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

Engagement and Disengagement: From the Basic Science of Emotion Regulation to an Anxiety Spectrum

Emotion regulation strategies vary in depth of processing. For instance, reappraisal requires greater engagement than distraction. This affects short-term and long-term response to stimuli. In this review, I describe how the "engagement-disengagement dimension" improves understanding of emotion regulation in normative contexts and in internalizing psychopathology. Part 1 reviews work from my laboratory and others, suggesting that relatively disengaged emotion regulation strategies (e.g., distraction), may have short-term benefits (e.g., faster implementation), but may come with long-term costs (e.g., increased processing of stimuli at subsequent encounter). Therefore, depending on the desired outcome, the adaptive selection of an emotion regulation strategy will be determined by extent of emotional engagement-disengagement. In Part 2, I describe how individuals with more comorbid internalizing psychopathology (e.g., multiple anxiety and depressive diagnoses) are characterized by disengagement from negative stimuli as measured by the late positive potential (LPP). In addition, I introduce a brain profile I have termed, HARM-A (heightened "alarm" and reduced motivated attention), which is characterized by a combination of heightened "alarm" (i.e., increased amygdala) and emotional disengagement (i.e., blunted LPPs) in response to negative stimuli. HARM-A prospectively predicts worse outcomes over 2 years in a mixed internalizing sample. As such, chronic disengagement from negative stimuli appears to contribute to more comorbid and more severe internalizing psychopathology. Overall, emotional disengagement can be beneficial in the short term but may be poorly suited to emotional coping in the longer term.

Childhood behavioral inhibition and overcontrol: Relationships with cognitive functioning, error monitoring, anxiety and obsessive-compulsive symptoms

Anxiety and obsessive-compulsive disorders are common childhood psychiatric disorders. Behavioral inhibition (BI) is a widely studied risk factor for anxiety. Less is known about overcontrol, a related behavioral phenotype characterized by concern for errors, perfectionism, and inflexibility and also associated with anxiety and obsessive-compulsive disorder. Both BI and overcontrol show associations with aberrant cognitive control and neural error responding (via the error-related negativity; ERN) yet it is unknown whether each imparts differential risk. Understanding whether overcontrol demonstrates independent associations from BI with cognitive functioning, neural error monitoring, and childhood anxiety and obsessive-compulsive presentations could aid in identifying a novel mechanistic treatment target. We assessed BI, overcontrol, cognitive functioning and psychopathology in a cross-sectional sample of 5-6 year old children (N = 126). Children completed an electroencephalogram (EEG) to assess the ERN. Overcontrol was associated with worse cognitive shifting, worse inhibitory control and higher anxiety and obsessive-compulsive symptoms, beyond BI. BI was associated with worse cognitive shifting, better inhibitory control and higher anxiety symptoms, beyond overcontrol. When assessed simultaneously, only overcontrol demonstrated a significant relationship with a blunted ERN. Moreover, overcontrol mediated (cross-sectionally) the well-established relationship between ERN and anxiety and obsessive-compulsive symptoms. BI and overcontrol impart differential risk for child cognitive functioning and anxiety while overcontrol demonstrates additional risk for aberrant neural error monitoring, anxiety and obsessive-compulsive presentations. Overcontrol may also be a mechanistic pathway between the ERN and transdiagnostic anxiety and obsessive-compulsive symptoms. Overcontrol may be a target warranted for early-childhood intervention in anxiety and OCD.

Temperamental risk for anxiety: emerging work on the infant brain and later neurocognitive development

Behavioral inhibition (BI), an infant temperament characterized by distress to novelty, is amongst the strongest early risk markers for future anxiety. In this review, we highlight three ways that recent research elucidates key details about the pathophysiology of anxiety in individuals with BI. First, atypical amygdala connectivity during infancy may be related to BI. Second, developmental shifts in cognitive control may portend risk for anxiety for children with BI. Lastly, distinct cognitive control processes moderate the BI-anxiety relation in different ways. Studying the intersection of these three streams of work may inform prevention or intervention work.

Validation of the Italian Version of the Behavioral Inhibition Questionnaire (BIQ) for Preschool Children

Behavioral Inhibition (BI) is a temperamental trait characterized by fear and wariness in reaction to new and unfamiliar stimuli, both social and non-social. BI has been recognized as possible forerunner of anxiety disorders, especially social anxiety and phobia; therefore, its assessment is clinically relevant. The present study aimed to examine the psychometric properties of the Italian adaptation of the Behavioral Inhibition Questionnaire (BIQ), which measures BI in preschool children. The BIQ was completed by 417 Italian parents (230 mothers, 187 fathers) of 270 preschoolers aged 3-5. Confirmatory factor analysis showed a good internal validity: the factorial structure was corresponding to the original six-factor version. Results showed excellent internal consistency, significant item-total correlations, good inter-rater reliability, convergent validity (by correlating the BIQ with the Italian Questionnaires of Temperament-QUIT, the Anxiety-Shy Conner's Scale and the Laboratory Temperament Assessment Battery) and discriminant validity (i.e., no correlation with Conners' ADHD scale). Significant correlations emerged between BI indexes and total BIQ scores of parents and maternal (but not paternal) versions of the questionnaire. Altogether, the results are promising and consistent with previous validation studies, suggesting the BIQ as a reliable and valid measure for evaluating parents' perception of BI in Italian preschoolers.