - Reinout W Wiers
- ADAPT lab, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WT, Amsterdam, the Netherlands.
| | - Susan M Bögels
- ADAPT lab, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WT, Amsterdam, the Netherlands; Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WT, Amsterdam, the Netherlands.
| |
Collapse
|
91
|
Maratos FA, Pessoa L. What drives prioritized visual processing? A motivational relevance account. PROGRESS IN BRAIN RESEARCH 2019; 247:111-148. [PMID: 31196431 DOI: 10.1016/bs.pbr.2019.03.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Emotion is fundamental to our being, and an essential aspect guiding behavior when rapid responding is required. This includes whether we approach or avoid a stimulus, and the accompanying physiological responses. A common tenet is that threat-related content drives stimulus processing and biases visual attention, so that rapid responding can be initiated. In this paper, it will be argued instead that prioritization of threatening stimuli should be encompassed within a motivational relevance framework. To more fully understand what is, or is not, prioritized for visual processing one must, however, additionally consider: (i) stimulus ambiguity and perceptual saliency; (ii) task demands, including both perceptual load and cognitive load; and (iii) endogenous/affective states of the individual. Combined with motivational relevance, this then leads to a multifactorial approach to understanding the drivers of prioritized visual processing. This accords with current recognition that the brain basis allowing for visual prioritization is also multifactorial, including transient, dynamic and overlapping networks. Taken together, the paper provides a reconceptualization of how "emotional" information prioritizes visual processing.
Collapse
Affiliation(s)
- Frances Anne Maratos
- Department of Psychology and Human Sciences Research Centre, University of Derby, Derby, United Kingdom.
| | - Luiz Pessoa
- Department of Psychology and Maryland Neuroimaging Center, University of Maryland, College Park, MD, United States
| |
Collapse
|
92
|
Hur J, Stockbridge MD, Fox AS, Shackman AJ. Dispositional negativity, cognition, and anxiety disorders: An integrative translational neuroscience framework. PROGRESS IN BRAIN RESEARCH 2019; 247:375-436. [PMID: 31196442 PMCID: PMC6578598 DOI: 10.1016/bs.pbr.2019.03.012] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
When extreme, anxiety can become debilitating. Anxiety disorders, which often first emerge early in development, are common and challenging to treat, yet the underlying mechanisms have only recently begun to come into focus. Here, we review new insights into the nature and biological bases of dispositional negativity, a fundamental dimension of childhood temperament and adult personality and a prominent risk factor for the development of pediatric and adult anxiety disorders. Converging lines of epidemiological, neurobiological, and mechanistic evidence suggest that dispositional negativity increases the likelihood of psychopathology via specific neurocognitive mechanisms, including attentional biases to threat and deficits in executive control. Collectively, these observations provide an integrative translational framework for understanding the development and maintenance of anxiety disorders in adults and youth and set the stage for developing improved intervention strategies.
Collapse
Affiliation(s)
- Juyoen Hur
- Department of Psychology, University of Maryland, College Park, MD, United States.
| | | | - Andrew S Fox
- Department of Psychology, University of California, Davis, CA, United States; California National Primate Research Center, University of California, Davis, CA, United States
| | - Alexander J Shackman
- Department of Psychology, University of Maryland, College Park, MD, United States; Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD, United States; Maryland Neuroimaging Center, University of Maryland, College Park, MD, United States.
| |
Collapse
|
93
|
Yu M, Westenberg PM, Li W, Wang J, Miers AC. Cultural evidence for interpretation bias as a feature of social anxiety in Chinese adolescents. ANXIETY STRESS AND COPING 2019; 32:376-386. [PMID: 30924366 DOI: 10.1080/10615806.2019.1598556] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background and Objectives: Interpretation bias (IB), defined as the tendency to interpret ambiguous social situations in a threatening manner, has increasingly been studied in children and adolescents. Compared to Western samples, the relation between IB and social anxiety in Chinese youth has received little attention. The present study was to mainly examine the relationship between IB and social anxiety among Chinese adolescents. Design: Cross-sectional design was utilized. Methods: IB, measured by the Adolescents' Interpretation Bias Questionnaire (AIBQ), and social anxiety were surveyed among a group of high socially anxious Chinese adolescents (n = 25) and a control group (n = 29). Participants were asked to rate the likelihood of interpretations coming to mind in social/non-social situations and to choose the most believable interpretation. Results: The high social anxiety group had more negative interpretations and beliefs in social situations, and the interpretation bias was particular to social anxiety versus depression. Additionally, the cognitive content-specificity hypothesis was supported; the high anxious group showed interpretation bias in social situations, but didn't have more negative interpretations of non-social situations, after controlling for depression. Conclusions: The present study yielded comparable findings as found in Western samples regarding the relation between IB and social anxiety.
Collapse
Affiliation(s)
- Meng Yu
- a Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology , Beijing Normal University , Beijing , P.R. People's Republic of China.,b Institute of Psychology, Developmental and Educational Psychology Unit , Leiden University , Leiden , Netherlands
| | - P Michiel Westenberg
- b Institute of Psychology, Developmental and Educational Psychology Unit , Leiden University , Leiden , Netherlands
| | - Wei Li
- c College of Educational Science and Technology , Northwest Minzu University , Lanzhou , P.R. People's Republic of China
| | - Jianping Wang
- a Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology , Beijing Normal University , Beijing , P.R. People's Republic of China
| | - Anne C Miers
- b Institute of Psychology, Developmental and Educational Psychology Unit , Leiden University , Leiden , Netherlands
| |
Collapse
|
94
|
Neil L, White H, Warren K, Pellicano E. Anxiety and Interpretation of Ambiguity in Autistic Children, Typical Children and Their Mothers. J Autism Dev Disord 2019; 49:1035-1047. [PMID: 30406913 PMCID: PMC6394784 DOI: 10.1007/s10803-018-3781-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Anxiety is highly prevalent in autistic children. Yet interpretation biases implicated in anxiety in non-autistic individuals have received little research attention in this group. Twenty-two autistic children and 25 typical children completed an ambiguous scenarios interview and questionnaire-based measures of anxiety. A subsample of mothers completed parent-report and adult relevant versions of the interview and anxiety questionnaires. Autistic children self-reported similar interpretations of ambiguous scenarios, and similar levels of anxiety, to their typical peers. In contrast, mothers of autistic children reported greater levels of anxiety, and more negative interpretations of ambiguous scenarios in both their children and themselves, relative to mothers of typical children. These data highlight the importance of including autistic children's self-reports when measuring and treating anxiety.
Collapse
Affiliation(s)
- Louise Neil
- Centre for Research in Autism and Education (CRAE), UCL Institute of Education, University College London, London, UK.
- Department of Clinical, Educational, and Health Psychology, University College London, 26 Bedford Way, London, WC1H 0AP, UK.
| | - Hannah White
- Centre for Research in Autism and Education (CRAE), UCL Institute of Education, University College London, London, UK
| | - Katy Warren
- Centre for Research in Autism and Education (CRAE), UCL Institute of Education, University College London, London, UK
| | - Elizabeth Pellicano
- Centre for Research in Autism and Education (CRAE), UCL Institute of Education, University College London, London, UK
- Department of Educational Studies, Macquarie University, Sydney, Australia
| |
Collapse
|
95
|
Klein AM, Bakens R, van Niekerk RE, Ouwens MA, Rapee RM, Bögels SM, Becker ES, Rinck M. The relation between generalized anxiety disorder symptoms and content-specific interpretation biases for auditory stimuli in children. J Behav Ther Exp Psychiatry 2018; 61:121-127. [PMID: 29990681 DOI: 10.1016/j.jbtep.2018.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 06/22/2018] [Accepted: 06/29/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Cognitive theories of fear suggest that biases in interpretation are content-specific: Fearful children should only interpret materials negatively if they are specifically related to the content of their fear. So far, there are only a few studies available that report on this postulated content-specificity of interpretation processes in childhood fear. The goal of this study was to examine interpretation bias and its content-specificity in children with varying levels of Generalized Anxiety Disorder (GAD) symptoms. METHODS In an Auditory Interpretation Task (AIT), two words that differ by one phoneme are acoustically blended so that one can hear only one of the words. In the current AIT, we included GAD-related blends, negatively-valenced fear-related blends and positive blends. Multiple-choice (n = 371) or open-ended (n = 295) responses were collected from 666 nonclinical children between 7 and 13 years of age. RESULTS Children with higher levels of self-reported GAD showed significantly more negative interpretations of ambiguous GAD-related blends in the multiple-choice version than children with lower levels of GAD. There were no differences when interpreting the other ambiguous blends. This result was not found with the open-ended version. LIMITATIONS Effects were relatively small, some GAD-stimuli were sub-optimal, and the task was administered in a classroom setting. Even though we ensured that all children were able to hear all words clearly, this may have impacted the results. CONCLUSIONS The findings only partly support the idea that fearful children display cognitive biases specific for fear-relevant stimuli, and more research is needed to replicate the results and test the usability of the AIT.
Collapse
Affiliation(s)
- Anke M Klein
- Behavioural Science Institute, Radboud University Nijmegen, the Netherlands; University of Amsterdam, the Netherlands.
| | - Rian Bakens
- Behavioural Science Institute, Radboud University Nijmegen, the Netherlands
| | | | | | - Ronald M Rapee
- Centre for Emotional Health, Macquarie University, Sydney, Australia
| | | | - Eni S Becker
- Behavioural Science Institute, Radboud University Nijmegen, the Netherlands
| | - Mike Rinck
- Behavioural Science Institute, Radboud University Nijmegen, the Netherlands
| |
Collapse
|
96
|
Biases in Interpretation as a Vulnerability Factor for Children of Parents With an Anxiety Disorder. J Am Acad Child Adolesc Psychiatry 2018; 57:462-470. [PMID: 29960691 DOI: 10.1016/j.jaac.2018.04.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 02/27/2018] [Accepted: 05/07/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Children of parents with an anxiety disorder have a higher risk of developing an anxiety disorder than children of parents without an anxiety disorder. Parental anxiety is not regarded as a causal risk factor itself, but is likely to be mediated via other mechanisms, for example via cognitive factors. We investigated whether children of parents with an anxiety disorder would show an interpretation bias corresponding to the diagnosis of their parent. We also explored whether children's interpretation biases were explained by parental anxiety and/or children's levels of anxiety. METHOD In total, 44 children of parents with a panic disorder (PD), 27 children of parents with a social anxiety disorder (SAD), 7 children of parents with SAD/PD, and 84 children of parents without an anxiety disorder (controls) participated in this study. Parents and children filled out the Screen for Child Anxiety Related Disorders (SCARED) questionnaire, and children performed two ambiguous scenario tasks: one with and one without video priming. RESULTS Children of parents with PD displayed significantly more negative interpretations of panic scenarios and social scenarios than controls. Negative interpretations of panic scenarios were explained by parental PD diagnosis and children's anxiety levels. These effects were not found for children of parents with SAD. Priming did not affect interpretation. CONCLUSION Our results showed that children of parents with PD have a higher chance of interpreting ambiguous situations more negatively than children of parents without anxiety disorders. More research is needed to study whether this negative bias predicts later development of anxiety disorders in children.
Collapse
|
97
|
Klein AM, Salemink E, de Hullu E, Houtkamp E, Papa M, van der Molen M. Cognitive Bias Modification Reduces Social Anxiety Symptoms in Socially Anxious Adolescents with Mild Intellectual Disabilities: A Randomized Controlled Trial. J Autism Dev Disord 2018; 48:3116-3126. [PMID: 29680962 PMCID: PMC6096836 DOI: 10.1007/s10803-018-3579-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The goal of this study was to examine the effects of Cognitive Bias Modification training for Interpretation (CBM-I) in socially anxious adolescents with Mild Intellectual Disabilities (MID). A total of 69 socially anxious adolescents with MID were randomly assigned to either a positive or a neutral control-CMB-I-training. Training included five sessions in a 3-week period, and each session consisted of 40 training items. Adolescents in the positive training group showed a significant reduction in negative interpretation bias on the two interpretation bias tasks after training compared to adolescents in the control-training group. Furthermore, in contrast to the control-training group, adolescents in the positive training reported a significant reduction of their social anxiety symptoms 10 weeks post-training.
Collapse
Affiliation(s)
- Anke M Klein
- Clinical, Neuro, and Developmental Psychology, VU Amsterdam, Amsterdam, The Netherlands.
- Developmental Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, Amsterdam, The Netherlands.
| | - Elske Salemink
- Developmental Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, Amsterdam, The Netherlands
| | - Eva de Hullu
- Clinical Psychology, Open University, Heerlen, The Netherlands
| | - Esther Houtkamp
- Clinical, Neuro, and Developmental Psychology, VU Amsterdam, Amsterdam, The Netherlands
| | - Marlissa Papa
- Clinical, Neuro, and Developmental Psychology, VU Amsterdam, Amsterdam, The Netherlands
| | - Mariët van der Molen
- Clinical, Neuro, and Developmental Psychology, VU Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
98
|
Lau JYF, Heathcote LC, Beale S, Gray S, Jacobs K, Wilkinson N, Crombez G. Cognitive Biases in Children and Adolescents With Chronic Pain: A Review of Findings and a Call for Developmental Research. THE JOURNAL OF PAIN 2018; 19:589-598. [PMID: 29374535 DOI: 10.1016/j.jpain.2018.01.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 12/22/2017] [Accepted: 01/03/2018] [Indexed: 12/30/2022]
Abstract
Cognitive biases that emphasize bodily harm, injury, and illness could play a role in the maintenance of chronic pain by facilitating fear and avoidance. Whereas extensive research has established attention, interpretation, and memory biases in adults with chronic pain, far less is known about these same biases in children and adolescents with pain. Studying cognitive biases in attention, interpretation, and memory in relation to pain occurring in youth is important because youth is a time when pain can first become chronic, and when relationships between cognitive biases and pain outcomes emerge and stabilize. Thus, youth potentially offers a time window for the prevention of chronic pain problems. In this article, we summarize the growing corpus of data that have measured cognitive biases in relation to pediatric pain. We conclude that although biases in attention, interpretation, and memory characterize children and adolescents with varying pain experiences, questions regarding the direction, magnitude, nature, and role of these biases remain. We call for independent extension of cognitive bias research in children and adolescents, using well powered longitudinal studies with wide age ranges and psychometrically sound experimental measures to clarify these findings and any developmental trends in the links between cognitive biases and pain outcomes. PERSPECTIVE This article provides a rationale for the theoretical and practical importance of studying the role of cognitive biases in children and adolescents with chronic pain, which has to date, been relatively understudied. Existing findings are reviewed critically, and recommendations for future research are offered.
Collapse
Affiliation(s)
- Jennifer Y F Lau
- Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Lauren C Heathcote
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University Medical School, Stanford, California
| | - Sarah Beale
- Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Suzy Gray
- Paediatric Rheumatology and Chronic Pain Service, Evelina London Children's Hospital, Guys and St. Thomas's Foundation Trust, London, United Kingdom
| | - Konrad Jacobs
- Oxford Centre for Children and Young People in Pain (OXCYPP) and Department of Children's Psychological Medicine, Oxford University Hospitals, Oxford, United Kingdom
| | - Nick Wilkinson
- Paediatric Rheumatology and Chronic Pain Service, Evelina London Children's Hospital, Guys and St. Thomas's Foundation Trust, London, United Kingdom
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Ghent Health Psychology Lab, Ghent University, Ghent, Belgium; Centre for Pain Research, University of Bath, Bath, United Kingdom
| |
Collapse
|