Developmental Relations Among Behavioral Inhibition, Anxiety, and Attention Biases to Threat and Positive Information

Intergenerational transmission of maternal prenatal anxiety to infant fearfulness: the mediating role of mother-infant bonding

PURPOSE

This study is the first to directly investigate the mechanistic role of maternal bonding toward her infant in the early intergenerational pathway of risk from maternal anxiety to infant fearfulness.

METHODS

Mothers (N = 216; Mage=32.78) reported on their anxiety and bonding at four time-points between pregnancy and ten-months postpartum. At four and ten-months postpartum, infant temperamental precursors of anxiety were assessed through maternal report and observation.

RESULTS

Cross-lagged longitudinal path modeling indicated a significant link between prenatal maternal anxiety and infant temperamental fearful withdrawal at 10-months postpartum (R2 = 0.117), which was fully explained by decreased maternal bonding at one-month postpartum and increased infant temperamental negative reactivity at 4-months postpartum.

CONCLUSION

Results support the need to foster maternal bonding in preventive perinatal care, particularly in the context of maternal anxiety.

Parenting as a Moderator of the Relation Between Child Inhibited Temperament and Anxiety in Western Contexts: A Systematic Review

The literature on the role of parenting in the relation between child inhibited temperament and child anxiety is inconsistent, with some literature supporting a moderating role and some literature supporting alternative (e.g., mediating) roles. A systematic review of the evidence that parenting moderates the longitudinal relation between child inhibited temperament and child anxiety is needed. A systematic review of the literature was conducted in February and March of 2022 and repeated in January of 2024. Ten articles met criteria for inclusion, with 39 moderation analyses of interest among them. All included studies were conducted in Western contexts with predominately White, middle-class families. Thus, the current review can only be generalized to this population. Despite inconsistent findings, some evidence indicated that avoidance-promoting parenting behaviors such as overprotection and overinvolvement moderate the relation between child inhibited temperament and social anxiety symptoms, in particular. There was a lack of evidence that parenting behaviors moderate the relation between child inhibited temperament and anxiety disorders, and that affect-related parenting behaviors (e.g., negativity) moderate the relation between child inhibited temperament and non-social anxiety symptoms. There was mixed evidence regarding the moderating role of control-related parenting behaviors in the relation between child inhibited temperament and non-social anxiety symptoms, with some evidence that encouraging behaviors moderate this relation. Future research is needed to clarify these inconsistent and nuanced findings and investigate this moderation in non-Western, non-White, and low-income populations.

Examining the Association between Punishment and Reward Sensitivity and Response Inhibition to Previously-Incentivized Cues across Development

Processing and learning from affective cues to guide goal-directed behavior may be particularly important during adolescence; yet the factors that promote and/or disrupt the ability to integrate value in order to guide decision making across development remain unclear. The present study (N = 1046) assessed individual difference factors (self-reported punishment and reward sensitivity) related to whether previously-rewarded and previously-punished cues differentially impact goal-directed behavior (response inhibition) in a large developmental sample. Participants were between the ages of 8-21 years (Mage = 14.29, SD = 3.97, 50.38% female). Previously-rewarded cues improved response inhibition among participants age 14 and older. Further, punishment sensitivity predicted overall improved response inhibition among participants aged 10 to 18. The results highlight two main factors that are associated with improvements in the ability to integrate value to guide goal-directed behaviour - cues in the environment (e.g., reward-laden cues) and individual differences in punishment sensitivity. These findings have implications for both educational and social policies aimed at characterizing the ways in which youth integrate value to guide decision making.

An Integrative Model of Youth Anxiety: Cognitive-Affective Processes and Parenting in Developmental Context

Multiple theoretical frameworks have been proposed to provide a more comprehensive picture of the risk factors that influence anxiety-related developmental trajectories. Nonetheless, there remains a need for an integrative model that outlines: (1) which risk factors may be most pertinent at different points in development, and (2) how parenting may maintain, exacerbate, or attenuate an affective style that is characterized by high negative emotional reactivity to unfamiliar, uncertain, and threatening situations. A developmentally informed, integrative model has the potential to guide treatment development and delivery, which is critical to reducing the public health burden associated with these disorders. This paper outlines a model integrating research on many well-established risk mechanisms for anxiety disorders, focusing on (1) the developmental progression from emotional reactivity constructs early in life to those involving higher-level cognitive processes later in youth, and (2) potential pathways by which parenting may impact the stability of youth's cognitive-affective responses to threat-relevant information across development.

Role of the intraparietal sulcus (IPS) in anxiety and cognition: Opportunities for intervention for anxiety-related disorders

Our objective was to review the literature on the parietal cortex and intraparietal sulcus (IPS) in anxiety-related disorders, as well as opportunities for using neuromodulation to target this region and reduce anxiety. We provide an overview of prior research demonstrating: 1) the importance of the IPS in attention, vigilance, and anxious arousal, 2) the potential for neuromodulation of the IPS to reduce unnecessary attention toward threat and anxious arousal as demonstrated in healthy samples; and 3) limited data on the potential for neuromodulation of the IPS to reduce hyper-attention toward threat and anxious arousal among clinical samples with anxiety-related disorders. Future research should evaluate the efficacy of IPS neuromodulation in fully powered clinical trials, as well as the value in augmenting evidence-based treatments for anxiety with IPS neuromodulation.

Anxiety disorders in children and adolescents: A summary and overview of the literature

Considerable work has advanced understanding of the nature, causes, management, and prevention of anxiety disorders in children and adolescents over the past 30 years. Prior to this time the primary focus was on school refusal and specific phobias. It is now recognised that children and adolescents experience the full gamut of anxiety disorders in very similar ways to adults and that anxiety disorders in the paediatric years can predict a lifelong mental-health struggle. Given the vast array of specific studies in this field, the current review summarises current knowledge about these high prevalence disorders, points to overarching limitations, and suggests potentially important future directions. Following a brief historical overview, the review summarises knowledge about demographic and epidemiological characteristics, distal and proximal risk factors, current treatment directions, and prevention. There is still a great deal to learn about the causes and treatments of child and adolescent anxiety disorders. By amalgamating our current knowledge, this review provides a window to the research directions that are likely to lead to future advances.

Fearful temperament in middle childhood predicts adolescent attention bias and anxiety symptoms: The moderating role of frontal EEG asymmetry

The current study provided first analyses of the moderating effect of baseline-to-task frontal EEG asymmetry on the associations between 9-year fearful temperament and adolescent attention bias to threat as well as anxiety symptoms. Participants include a community sample of 122 children (60 boys, 62 girls; Mage = 14.66 years; Range = 11.82-18.13 years). Baseline-to-task frontal EEG asymmetry at age 9 moderated the relation between fearful temperament at age 9 and adolescent anxiety symptoms. Specifically, fearful temperament predicted adolescent anxiety symptoms when children showed greater right activation from baseline to an executive function task, but not greater left activation. Baseline-to-task frontal EEG asymmetry moderated the association between fearful temperament and sustained (i.e., stimulus onset asynchrony is 1250 ms) but not automatic attention bias (i.e., stimulus onset asynchrony is 500 ms). Children with greater left frontal activation from baseline to task more efficiently direct attention away from threat. Adolescent automatic attention bias to threat was related to concurrent anxiety symptoms. These findings illustrate the importance of considering frontal EEG asymmetry to shape how fearful children process threat and to influence their behavioral problems.

Annual Research Review: Developmental pathways linking early behavioral inhibition to later anxiety

Behavioral Inhibition is a temperament identified in the first years of life that enhances the risk for development of anxiety during late childhood and adolescence. Amongst children characterized with this temperament, only around 40 percent go on to develop anxiety disorders, meaning that more than half of these children do not. Over the past 20 years, research has documented within-child and socio-contextual factors that support differing developmental pathways. This review provides a historical perspective on the research documenting the origins of this temperament, its biological correlates, and the factors that enhance or mitigate risk for development of anxiety. We review as well, research findings from two longitudinal cohorts that have identified moderators of behavioral inhibition in understanding pathways to anxiety. Research on these moderators has led us to develop the Detection and Dual Control (DDC) framework to understand differing developmental trajectories among behaviorally inhibited children. In this review, we use this framework to explain why and how specific cognitive and socio-contextual factors influence differential pathways to anxiety versus resilience.

Behavioural inhibition and early neural processing of happy and angry faces interact to predict anxiety: a longitudinal ERP study

Limited prospective research has examined whether attention biases to emotion moderate associations between Behavioural Inhibition (BI) and anxiety in preschool-aged children. Furthermore, there has been an over-reliance on behavioral measures in previous studies. Accordingly, we assessed anxiety in a sample of preschool-aged children (3-4 years) at baseline, and again approximately 6 and 11 months later, after they started school. At baseline, children completed an assessment of BI and an EEG task where they were presented with angry, happy, and neutral faces. EEG analyses focused on ERPs (P1, P2, N2) associated with specific stages of attention allocation. Interactions between BI and emotion bias (ERP amplitude for emotional versus neutral faces) were found for N2 and P1. For N2, BI was significantly associated with higher overall anxiety when an angry bias was present. Interestingly for P1, BI was associated with higher overall anxiety when a happy bias was absent. Finally, interactions were found between linear time and happy and angry bias for P1, with a greater linear decrease in anxiety over time when biases were high. These results suggest that attention to emotional stimuli moderates the BI-anxiety relationship across early development.

Childhood inhibition predicts adolescent social anxiety: Findings from a longitudinal twin study

An enduring issue in the study of mental health is identifying developmental processes that explain how childhood characteristics progress to maladaptive forms. We examine the role that behavioral inhibition (BI) has on social anxiety (SA) during adolescence in 868 families of twins assessed at ages 8, 13, and 15 years. Multimodal assessments of BI and SA were completed at each phase, with additional measures (e.g., parenting stress) for parents and twins. Analyses were conducted in several steps: first, we used a cross-lagged panel model to demonstrate bidirectional paths between BI and SA; second a biometric Cholesky decomposition showed that both genetic and environmental influences on childhood BI also affect adolescent SA; next, multilevel phenotypic models tested moderation effects between BI and SA. We tested seven potential moderators of the BI to SA prediction in individual models and included only those that emerged as significant in a final conditional model examining predictors of SA. Though several main effects emerged as significant, only parenting stress had a significant interaction with BI to predict SA, highlighting the importance of environmental moderators in models examining temperamental effects on later psychological symptoms. This comprehensive assessment continues to build the prototype for such developmental psychopathology models.

Attentional biases in human anxiety

Across clinical and subclinical samples, anxiety has been associated with increased attentional capture by cues signaling danger. Various cognitive models attribute the onset and maintenance of anxiety symptoms to maladaptive selective information processing. In this brief review, we 1) describe the evidence for the relations between anxiety and attention bias toward threat, 2) discuss the neurobiology of anxiety-related differences in threat bias, 3) summarize work investigating the developmental origins of attention bias toward threat, and 4) examine efforts to translate threat bias research into clinical intervention. Future directions in each area are discussed, including the use of novel analytic approaches improving characterization of threat-processing-related brain networks, clarifying the role of cognitive control in the development of attention bias toward threat, and the need for larger, well-controlled randomized clinical trials examining moderators and mediators of treatment response. Ultimately, this work has important implications for understanding the etiology of and for intervening on anxiety difficulties among children and adults.

Developing an Anxiety Screening Tool for Children in South Africa: Protocol for a Mixed Methods Study

BACKGROUND

Early childhood experiences such as trauma, exposure to violence, and poverty can significantly contribute to childhood anxiety, which is viewed as the most common mental health issue among children. In South Africa, there is no uniform tool to screen for anxiety during early childhood. This study aims to develop a tool to screen for anxiety in children aged 4 to 8 years, which could be utilized by preschool and foundation phase teachers to aid in the early identification of childhood anxiety.

OBJECTIVE

The overall objective of this study is to explore understanding and perceptions of childhood anxiety among teachers, parents, and experts and to develop a tool to screen for anxiety in children aged 4 to 8 years.

METHODS

This project will use a mixed method design that will consist of 4 stages. Stage 1 will consist of a scoping review. In Stage 2, data will be collected via semistructured interviews with 60 participants, including parents, teachers, and experts, and will be thematically analyzed. Stage 3 will consist of 20 experts and the researcher collaboratively formulating the proposed screening tool in the form of an e-Delphi component. Once the tool is refined, it will be piloted in Stage 4 with 20 teachers, and data will be analyzed with the Shapiro-Wilk test to test for normality. Additionally, factor analysis will be done to refine and restructure the tool as necessary.

RESULTS

This project was funded from April 2020 to December 2021. Data collection began in September 2022 and is projected to conclude in December 2022 for the qualitative component. The e-Delphi component is expected to be carried out from March to November 2023. Ethical approval was obtained from the Biomedical Research Ethics Committee in November 2021.

CONCLUSIONS

Anxiety in early childhood has been linked to various repercussions in adolescence and adulthood, such as school dropout, substance abuse, anxiety disorders, depression, and suicide ideation. Therefore, identifying the presence of anxiety earlier on and providing the necessary referral services could aid in reducing the negative consequences of unidentified and untreated anxiety in early childhood.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/37364.

Bi-directional relations between attention and social fear across the first two years of life

This study examined longitudinal relations between attention and social fear across the first two years of life. Our sample consisted of 357 infants and their caregivers across three sites. Data was collected at 4, 8, 12, 18, and 24 months of age. At all 5 assessments, the infants participated in 2 eye-tracking tasks (Vigilance and Overlap) which measured different components of attention bias (orientation, engagement, and disengagement), and parents completed questionnaires assessing infant temperament. For the first three assessments, social fear was measured using the Infant Behavioral Questionnaire-Revised (IBQ-R; Gartstein & Rothbart, 2003) focused on interactions with strangers, and for the final two time points, we used the social fearfulness subscale on the Toddler Behavior Assessment Questionnaire (TBAQ; Goldsmith, 1996). The results of a random intercept cross-lagged panel model showed intermittent evidence of uni-directional and reciprocal relations between attention to both threatening and positive emotion facial configurations and social fear. Our findings suggest that characteristics of behaviorally inhibited temperament-in this case, social fear-begin to interact with attention biases to emotion in the very first year of life, which carries implications for the timing of future interventions designed to mitigate the early development of maladaptive patterns of attention.

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.

Signaled night awakening and its association with social information processing and socio-emotional development across the first two years

STUDY OBJECTIVES

Night awakening is common in infancy, and some infants continue to have signaled night awakenings throughout early childhood. However, the influence of signaled night awakening on children's social development is less explored. In the present study, longitudinal associations between signaled night awakening, social information processing, and socio-emotional development were measured within the CHILD-SLEEP birth cohort in two groups formed based on parent-reported night awakenings.

METHODS

At 8 months, there were 77 infants in the waking group (≥3 awakenings) and 69 infants in the nonwaking group (≤1 awakening). At 8 and 24 months, social information processing was measured as children's attention to neutral and emotional faces, and at 24 months, parent-reported socio-emotional behavior was measured with the Brief Infant-Toddler Social and Emotional Assessment (BITSEA) questionnaire.

RESULTS

The two groups showed different patterns of attention to emotional faces. The waking group had a more pronounced attentional bias to fearful versus happy faces, whereas in the nonwaking group, attention to fearful and happy faces did not differ. In addition, at 24 months, the waking group had more dysregulation problems and lower social competence than the nonwaking group, but no clear differences in internalizing or externalizing problems were found.

CONCLUSIONS

Our results contribute to the literature by showing that during the first 2 years of life, signaled night awakening is associated with social information processing and socio-emotional behavior.

Mobile Eye Tracking Captures Changes in Attention Over Time During a Naturalistic Threat Paradigm in Behaviorally Inhibited Children

Attentional biases to and away from threat are considered hallmarks of temperamental Behavioral Inhibition (BI), which is a documented risk factor for social anxiety disorder. However, most research on affective attentional biases has traditionally been constrained to computer screens, where stimuli often lack ecological validity. Moreover, prior research predominantly focuses on momentary presentations of stimuli, rather than examining how attention may change over the course of prolonged exposure to salient people and objects. Here, in a sample of children oversampled for BI, we used mobile eye-tracking to examine attention to an experimenter wearing a "scary" or novel gorilla mask, as well as attention to the experimenter after mask removal as a recovery from exposure. Conditional growth curve modeling was used to examine how level of BI related to attentional trajectories over the course of the exposure. We found a main effect of BI in the initial exposure to the mask, with a positive association between level of BI and proportion of gaze allocated to the stranger's masked face over time. Additionally, there was a main effect of BI on proportion of gaze allocated to the stranger's face plus their mask during the recovery period when the mask was removed.

Expressions of positive and negative shyness in preschool-age children: Temperamental correlates and visual attention to emotions

Recent empirical evidence shows heterogeneity in the expression of shyness in children. Some children tend to express their shyness displaying positive affect along with gaze aversions (positive shyness), whereas others display more negative emotional reactions accompanied by gaze aversions (negative shyness). Temperamental differences in approach-avoidance tendencies are likely to explain these differences in shyness expression in children and influence their visual attention to social stimuli, yet little empirical attention has been devoted to these associations. Our study examined the temperamental profile (approach, fear, and inhibitory control) associated with positive and negative shyness and the relation between expression of shyness and attention to social stimuli in 47 children aged 3-6 years. Children's positive and negative expressions of shyness were assessed using a performance task. Visual attention to facial emotional expressions was measured with the dot - probe task, and temperament was measured with maternal reports. Positive shyness was found to be positively associated with temperamental dimensions of approach, inhibitory control, and fear. Positive shyness was significantly associated with attentional orientation to positive facial expressions and with less attentional avoidance of threatening facial expressions. Negative shyness was positively associated only with temperamental fear, and no associations were found with attention to social stimuli. Our study provides empirical support for the association between temperament and the multidimensional character of the expression of positive shyness and adds relevant evidence regarding the connection between the expression of shyness and attention to social stimuli.

Early social adversity modulates the relation between attention biases and socioemotional behaviour in juvenile macaques

Affect-biased attention may play a fundamental role in early socioemotional development, but factors influencing its emergence and associations with typical versus pathological outcomes remain unclear. Here, we adopted a nonhuman primate model of early social adversity (ESA) to: (1) establish whether juvenile, pre-adolescent macaques demonstrate attention biases to both threatening and reward-related dynamic facial gestures; (2) examine the effects of early social experience on such biases; and (3) investigate how this relation may be linked to socioemotional behaviour. Two groups of juvenile macaques (ESA exposed and non-ESA exposed) were presented with pairs of dynamic facial gestures comprising two conditions: neutral-threat and neutral-lipsmacking. Attention biases to threat and lipsmacking were calculated as the proportion of gaze to the affective versus neutral gesture. Measures of anxiety and social engagement were also acquired from videos of the subjects in their everyday social environment. Results revealed that while both groups demonstrated an attention bias towards threatening facial gestures, a greater bias linked to anxiety was demonstrated by the ESA group only. Only the non-ESA group demonstrated a significant attention bias towards lipsmacking, and the degree of this positive bias was related to duration and frequency of social engagement in this group. These findings offer important insights into the effects of early social experience on affect-biased attention and related socioemotional behaviour in nonhuman primates, and demonstrate the utility of this model for future investigations into the neural and learning mechanisms underlying this relationship across development.

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

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

Developmental associations between risk-taking and anxiety symptoms across ages 8-12 years

This study explored the transactional association between anxiety symptoms and risk‐avoidance in Dutch elementary schoolchildren (N = 1200; 50% girls) across ages 8–12. Anxiety symptoms were obtained using self‐, peer‐, and teacher‐reports. Risk‐avoidance was measured using the Balloon Analogue Risk Task—Youth Version. Random‐intercept cross‐lagged panel models showed that, across informants, increases in anxiety symptoms predicted decreases in risk‐taking. Apart from minor exceptions, this effect was similar across sexes. For peer‐reports, the reverse path from decreases in risk‐taking to increased anxiety was also found. Overall, this study gives insight into the developmental link between symptoms of anxiety and risk‐avoidance which is important for early signaling and prevention as well as for our understanding of the consequences of childhood anxiety symptoms.

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

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

Fearful Temperament and the Risk for Child and Adolescent Anxiety: The Role of Attention Biases and Effortful Control

Fearful temperament represents one of the most robust predictors of child and adolescent anxiety; however, not all children with fearful temperament unvaryingly develop anxiety. Diverse processes resulting from the interplay between automatic processing (i.e., attention bias) and controlled processing (i.e., effortful control) drive the trajectories toward more adaptive or maladaptive directions. In this review, we examine the associations between fearful temperament, attention bias, and anxiety, as well as the moderating effect of effortful control. Based on the reviewed literature, we propose a two-mechanism developmental model of attention bias that underlies the association between fearful temperament and anxiety. We propose that the sub-components of effortful control (i.e., attentional control and inhibitory control) play different roles depending on individuals' temperaments, initial automatic biases, and goal priorities. Our model may help resolve some of the mixed findings and conflicts in the current literature. It may also advance our knowledge regarding the cognitive mechanisms linking fearful temperament and anxiety, as well as facilitate the continuing efforts in identifying and intervening with children who are at risk. Finally, we conclude the review with a discussion on the existing limitations and then propose questions for future research.

Vigilant or avoidant? Children's temperamental shyness, patterns of gaze, and physiology during social threat

Temperamental shyness is characterized by fear, wariness, and the perception of threat in response to social novelty. Previous work has been inconsistent regarding attentional patterns to social threat among shy children, with evidence for both avoidance and vigilance. We examined relations between children's shyness and gaze aversion during the approach of a stranger (i.e., a context of social novelty), and tested whether these patterns of gaze moderated relations between shyness and autonomic reactivity and recovery. Participants included 152 typically-developing children (M_age  = 7.82 years, SD = 0.44 years) who had their respiratory sinus arrhythmia (RSA) recorded during baseline, social novelty, and recovery. Children's shyness correlated with increases in self-reported nervousness from baseline to social novelty, providing support for perceived threat. Results revealed that children's proportion of gaze aversion from social novelty was related to shyness in a U-shape pattern such that both low levels of gaze aversion (i.e., attentional vigilance) and high levels of gaze aversion (i.e., attentional avoidance) were related to higher levels of shyness. Further, we found that children's shyness was directly related to decreases in RSA from baseline to social novelty, whereas quadratic gaze to social novelty moderated the relation between shyness and RSA recovery. Specifically, shyness was related to greater RSA recovery among children who exhibited attentional vigilance during the novel social interaction. Our findings provide support for both avoidance of, and vigilance to, social threat among different shy children, and these gaze strategies may be differentially related to physiological regulation during novel social encounters.

Understanding the Emergence of Social Anxiety in Children With Behavioral Inhibition

Behavioral inhibition (BI) is a temperament characterized in early childhood by distress to novelty and avoidance of unfamiliar people, and it is one of the best-known risk factors for the development of social anxiety. However, nearly 60% of children with BI do not go on to meet criteria for social anxiety disorder. In this review we present an approach to understanding differential developmental trajectories among children with BI. We review research using laboratory-based tasks that isolate specific attention processes that enhance versus mitigate risk for social anxiety among behaviorally inhibited children and studies that suggest that BI is associated with heightened detection of novelty or threat. Moreover, stimulus-driven control processes, which we term "automatic control," increase the probability that behaviorally inhibited children display socially reticent behavior and develop social anxiety. In contrast, goal-driven control processes, which we term "planful control," decrease risk for anxiety. We suggest that these three categories of processes (detection, automatic control, and planful control) function together to determine whether behaviorally inhibited children are able to flexibly regulate their initial reactions to novelty, and in turn, decrease risk for social anxiety. Although laboratory-based tasks have identified these processes underlying risk and resilience, the challenge is linking them to the emotions, thoughts, and behaviors of behaviorally inhibited children in real-world contexts.

Multimodal examination of emotion processing systems associated with negative affectivity across early childhood

High Temperamental Negative Affectivity in early childhood has been found to predict later emotion dysregulation. While much work has been conducted to separately probe bio-behavioral systems associated with Negative Affectivity, very little work has examined the relations among multiple systems across age. In this study, we use multi-modal methods to index neurobiological systems associated with Negative Affectivity in 53 4-7-year-old children. Prefrontal activation during emotion regulation was measured using functional near-infrared spectroscopy over the lateral prefrontal cortex (PFC) while children played a game designed to elicit frustration in Social (Happy and Angry faces) and Nonsocial contexts. Gaze behaviors while free-viewing Happy and Angry faces were also measured. Finally, Negative Affectivity was indexed using a score composite based on factor analysis of parent-reported temperament. Using mixed-effects linear models, we found an age-dependent association between Negative Affectivity and both PFC activation during frustration and fixation duration on the mouth area of Happy faces, such that older children high in Negative Affectivity spent less time looking at the mouths of Happy faces and had lower PFC activation in response to frustration (ps<0.034). These results provide further insight to how Negative Affectivity may be associated with changes in affective neurobiological systems across early childhood.

Prospective Association between Childhood Behavioral Inhibition and Anxiety: a Meta-Analysis

Behavioral inhibition (BI) is a risk factor for anxiety. However, the estimates of the strength of this association vary widely. In addition, while BI is a strong predictor of social anxiety disorder (SAD), its association with other anxiety disorders is unclear. The current study sought to establish the relationship between BI and anxiety and to quantify this association for a range of anxiety disorders. We searched PsycInfo, PubMed and Embase for articles published before May 18th, 2019 using search terms for BI, anxiety and prospective study design. We selected articles which assessed the prospective relationship between BI in childhood and anxiety. Using random-effects meta-analysis with robust variance estimation, which allowed for the inclusion of multiple follow-ups of the same sample, we established the association between BI and any anxiety. We also explored the association between BI and individual anxiety disorders. Data from 27 studies consisting of 35 follow-ups of 20 unique samples indicated that BI prospectively increases the odds of anxiety (OR = 2.80, 95% CI 2.03 to 3.86, p < 0.001). There was also a positive association between BI and all individual anxiety disorders, with effect sizes ranging from small in the case of specific phobia (OR = 1.49, 95% CI 1.03 to 2.14, p = 0.03) to large in the case of SAD (OR = 5.84, 95% CI 3.38 to 10.09, p < 0.001). BI in early childhood is a strong risk factor for anxiety. Targeting BI may help reduce the number of children who will develop anxiety disorders.

Attention Bias and Prodromal Anxiety Symptoms in Toddlers With Fragile X Syndrome and Down Syndrome

Early identification of behavioral risk markers for anxiety is essential to optimize long-term outcomes in children with neurodevelopmental disorders. This study analyzed attentional avoidance and its relation to anxiety and autism spectrum disorder (ASD) symptomatology during social and nonsocial fear conditions in toddlers with fragile X syndrome (FXS) and Down syndrome (DS). Toddlers with FXS and DS exhibited increased nonsocial attentional avoidance relative to typically developing (TD) toddlers. Attentional avoidance was not related to anxiety symptom severity in any group; however, higher ASD symptom severity was related to more social attentional avoidance in the FXS and TD groups. Findings suggest that there may be different underlying mechanisms driving attentional avoidance across neurodevelopmental disorders.

Cardiorespiratory Response to Moderate Hypercapnia in Female College Students Expressing Behaviorally Inhibited Temperament

Behaviorally inhibited (BI) temperament is marked by heightened behavioral sensitivity to environmental threats. The degree to which threat sensitivity is reflected in cardiorespiratory responses has been relatively unexplored. Female college students were exposed to modest hypercapnia (7.0% CO₂) or ambient air (AA) while engaging in a computerized task with cued reinforcement features. All physiological variables except for blood pressure were processed in 4 min epochs corresponding to pre-exposure, exposure, and post-exposure. Primary respiratory measures were respiratory frequency (f_b), tidal volume (V_T), and minute ventilation (V_E). Electrocardiograms (ECGs) were processed using ARTiiFACT software with resultant heart rate variability (HRV) measures in the frequency domain and time domain. Consistent with the literature, modest hypercapnia increased V_T, F_b, and V_E. No differences in respiratory parameters were detected between BI and non-behaviorally inhibited individuals (NI). For HRV in the time domain, RMSSD and NN50 values increased during CO₂ inhalation which then returned to pre-exposure levels after CO₂ cessation. Hypercapnia increased high frequency (HF) power which then recovered. BI exhibited reduced low frequency (LF) power during the pre-exposure period. For NI, LF power reduced over the subsequent phases ameliorating differences between BI and NI. Hypercapnia improved the task performance of BI. This is the largest study of female reactivity to hypercapnia and associated HRV to date. In general, hypercapnia increased time domain HRV and HF power, suggesting a strong vagal influence. Those expressing BI exhibited similar respiratory and HRV reactivity to NI despite inherently reduced LF power. Although 7% CO₂ represents a mild challenge to the respiratory and cardiovascular systems, it is nonetheless sufficient to explore inherent difference in stress reactivity in those vulnerable to develop anxiety disorders.

Psychometric properties of threat-related attentional bias in young children using eye-tracking

Anxiety is one of the most common forms of child psychopathology associated with persistent impairment across the lifespan. Therefore, investigating mechanisms that underlie anxiety in early childhood may improve prevention and intervention efforts. Researchers have linked selective attention toward threat (i.e., attentional bias to threat) with the development of anxiety. However, previous work on attentional bias has used less reliable, reaction time (RT)-based measures of attention. Additionally, few studies have used eye-tracking to measure attentional bias in young children. In the present study, we investigated the psychometric properties of an eye-tracking measure of attentional bias in a sample of young children between 6- and 9-years-old and explored if trait and clinical anxiety were related to attentional biases to threat. Results showed good psychometric properties for threat and neutral attentional biases, comparable to those found in adult eye-tracking studies. Temperamental and clinical anxiety did not significantly relate to threat/neutral dwell time and attentional biases. The significance of these null findings was discussed in relation to existing developmental theories of attentional biases. Future studies should explore if temperamental or clinical anxiety prospectively predict threat attentional bias and the onset of anxiety in older children using a longitudinal design.

Converging Multi-modal Evidence for Implicit Threat-Related Bias in Pediatric Anxiety Disorders

This report examines the relationship between pediatric anxiety disorders and implicit bias evoked by threats. To do so, the report uses two tasks that assess implicit bias to negative-valence faces, the first by eye-gaze and the second by measuring body-movement parameters. The report contrasts task performance in 51 treatment-seeking, medication-free pediatric patients with anxiety disorders and 36 healthy peers. Among these youth, 53 completed an eye-gaze task, 74 completed a body-movement task, and 40 completed both tasks. On the eye-gaze task, patients displayed longer gaze duration on negative relative to non-negative valence faces than healthy peers, F(1, 174) = 8.27, p = .005. In contrast, on the body-movement task, patients displayed a greater tendency to behaviorally avoid negative-valence faces than healthy peers, F(1, 72) = 4.68, p = .033. Finally, implicit bias measures on the two tasks were correlated, r(38) = .31, p = .049. In sum, we found an association between pediatric anxiety disorders and implicit threat bias on two tasks, one measuring eye-gaze and the other measuring whole-body movements. Converging evidence for implicit threat bias encourages future research using multiple tasks in anxiety.

Charting the physiological time course of help-seeking during late childhood: Patterns of individual difference

In this study, we explored whether variability in children's physiological reactivity-respiratory sinus arrhythmia and electrodermal activity-predict concurrent and subsequent levels of children's observed help-seeking (HS) from their mothers during a failure task. In addition, we tested whether children's perceptions of maternal positivity pre-task (CPMP) and children's fearful temperament moderate these effects. In a community sample of 101 mother-child dyads, children (8-12 years of age) underwent a repeated failure task while their respiratory sinus arrythmia and electrodermal activity were monitored; their HS behaviors were later coded. Multilevel path analyses indicated that high-fearful children increased their HS at the same time as and following increased physiological reactivity regardless of CPMP pre-task. Low-fearful children showed increases in HS at the same time as and following increased physiological reactivity only when they perceived their mothers' affect to be positive. This study demonstrates children's individual differences in the physiological underpinning of time-linked HS behaviors.

Emotional distractors and attentional control in anxious youth: eye tracking and fMRI data

Attentional control theory suggests that high cognitive demands impair the flexible deployment of attention control in anxious adults, particularly when paired with external threats. Extending this work to pediatric anxiety, we report two studies utilising eye tracking (Study 1) and functional magnetic resonance imaging (Study 2). Both studies use a visual search paradigm to examine anxiety-related differences in the impact of threat on attentional control at varying levels of task difficulty. In Study 1, youth ages 8-18 years (N = 109), completed the paradigm during eye tracking. Results indicated that youth with more severe anxiety took longer to fixate on and identify the target, specifically on difficult trials, compared to youth with less anxiety. However, no anxiety-related effects of emotional distraction (faces) emerged. In Study 2, a separate cohort of 8-18-year-olds (N = 72) completed a similar paradigm during fMRI. Behaviourally, youth with more severe anxiety were slower to respond on searches following non-threatening, compared to threatening, distractors, but this effect did not vary by task difficulty. The same interaction emerged in the neuroimaging analysis in the superior parietal lobule and precentral gyrus-more severe anxiety was associated with greater brain response following non-threatening distractors. Theoretical implications of these inconsistent findings are discussed.

The roles of temperamental inhibition in affective and cognitive empathy in Chinese toddlers

Empathy, crucial to harmonious interpersonal relationships and moral development, has both affective and cognitive components. Previous studies found that toddlers' temperamental inhibition may influence their empathy, but mainly focused on emotional response to others' distress. Little is known about whether inhibited children's poor empathy is due to high reactivity and social withdrawal when sharing others' affective states, such as distress (affective empathy), or to a difficulty in comprehending and inferring others' perspective (cognitive empathy). The current study investigated the role of behavioral inhibition (BI) in affective empathy (response to pain simulation) and cognitive empathy (performance in perspective-taking task) among 163 Chinese toddlers and tested in both only and non-only children. Correlation analyses showed that BI was only negatively associated with affective empathy. The relation between BI and cognitive empathy was moderated by self-regulation and inhibited children who were low in self-regulation presented low cognitive empathy. Additionally, only children presented advanced cognitive empathy but poorer affective empathy than non-only children. These findings imply different roles of BI in affective versus cognitive empathy in early childhood. Although highly inhibited children rarely show positive social expression toward others' distress, caution is needed in inferring that they lack a capacity for cognitive empathy.

Behavioral Inhibition in Early Childhood and Adjustment in Late Adolescence in China

This study examined relations between behavioral inhibition in toddlerhood and social, school, and psychological adjustment in late adolescence in China. Data on behavioral inhibition were collected from a sample of 2-year-olds (initial N = 247). Follow-up data were collected at 7 years for peer relationships and 19 years for adjustment across domains. The results showed that early inhibition positively predicted later social competence and school adjustment. Peer relationships in middle childhood served as a protective factor in the development of depression of inhibited children. The results indicate the distinct functional meaning of behavioral inhibition in the Chinese context from a developmental perspective.

Multi-method assessment of irritability and differential linkages to neurophysiological indicators of attention allocation to emotional faces in young children

Facilitated attention toward angry stimuli (attention bias) may contribute to anger proneness and temper outbursts exhibited by children with high irritability. However, most studies linking attention bias and irritability rely on behavioral measures with limited precision and no studies have explored these associations in young children. The present study explores irritability-related attention biases toward anger in young children (N = 128; ages 4-7 years) engaged in a dot-probe task with emotional faces, as assessed with event-related brain potential (ERP) indices of early selective attention and multi-method assessment of irritability. Irritability assessed via semi-structured clinical interview predicted larger anterior N1 amplitudes to all faces. In contrast, irritability assessed via a laboratory observation paradigm predicted reduced P1 amplitudes to angry relative to neutral faces. These findings suggest that altered early attentional processing occurs in young children with high irritability; however, the nature of these patterns may vary with methodological features of the irritability assessments. Future investigations using different assessment tools may provide greater clarity regarding the underlying neurocognitive correlates of irritability. Such studies may also contribute to the ongoing debates about how to best define and measure irritability across the developmental spectrum in a manner that is most informative for linkage to neural processes.

Behavioral Inhibition in Childhood as A Risk Factor for Development of Social Anxiety Disorder: A Longitudinal Study

Previous research has suggested the association between behavioral inhibition (BI) and the development of social anxiety disorder in childhood. However, there is scarce research using longitudinal methodology in Spanish-speaking populations. To cover this gap, the sample comprised 73 children ranging from six to eight years who had been examined for BI two years earlier in home and school settings. Children and their parents were administered the Anxiety Disorders Interview Schedule for DSM-5-Child and Parent Versions to assess the presence of possible anxiety disorders. The results revealed the stability of BI symptomatology over time. Data also showed that BI children were almost ten times more likely to develop social anxiety disorder two years later, compared to no-BI children. As a result, findings suggest behavioral inhibition strongly predicts social anxiety disorder, making BI a logical focus for selective preventive interventions. Therefore, screening for behavioral inhibition holds promise for primary prevention.

Attention bias to reward predicts behavioral problems and moderates early risk to externalizing and attention problems

The current study had three goals. First, we replicated recent evidence that suggests a concurrent relation between attention bias to reward and externalizing and attention problems at age 7. Second, we extended these findings by examining the relations between attention and behavioral measures of early exuberance (3 years), early effortful control (4 years), and concurrent effortful control (7 years), as well as later behavioral problems (9 years). Third, we evaluated the role of attention to reward in the longitudinal pathways between early exuberance and early effortful control to predict externalizing and attention problems. Results revealed that attention bias to reward was associated concurrently and longitudinally with behavioral problems. Moreover, greater reward bias was concurrently associated with lower levels of parent-reported effortful control. Finally, attention bias to reward moderated the longitudinal relations between early risk factors for behavioral problems (gender, exuberance, and effortful control) and later externalizing and attention problems, such that these early risk factors were most predictive of behavioral problems for males with a large attention bias to reward. These findings suggest that attention bias to reward may act as a moderator of early risk, aiding the identification of children at the highest risk for later behavioral problems.

Levels of early-childhood behavioral inhibition predict distinct neurodevelopmental pathways to pediatric anxiety

BACKGROUND

Anxiety symptoms gradually emerge during childhood and adolescence. Individual differences in behavioral inhibition (BI), an early-childhood temperament, may shape developmental paths through which these symptoms arise. Cross-sectional research suggests that level of early-childhood BI moderates associations between later anxiety symptoms and threat-related amygdala-prefrontal cortex (PFC) circuitry function. However, no study has characterized these associations longitudinally. Here, we tested whether level of early-childhood BI predicts distinct evolving associations between amygdala-PFC function and anxiety symptoms across development.

METHODS

Eighty-seven children previously assessed for BI level in early childhood provided data at ages 10 and/or 13 years, consisting of assessments of anxiety and an fMRI-based dot-probe task (including threat, happy, and neutral stimuli). Using linear-mixed-effects models, we investigated longitudinal changes in associations between anxiety symptoms and threat-related amygdala-PFC connectivity, as a function of early-childhood BI.

RESULTS

In children with a history of high early-childhood BI, anxiety symptoms became, with age, more negatively associated with right amygdala-left dorsolateral-PFC connectivity when attention was to be maintained on threat. In contrast, with age, low-BI children showed an increasingly positive anxiety-connectivity association during the same task condition. Behaviorally, at age 10, anxiety symptoms did not relate to fluctuations in attention bias (attention bias variability, ABV) in either group; by age 13, low-BI children showed a negative anxiety-ABV association, whereas high-BI children showed a positive anxiety-ABV association.

CONCLUSIONS

Early-childhood BI levels predict distinct neurodevelopmental pathways to pediatric anxiety symptoms. These pathways involve distinct relations among brain function, behavior, and anxiety symptoms, which may inform diagnosis and treatment.

Positive social feedback alters emotional ratings and reward valuation of neutral faces

Evaluation of facial and vocal emotional cues is vital in social interactions but can be highly influenced by characteristics of the observer, such as sex, age, and symptoms of affective disorders. Our evaluations of others' emotional expressions are likely to change as we get to know them and anticipate how they are likely to behave. However, the role of associative learning in the evaluation of social cues remains poorly understood. In this study, we investigated whether emotional ratings (valence and arousal) and reward valuation ("liking" and "wanting" measures) of neutral facial expressions can be altered through associative learning. We also examined whether emotional ratings and reward valuation varied with symptoms of anxiety and depression, disorders known to impair socio-affective functioning. Participants (N = 324) were young adults, ranging in scores across dimensions of depression and anxiety symptoms: "general distress" (common to depression and anxiety), "anhedonia-apprehension" (more specific to depression), and "fears" (more specific to anxiety). They rated neutral faces and completed a probabilistic learning task that paired images of neutral faces with positive or negative social feedback. Results demonstrated that pairing neutral faces with positive social feedback increased ratings of arousal, valence, and reward valuation (both "liking" and "wanting"). Pairing neutral faces with negative feedback reduced valence ratings and reduced "wanting," but did not impact arousal ratings or "liking." Symptoms of general distress were associated with negative bias in valence ratings, symptoms of anhedonia-apprehension were associated with reduced "wanting," and symptoms of fears were associated with altered accuracy over trials. Notably, the association between general distress and negative bias was reduced following the associative learning task. This suggests that disrupted evaluation of social cues can be improved through brief training.

Phenomenological contribution to understanding of vocally disruptive behaviour: A clinical case study in a patient with dementia

BACKGROUND

Behavioural and psychological symptoms of dementia (BPSD) cause great suffering in patients and their families. Phenomenology can help clarify the diagnosis and propose some new therapeutic responses using Daseinsanalyse. Separation issues understood using the phenomenological description of the melancholic type (MT) by Tellenbach may further shed light on our understanding of depression in dementia.

SUBJECT AND METHODS

In a 90-year-old woman presenting with advanced (Clinical Dementia Rating 3) mixed dementia and BPSD in the form of vocally disruptive behaviour (VDB), we discuss separation anxiety as the aetiopathogenic hypothesis. Depression and BPSD were assessed using the Neuropsychiatric Inventory, Cornell scale, and Montgomery-Åsberg Depression Rating Scale to confirm our second phenomenological diagnostic hypothesis, ie, melancholy. The Big Five Inventory scale filled in by a proxy was also used to evaluate the patient's premorbid personality. We then propose an explanatory frame of VDB and depression through the standard phenomenological assessment of its relation to time, space, self, and other.

RESULTS

Confirming MT, we found an inhibited temperament and low openness to experience in the patient, as well as a symbiotic relationship with a close relative (the other).

CONCLUSION

Separation anxiety may well explain the patient's MT expressed by VDB. Melancholic type and her symbiotic relationship led to a situation unbearable to the patient and her close relative unable to delegate care to a specialized team.

RUNNING HEAD

Phenomenology in vocally disruptive behaviour in dementia. We have found new explanations in similar clinical cases in dementia as follows. A patient presenting with vocally disruptive behaviour has a melancholic type, a behavioural-inhibited temperament, and marital violence in the past. Phenomenology may help explain this profile with neurobiological disorders. The life trajectory, from childhood into older age, must be taken into account to understand behavioural and psychological symptoms of dementia.

Stationary and ambulatory attention patterns are differentially associated with early temperamental risk for socioemotional problems: Preliminary evidence from a multimodal eye-tracking investigation

Behavioral Inhibition (BI) is a temperament type that predicts social withdrawal in childhood and anxiety disorders later in life. However, not all BI children develop anxiety. Attention bias (AB) may enhance the vulnerability for anxiety in BI children, and interfere with their development of effective emotion regulation. In order to fully probe attention patterns, we used traditional measures of reaction time (RT), stationary eye-tracking, and recently emerging mobile eye-tracking measures of attention in a sample of 5- to 7-year-olds characterized as BI (N = 23) or non-BI (N = 58) using parent reports. There were no BI-related differences in RT or stationary eye-tracking indices of AB in a dot-probe task. However, findings in a subsample from whom eye-tracking data were collected during a live social interaction indicated that BI children (N = 12) directed fewer gaze shifts to the stranger than non-BI children (N = 25). Moreover, the frequency of gazes toward the stranger was positively associated with stationary AB only in BI, but not in non-BI, children. Hence, BI was characterized by a consistent pattern of attention across stationary and ambulatory measures. We demonstrate the utility of mobile eye-tracking as an effective tool to extend the assessment of attention and regulation to social interactive contexts.

Intergenerational transmission of attentional bias and anxiety

Earlier evidence has revealed a bi-directional causal relationship between anxiety and attention biases in adults and children. This study investigated the prospective and concurrent relations between anxiety and attentional bias in a sample of 89 families (mothers, fathers, and first-born children). Parents' and children's attentional bias was measured when children were 7.5 years old, using both a visual probe task and visual search task with angry versus happy facial expressions. Generalized and social anxiety symptoms in parents and children were measured when children were 4.5 and 7.5 years old. Anxiety in parents and children was prospectively (but not concurrently) related to their respective attentional biases to threat: All participants showed a larger attentional bias to threat in the visual search (but not in the visual probe) task if they were more anxious at the 4.5 (but not at the 7.5) year measurement. Moreover, parents' anxiety levels were prospectively predictive of the visual search attentional bias of their children after controlling for child anxiety. More anxiety in mothers at 4.5 years was related to a faster detection of angry among happy faces, while more anxiety in fathers predicted a faster detection of happy among angry faces in children at 7.5 years. We found no direct association between parental and child attentional biases. Our study contributes to the recently emerging literature on attentional biases as a potential mechanism in the intergenerational transmission of anxiety by showing that parents' anxiety rather than parents' attentional bias contributes to the intergenerational transmission of risk for child anxiety.

Using Measurement Invariance to Study Social Withdrawal in Children With Developmental Language Disorders

Purpose

Teacher ratings were used to compare children with developmental language disorders (DLD) and their typically developing peers on 2 subtypes of social withdrawal (shyness and unsociability). Measurement invariance analysis was utilized to determine if teachers rated the 2 groups using the same underlying construct for each of the rating scale items that have been designed to assess withdrawn behavior.

Method

The Teacher Behavior Rating Scale (TBRS; C. H. Hart & Robinson, 1996 ) was administered to the teachers of 173 children with DLD and 182 typically developing children (age range: 5;0–12;11 years;months) to compare 2 subtypes of withdrawal, shyness and unsociability. Measurement invariance analysis was used to establish an appropriate basis for comparing the latent group means and other structural parameters, and partial invariance models were used to compare the groups.

Results

For the TBRS, shyness and unsociability were measured by 4 and 5 items, respectively. The measurement invariance analysis indicated that classroom teachers approached 1 item on each of these scales using a different underlying construct when rating the 2 groups of children. Taking this into account, the groups were compared. Teachers rated children with DLD as significantly more withdrawn on both shyness and unsociability in comparison with typically developing children. Age and gender were not significant factors.

Conclusions

When conducting assessments, it should not be assumed that teachers or other raters approach even commonly used rating scale items using the same underlying perception for typically developing children and children with disorders. However, the analysis of invariant items on the TBRS reconfirmed that children with DLD are at risk for social withdrawal as operationalized by assessments of both shyness and unsociability.

Supplemental Material

https://doi.org/10.23641/asha.7789472

Dispositional negativity, cognition, and anxiety disorders: An integrative translational neuroscience framework

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.

Threat-related Attention Bias in Socioemotional Development: A Critical Review and Methodological Considerations

Cross-sectional evidence suggests that attention bias to threat is linked to anxiety disorders and anxiety vulnerability in both children and adults. However, there is a lack of developmental evidence regarding the causal mechanisms through which attention bias to threat might convey risks for socioemotional problems, such as anxiety. Gaining insights into this question demands longitudinal research to track the complex interplay between threat-related attention and socioemotional functioning. Developing and implementing reliable and valid assessments tools is essential to this line of work. This review presents theoretical accounts and empirical evidence from behavioral, eye-tracking, and neural assessments of attention to discuss our current understanding of the development of normative threat-related attention in infancy, as well as maladaptive threat-related attention patterns that may be associated with the development of anxiety. This review highlights the importance of measuring threat-related attention using multiple attention paradigms at multiple levels of analysis. In order to understand if and how threat-related attention bias in real-life, social interactive contexts can predict socioemotional development outcomes, this review proposes that future research cannot solely rely on screen-based paradigms but needs to extend the assessment of threat-related attention to naturalistic settings. Mobile eye-tracking technology provides an effective tool for capturing threat-related attention processes in vivo as children navigate fear-eliciting environments and may help us uncover more proximal bio-psycho-behavioral markers of anxiety.