Genetic influences on anxiety in children: what we've learned and where we're heading

Validating the questionnaire of achievement of developmental task (QADT) to measure achieving mental wellness in school-aged children

Introduction

This article presents a verification of the factor structure and validation of the Questionnaire of Achievement of Developmental Task (QADT), designed to measure children's social expectations in early childhood. Three tasks, important from the point of view of both children's functioning at a given life stage and preparation for the next developmental phase, were selected. These are school skills, cooperation with others and a sense of competence. The research aimed to verify the tool's psychometric validity and establish relationships between developmental tasks and indicators of children's mental health.

Method

The study was conducted in primary school's 4th, 5th and 6th grades (N = 453). The QADT, Brief Multidimensional Students' Life Satisfaction Scale and Center for Epidemiological Studies Depression Scale for Children were used.

Results

The tool shows sufficient validity and reliability. The hypothesis regarding associations between the level of developmental task completion and life satisfaction and depressive symptoms was also confirmed.

Conclusions

The QADT tool can be used in scientific research. This work contributes to the growing body of literature on factors influencing children's mental health and underscores the importance of measuring social expectations of children in early childhood. It also highlights the need to consider developmental tasks in clinical practice and interventions to improve children's mental health. Ultimately, the findings of this study can inform the development of effective preventive and intervention strategies to promote children's mental health and well-being.

The Role of Parental Verbal Threat Information in Children's Fear Acquisition: A Systematic Review and Meta-analysis

Children can acquire fears of novel stimuli as a result of listening to parental verbal threat information about these stimuli (i.e., instructional learning). While empirical studies have shown that learning via parental information occurs, the effect size of parental verbal threat information on child fear of a novel stimulus has not yet been measured in a meta-analysis. We conducted a systematic review and meta analysis to assess the effect of parents' verbal statements on their children's fear acquisition. Additionally, we explored potential moderators of this effect, namely, parent and child anxiety levels, as well as child age. WebOfScience, Pubmed, Medline, and PsycINFO were used to identify eligible studies that assessed children's (30 months to 18 years old) fear of novel stimuli after being exposed to parental verbal threat information. We selected 17 studies for the meta-analysis and 18 for the systematic review. The meta-analysis revealed a significant causal effect of parental verbal threat information on children's fear reaction towards novel stimuli [g = 1.26]. No evidence was found for a moderation of verbal learning effects, neither by child or parent anxiety levels nor by child age. The effect of parents' verbal threat information on children's fear of novel stimuli is large and not dependent on anxiety levels or child age.

Family risk factors in the acquisition of anxiety: Behavioral inhibition and Social Fear Learning from Parents

Anxiety runs in families, likely reflecting shared genetic risk and shared exposure to signals of threat and fear messaging. Children begin to internalize these signals from the earliest months of life, providing a causal or treatment mechanism that is tractable to intervention. The data suggest that while temperamentally fearful children differentially respond to parental verbal and nonverbal signaling, the impact may be more powerful prior to early childhood.

The Effect of CRHBP rs10062367 Polymorphism and Parenting Styles on Internalizing Problems in Preschoolers: The Moderating Effect of Sensory Processing Sensitivity

The present study aimed to examine how CRHBP rs10062367 polymorphism interacted with parenting styles and sensory processing sensitivity (SPS) to impact on preschoolers' internalizing problems. A total of 446 preschoolers (Mage = 4.55, SD = 1.07) participated in the study and their saliva were extracted to genotype the CRHBP rs10062367 polymorphism, and their parents were invited to complete a battery of questionnaires to assess parenting styles, preschoolers' SPS, and internalizing problems. Results indicated that high SPS preschoolers with A allele exhibited fewer internalizing problems under the condition of positive parenting while they exhibited more internalizing problems under the condition of negative parenting. The findings provide support for the Differential Susceptibility Model/Biological Sensitivity to Context Theory that A allele of rs10062367 and high SPS might be the "susceptibility markers" of children to environments.

"Covid-19 is dangerous": The role of parental verbal threat information on children's fear of Covid-19

INTRODUCTION

Theoretical and empirical evidence suggests that the effect of parental verbal threat information on the offspring's fear acquisition of novel stimuli may be causal. The current study investigated this verbal fear acquisition pathway from parents to children in the unique context of Covid-19 as a novel environmental threat for parents and children.

METHODS

Using an online cross-sectional survey, we collected data about fear of Covid-19, parent-child communication, parental anxiety, and child temperament, in the period between June 11th 2020 and May 28th 2021. Participants were 8 to 18-year-old children (N = 195; Mage  = 14.23; 113 girls) and their parents (N = 193; Mage  = 47.82; 146 mothers) living in the Netherlands.

RESULTS

Children of parents with stronger Covid-19 fears also reported stronger Covid-19 fears. Moreover, parents who were more fearful of Covid-19 provided more threat-related information about the virus to their children. More parental threat information in turn was related to stronger fear of Covid-19 in their children, and partly mediated the link between parent and child fear of the virus. The link between parental threat information and children's fear of Covid-19 was not moderated by child temperament or parental anxiety.

CONCLUSIONS

Parental communication about Covid-19 may play a role in children's fear acquisition of Covid-19. The lack of moderation of this link by parental anxiety and child temperament may reflect the potentially adaptive nature of verbal fear transmission during the first year of the pandemic and the nonclinical levels of fear in this community sample.

Genome-wide Association Meta-analysis of Childhood and Adolescent Internalizing Symptoms

OBJECTIVE

To investigate the genetic architecture of internalizing symptoms in childhood and adolescence.

METHOD

In 22 cohorts, multiple univariate genome-wide association studies (GWASs) were performed using repeated assessments of internalizing symptoms, in a total of 64,561 children and adolescents between 3 and 18 years of age. Results were aggregated in meta-analyses that accounted for sample overlap, first using all available data, and then using subsets of measurements grouped by rater, age, and instrument.

RESULTS

The meta-analysis of overall internalizing symptoms (INToverall) detected no genome-wide significant hits and showed low single nucleotide polymorphism (SNP) heritability (1.66%, 95% CI = 0.84-2.48%, neffective = 132,260). Stratified analyses indicated rater-based heterogeneity in genetic effects, with self-reported internalizing symptoms showing the highest heritability (5.63%, 95% CI = 3.08%-8.18%). The contribution of additive genetic effects on internalizing symptoms appeared to be stable over age, with overlapping estimates of SNP heritability from early childhood to adolescence. Genetic correlations were observed with adult anxiety, depression, and the well-being spectrum (|rg| > 0.70), as well as with insomnia, loneliness, attention-deficit/hyperactivity disorder, autism, and childhood aggression (range |rg| = 0.42-0.60), whereas there were no robust associations with schizophrenia, bipolar disorder, obsessive-compulsive disorder, or anorexia nervosa.

CONCLUSION

Genetic correlations indicate that childhood and adolescent internalizing symptoms share substantial genetic vulnerabilities with adult internalizing disorders and other childhood psychiatric traits, which could partially explain both the persistence of internalizing symptoms over time and the high comorbidity among childhood psychiatric traits. Reducing phenotypic heterogeneity in childhood samples will be key in paving the way to future GWAS success.

Parent-to-Child Anxiety Transmission Through Dyadic Social Dynamics: A Dynamic Developmental Model

The intergenerational transmission of psychopathology is one of the strongest known risk factors for childhood disorder and may be a malleable target for prevention and intervention. Anxious parents have distinct parenting profiles that impact socioemotional development, and these parenting effects may result in broad alterations to the biological and cognitive functioning of their children. Better understanding the functional mechanisms by which parental risk is passed on to children can provide (1) novel markers of risk for socioemotional difficulties, (2) specific targets for intervention, and (3) behavioral and biological indices of treatment response. We propose a developmental model in which dyadic social dynamics serve as a key conduit in parent-to-child transmission of anxiety. Dyadic social dynamics capture the moment-to-moment interactions between parent and child that occur on a daily basis. In shaping the developmental trajectory from familial risk to actual symptoms, dyadic processes act on mechanisms of risk that are evident prior to, and in the absence of, any eventual disorder onset. First, we discuss dyadic synchrony or the moment-to-moment coordination between parent and child within different levels of analysis, including neural, autonomic, behavioral, and emotional processes. Second, we discuss how overt emotion modeling of distress is observed and internalized by children and later reflected in their own behavior. Thus, unlike synchrony, this is a more sequential process that cuts across levels of analysis. We also discuss maladaptive cognitive and affective processing that is often evident with increases in child anxiety symptoms. Finally, we discuss additional moderators (e.g., parent sex, child fearful temperament) that may impact dyadic processes. Our model is proposed as a conceptual framework for testing hypotheses regarding dynamic processes that may ultimately guide novel treatment approaches aimed at intervening on dyadically linked biobehavioral mechanisms before symptom onset.

Combined Emotional Socialization Training and Family Accommodation Modification: Impact on Emotional Regulation and Anxiety Symptoms in Anxious Children

Past studies show that emotional socialization and family accommodation are involved in children's anxiety, but research has yet to investigate whether targeting emotional socialization training (EST), family accommodation modification (FAM), or EST and FAM in tandem can reduce anxiety in children. The purpose of this study was to evaluate the efficacy of a combination of EST and FAM on improving emotion regulation (ER) and reducing anxiety symptoms in anxious children. The sample consisted of 80 children with an anxiety disorder (M_age = 6.7, SD = 0.1) and their mothers. Mothers were randomly assigned to an EST (n = 17), FAM (n = 16), Combined (n = 17), or a waitlist control (WLC) (n = 16) groups. Mothers completed The Emotion Regulation Checklist (ERC) and Spence Children's Anxiety Scale (SCAS) at pre-test, post-test, and at 6-month of follow-up. The results showed that the EST, FAM, and Combined groups were more effective than WLC in improving ER and reducing anxiety severity at post-test and follow-up. Among the intervention groups, children in the combined group showed greater reductions in the severity of anxiety symptoms and emotion dysregulation than the other two groups. Assisting parents to use strategies that encourage healthy emotion regulation and decrease family accommodation might help reduce the severity of children's anxiety symptoms.

Family alliance as a developmental antecedent of depressive and anxiety symptoms in early adolescence: Friendship quality as a mediating factor

Family interactions constitute a critical context in which children can learn the basic relational skills that they need to make friends. In turn, friendship quality is a robust predictor of child socioemotional functioning. Therefore, friendship is likely to act as a bridge in a socioemotional developmental cascade linking early family interactions to child subsequent socioemotional adjustment. This study aimed to examine a mediation model linking family alliance (the degree of mother-father-child engagement and coordination in joint activities) in kindergarten to anxiety and depressive symptoms in early adolescence through the mediating role of friendship quality in middle childhood. The family alliance of 87 mother-father-child triads was assessed when children were aged 6 years based on a 15-min videotaped interaction. Children reported on the quality of their relationship with their best friend at age 10 and on their anxiety and depressive symptoms at both 12 and 13 years (averaged). Results showed that children who experienced better family alliance at 6 years had higher relationship quality with their best friend at 10 years which in turn, predicted less anxiety (but not depressive) symptoms in early adolescence. There was a significant indirect effect of family alliance on anxiety through friendship quality. Findings suggest that family alliance may play a central role in shaping children's capacity to develop high-quality friendships, with implications for their subsequent socioemotional functioning. Further longitudinal studies are needed to examine the reciprocal influences unfolding over time that are likely to characterize developmental cascades among family systems, children's developing friendships, and their socioemotional functioning.

Family based treatment of anxiety disorders: A review of the literature (2010-2019)

Anxiety disorders are the most common and impairing mental health problems across the lifespan. Familial factors are strongly implicated in the onset and maintenance of anxiety, but available evidence-based treatments are usually individual-focused. The aim of this review was to evaluate the current evidence base (2010-2019) of family based interventions addressing youth and adult anxiety and highlight findings comparing family based and individual-focused treatments. A systematic literature search was conducted. Articles were considered if they targeted primarily anxiety-related issues and utilized a randomized controlled trial design, resulting in 22 included youth studies. No adult studies met criteria for inclusion. Overall, family based treatments performed better than no-treatment controls and as well as individual-based interventions, with some evidence that family based interventions might outperform individual-based ones in certain populations (i.e., autism). Family based interventions may represent a good alternative for anxiety treatment in youth. Additional research on family based treatment for anxiety is adults is needed.

Aetiology of shame and its association with adolescent depression and anxiety: results from a prospective twin and sibling study

BACKGROUND

Shame is considered a maladaptive self-conscious emotion that commonly co-occurs alongside depression and anxiety. Little is known, however, about the aetiology of shame and its associations with depression and anxiety. We estimated, for the first time, genetic and environmental influences on shame and on its associations with depression and anxiety in adolescence.

METHODS

The sample was twin and sibling pairs from the Genesis 1219 Study (Time 1, N = 2,685; males 42.8%, M_age  = 14.95, SD = 1.67, age range: 12-21; Time 2, N = 1618; males 39.7%, M_age  = 16.97, SD = 1.64, age range: 14-23). Participants completed validated questionnaires to measure shame (at Time 1), depression and anxiety (at Times 1 and 2).

RESULTS

Shame was moderately to strongly associated with concurrent depression and anxiety. Prospectively, shame was significantly associated with an increase in depression, but not anxiety. Genetic analyses revealed that shame was moderately heritable with substantial nonshared environmental influence. The associations between shame and concurrent depression and anxiety were primarily accounted for by overlapping genetic influences. Prospectively, the association between shame and later depression was primarily accounted for by genetic and nonshared environmental influences shared with earlier depression. The unique association between shame and later depression was mostly explained by common nonshared environmental influences.

CONCLUSIONS

The findings offer novel evidence regarding aetiology of shame-although moderately heritable, shame in adolescents may also result from nonshared environmental factors. Genetic and nonshared environmental influences contribute to the co-occurrence of shame with depression and anxiety.

The Longitudinal Interplay Between Social Network and Psychopathology in Multi-Problem Young Adult Men; Separating Within-and Between-Person Effects

Young adulthood is characterized by many life changes. Especially for young men with problems across different life domains (i.e., multi-problem), these changes may entail obstacles. Incidences of psychopathology increase during young adulthood and at the same time important shifts in social networks - such as changing relations with peers and parents, isolation, or deviant peer affiliation - take place. The present study examined the longitudinal interplay between psychopathology and social network characteristics over the course of 1 year in multi-problem young adults, at both between-person and within-person level. A sample of 696 multi-problem young adult men (age 18-27) participated in this three wave study. We used traditional cross-lagged panel models (CLPM) to examine how social network characteristics and psychopathology are related at the between-person level, and random intercept cross-lagged panel models (RI-CLPM) to examine within-person links. Between-person associations between internalizing problems and social networks were bidirectional, and externalizing problems were related to problematic social network characteristics, but not vice versa. At the within-person level, no such cross-lagged paths were found. Overall, results indicated that in multi-problem young adults, social network characteristics and psychopathology are related. However, looking at within-person processes this relation is not reciprocal.

Impacts of Psychopharmaceuticals on the Neurodevelopment of Aquatic Wildlife: A Call for Increased Knowledge Exchange across Disciplines to Highlight Implications for Human Health

The global use of psychopharmaceuticals such as antidepressants has been steadily increasing. However, the environmental consequences of increased use are rarely considered by medical professionals. Worldwide monitoring efforts have shown that pharmaceuticals are amongst the multitude of anthropogenic pollutants found in our waterways, where excretion via urine and feces is thought to be the primary mode of pharmaceutical contamination. Despite the lack of clarity surrounding the effects of the unintentional exposure to these chemicals, most notably in babies and in developing fetuses, the US Environmental Protection Agency does not currently regulate any psychopharmaceuticals in drinking water. As the underlying reasons for the increased incidence of mental illness—particularly in young children and adolescents—are poorly understood, the potential effects of unintentional exposure warrant more attention. Thus, although links between environmental contamination and physiological and behavioral changes in wildlife species—most notably in fish—have been used by ecologists and wildlife biologists to drive conservation policy and management practices, we hypothesize that this knowledge may be underutilized by medical professionals. In order to test this hypothesis, we created a hierarchically-organized citation network built around a highly-cited “parent” article to explore connections between aquatic toxicology and medical fields related to neurodevelopment. As suspected, we observed that studies in medical fields such as developmental neuroscience, obstetrics and gynecology, pediatrics, and psychiatry cite very few to no papers in the aquatic sciences. Our results underscore the need for increased transdisciplinary communication and information exchange between the aquatic sciences and medical fields.

The role of genetic and environmental factors in covariation between anxiety and anger in childhood

Higher levels of anger expression, as well as lower levels of anger control, have been reported for adults with anxiety disorders compared to individuals without anxiety disorders. Different to the research on adults, very few studies examined the relationship between anxiety and anger in childhood. In our study, we investigated 398 Italian twin pairs (74 MZ male, 70 MZ female, 134 same-sex dizygotic-53 male, 81 female-, and 120 unlike-sex dizygotic twin pairs), aged 8-17 (mean 13.06 ± 2.59): (i) the heritability of a childhood anger phenotype; (ii) the association between five anxiety domains and anger; (iii) the role of possible common etiological factors in explaining the observed comorbidity and overlap in the risk between anxiety phenotypes and anger. The study demonstrated that anger, assessed by CBCL items, is heritable in children at a similar rate to prior studies (40%). Our research found low to moderate rate of correlation between anger and anxiety (from 0.10 to 0.19). Finally, the present study found that the majority of etiological influences on anxiety and anger are independent of each other. Data showed that shared environmental influences have some small effects on the phenotypic covariation between the anxiety phenotypes and anger (12%); whereas unique environmental influences have an almost negligible effect (1%). Our analyses did not reveal the effect of genetic effects in explaining the covariation between these phenotypes.

Mental Imagery and its Relevance for Psychopathology and Psychological Treatment in Children and Adolescents: a Systematic Review

This review provides an overview of the current state of research concerning the role of mental imagery (MI) in mental disorders and evaluates treatment methods for changing MI in childhood. A systematic literature search using PubMed/Medline, Web of Science, and PsycINFO from 1872 to September 2020 was conducted. Fourteen studies were identified investigating MI, and fourteen studies were included referring to interventions for changing MI. Data from the included studies was entered into a data extraction sheet. The methodological quality was then evaluated. MI in childhood is vivid, frequent, and has a significant influence on cognitions and behavior in posttraumatic stress disorder (PTSD), social anxiety disorder (SAD), and depression. The imagery’s perspective might mediate the effect of MI on the intensity of anxiety. Imagery rescripting, emotive imagery, imagery rehearsal therapy, and rational-emotive therapy with imagery were found to have significant effects on symptoms of anxiety disorders and nightmares. In childhood, MI seems to contribute to the maintenance of SAD, PTSD, and depression. If adapted to the developmental stages of children, interventions targeting MI are effective in the treatment of mental disorders.

The association between current maternal psychological control, anxiety symptoms, and emotional regulatory processes in emerging adults

BACKGROUND AND OBJECTIVES

High levels of psychological control (PC), the (intentional or unintentional) attempt by parents to control their child's emotional experience, have been associated with increased risk for anxiety in youth. However, little is known regarding the association between PC and anxiety in emerging adulthood, a developmental period marked by various life transitions and high risk for the onset of internalizing symptoms, or about the relation between current parental PC and emotional regulatory processes during this stage. The current study examined whether perceived maternal PC was significantly associated with anxiety symptoms and both objective (psychophysiological; respiratory sinus arrhythmia) and subjective (self-reported) emotion regulatory processes.

METHODS

Participants (N = 125; ages 18 to 25) completed self-reports on their anxiety symptoms, emotion regulation abilities, and perceptions of their mother' behavior, and participated in a laboratory stressor, the Trier-Social Stress Test, while psychophysiological data were acquired.

RESULTS

Emerging adults who reported higher maternal PC also reported higher anxiety symptoms and evidenced greater emotion regulation difficulties on both objective and subjective indices than those who reported lower maternal PC. Moreover, the association between PC and anxiety levels was statistically mediated by self-reported emotion regulation difficulties.

LIMITATIONS

Results of this study should be interpreted in light of its limitations, which include it being cross-sectional in nature with a primarily female sample. Further, perceptions of maternal, but not paternal, parenting were examined.

CONCLUSIONS

Findings might have implications for targeting both psychological control and emotion regulation difficulties in personalized anxiety interventions during this high-risk developmental period.

Fear and Anxiety Pathways Associated with Root Canal Treatments Amongst a Population of East Asian Origin

Objective

This study aimed to identify and compare the pathways of endodontic fear and anxiety amongst East Asian origin patients attending Griffith University's Dental Clinics, Gold Coast, Australia.

Methods

East Asian patients who attended the Griffith University dental clinics were included in this study. The "My Endodontic Fear" survey was used. The pathways involved in self-perception of dental fear and anxiety were assessed through 5 different questions. Chi-square test was for statistical analysis and the level of significance was set at P<0.05.

Results

One hundred and forty six participants (n=146) (ages 18-62 years) of East Asian descent met the criteria to participate. 58.2% were females, and 41.8% males. The ethnicities were split into Chinese origin and non-Chinese origin (Korean, Phillipino, Japanese, Vietnamese). Results indicate multiple pathways affect the origin of fear, regardless of ethnicity. The Cognitive Conditioning pathway was the primary pathway selected by the Chinese and non-Chinese sub groups (51.4%, 43.6%) followed by the Informative (38.3%, 38.5%), then Vicarious (27.1%, 33.3%) and Parental (18.7%, 33.3%) pathways respectively.The Verbal Threat pathway was the least selected pathway for both groups, however the non- Chinese group selected this pathway significantly more often than the Chinese group (P<0.001).

Conclusion

This study demonstrates that the Cognitive Conditioning pathway was the primary fear and anxiety pathway utilized by both East Asian sub-groups. Understanding how patients develop fear and anxiety can help treating dentists discuss triggering factors for patients and alleviate undue anxiety prior to treatment.

Helping parents to help children overcome fear: The influence of a short video tutorial

OBJECTIVES

Anxiety runs in families, and its transmission is largely environmental. However, studies rarely explore this process in clinically anxious parents or ask participants to face a genuine fear. We also do not know whether this process is modifiable. This study will explore these questions using a sample of clinically anxious parents.

DESIGN

Experimental design comparing clinically anxious parents with non-anxious parents, and exploring the effects of a tutorial intervention versus a control group.

METHODS

Parents with and without anxiety disorders and their children (5-9 years) participated (N = 72). Children chose two fearful animal stimuli. Parents helped the child approach the first in graded steps. The following parental behaviours were recorded: positive/negative verbal information; positive/negative modelling; encouragement/praising of approach/avoidance behaviours. Half the parents were then randomly assigned to a short video tutorial advising how to help children cope with fearful situations. The remainder watched a control video. The approach task was repeated with the second stimulus.

RESULTS

Parenting behaviours fell into two categories: 'approach parenting' (encouraging/praising/modelling approach; positive verbal information) and 'avoidance parenting' (encouraging/praising/modelling avoidance; negative verbal information). The parenting tutorial increased 'approach parenting' and decreased 'avoidance parenting' and was associated with increased child approach towards fearful stimuli. This was not moderated by parent or child anxiety.

CONCLUSIONS

Parenting, particularly 'avoidance parenting', is associated with children's approach and avoidance. A short video tutorial modified these parenting behaviours and reduced avoidance. These effects were apparent regardless of parent or child anxiety level.

PRACTITIONER POINTS

Avoidance and approach parenting may influence children's response to fearful stimuli. Avoidance parenting may be more problematic than lack of approach parenting. Approach and avoidance parenting are amenable to manipulation by short video tutorial. Parenting improvement resulted in increased approach behaviour in children.

Featured Article: The Relationship Between Parent and Child Distress in Pediatric Cancer: A Meta-Analysis

Objective

Parents and children affected by pediatric cancer are at risk for psychological distress, including depression, anxiety, and post-traumatic stress. A link is believed to exist between parent and child distress; however, no systematic analysis of this relationship has occurred. A meta-analysis was conducted to assess the relationship between parent and child distress among families affected by pediatric cancer.

Methods

A systematic review and meta-analysis was conducted using EBSCO (searching PsycINFO, MEDLINE, Academic search Premiere, and Health Source: Nursing/Academic Edition) and PubMed. The initial search yielded a total of 29,118 articles. Inclusion criteria were that studies assessed the relation between parent and child distress in the context of pediatric cancer, were written in English, and were published in peer-reviewed journals. 28 articles met inclusion criteria.

Results

A statistically significant association was found between overall parent and child distress (r = .32, p < .001), such that increased parent-reported distress was associated with increased distress in their children. Significant relationships were also present among each type of parental distress (i.e., depression, anxiety, post-traumatic stress, and global distress; rs = .31–.51, ps < .001) and overall child distress. Moderation analyses via meta-regression indicated that parent proxy-report of child symptoms was associated with a stronger relationship between parent and child distress than child self-report of their own distress.

Conclusions

Aligned with the social–ecological framework, familial factors appear to be highly relevant in understanding distress following pediatric cancer diagnosis. Indeed, greater parent distress was associated with greater child distress.

Latent Profiles of Perceived Parental Psychopathology: Associations with Emerging Adult Psychological Problems

The understanding of the complex relations between parent and child psychopathology would be enhanced if common patterns of parental problem types or particular parent dyads were identified. The current study used latent profile analysis to allow for a person-centered approach to the examination of which parental psychopathology subgroups based on their perceived depressive, anxiety, and antisocial problems are both most common and most strongly associated with emerging adult psychopathology. Participants included 2204 emerging adults enrolled in a Southern United States university who reported on their perceptions of their parents' and their own current psychological problems. A 5-profile solution for perceived parental psychopathology was identified and represented anticipated groups (e.g., low problems, high problems, high internalizing only, high externalizing only). The largest effects of these profiles were found for emerging adult antisocial problems, and paternal profiles demonstrated larger effect sizes relative to maternal profiles. When both parents were perceived as having elevated problems, emerging adults also generally reported the highest rates of their own psychological problems. Results also suggest that perceiving as having low problems may protect against the negative effects of the other parent's antisocial problems or depressive/anxiety problems, but may not be sufficient when a parent has elevated problems across domains. Findings indicate the importance of considering varying levels of psychopathology.

Friendship Quality Moderates the Relation Between Maternal Anxiety and Trajectories of Adolescent Internalizing Symptoms

The current study examined the moderating role of friendship quality on the relation between maternal anxiety and internalizing symptoms in a 3-year prospective study of adolescent development. Participants included 177 adolescents (M _age = 16.05, SD _age = 0.91) and their mothers. Mothers reported their own levels of anxiety; youth completed self-reports of internalizing symptoms and friendship quality. Positive friendship quality moderated the relation between maternal anxiety and initial levels of internalizing symptoms. Maternal anxiety was associated with steeper increases in internalizing symptoms over time, but only for those with greater negative peer interactions. Findings underscore the important role of both parental and peer relationships in the development of internalizing symptoms and highlight specific avenues for clinical interventions.

Etiological Distinction Across Dimensions of Math Anxiety

Analyses have suggested math anxiety is a multidimensional construct. However, previous behavioral genetic work examining math anxiety was unidimensional. Thus, the purpose of the present study was to examine different approaches for specifying behavioral genetic models of math anxiety as a multidimensional construct. Three models were compared: a unidimensional model, a three dimension multidimensional model, and a bi-factor model, which partitioned variance into one common factor shared across three dimensions of math anxiety and examined residual variance in each dimension. The best fitting model was a bi-factor AE model, which suggested moderate heritability of general math anxiety and that each dimension of math anxiety had unique etiological influences not accounted for by shared variance with the general math anxiety factor. Thus, while there was evidence of shared etiology, there was also evidence of some etiological distinction across dimensions of math anxiety. The results demonstrate the importance of taking into account the dimensionality of the scale when interpreting similarity across twins.

Associations between Parental Psychopathology and Sexual Behavior in an Outpatient Psychiatric Sample

Early age of sexual debut is associated with an increase in negative outcomes, including higher incidence of nonconsensual sexual experiences, higher rates of sexually transmitted infections, and risky sexual practices. Little research has examined the role of parental psychopathology as a predictor of adolescent sexual activity, however. The current study aims to close this gap by examining the relationship between parental psychopathology and sexual activity in a longitudinal sample of youth. Participants were 685 adolescents from the Longitudinal Assessment of Manic Symptoms study, the majority of whom were male (67%) and White (65%). Analyses considering likelihood of sexual initiation included the full sample, whereas analyses considering predictors of the age of sexual debut included the 162 participants who reported ever having sexual intercourse (62% male, 51% White) via the Youth Risk Behavior Surveillance-High School version. Cox regression analyses suggested that maternal generalized anxiety disorder predicted decreased likelihood of initiating sex during the 8-year follow-up period, whereas paternal conduct disorder predicted increased likelihood of initiating sex. Multivariate linear regressions also showed that maternal conduct disorder predicted earlier age of sexual debut among those who had initiated, whereas paternal antisocial personality disorder predicted later age of sexual debut. These associations were observed in both male and female adolescents. Furthermore, these effects were largely not explained by the established relationship between youth psychopathology and sexual behavior. Results have implications for interventions aimed at decreasing sexual risk taking in vulnerable youth.

Genetic and environmental influences on internalizing psychopathology across age and pubertal development

Symptoms of anxiety and depression are commonly comorbid and partially share a genetic etiology. Mean levels of anxiety and depression increase over the transition to adolescence, particularly in girls, suggesting a possible role of pubertal development in the activation of underlying genetic risks. The current study examined how genetic and environmental influences on anxiety and depression differed by chronological age and pubertal status. We analyzed composite scores from child self-reports and parent informant-reports of internalizing symptomology in a racially and socioeconomically diverse sample of 1,913 individual twins from 1,006 pairs (ages 8-20 years) from the Texas Twin Project. Biometric models tested age and pubertal status as moderators of genetic and environmental influences shared between and specific to anxiety and depression to determine whether etiology of internalizing symptomology differs across development as a function of age or puberty. Genetic influences did not increase as a function of age or puberty, but instead shared environmental effects decreased with age. In an exploratory model that considered the moderators simultaneously, developmental differences in etiology were reflected in genetic and environmental effects unique to depression. Results suggest that genetic variance in internalizing problems is relatively constant during adolescence, with environmental influences more varied across development. (PsycINFO Database Record

Be Your Own Superhero: A Case of a Young Boy With Selective Mutism and Complex Comorbidities

This case study outlines the treatment of a 5-year-old Caucasian male who presented with symptoms of selective mutism (SM) along with significant impairment related to comorbid anxiety and speech difficulties. To address these symptoms, Integrated Behavior Therapy for Selective Mutism (IBTSM) was utilized for the treatment of this young boy’s SM and comorbid anxiety. An attachment focus was incorporated as a framework for conceptualizing his SM symptoms. As the treatment of this young boy’s symptoms proceeded, it became clear that his underlying speech difficulties needed to be addressed as well, as these difficulties were preventing expected progress to occur. Thus, this young boy’s treatment was individualized to fit his unique difficulties. In shifting the treatment focus to “being brave like a superhero,” significant decreases were achieved in this young boy’s overall internalizing and Diagnostic and Statistical Manual of Mental Disorders ( DSM)-related anxiety symptoms, facilitating a successful transition to speech and language therapy. This case study is distinctive in its description of the complexities that may come along with treating symptoms that appear consistent with SM along with other comorbid conditions and nuanced circumstances.

Looking into some of the risk factors of mental health: the mediating role of maladaptive schemas in mothers’ parenting style and child anxiety disorders

Purpose

Anxiety disorders have a high prevalence in children. Those children with anxious symptoms are more likely to experience significant disruption in their lives. This disruption can interrupt or even stop a child from participating in a variety of typical childhood experiences. It is understood that genetic and environmental factors may cause this disorder. The purpose of this paper is to focus on environmental factors, namely, the mediating role of maladaptive schemas in mothers’ child-rearing and childhood anxiety disorders.

Design/methodology/approach

This study used correlation-modeling to assess the analysis. The sample included 326 students (aged 9-12 years old) and their mothers. The parenting style (Baumrind, 1973), Early Maladaptive Schema (Rijkeboer and de Boo, 2010), and anxiety disorders (Muriset al., 2006) questionnaires were used in this study.

Findings

The results showed a relationship between parenting styles of mothers and childhood anxiety disorders, a significant correlation between childhood maladaptive schemas and childhood anxiety disorders, a relation between child-rearing styles and childhood maladaptive schemas, and finally a mediating role on childhood anxiety disorders and mothers’ child-rearing styles for some childhood maladaptive schemas.

Originality/value

This research contributes to the knowledge base of the importance of children’s mental health. The paper analyzes the relationship of mothers’ parenting styles and children’s anxiety. It also focuses on maladaptive schemas as a mediator and its relationship with childhood anxiety disorders.

Neural correlates of attention bias to masked facial threat cues: Examining children at-risk for social anxiety disorder

Background

Behavioral inhibition (BI) is an early-appearing temperament trait and a robust predictor of social anxiety disorder (SAD). Both BI and anxiety may have distinct patterns of emotion processing marked by heightened neural responses to threat cues. BI and anxious children display similar frontolimbic patterns when completing an emotion-face attention bias task with supraliminal presentation. Anxious children also show a distinct neural response to the same task with subliminal face presentations, probing stimulus-driven attention networks. We do not have parallel data available for BI children, limiting our understanding of underlying affective mechanisms potentially linking early BI to the later emergence of anxiety.

Method

We examined the neural response to subliminal threat presentation during an emotion-face masked dot-probe task in children oversampled for BI (N = 67; 30 BI, 9–12 yrs).

Results

Non-BI children displayed greater activation versus BI children in several regions in response to threat faces versus neutral faces, including striatum, prefrontal and temporal lobes. When comparing congruent and incongruent trials, which require attention disengagement, BI children showed greater activation than non-BI children in the cerebellum, which is implicated in rapidly coordinating information processing, aversive conditioning, and learning the precise timing of anticipatory responses.

Conclusions

Non-BI children may more readily engage rapid coordinated frontolimbic circuitry to salient stimuli, whereas BI children may preferentially engage subcortical circuitry, in response to limbic “alarms” triggered by subliminal threat cues. These data help reveal the extent to which temperamental risk shares similar neurocircuitry previously documented in anxious adolescents and young adults in response to masked threat.

•

All children displayed amygdala activation in response to brief threat cues.

•

Non-BI children displayed activation in striatum, PFC and temporal lobes.

•

BI children showed greater activation in the cerebellum.

Parenting Strategies to Deal with Children's Anxiety: Do Parents Do What They Say They Do?

Parents' perceptions about their strategies to deal with children's anxiety have been minimally explored. Based on a mixed-method approach, the current study compared the strategies that parents said they use more frequently to deal with their child's anxious behaviors and the strategies they actually used during two mildly anxiogenic interactions with their child. Forty-two parents of children with anxiety disorders, aged 9-12 years, participated in the study. Semi-structured interviews were administered to identify parental perceptions about their strategies to deal with their children's anxiety. Subsequently dyadic interactions were observed and coded by two independent coders. We found discrepancies relating to four strategies. Significantly more parents used strategies based on overinvolvement and anxious behavior during the interactions than had been reported by them in the interviews. In contrast, reassurance and reinforcement of avoidance/dependence were used in interactions by fewer parents than would be expected, according to the interviews. Relevant implications for assessment and intervention with families of anxious children are suggested.

Verbal Information Transfer in Real-Life: When Mothers Worry About Their Child Starting School

Verbal information transfer, one of Rachman's three pathways to fear, may be one way in which vulnerability for anxiety may be transmitted from parents to children. A community sample of mothers and their preschool-aged children (N = 65) completed observational tasks relating to the child starting school. Mothers were asked to tell their child about social aspects of school; then children completed a brief play assessment involving ambiguous, school-based social scenarios. Mothers completed self-report questionnaires on social anxiety symptoms, general anxiety and depressive symptoms as well as a questionnaire on child anxiety symptoms and indicated whether they were personally worried about their child starting school. There was a significant difference in the information given to children about school between mothers who stated they were worried and those who stated they were not, with mothers who were worried more likely to mention unresolved threat, use at least one anxiety-related word, and show clear/consistent negativity (all ps < .01). Significant associations were also found between the emotional tone of mothers' descriptions of school and children's own representations of school. These findings support the theory that the information mothers give to their child may be influenced by their own concerns regarding their child, and that this verbal information affects child representations.

Effects of maternal health anxiety on children's health complaints, emotional symptoms, and quality of life

Little is known about family risk factors and intergenerational transmission of psychological disturbance in the development of health anxiety (HA). This study investigated HA and related concepts in 8- to 17-year-old children who had been exposed to different maternal health status. Using a family case-control design, three family groups were included: (1) 50 case children of mothers with severe (HA); (2) 49 control children of mothers with rheumatoid arthritis (RA); and (3) 51 control children of healthy mothers. Children and mothers completed a battery of standardised questionnaires. Case children reported significantly higher level of HA symptoms than children of mothers with RA but not compared to children of healthy mothers. There was no significant difference between the children's self-reports in the three groups with regard to anxiety symptoms in general, physical complaints, or quality of life. In contrast, mothers with HA reported their children as having more emotional and physical symptoms than mothers in one or both control groups. Compared to mothers with RA but not healthy mothers, mothers with HA also reported more visits to the general practitioner with their children during the past year. The findings suggest that maternal HA only weakly affects children's own report of HA and thereby may not be a strong risk factor for the development of HA symptoms in childhood. However, mothers with severe HA seem to conceive their children as more ill and present them more often in the health care system which could, therefore, be an important target for intervention in adult patients.

Relationship of Genetic Variants With Procedural Pain, Anxiety, and Distress in Children

OBJECTIVE

This study used a candidate gene approach to examine genomic variation associated with pain, anxiety, and distress in children undergoing a medical procedure.

STUDY DESIGN

Children aged 4-10 years having an IV catheter insertion were recruited from three Midwestern children's hospitals. Self-report measures of pain, anxiety, and distress were obtained as well as an observed measure of distress. Samples were collected from children and biological parents for analysis of genomic variation. Genotyped variants had known or suspected association with phenotypes of interest. Analyses included child-only association and family-based transmission disequilibrium tests.

RESULTS

Genotype and phenotype data were available from 828 children and 376 family trios. Children were 50% male, had a mean age of 7.2 years, and were 84% White/non-Hispanic. In family-based analysis, one single-nucleotide polymorphism (SNP; rs1143629, interleukin ( IL1B) 1β) was associated with observed child distress at Bonferroni-corrected levels of significance ( p = .00013), while two approached significance for association with high state anxiety (rs6330 Nerve Growth Factor, Beta Subunit, [ NGFB]) and high trait anxiety (rs6265 brain-derived neurotrophic factor [ BDNF]). In the child-only analysis, multiple SNPs showed nominal evidence of relationships with phenotypes of interest. rs6265 BDNF and rs2941026 cholecystokinin B receptor had possible relationships with trait anxiety in child-only and family-based analyses.

CONCLUSIONS

Exploring genomic variation furthers our understanding of pain, anxiety, and distress and facilitates genomic screening to identify children at high risk of procedural pain, anxiety, and distress. Combined with clinical observations and knowledge, such explorations could help guide tailoring of interventions to limit procedure-related distress and identify genes and pathways of interest for future genotype-phenotype studies.

Contagion of Anxiety Symptoms Among Adolescent Siblings: A Twin Study

This study examined whether social contagion of anxiety symptoms is present between siblings during early adolescence and whether this process is moderated by sex, relationship quality, and zygosity. Based on 634 monozygotic and dizygotic twins (336 females) assessed in Grades 6 and 7, anxiety symptoms and sibling relationship quality were measured with self-report questionnaires. The predictive association of the co-twin's level of anxiety with adolescents' own increased anxiety 1 year later was only observed in same-sex twin dyads (monozygotic and dizygotic) and was higher for those who perceived a higher level of relationship quality with their co-twin. Raising awareness of a possible sibling contagion of anxiety may be useful for preventing the development of anxiety symptoms in youth.

Parenting and the Adjustment of Children Born to Gay Fathers Through Surrogacy

Findings are presented on a study of 40 gay father families created through surrogacy and a comparison group of 55 lesbian mother families created through donor insemination with a child aged 3–9 years. Standardized interview, observational and questionnaire measures of stigmatization, quality of parent–child relationships, and children's adjustment were administered to parents, children, and teachers. Children in both family types showed high levels of adjustment with lower levels of children's internalizing problems reported by gay fathers. Irrespective of family type, children whose parents perceived greater stigmatization and children who experienced higher levels of negative parenting showed higher levels of parent‐reported externalizing problems. The findings contribute to theoretical understanding of the role of family structure and family processes in child adjustment.

Developmental changes in genetic and environmental influences on Chinese child and adolescent anxiety and depression

BACKGROUND

Twin and family studies using Western samples have established that child and adolescent anxiety and depression are under substantial genetic, modest shared environmental, and substantial non-shared environmental influences. Generalizability of these findings to non-Western societies remains largely unknown, particularly regarding the changes of genetic and environmental influences with age. The current study examined changes in genetic and environmental influences on self-reported anxiety and depression from late childhood to mid-adolescence among a Chinese twin sample. Sex differences were also examined.

METHOD

Self-reported anxiety and depression were collected from 712 10- to 12-year-old Chinese twins (mean = 10.88 years, 49% males) and again 3 years later. Quantitative genetic modeling was used to examine developmental changes in genetic and environmental influences on anxiety and depression, and sex differences.

RESULTS

Heritability of anxiety and depression in late childhood (23 and 20%) decreased to negligible in mid-adolescence, while shared environmental influences increased (20 and 27% to 57 and 60%). Shared environmental factors explained most of the continuity of anxiety and depression (75 and 77%). Non-shared environmental factors were largely time-specific. No sex differences were observed.

CONCLUSIONS

Shared environmental influences might be more pronounced during the transition period of adolescence in non-Western societies such as China. Future research should examine similarities and differences in the genetic and environmental etiologies of child and adolescent internalizing and other psychopathology in development between Western and non-Western societies.

Peer Victimization and Anxiety in Genetically Vulnerable Youth: The Protective Roles of Teachers' Self-Efficacy and Anti-Bullying Classroom Rules

Many victimized youngsters are at risk of developing internalizing problems, and this risk seems to be especially pronounced when they are genetically vulnerable for these problems. It is unclear, however, whether protective features of the school environment such as anti-bullying classroom policies and teacher's perceived self-efficacy in handling bullying situations can mitigate these negative outcomes. Using a genetically informed design based on twins, this study examined the potential moderating role of classroom anti-bullying policies and teachers' perceived self-efficacy in handling bullying situations in regard to the additive and interactive effects of peer victimization and genetic vulnerability on anxiety symptoms. To this end, 208 monozygotic and same-sex dizygotic twins (120 girls) rated their level of anxiety and peer victimization in grade 6 (mean age = 12.1 years, SD = 2.8). Teachers rated their self-efficacy in handling bullying situations and the extent of anti-bullying classroom policies. Multilevel regressions revealed triple interactions showing that genetic disposition for anxiety predicted actual anxiety for twins who were highly victimized by their peers, but only when their teachers had low perceived self-efficacy in handling bullying situations or when anti-bullying classroom rules were absent or rarely enforced. In contrast, for victimized youth with teachers who perceive themselves as effective or in classrooms where anti-bullying classroom policies were strongly enforced, genetic disposition for anxiety was not associated with actual anxiety symptoms. Anti-bullying programs should continue to promote teachers' involvement, as well as the enforcement of anti-bullying classroom policies, in order to diminish peer victimization and its related consequences.

Neural correlates of attention biases, behavioral inhibition, and social anxiety in children: An ERP study

Behavioral inhibition (BI) is a biologically-based temperament characterized by vigilance toward threat. Over time, many children with BI increasingly fear social circumstances and display maladaptive social behavior. BI is also one of the strongest individual risk factors for developing social anxiety disorder. Although research has established a link between BI and anxiety, its causal mechanism remains unclear. Attention biases may underlie this relation. The current study examined neural markers of the BI-attention-anxiety link in children ages 9-12 years (N=99, Mean=9.97, SD=0.97). ERP measures were collected as children completed an attention-bias (dot-probe) task with neutral and angry faces. P2 and N2 amplitudes were associated with social anxiety and attention bias, respectively. Specifically, augmented P2 was related to decreased symptoms of social anxiety and moderated the relation between BI and social anxiety, suggesting that increasing attention mobilization may serve as a compensatory mechanism that attenuates social anxiety in individuals with high BI. The BI by N2 interaction found that larger N2 related to threat avoidance with increasing levels of BI, consistent with over-controlled socio-emotional functioning. Lastly, children without BI (BN) showed an augmented P1 to probes replacing angry faces, suggesting maintenance of attentional resources in threat-related contexts.

Parental Attitudes, Beliefs, and Understanding of Anxiety (PABUA): Development and psychometric properties of a measure

The Parental Attitudes, Beliefs, and Understanding of Anxiety (PABUA) was developed to assess parental beliefs about their child's anxiety, parents' perceived ability to cope with their child's anxiety and to help their child manage anxious symptoms, and to evaluate parents' understanding of various parenting strategies in response to their child's anxiety. The study evaluated the PABUA in mother-child dyads (N=192) seeking treatment for youth anxiety. Exploratory factor analysis yielded a three-factor solution and identified PABUA scales of Overprotection, Distress, and Approach (with Cronbach's alpha ranging from .67 to .83). Convergent and divergent validity of PABUA scales was supported by the pattern of associations with measures of experiential avoidance, beliefs related to children's anxiety, empathy, trait anxiety, and depressive symptoms; parent-reported family functioning; parent- and youth-reported anxiety severity; and parent-reported functional impairment (n=83). Results provide preliminary support for the PABUA as a measure of parental attitudes and beliefs about anxiety, and future studies that investigate this measure with large and diverse samples are encouraged.

Autism Spectrum Disorders and Other Mental Health Problems: Exploring Etiological Overlaps and Phenotypic Causal Associations

OBJECTIVE

Recent studies have highlighted the impact of coexisting mental health problems in autism spectrum disorders (ASD). No twin studies to date have reported on individuals meeting diagnostic criteria of ASD. This twin study reports on the etiological overlap between the diagnosis of ASD and emotional symptoms, hyperactivity, and conduct problems measured with the Strengths and Difficulties Questionnaire.

METHOD

Genetic and environmental influences on the covariance between ASD and coexisting problems were estimated, in line with the correlated risks model prediction. Phenotypic causality models were also fitted to explore alternative explanations of comorbidity: namely, that coexisting problems are the result of or result in ASD symptoms; that they increase recognition of ASD; or that they arise due to an over-observation bias/confusion when differentiating between phenotypes.

RESULTS

More than 50% of twins with broad spectrum/ASD met the borderline/abnormal levels cut-off criteria for emotional symptoms or hyperactivity, and approximately 25% met these criteria for the 3 reported problems. In comparison, between 13% and 16% of unaffected twins scored above the cut-offs. The phenotypic correlation between ASD and emotional symptoms was explained entirely by genetic influences and accompanied by a moderate genetic correlation (0.42). The opposite was true for the overlap with conduct problems, as nonshared-environmental factors had the strongest impact. For hyperactivity, the best-fitting model suggested a unidirectional phenotypic influence of hyperactivity on ASD.

CONCLUSION

Our findings suggest a possible effect of hyperactivity on identification of ASD. The lack of genetic influences on conduct problems-ASD overlap further supports the genetic independence of these 2 phenotypes. Finally, the co-occurrence of emotional symptoms in ASD, compared to other co-occurring problems, is completely explained by common genetic effects.

Mental Imagery in Depression: Phenomenology, Potential Mechanisms, and Treatment Implications

Mental imagery is an experience like perception in the absence of a percept. It is a ubiquitous feature of human cognition, yet it has been relatively neglected in the etiology, maintenance, and treatment of depression. Imagery abnormalities in depression include an excess of intrusive negative mental imagery; impoverished positive imagery; bias for observer perspective imagery; and overgeneral memory, in which specific imagery is lacking. We consider the contribution of imagery dysfunctions to depressive psychopathology and implications for cognitive behavioral interventions. Treatment advances capitalizing on the representational format of imagery (as opposed to its content) are reviewed, including imagery rescripting, positive imagery generation, and memory specificity training. Consideration of mental imagery can contribute to clinical assessment and imagery-focused psychological therapeutic techniques and promote investigation of underlying mechanisms for treatment innovation. Research into mental imagery in depression is at an early stage. Work that bridges clinical psychology and neuroscience in the investigation of imagery-related mechanisms is recommended.

Analysis of Behavioral and Emotional Problems in Children Highlights the Role of Genotype × Environment Interaction

This study tested for Genotype × Environment (G × E) interaction on behavioral and emotional problems in children using new methods that do not require identification of candidate genes or environments, can distinguish between interaction with shared and unique environment, and are insensitive to scale effects. Parental ratings of problem behavior from 14,755 twin pairs (5.3 years, SD = 0.22) indicated G × E interaction on emotional liability, social isolation, aggression, attention problems, dependency, anxiety, and physical coordination. Environmental influences increased in children who were genetically more predisposed to problem behavior, with ~20% of the variance due to G × E interaction (8% for anxiety to 37% for attention problems). Ignoring G × E interaction does not greatly bias heritability estimates, but it does offer a comprehensive model of the etiology for childhood problems.

Parental involvement: contribution to childhood anxiety and its treatment

Anxiety disorders are prevalent in youth. Despite demonstrated efficacy of cognitive behavioral therapy (CBT), approximately 40% of anxiety-disordered youth remain unresponsive to treatment. Because developmental and etiological models suggest that parental factors are relevant to the onset and maintenance of childhood anxiety, researchers have proposed and investigated family-based interventions with increased parent work in treatment, aiming to improve the efficacy of treatment for childhood anxiety. However, contrary to what theoretical models suggest, data to date did not indicate additive benefit of family-based CBT in comparison with child-centered modality. Is parent/family involvement unnecessary when treating childhood anxiety disorders? Or could there be the need for specificity (tailored family-based treatment) that is guided by a revised conceptualization that improves the implementation of a family-based intervention? The current review examines (1) relevant parental factors that have been found to be associated with the development and maintenance of childhood anxiety and (2) interventions that incorporate parental involvement. Relevant findings are integrated to formulate a "targeted" treatment approach for parental involvement in CBT for youth anxiety. Specifically, there is potential in the assessment of parent/family factors prior to treatment (for appropriateness) followed by a target-oriented implementation of parent training.

Frontolimbic functioning during threat-related attention: Relations to early behavioral inhibition and anxiety in children

Children with behavioral inhibition (BI), a temperament characterized by biologically-based hyper-vigilance to novelty, display threat-related attention biases (AB) that shape developmental trajectories of risk for anxiety. Here we explore the relations between BI, neural function, and anxiety. Fifty-six 9-12-year-olds (23 behaviorally inhibited) performed the dot-probe task while undergoing fMRI. AB scores were not associated with BI group or parent-rated anxiety symptoms. Trials requiring attention orienting away from threat engaged an executive and threat-attention network (dlPFC, vlPFC, mPFC, and amygdala). Within that network, behaviorally inhibited children showed greater activation in the right dlPFC. Heightened dlPFC activation related to increased anxiety, and BI levels accounted for the direct relation between dlPFC activation and anxiety. Behaviorally inhibited children may engage the executive attention system during threat-related processing as a compensatory mechanism. We provide preliminary evidence that the link between PFC functioning and anxiety might be attributed to early-emerging temperamental vulnerabilities present before the emergence of clinical anxiety.

Socially anxious mothers' narratives to their children and their relation to child representations and adjustment

Anxious mothers' parenting, particularly transfer of threat information, has been considered important in their children's risk for social anxiety disorder (SAnxD), and maternal narratives concerning potential social threat could elucidate this contribution. Maternal narratives to their preschool 4- to 5-year-old children, via a picture book about starting school, were assessed in socially anxious (N = 73), and nonanxious (N = 63) mothers. Child representations of school were assessed via doll play (DP). After one school term, mothers (Child Behavior Checklist [CBCL]) and teachers (Teacher Report Form) reported on child internalizing problems, and child SAnxD was assessed via maternal interview. Relations between these variables, infant behavioral inhibition, and attachment, were examined. Socially anxious mothers showed more negative (higher threat attribution) and less supportive (lower encouragement) narratives than controls, and their children's DP representations SAnxD and CBCL scores were more adverse. High narrative threat predicted child SAnxD; lower encouragement predicted negative child CBCL scores and, particularly for behaviorally inhibited children, Teacher Report Form scores and DP representations. In securely attached children, CBCL scores and risk for SAnxD were affected by maternal anxiety and threat attributions, respectively. Low encouragement mediated the effects of maternal anxiety on child DP representations and CBCL scores. Maternal narratives are affected by social anxiety and contribute to adverse child outcome.

Genetic and environmental contributions to anxiety among Chinese children and adolescents--a multi-informant twin study

BACKGROUND

Child and adolescent anxiety has become a major public health concern in China, but little was known about the etiology of anxiety in Chinese children and adolescents. The present study aimed to investigate genetic and environmental influences on trait anxiety among Chinese children and adolescents. Rater, sex, and age differences on these estimates were also examined.

METHODS

Self-reported and parent-reported child's trait anxiety was collected from 1,104 pairs of same-sex twins aged 9-18 years. Genetic models were fitted to data from each informant to determine the genetic (A), shared (C), and non-shared environmental (E) influences on trait anxiety.

RESULTS

The parameter estimates and 95% confidence intervals (CI) of A, C, E on self-reported trait anxiety were 50% [30%, 60%], 5% [0%, 24%], 45% [40%, 49%]. For parent-reported data, the corresponding parameter estimates were 63% [47%, 78%], 13% [1%, 28%], and 24% [22%, 27%], respectively. The heritability of anxiety was higher in girls for self-reported data, but higher in boys for parent-reported data. There was no significant age difference in genetic and environmental contributions for self-reported data, but a significant increase of heritability with age for parent-reported data.

CONCLUSIONS

The trait anxiety in Chinese children and adolescents was highly heritable. Non-shared environmental factors also played an important role. The estimates of genetic and environmental effects differed by rater, sex and age. Our findings largely suggest the cross-cultural generalizability of the etiological model of child and adolescent anxiety.

Nature and psychological management of anxiety disorders in youth

Anxiety disorders affect around 5% of the paediatric population at any given time and are associated with high social and personal impact. These disorders typically begin early in life, and children with anxiety disorders are at increased risk for a variety of later difficulties across the life-span. Although causes of anxiety in childhood are not fully understood, there is a strong heritable component. Additional risk factors include temperament, parent psychopathology, parent handling and peer interactions. Psychological treatments have demonstrated good efficacy with around 60% of anxious youth being in diagnostic remission immediately following treatment and a further 10% remitting over the following months. Because young people with anxiety disorders are among the least likely to seek appropriate help, paediatricians are in a unique position to identify anxious young people, educate families and recommend appropriate intervention.

Friendship Experiences and Anxiety Among Children: A Genetically Informed Study

This study examined (a) whether, in line with a gene-environment correlation (rGE), a genetic disposition for anxiety puts children at risk of having anxious friends or having no reciprocal friends; (b) to what extent these friendship experiences are related to anxiety symptoms, when controlling for sex and genetic disposition for this trait; and (c) the additive and interactive predictive links of the reciprocal best friend's anxiety symptoms and of friendship quality with children's anxiety symptoms. Using a genetically informed design based on 521 monozygotic and ic twins (264 girls; 87% of European descent) assessed in Grade 4 (M age = 10.04 years, SD = .26), anxiety symptoms and perceived friendship quality were measured with self-report questionnaires. Results indicated that, in line with rGE, children with a strong genetic disposition for anxiety were more likely to have anxious friends than nonanxious friends. Moreover, controlling for their genetic risk for anxiety, children with anxious friends showed higher levels of anxiety symptoms than children with nonanxious friends but did not differ from those without reciprocal friends. Additional analyses suggested a possible contagion of anxiety symptoms between reciprocal best friends when perceived negative features of friendship were high. These results underline the importance of teaching strategies such as problem solving that enhance friendship quality to limit the potential social contagion of anxiety symptoms.

Genetic and environmental contributions to social anxiety across different ages: a meta-analytic approach to twin data

Social anxiety disorder (SAD) and social anxiety symptoms (SAS) have been largely studied both epidemiologically and genetically, however, estimates of genetic and environmental influences for these phenotypes widely vary across reports. Based upon available literature, 13 cohorts (42,585 subjects) were included in 3 meta-analytic estimates of the standardized variance components of aetiological influences on SAD/SAS, on the effect of age and of phenotype (symptoms vs. diagnosis). The proportions of variance accounted for by genetic and environmental factors were calculated by averaging estimates among studies, and pondered by the number of individuals in each sample. Meta-analytic estimations showed that genetic and non-shared environmental factors explain most of individual differences for SAD/SAS. In adults, the genetic contribution was half than that in younger patients, with higher contribution of non-shared environmental influences. In contrast, the shared environmental factors seem to be less relevant.