The Developmental Unfolding of ADHD Symptoms from Early Childhood Through Adolescence: Early Effects of Exuberant Temperament, Parenting and Executive Functioning

Temperament, parenting, and executive functioning (EF) are individual and contextual factors that have been identified to play a role in the development of Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms. Specifically, exuberant temperament in toddlerhood has been associated with both adaptive and maladaptive outcomes, including ADHD symptoms. Therefore, it is important to understand factors that predict which exuberant children experience increased ADHD symptoms and the specific mechanisms through which early exuberant temperament impacts later ADHD symptoms. Using a multi-method, prospective longitudinal design, this study examined a moderated mediation model wherein the interactive effects of observed exuberance and parenting at age 3 predicted the development of parent-reported ADHD symptoms from childhood through adolescence (age 5, 7, 9, 12, and 15) via child EF (i.e., inhibitory control) at age 4. Parent-child dyads (n = 291) from a longitudinal study on child temperament were included. A piecewise model of ADHD symptom growth demonstrated stability in ADHD symptoms from age 5-9 and a decrease from age 9-15. Results support a moderated mediation model wherein an increase in ADHD symptoms throughout childhood was predicted from early childhood exuberant temperament by way of EF, but only for children whose parents displayed less directive parenting. Findings suggest identifiable early markers of risk, including temperament, parenting, and EF- pointing to possible targets for early intervention/prevention.

Social versus non-social behavioral inhibition: Differential prediction from early childhood of long-term psychosocial outcomes

Behavioral inhibition (BI) is a temperamental style characterized by cautious and fearful behaviors in novel situations. The present multi-method, longitudinal study examined whether young children's observed and parent-reported BI in social versus non-social contexts predicts different long-term psychosocial outcomes. Participants (N = 279) were drawn from a longitudinal study of socioemotional development. BI in social contexts ("social BI") was measured via children's observed wariness toward unfamiliar adults and peers at 24 and 36 months and parents' reports of children's social fear/shyness at 24, 36, and 48 months. BI in non-social contexts ("non-social BI") was measured via children's observed fearful responses to masks and novel toys, and parents' reports of children's distress to non-social novelty at 9 months and non-social fear at 48 months. At 15 years, anxiety was assessed via adolescent- and parent-reports, and global internalizing and externalizing problems were assessed via parent-reports. Confirmatory factor analysis showed that a two-factor model fit the BI data significantly better than a single-factor model, providing evidence for the dissociation of BI in social versus non-social contexts. Social BI was uniquely associated with adolescent social anxiety, whereas non-social BI was specifically associated with adolescent separation anxiety. Neither social BI nor non-social BI predicted global internalizing and externalizing problems, providing evidence for the specific relations between BI and anxiety problems. Together, these results suggest that young children's inhibited responses in social versus non-social situations predict different subtypes of anxiety problems in adolescence, highlighting the multifaceted nature of BI and the divergent trajectories of different anxiety problems.

Encouraging a Peer in Need: The Impacts of Social Anxiety and Peer Familiarity

Extant research has produced conflicting findings regarding the link between social fearfulness and prosocial behavior, with some studies reporting negative relations and others reporting null effects. Furthermore, these studies have focused predominantly on toddlerhood, and few have examined prosociality between peers. The present study investigated whether the link between social anxiety and a prosocial behavior (i.e., providing encouragement) varied depending on interpersonal and situational factors (i.e., one's familiarity with a peer, the level of support sought by a peer, respectively). We tested this question using a multimethod approach, which included an ecologically valid stress inducing task and dyadic design with a sample of 9- to 10-year-olds (N = 447). Results revealed that social anxiety was related negatively to providing encouragement among familiar and unfamiliar dyads. In familiar dyads, however, this main effect was qualified by an interaction with the level of support sought by one's peer. Compared to those low in social anxiety, children high in social anxiety provided relatively less encouragement in response to higher levels of support seeking from their peers. The findings are considered in relation to theorizing regarding the effect of overarousal on children's prosocial behavior.

Which Anxious Adolescents Were Most Affected by the COVID-19 Pandemic?

Although the COVID-19 pandemic caused significant stress and anxiety among many, individuals' experiences varied. We examined if specific forms of anxiety predicted distinct trajectories of anxiety, perceived stress, and COVID-related worries during three early months of the pandemic. In a longitudinal study (N = 291), adolescents' (n = 194) social and generalized anxiety levels were assessed via parent- and self-reports and clinical diagnostic interviews. In young adulthood (n = 164), anxiety, stress, and COVID-related worries were assessed thrice during the pandemic. Pre-pandemic generalized anxiety predicted higher initial levels and maintenance of anxiety, stress, and COVID-related worries during the pandemic. In contrast, pre-pandemic social anxiety predicted lower initial levels of anxiety, stress, and COVID-related worries, but this initial effect on anxiety and stress was offset over time by social anxiety's positive effect on the slope. Our results highlight the importance of understanding how pre-pandemic factors influence individuals' experiences during the pandemic.

Trajectories of socially anxious behavior from age 5 to 13: Temperamental and sociocognitive pathways

The authors examined temperamental and sociocognitive predictors of socially anxious behavior from preschool to early adolescence. Children (N = 227; 59% male; 69% White) completed a speech task at ages 5, 7, 10, and 13 and socially anxious behaviors were coded. Behavioral inhibition (BI) was assessed at ages 2/3 and Theory of Mind (ToM) was assessed at age 4. Data collection occurred between 2003 and 2016. Three trajectories of socially anxious behavior were identified: high stable, average increasing, and low stable. Higher BI was related to the high stable trajectory, whereas lower ToM was related to the increasing trajectory of socially anxious behavior. There are heterogenous pathways of socially anxious behavior, which may be uniquely influenced by early temperamental and sociocognitive factors.

A Developmental Pathway From Early Behavioral Inhibition to Young Adults' Anxiety During the COVID-19 Pandemic

Objective

The COVID-19 pandemic has brought unprecedented changes to young adults' lives, resulting in mental health difficulties for many; however, some individuals are particularly prone to heightened anxiety. Little is known about the early life predictors of anxiety during the pandemic. We examined a developmental pathway from behavioral inhibition (BI), a temperament characterized by fearful responses toward novelty, to changes in young adults' anxiety during the initial period of the pandemic. We hypothesized that a stable pattern of BI across early childhood would predict greater adolescent worry dysregulation, which in turn would predict increases in young adult anxiety during a stressful phase of the pandemic.

Method

Participants (N = 291; 54% female) were followed from toddlerhood to young adulthood. BI was observed at ages 2 and 3 years. Social wariness was observed at age 7 years. Participants rated their worry dysregulation in adolescence (age 15) and anxiety in young adulthood (age 18) at 2 assessments during the COVID-19 pandemic, 1 month apart.

Results

A significant moderated mediation, in which a stable pattern of BI from toddlerhood to childhood, as compared to the absence of this pattern, predicted greater worry dysregulation in adolescence. Worry dysregulation predicted elevated young adult anxiety in the second assessment during COVID-19, even after accounting for the first assessment.

Conclusion

This study identifies a developmental pathway from toddlerhood BI to young adults' elevated anxiety during the COVID-19 pandemic. Findings have implications for early identification of individuals at risk for dysregulated worry and the prevention of anxiety during stressful life events in young adulthood.Reprinted from J Am Acad Child Adolesc Psychiatry, 60, Zeytinoglu et al., A Developmental Pathway From Early Behavioral Inhibition to Young Adults' Anxiety During the COVID-19 Pandemic, pp. 1300-1308, copyright 2021, with permission from Elsevier.

Bidirectional and interactive effects of child temperament and parenting in early childhood on the trajectory of social anxiety in adolescence

INTRODUCTION

Research suggests that certain parenting behaviors are best suited to promote optimal child development, depending on a child's distinctive temperamental presentation. This multimethod, longitudinal study examines the interactive effect of parenting and temperament in early childhood on the developmental trajectory of social anxiety in adolescence.

METHODS

Longitudinal growth modeling was used to examine the developmental trajectory of child social anxiety from age 9-15 and the interactive effect of parenting and child temperament at 36 months on the developmental trajectory of child social anxiety from age 9-15.

RESULTS

The slope of social anxiety from age 9-15 suggested a decrease in social anxiety throughout early adolescence. Furthermore, 36-month behavioral inhibition (BI) predicted the trajectory of child social anxiety from age 9-15 when parents displayed low and high levels of dismissive and supportive parenting (at 36 months).

CONCLUSIONS

Results support an interactive effect of infant temperament and parenting in early childhood (at 36 months) on the developmental trajectory of child social anxiety from age 9-15. Specifically, results suggest that engaging highly inhibited children with high supportive and low dismissive parenting may help reduce social anxiety over time in adolescence. Furthermore, parenting needs may differ for children high or low in BI to impact the developmental trajectory of social anxiety in adolescence, such that children who are high BI seem to benefit from low dismissive and high supportive parenting, and children who are low in BI seem to benefit more from high dismissive parenting.

Pathways from maternal shyness to adolescent social anxiety

BACKGROUND

Social anxiety is amongst the most prevalent adolescent mental health problems; however, it is often unrecognized due to its comorbidity with other anxiety problems such as generalized anxiety. Thus, understanding the unique developmental pathways to social anxiety is critical for improving its prevention. We examined the pathway from maternal shyness, when children were 4 years old, to adolescents' social anxiety at age 15 through social wariness at age 7. We hypothesized that childhood social wariness would mediate the association between maternal shyness and social anxiety in adolescence.

METHODS

Participants (N = 291; 54% female) were followed from early childhood to adolescence. Mothers reported on their own shyness when children were 4 years old. Social wariness toward unfamiliar peers was observed in the laboratory at ages 4 and 7. Adolescent social anxiety and generalized anxiety were assessed via self-report, parent-report, and clinical diagnoses at age 15.

RESULTS

Maternal shyness was positively associated with adolescent social anxiety but not generalized anxiety at age 15. Higher levels of maternal shyness at age 4 predicted greater social wariness at age 7, which in turn predicted greater social anxiety but not generalized anxiety at age 15. Social wariness at age 7 partially mediated the association between maternal shyness and adolescent social anxiety.

CONCLUSIONS

This study identifies a unique developmental pathway from maternal shyness to adolescent social anxiety. Findings suggest that childhood social wariness connects maternal shyness to adolescent social anxiety.

Toddler Exuberance as an Influence on Positive Social Behavior in a High-Intensity Context in Middle Childhood

Exuberance, a profile of temperament characterized in toddlerhood by high approach motivation, positive affect, and sociability, is associated with both adaptive and maladaptive socioemotional outcomes. The aims of the current study were to introduce a novel approach/avoidance-eliciting social task, as well as longitudinally extend our understanding of toddlerhood exuberance to outcomes in middle childhood. Specifically, affect and social behavior at age seven during a high-intensity game were compared to that observed during a low-intensity freeplay task. As part of a longitudinal study, 291 infants were selected at 4 months for a wide range of reactivity to novelty. The sample was assessed repeatedly across early childhood (9, 24, and 36 months of age) and at 7 years of age. A high exuberance profile was formed with approach, positive, and sociable behaviors observed in the laboratory from 4 to 36 months. At 7 years of age, affect and social behavior were assessed during high- and low-intensity interactions with an unfamiliar peer in the laboratory. Path Analyses using structural equation models demonstrated that a high exuberance profile was associated with greater positive social behavior at age 7 during a high-intensity game, but not negative social behavior or behavior during a low-intensity freeplay task. These results illuminate the need for targeted methodology, such as high-intensity approach/avoidance-eliciting social tasks, in order to clarify the links between early temperament and adaptive or maladaptive socioemotional outcomes across development.

A Developmental Pathway From Early Behavioral Inhibition to Young Adults' Anxiety During the COVID-19 Pandemic

OBJECTIVE

The COVID-19 pandemic has brought unprecedented changes to young adults' lives, resulting in mental health difficulties for many; however, some individuals are particularly prone to heightened anxiety. Little is known about the early life predictors of anxiety during the pandemic. We examined a developmental pathway from behavioral inhibition (BI), a temperament characterized by fearful responses toward novelty, to changes in young adults' anxiety during the initial period of the pandemic. We hypothesized that a stable pattern of BI across early childhood would predict greater adolescent worry dysregulation, which in turn would predict increases in young adult anxiety during a stressful phase of the pandemic.

METHOD

Participants (N = 291; 54% female) were followed from toddlerhood to young adulthood. BI was observed at ages 2 and 3 years. Social wariness was observed at age 7 years. Participants rated their worry dysregulation in adolescence (age 15) and anxiety in young adulthood (age 18) at 2 assessments during the COVID-19 pandemic, 1 month apart.

RESULTS

A significant moderated mediation, in which a stable pattern of BI from toddlerhood to childhood, as compared to the absence of this pattern, predicted greater worry dysregulation in adolescence. Worry dysregulation predicted elevated young adult anxiety in the second assessment during COVID-19, even after accounting for the first assessment.

CONCLUSION

This study identifies a developmental pathway from toddlerhood BI to young adults' elevated anxiety during the COVID-19 pandemic. Findings have implications for early identification of individuals at risk for dysregulated worry and the prevention of anxiety during stressful life events in young adulthood.

Neurocognitive Profiles in Adolescence Predict Subsequent Anxiety Trajectories During the COVID-19 Pandemic

Background

The COVID-19 pandemic has created increased stress and anxiety for many; however, some individuals are particularly prone to heightened anxiety. It is unclear if and how prestress neurocognitive factors moderate risk for anxiety during high-stress situations. Enhanced error monitoring and a cognitive control strategy of more instantaneous (reactive) control have both been independently related to anxiety. We examined if a specific neurocognitive profile characterized by heightened error monitoring and a more reactive cognitive control strategy in adolescence predicts young adults’ anxiety trajectories across 3 early months of the COVID-19 pandemic.

Methods

As part of a longitudinal study (N = 291), data were acquired in adolescence (13 years) on error monitoring (n = 124) and cognitive control strategy (n = 119). In young adulthood (18 years), anxiety was assessed three times during the COVID-19 pandemic (n = 162).

Results

On average, participants experienced greater anxiety in the first COVID-19 pandemic assessment, then anxiety decreased in the following months. Error monitoring and cognitive control strategy interacted to predict anxiety trajectories, such that among adolescents with an increased reliance on reactive control, error monitoring predicted greater anxiety in the first assessment but greater decreases the following months as stay-at-home orders were lifted and families adapted to the restrictions.

Conclusions

Results suggest that neurocognitive profiles in adolescence predict young adults’ anxiety responses during a highly stressful period, such as the initial months of the COVID-19 pandemic. Our findings have implications for the early identification of individuals at greater risk for anxiety.

Transactional Associations Between Parent and Late Adolescent Internalizing Symptoms During the COVID-19 Pandemic: The Moderating Role of Avoidant Coping

Extensive research has demonstrated the transactional nature of parent-child psychopathology, with limited studies examining these effects during late adolescence and none, to our knowledge, longitudinally during the COVID-19 pandemic. The current study examined the cross-lagged effects of parent and adolescent internalizing symptoms during the COVID-19 pandemic and the moderating role of avoidant coping. A sample of 291 adolescents (Age_mean = 18.27; 53% female; 61% White) and their parents rated their own anxiety and depressive symptoms and coping during the first two months following stay-at-home orders during the COVID-19 pandemic. Parent internalizing symptoms at the first assessment predicted adolescent internalizing symptoms at the second assessment. Adolescent avoidant coping style moderated this effect of parent internalizing symptoms on adolescent internalizing symptoms in the subsequent month, such that parent internalizing symptoms predicted child internalizing symptoms only among adolescents with moderate to high rates of avoidant coping. Follow-up analyses indicated different patterns when examining depressive and anxiety symptoms separately. The results highlight complex family dynamics between adolescents and their parents and begin to differentiate how individual characteristics impact the response to a significant life event such as the COVID-19 pandemic.

Infant behavioral inhibition predicts personality and social outcomes three decades later

Does infant temperament predict adult personality and life-course patterns? To date, there is scant evidence examining relations between child temperament and adult outcomes, and extant research has relied on limited methods for measuring temperament such as maternal report. This prospective longitudinal study followed a cohort of infants (n = 165) for three decades to examine whether infant behavioral inhibition, a temperament characterized by cautious and fearful behaviors to unfamiliar situations, shapes long-term personality, social relationships, vocational/education, and mental health outcomes in adulthood. At age 14 mo, behavioral inhibition was assessed using an observation paradigm. In adolescence (15 y; n = 115), error monitoring event-related potentials were measured in a flanker task. In adulthood (26 y; n = 109), personality, psychopathology, and sociodemographics were self-reported using questionnaires. We found that infants with higher levels of behavioral inhibition at 14 mo grew up to become more reserved and introverted adults (β = 0.34) with lower social functioning with friends and family (β = -0.23) at age 26. Infant behavioral inhibition was also a specific risk factor for adult internalizing (i.e., anxiety and depression, β = 0.20) psychopathology, rather than a transdiagnostic risk for general and externalizing psychopathology. We identified a neurophysiologic mechanism underlying risk and resilience for later psychopathology. Heightened error monitoring in adolescence moderated higher levels of adult internalizing psychopathology among behaviorally inhibited individuals. These findings suggest meaningful continuity between infant temperament and the development of adult personality. They provide the earliest evidence suggesting that the foundation of long-term well-being is rooted in individual differences in temperament observed in infancy.

Longitudinal patterns of anger reactivity and risk-taking: The role of peer-context

The current study examined the interplay between children's dispositional anger and susceptibility to peers' influence in increasing children's risk-taking behaviors. Participants in the current study were children from a larger study of temperament and social-emotional development who were followed across 9, 24, 36, 48, and 60 months. Dispositional anger was measured using mothers' reports across 9 and 48 months. At 60 months, children played a risk-taking computer game in presence of an unfamiliar peer who watched the child play. The child's risk-taking was assessed during the game as the unfamiliar peers' reactions were coded based on comments that were peer directed, reflective of praising the target child's performance, or object directed, indicative of excitement toward the game. A latent profile analysis revealed three longitudinal anger profiles across infancy to early childhood: high stable, average stable, and low stable anger. Results suggested that as peers' object-directed comments predicted risk-taking independent of children's anger, the association between peer-directed comments and risk-taking was dependent on children's dispositional anger. Specifically, when peers praised the target child's performance, children in the high stable anger profile showed increased risk-taking propensity. Findings are discussed based on the importance of considering both temperamental characteristics and aspects of the peer context in relation to children's risk-taking.

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.

Investigation of a developmental pathway from infant anger reactivity to childhood inhibitory control and ADHD symptoms: interactive effects of early maternal caregiving

BACKGROUND

ADHD is a neurodevelopmental disorder with a complex pathogenesis. Individual differences in temperamental reactivity - in particular, anger reactivity - are predictive of ADHD. The goal of this study was to examine the moderating (maternal caregiving behaviors; MCB) and mediating (inhibitory control) variables of reactivity using a 9-year multimethod prospective longitudinal design.

METHODS

Participants included 291 children (135 male; 156 female) who participated in a larger study of temperament and social-emotional development. Anger reactivity was assessed by observation of facial anger during an arm restraint task, and MCB were observed during a series of semi-structured mother-infant tasks, both at 9 months of age. Inhibitory control was assessed by performance on a go/no-go task at 5 years of age. ADHD symptoms were assessed by parent and teacher report questionnaires at 7 and 9 years, respectively.

RESULTS

Anger reactivity and poor inhibitory control were predictive of later ADHD symptoms. Results supported a moderated mediation model, in which the indirect effects of anger reactivity on ADHD symptoms through inhibitory control were conditional on quality of early MCB. Inhibitory control mediated the effect of anger reactivity on ADHD symptoms, but only among children exposed to lower-quality MCB.

CONCLUSIONS

Infant anger reactivity exerts a direct effect on later ADHD from infancy, suggesting anger reactivity as a very early indicator of ADHD risk. Higher-quality caregiving did not buffer against the direct risk of anger reactivity on ADHD but did buffer against the indirect risk by reducing the negative effect of anger reactivity on inhibitory control. Thus, in the developmental pathway from anger reactivity to ADHD, more sensitive, less intrusive parenting supports the development of protective mechanisms (i.e. inhibitory control) to remediate ADHD risk.

Infant temperament reactivity and early maternal caregiving: independent and interactive links to later childhood attention-deficit/hyperactivity disorder symptoms

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with origins early in life. There is growing evidence that individual differences in temperament reactivity are predictive of ADHD symptoms, yet little is known about the relations between temperament reactivity in early infancy and later ADHD symptoms or the combined effect of reactivity with early environmental factors on ADHD symptom development. Using a 9-year prospective longitudinal design, this study tested the independent and interactive contributions of infant reactivity and maternal caregiving behaviors (MCB) on parent- and teacher-reported childhood ADHD symptoms.

METHODS

Participants included 291 children (135 male; 156 female) who participated in a larger study of temperament and social-emotional development. Reactivity was assessed by behavioral observation of negative affect, positive affect, and motor activity during novel stimuli presentations at 4 months of age. MCB were observed during a series of semistructured mother-infant tasks at 9 months of age. Finally, ADHD symptoms were assessed by parent- and teacher-report questionnaires at 7 and 9 years, respectively.

RESULTS

Reactivity was predictive of ADHD symptoms, but results were sex specific. For boys, infant motor activity was positively predictive of later ADHD symptoms, but only at lower quality MCB. For girls, infant positive affect was positively predictive of later ADHD symptoms at lower quality MCB, and-unexpectedly-infant positive affect and motor activity were negatively predictive of later ADHD symptoms at higher quality MCB.

CONCLUSIONS

These results point to early parenting as a moderating factor to mitigate temperament-related risk for later ADHD, suggesting this as a potential intervention target to mitigate risk for ADHD among reactive infants.

Early-childhood social reticence predicts SCR-BOLD coupling during fear extinction recall in preadolescent youth

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Threat circuit function may develop differently in children with different temperamental profiles, such as high vs. low social reticence.

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We relate individual differences in longitudinally assessed, observed socially reticent behavior to brain-physiology interactions during extinction recall.

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Childhood social reticence predicts a distinct pattern of hemodynamic-autonomic covariation when recalling extinguished threat and safety cues.

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Covariation patterns indicated that socially reticent youth had difficulty tracking safety as a function of stimulus resemblance to the safe stimulus.

Social Reticence (SR) is a temperament construct identified in early childhood that is expressed as shy, anxiously avoidant behavior and, particularly when stable, robustly associated with risk for anxiety disorders. Threat circuit function may develop differently for children high on SR than low on SR. We compared brain function and behavior during extinction recall in a sample of 11-to-15-year-old children characterized in early childhood on a continuum of SR. Three weeks after undergoing fear conditioning and extinction, participants completed a functional magnetic resonance imaging extinction recall task assessing memory and threat differentiation for conditioned stimuli. Whereas self-report and psychophysiological measures of differential conditioning, extinction, and extinction recall were largely similar across participants, SR-related differences in brain function emerged during extinction recall. Specifically, childhood SR was associated with a distinct pattern of hemodynamic-autonomic covariation in the brain when recalling extinguished threat and safety cues. SR and attention focus impacted associations between trial-by-trial variation in autonomic responding and in brain activation. These interactions occurred in three main brain areas: the anterior insular cortex (AIC), the anterior subdivision of the medial cingulate cortex (aMCC), and the dorsolateral prefrontal cortex (dlPFC). This pattern of SCR-BOLD coupling may reflect selective difficulty tracking safety in a temperamentally at-risk population.

Caregiving Disruptions Affect Growth and Pubertal Development in Early Adolescence in Institutionalized and Fostered Romanian Children: A Randomized Clinical Trial

OBJECTIVES

To determine the effects of foster care vs institutional care, as well as disruptions in the caregiving environment on physical development through early adolescence.

STUDY DESIGN

This was a randomized controlled trial of 114 institutionalized, though otherwise healthy, children from 6 orphanages and 51 never institutionalized control children living in birth families (family care group) in Bucharest, Romania. Children were followed from baseline (21 months, range 5-31) through age 12 years for caregiving disruptions and growth trajectories and through age 14 years for pubertal development.

RESULTS

Children randomized to the foster care group showed greater rates of growth in height, weight, and body mass index (BMI) through age 12 years than institutionalized group. Tanner development was delayed in institutionalized group boys compared with foster care group and family care group boys at 12 but not 14 years. There were no differences in Tanner development and age of menarche among foster care group, institutionalized group, and family care group girls at ages 12 and 14 years. More disruptions in caregiving between 30 months and 12 years moderated decreases in growth rates of height in foster care group and weight in foster care group and institutionalized group across age. institutionalized group boys with ≥2 disruptions showed lower Tanner scores at age 12 vs institutionalized group and foster care group boys with <2 disruptions. foster care group girls with ≥2 disruptions had higher Tanner scores at age 14 vs foster care group girls with <2 disruptions. Age of menarche was not affected by caregiving disruptions.

CONCLUSIONS

For children who experienced early institutionalization, stable placement within family care is essential to ensuring the best outcomes for physical developmental.

TRIAL REGISTRATION

clinicaltrials.gov: NCT00747396.

Longitudinal Relations between Behavioral Inhibition and Social Information Processing: Moderating Role of Maternal Supportive Reactions to Children's Emotions

Utilizing multiple measures of interpretive biases, the current study examined the roles of toddlers' behavioral inhibition (BI) and maternal supportive reactions to children's negative emotions in relation to children's interpretive biases across middle to late childhood. Toddlers' BI was measured during several laboratory tasks (n = 248) at 2 and 3 years of age. Mothers reported on their reactions to children's negative emotional expressions when children were 7 years old (n = 203), and children's interpretations of social cues were assessed at 7 and 10 years of age (ns = 179 and 161, respectively). Toddlers with high levels of BI expressed less positivity towards social engagement with unfamiliar peers during discussion of ambiguous social situations. Further, children with high BI were less likely to attribute the cause of negative social situations to external factors, particularly when mothers were less accepting of children's negative emotional displays. Findings are discussed in terms of cognition related to the interpretation of ambiguous and threat-related social situations among temperamentally at-risk children.

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

This study examined relations between behavioral inhibition (BI) assessed in toddlerhood (n = 268) and attention biases (AB) to threat and positive faces and maternal-reported anxiety assessed when children were 5- and 7-year-old. Results revealed that BI predicted anxiety at age 7 in children with AB toward threat, away from positive, or with no bias, at age 7; BI did not predict anxiety for children displaying AB away from threat or toward positive. Five-year AB did not moderate the link between BI and 7-year anxiety. No direct association between AB and BI or anxiety was detected; moreover, children did not show stable AB across development. These findings extend our understanding of the developmental links among BI, AB, and anxiety.

Approach Behaviour, Stress and Substance Use in Young Adults

We investigated the interaction between approach behaviours (measured through performance on a resource-gathering task) and self-reported global life stress to predict substance use. Our hypothesis that high levels of approach behaviour in combination with high life stress would predict elevated substance use was guided by the reinforcement sensitivity theory (Gray & McNaughton, ). Ninety-three young adult students (61 women and 32 men) completed a computerized resource-gathering task and questionnaires assessing global life stress and substance use. Consistent with the hypothesis, approach behaviour was positively related to substance use for individuals with high life stress. The findings suggest that person by environment interactions are useful in understanding substance use and we discuss how approach-motivated individuals may arrive at different substance use outcomes as a function of stressful contexts. Copyright © 2016 John Wiley & Sons, Ltd.

IQ at age 12 following a history of institutional care: Findings from the Bucharest Early Intervention Project

Young children removed from institutions and placed into foster care or adoptive homes have been shown to experience significant gains in IQ relative to children who remain in institutions. Less is known about the long-term impact of severe early deprivation on development in late childhood. Data are presented from a follow-up of children at 12 years of age in the Bucharest Early Intervention Project, a randomized clinical trial of foster care for institutionally reared children. Of the original 136 children in the study, 107 were tested with the Wechsler Intelligence Scale for Children-IV. Results revealed continued benefit from the intervention through age 12, with 12-year-old children placed in foster care scoring significantly higher on full-scale IQ compared to their peers who received prolonged institutional care. Longitudinal IQ data revealed 2 IQ profiles from early to late childhood. Attachment security emerged as a significant predictor of a profile of stable, typical IQ scores over time. We demonstrate the continued importance of foster care intervention and the negative effects of severe, early psychosocial deprivation on IQ into late childhood. (PsycINFO Database Record

Early-Childhood Social Reticence Predicts Brain Function in Preadolescent Youths During Distinct Forms of Peer Evaluation

Social reticence is expressed as shy, anxiously avoidant behavior in early childhood. With development, overt signs of social reticence may diminish but could still manifest themselves in neural responses to peers. We obtained measures of social reticence across 2 to 7 years of age. At age 11, preadolescents previously characterized as high (n = 30) or low (n = 23) in social reticence completed a novel functional-MRI-based peer-interaction task that quantifies neural responses to the anticipation and receipt of distinct forms of social evaluation. High (but not low) social reticence in early childhood predicted greater activity in dorsal anterior cingulate cortex and left and right insula, brain regions implicated in processing salience and distress, when participants anticipated unpredictable compared with predictable feedback. High social reticence was also associated with negative functional connectivity between insula and ventromedial prefrontal cortex, a region commonly implicated in affect regulation. Finally, among participants with high social reticence, negative evaluation was associated with increased amygdala activity, but only during feedback from unpredictable peers.

Early Childhood Behavioral Inhibition Predicts Cortical Thickness in Adulthood

OBJECTIVE

Behavioral inhibition (BI) during early childhood predicts risk for anxiety disorders and altered cognitive control in adolescence. Although BI has been linked to variation in brain function through adulthood, few studies have examined relations between early childhood BI and adult brain structure.

METHOD

The relation between early childhood BI and cortical thickness in adulthood was examined in a cohort of individuals followed since early childhood (N = 53, mean age 20.5 years). Analyses tested whether anxiety and/or cognitive control during adolescence moderated relations between BI and cortical thickness. Cognitive control was measured with the Eriksen Flanker Task. Initial analyses examined cortical thickness in regions of interest previously implicated in BI, anxiety disorders, and cognitive control: dorsal anterior cingulate (dACC), anterior insula (aI), and subgenual anterior cingulate (sgACC); and volumes of the amygdala and hippocampus. Exploratory analyses examined relations across the prefrontal cortex.

RESULTS

BI during early childhood related to thinner dACC in adulthood. Neither anxiety nor cognitive control moderated this relation. A stronger congruency effect on the Eriksen Flanker Task during adolescence independently related to thinner dACC in adulthood. Higher anxiety during adolescence related to thicker cortex in the right ventrolateral prefrontal cortex (VLPFC) in adulthood among those with low BI as children.

CONCLUSION

Temperament in early childhood and the interaction between temperament and later anxiety relate to adult brain structure. These results are consistent with prior work associating BI and anxiety with functional brain variability in the dACC and VLPFC.

Early childhood behavioral inhibition, adult psychopathology and the buffering effects of adolescent social networks: a twenty-year prospective study

BACKGROUND

We examined whether the temperament of behavioral inhibition is a significant marker for psychopathology in early adulthood and whether such risk is buffered by peer social networks.

METHODS

Participants (N = 165) were from a prospective study spanning the first two decades of life. Temperament was characterized during infancy and early childhood. Extent of involvement in peer social networks was measured during adolescence, and psychopathology was assessed in early adulthood. Latent Class Analyses generated comprehensive variables at each of three study time-points. Regressions assessed (a) the direct effect of early behavioral inhibition on adult psychopathology (b) the moderating effect of adolescent involvement in social peer networks on the link between temperamental risk and adult psychopathology.

RESULTS

Stable behavioral inhibition in early childhood was negatively associated with adult mental health (R(2 ) = .07, p = .005, β = -.26), specifically increasing risk for adult anxiety disorders (R(2) = .04, p = .037, β = .19). These temperament-pathology relations were significantly moderated by adolescent peer group social involvement and network size (Total R(2) = .13, p = .027, β = -.22). Temperament predicted heightened risk for adult anxiety when adolescent social involvement was low (p = .002, β = .43), but not when adolescent social involvement was high.

CONCLUSIONS

Stable behavioral inhibition throughout early childhood is a risk factor for adult anxiety disorders and interacts with adolescent social involvement to moderate risk. This is the first study to demonstrate the critical role of adolescent involvement in socially active networks in moderating long-lasting temperamental risk over the course of two decades, thus informing prevention/intervention approaches.

Early social fear in relation to play with an unfamiliar peer: Actor and partner effects

The purpose of this study was to examine the associations between maternal reports of social fear at 24 months and social behaviors with an unfamiliar peer during play at 36 months, using the Actor-Partner Interdependence Model (APIM; Kashy & Kenny, 1999). The APIM model was used to not only replicate previous findings of direct effects of early social fear on children's own social behavior (i.e., actor effects), but also to extend these findings by examining whether children's early social fear relates to an unfamiliar peer's behavior at 36 months (i.e., partner effects). Results revealed that social fear was associated with lower levels of children's own social engagement as well as less social engagement and dysregulated behavior in their play partners. These findings show that toddlers' social interactive behaviors are interdependent and reflect unique contributions of both the individual and their social partner's characteristics. In contrast, social fear was associated with children's own social wariness with the unfamiliar peer, but not their play partners' wariness. We discuss findings in terms of the influence of early social fear on young children's interpersonal environments and the potential role of these altered environments in supporting continuity of social fear and wariness over time.

Contextual startle responses moderate the relation between behavioral inhibition and anxiety in middle childhood

Behavioral inhibition (BI), a temperament characterized in early childhood by wariness and avoidance of novelty, is a risk factor for anxiety disorders. An enhanced startle response has been observed in adolescents characterized with BI in childhood, particularly when they also manifest concurrent symptoms of anxiety. However, no prior study has examined relations among BI, startle responsivity, and anxiety in a prospective manner. Data for the present study were from a longitudinal study of infant temperament. Maternal reports and observations of BI were assessed at ages 2 and 3. At age 7, participants completed a startle procedure, while electromyography was collected, where participants viewed different colors on a screen that were associated with either the delivery of an aversive stimulus (i.e., puff of air to the larynx; threat cue) or the absence of the aversive stimulus (i.e., safety cue). Parental reports of child anxiety were collected when children were 7 and 9 years of age. Results revealed that startle responses at age 7 moderated the relation between early BI and 9-year anxiety. These findings provide insight into one potential mechanism that may place behaviorally inhibited children at risk for anxiety.

Temperament and Parenting Styles in Early Childhood Differentially Influence Neural Response to Peer Evaluation in Adolescence

Behavioral inhibition (BI) is a temperament characterized by social reticence and withdrawal from unfamiliar or novel contexts and conveys risk for social anxiety disorder. Developmental outcomes associated with this temperament can be influenced by children's caregiving context. The convergence of a child's temperamental disposition and rearing environment is ultimately expressed at both the behavioral and neural levels in emotional and cognitive response patterns to social challenges. The present study used functional neuroimaging to assess the moderating effects of different parenting styles on neural response to peer rejection in two groups of adolescents characterized by their early childhood temperament (M(age) = 17.89 years, N = 39, 17 males, 22 females; 18 with BI; 21 without BI). The moderating effects of authoritarian and authoritative parenting styles were examined in three brain regions linked with social anxiety: ventrolateral prefrontal cortex (vlPFC), striatum, and amygdala. In youth characterized with BI in childhood, but not in those without BI, diminished responses to peer rejection in vlPFC were associated with higher levels of authoritarian parenting. In contrast, all youth showed decreased caudate response to peer rejection at higher levels of authoritative parenting. These findings indicate that BI in early life relates to greater neurobiological sensitivity to variance in parenting styles, particularly harsh parenting, in late adolescence. These results are discussed in relation to biopsychosocial models of development.

Early Behavioral Inhibition and Emotion Regulation: Pathways Toward Social Competence in Middle Childhood

This study examined emotion regulation (ER) as a mediator in the relation between early behavioral inhibition (BI) and later social competence (N = 257), and whether this mediation varied depending on BI levels. Maternal report and observational measures were used to assess BI (ages 2 and 3). Children's ER strategies (age 5) and social competence with an unfamiliar peer (age 7) were measured using observational measures. Results showed that BI predicted less engaged ER strategies during a disappointment task, and engaged ER predicted higher social competence. Engaged ER mediated the effect of BI on social competence, but only for highly inhibited children. Findings elucidate developmental trajectories of risk and resilience, and suggest targeting regulatory strategies in early prevention efforts with highly inhibited children.

Infant attachment security and early childhood behavioral inhibition interact to predict adolescent social anxiety symptoms

Insecure attachment and behavioral inhibition (BI) increase risk for internalizing problems, but few longitudinal studies have examined their interaction in predicting adolescent anxiety. This study included 165 adolescents (ages 14-17 years) selected based on their reactivity to novelty at 4 months. Infant attachment was assessed with the Strange Situation. Multimethod BI assessments were conducted across childhood. Adolescents and their parents independently reported on anxiety. The interaction of attachment and BI significantly predicted adolescent anxiety symptoms, such that BI and anxiety were only associated among adolescents with histories of insecure attachment. Exploratory analyses revealed that this effect was driven by insecure-resistant attachment and that the association between BI and social anxiety was significant only for insecure males. Clinical implications are discussed.

The relation between reactivity at 4 months and Behavioral Inhibition in the second year: Replication Across Three Independent Samples

This paper examines the predictive relations between two infant temperamental biases assessed at 4 months and inhibited behavior during the first two years of life in three independent samples from two research laboratories. Although each sample used slightly different criteria for classifying infants, the results across samples were consistent. Infants of both genders who displayed high levels of motor activity and distress to unfamiliar events were more inhibited at 14 months of age. By 24 months there were significant sex differences: boys identified as high reactive were more inhibited than high reactive girls.

Longitudinal trajectories of social reticence with unfamiliar peers across early childhood

Behavioral inhibition is a temperament assessed in the toddler period via children's responses to novel contexts, objects, and unfamiliar adults. Social reticence is observed as onlooking, unoccupied behavior in the presence of unfamiliar peers and is linked to earlier behavioral inhibition. In the current study, we assessed behavioral inhibition in a sample of 262 children at ages 2 and 3, and then assessed social reticence in these same children as they interacted with an unfamiliar, same-age, same-sex peer at 2, 3, 4, and 5 years of age. As expected, early behavioral inhibition was related to social reticence at each age. However, multiple trajectories of social reticence were observed including High-Stable, High-Decreasing, and Low-Increasing, with the High-Stable and High-Decreasing trajectories associated with greater behavioral inhibition compared to the Low-Increasing trajectory. In addition, children in the High-Stable social reticence trajectory were rated higher than all others on 60-month Internalizing problems. Children in the Low-Increasing trajectory were rated higher on 60-month Externalizing problems than children in the High-Decreasing trajectory. These results illustrate the multiple developmental pathways for behaviorally inhibited toddlers and suggest patterns across early childhood associated with heightened risk for psychopathology.

Cognitive control moderates early childhood temperament in predicting social behavior in 7-year-old children: an ERP study

Behavioral inhibition (BI) is a temperament associated with heightened vigilance and fear of novelty in early childhood, and social reticence and increased risk for anxiety problems later in development. However, not all behaviorally inhibited children develop signs of anxiety. One mechanism that might contribute to the variability in developmental trajectories is the recruitment of cognitive-control resources. The current study measured N2 activation, an ERP (event-related potential) associated with cognitive control, and modeled source-space activation (LORETA; Low Resolution Brain Electromagnetic Tomography) at 7 years of age while children performed a go/no-go task. Activation was estimated for the entire cortex and then exported for four regions of interest: ventromedial prefrontal cortex (VMPFC), ventrolateral prefrontal cortex (VLPFC), dorsal anterior cingulate cortex (dorsal ACC), and dorsal lateral prefrontal cortex (DLPFC). BI was measured in early childhood (ages 2 and 3 years). Anxiety problems and social reticence were measured at 7 years of age to ascertain stability of temperamental style. Results revealed that BI was associated with increased performance accuracy, longer reaction times, greater (more negative) N2 activation, and higher estimated dorsal ACC and DLPFC activation. Furthermore, early BI was only associated with social reticence at age 7 at higher (more negative) levels of N2 activation or higher estimated dorsal ACC or DLPFC activation. Results are discussed in the context of overcontrolled behavior contributing to social reticence and signs of anxiety in middle childhood.

The Effects of Early Institutionalization and Foster Care Intervention on Children's Social Behaviors at Age 8

The present study compared the social behaviors of 8-year-old previously institutionalized Romanian children from the Bucharest Early Intervention Project (BEIP) in two groups: 1) children randomized to foster care homes (FCG), and 2) children randomized to care as usual (remaining in institutions) (CAUG). Children were observed interacting with an age and gender-matched unfamiliar, non-institutionalized peer from the community (NIG) during six interactive tasks, and their behavior was coded for speech reticence, social engagement, task orientation, social withdrawal, and conversational competence. Group comparisons revealed that FCG children were rated as significantly less reticent during a speech task than CAUG children. For CAUG children, longer time spent in institutional care was related to greater speech reticence and lower social engagement. Using an Actor-Partner Interdependence Model, CAUG children's behaviors, but not FCG, were found to influence the behavior of unfamiliar peers. These findings are the first to characterize institutionalized children's observed social behaviors towards new peers during middle childhood and highlight the positive effects of foster care intervention in the social domain.

Identification of emotional facial expressions among behaviorally inhibited adolescents with lifetime anxiety disorders

The current study examined differences in emotion expression identification between adolescents characterised with behavioural inhibition (BI) in childhood with and without a lifetime history of anxiety disorder. Participants were originally assessed for BI during toddlerhood and for social reticence during childhood. During adolescence, participants returned to the laboratory and completed a facial emotion identification task and a clinical psychiatric interview. Results revealed that behaviorally inhibited adolescents with a lifetime history of anxiety disorder displayed a lower threshold for identifying fear relative to anger emotion expressions compared to non-anxious behaviorally inhibited adolescents and non-inhibited adolescents with or without anxiety. These findings were specific to behaviorally inhibited adolescents with a lifetime history of social anxiety disorder. Thus, adolescents with a history of both BI and anxiety, specifically social anxiety, are more likely to differ from other adolescents in their identification of fearful facial expressions. This offers further evidence that perturbations in the processing of emotional stimuli may underlie the aetiology of anxiety disorders.

Cognitive conflict links behavioral inhibition and social problem solving during social exclusion in childhood

Behavioral inhibition (BI) is a temperament characterized by heightened negative affect and social reticence to unfamiliar peers. In a longitudinal study, 291 infants were assessed for BI at 24 and 36 months of age. At age 7, N2 amplitude was measured during a Flanker task. Also at age 7, children experienced social exclusion in the lab during an interaction with an unfamiliar peer and an experimenter. Our findings indicate that children characterized as high in BI, relative to those low in BI, had larger (i.e., more negative) N2 amplitudes. Additionally, among children with a large N2, BI was positively related to withdrawal and negatively related to assertiveness during social exclusion. These findings suggest that variations in conflict detection among behaviorally inhibited children plays a role in their social behavior during stressful social situations.

Enduring influence of early temperament on neural mechanisms mediating attention-emotion conflict in adults

BACKGROUND

Behavioral inhibition, a temperament identified in early childhood, is often associated with dysregulated attention and affective processing, particularly in response to threat. Longitudinal studies find that the manifestation of perturbed attention and affective processing often dissipates with age. Yet, childhood behavioral inhibition continues to predict perturbed brain function into adulthood. This suggests that adults with childhood behavioral inhibition may engage compensatory processes to effectively regulate emotion-related attention. However, it is unknown whether perturbations in brain function reflect compensation for attention bias to emotional stimuli generally, or to threatening contexts more specifically. The present study tests these possibilities.

METHODS

Adults with and without a history of stable childhood behavioral inhibition completed an attention-control task in the context of threatening and nonthreatening stimuli while undergoing functional magnetic resonance imaging. Participants were asked to identify the gender of fearful (threatening) and happy (nonthreatening) faces, while ignoring both the face emotion and overlaid congruent (low attention control, LAC) or incongruent (high attention control, HAC) gender words.

RESULTS

When fearful faces were present, adults with stable childhood behavioral inhibition exhibited more activity in striatum, cingulate, and dorsolateral prefrontal cortex for HAC trials compared with LAC trials, relative to those without behavioral inhibition. When happy faces were present, the opposite activation pattern emerged. No group differences in behavior were observed.

CONCLUSIONS

Among adults, stable childhood behavioral inhibition predicts neural, but not behavioral, responding when attention control is engaged in discrete emotional contexts. This suggests a mechanism by which adults may compensate for the behavioral manifestation of threat-based attention biases.

Associations Between Behavioral Inhibition and Children's Social Problem Solving Behavior During Social Exclusion

The current study examined the associations between the early childhood temperament of behavioral inhibition and children's displays of social problem-solving (SPS) behavior during social exclusion. During toddlerhood (ages 2-3), maternal report and behavioral observations of behavioral inhibition were collected. At age 7, children's SPS behaviors were observed during a laboratory social exclusion task based on the commonly used Cyberball game. Results showed that behavioral inhibition was positively associated with displayed social withdrawal and negatively associated with assertive behavior during the observed social exclusion task at 7 years of age. These results add to our understanding of inhibited children's SPS behaviors during social exclusion and provide evidence for the associations between toddler temperament and children's social behavior during middle childhood.

Social Problem-Solving in Early Childhood: Developmental Change and the Influence of Shyness

The purpose of this study was to examine developmental change and the influence of shyness on social problem-solving (SPS). At 24, 36, and 48 months, children (N=570) were observed while interacting with an unfamiliar peer during an SPS task and at 24 months, maternal report of shyness was collected. Results showed that across the full sample, children displayed low but stable levels of withdrawn SPS and increasing levels of SPS competence over development. In addition, results showed that 24-month shyness was associated with high-increasing and high-decreasing withdrawn SPS trajectories compared to the low-increasing withdrawn SPS trajectory. Shyness was also associated with the low-increasing compared to the high-increasing SPS competence trajectory. Findings demonstrate the development of SPS competence over early childhood, as well as the influence of early shyness on this developmental course, with some shy children showing improvement in SPS skills and others continuing to show SPS difficulties over time.

Maternal over-control moderates the association between early childhood behavioral inhibition and adolescent social anxiety symptoms

Behavioral inhibition (BI) and maternal over-control are early risk factors for later childhood internalizing problems, particularly social anxiety disorder (SAD). Consistently high BI across childhood appears to confer risk for the onset of SAD by adolescence. However, no prior studies have prospectively examined observed maternal over-control as a risk factor for adolescent social anxiety (SA) among children initially selected for BI. The present prospective longitudinal study examines the direct and indirect relations between these early risk factors and adolescent SA symptoms and SAD, using a multi-method approach. The sample consisted of 176 participants initially recruited as infants and assessed for temperamental reactivity to novel stimuli at age 4 months. BI was measured via observations and parent-report across multiple assessments between the ages of 14 months and 7 years. Maternal over-control was assessed observationally during parent-child interaction tasks at 7 years. Adolescents (ages 14-17 years) and parents provided independent reports of adolescent SA symptoms. Results indicated that higher maternal over-control at 7 years predicted higher SA symptoms and lifetime rates of SAD during adolescence. Additionally, there was a significant interaction between consistently high BI and maternal over-control, such that patterns of consistently high BI predicted higher adolescent SA symptoms in the presence of high maternal over-control. High BI across childhood was not significantly associated with adolescent SA symptoms when children experienced low maternal over-control. These findings have the potential to inform prevention and early intervention programs by identifying particularly at-risk youth and specific targets of treatment.

Attention to threats and combat-related posttraumatic stress symptoms: prospective associations and moderation by the serotonin transporter gene

IMPORTANCE

Combat places soldiers at risk for posttraumatic stress disorder (PTSD). The excessive rates of PTSD and other adjustment disorders in soldiers returning home make it imperative to identify risk and resilience factors that could be targeted by novel therapeutic treatments.

OBJECTIVE

To investigate the interplay among attention to threat, combat exposure, and other risk factors for PTSD symptoms in soldiers deployed to combat.

DESIGN AND SETTING

Longitudinal prospective study of Israeli Defense Force infantry soldiers carried out in 2008 through 2010. Repeated measurements during a 1-year period included baseline and predeployment data collected in training camps and deployment data collected in the combat theater.

PARTICIPANTS

Infantry soldiers (1085 men; mean age, 18.8 years).

MAIN OUTCOME MEASURES

Postcombat PTSD symptoms. RESULTS Soldiers developed threat vigilance during combat deployment, particularly when they were exposed to high-intensity combat, as indicated by faster response times to targets appearing at the location of threat relative to neutral stimuli (P < .001). Threat-related attention bias also interacted with combat exposure to predict risk for PTSD (P < .05). Bias toward threat at recruitment (P < .001) and bias away from threat just before deployment (P < .05) predicted postcombat PTSD symptoms. Moreover, these threat-related attention associations with PTSD were moderated by genetic and environmental factors, including serotonin transporter (5-HTTLPR) genotype.

CONCLUSIONS AND RELEVANCE

Combat exposure interacts with threat-related attention to place soldiers at risk for PTSD, and interactions with other risk factors account for considerable variance in PTSD vulnerability. Understanding these associations informs research on novel attention bias modification techniques and prevention of PTSD.

Effects of early intervention and the moderating effects of brain activity on institutionalized children's social skills at age 8

The present study examined the social skills of previously institutionalized, 8-y-old Romanian children from the Bucharest Early Intervention Project and the influence of attachment security and brain electrical activity (alpha power) on these skills. Participants included children randomized to an intervention involving foster care [Foster Care Group (FCG)], children randomized to remain in institutions [Care As Usual Group (CAUG)], and never-institutionalized children living with their families in the Bucharest community [Never-Institutionalized Group (NIG)]. A continuous rating of children's attachment security to their primary caregiver was assessed at 42 mo of age. When children were 8 y old, teachers rated their social skills, and the children's resting electroencephalogram alpha power was recorded. Teachers rated social skills of FCG children who were placed into foster care before 20 mo of age as no different from NIG children, and both of these groups were higher than CAUG children and FCG children placed after 20 mo. Electroencephalogram alpha power at age 8 significantly moderated the relations between attachment security and social skills. These findings characterize institutionalized children's social skills in middle childhood within the context of a randomized intervention while highlighting the roles of both relational and biological factors in these developmental trajectories.

Early childhood temperament predicts substance use in young adults

Behavioral inhibition (BI) is an important early childhood marker of risk for later psychiatric problems. The current 20-year prospective, longitudinal study focused on individual differences in this early temperament and adolescent brain function. As adolescents, 83 participants initially identified in infancy with the temperament of BI were assessed using functional imaging to examine striatal responses to incentives. Five years later, as young adults, these participants provided self-report of their substance use. Our findings show that children's early temperament interacts with their striatal sensitivity to incentives in adolescence to predict their level of substance use in young adulthood. Those young adults who, as children, showed the highest levels of BI reported the greatest substance use if, as adolescents, they also exhibited striatal hypersensitivity to incentives. These longitudinal data delineate one developmental pathway involving early biology and brain mechanisms for substance use in young adulthood.

The relations among theory of mind, behavioral inhibition, and peer interactions in early childhood

The current study examined relations among child temperament, peer interaction, and theory of mind (ToM) development. We hypothesized that 1) children classified as behaviorally inhibited at 24 months would show less ToM understanding at 36 months in comparison to non-behaviorally inhibited children, 2) children who displayed negative peer interaction behaviors in a peer dyadic interaction at 24 months would exhibit less ToM understanding at 36 months, and 3) Behavioral inhibition (BI) and the degree of negative behaviors during a peer interaction would jointly influence ToM development, such that children with both heightened BI and negative peer interaction behaviors would exhibit worse ToM performance than behaviorally inhibited children who did not display negative social behaviors. Both BI and negative peer interaction behaviors were associated with passing fewer ToM tasks. The data revealed that children high in both BI and negative peer interaction behaviors passed fewer ToM tasks at 36 months of age than those high in BI and low in negative peer interactions or those low in BI.

Attention biases to threat link behavioral inhibition to social withdrawal over time in very young children

Behaviorally inhibited children display a temperamental profile characterized by social withdrawal and anxious behaviors. Previous research, focused largely on adolescents, suggests that attention biases to threat may sustain high levels of behavioral inhibition (BI) over time, helping link early temperament to social outcomes. However, no prior studies examine the association between attention bias and BI before adolescence. The current study examined the interrelations among BI, attention biases to threat, and social withdrawal already manifest in early childhood. Children (N=187, 83 Male, M (age)=61.96 months) were characterized for BI in toddlerhood (24 & 36 months). At 5 years, they completed an attention bias task and concurrent social withdrawal was measured. As expected, BI in toddlerhood predicted high levels of social withdrawal in early childhood. However, this relation was moderated by attention bias. The BI-withdrawal association was only evident for children who displayed an attention bias toward threat. The data provide further support for models associating attention with socioemotional development and the later emergence of clinical anxiety.

Behavioral inhibition and anxiety: the moderating roles of inhibitory control and attention shifting

Behavioral inhibition (BI), a temperament identified in early childhood, is associated with social reticence in childhood and an increased risk for anxiety problems in adolescence and adulthood. However, not all behaviorally inhibited children remain reticent or develop an anxiety disorder. One possible mechanism accounting for the variability in the developmental trajectories of BI is a child's ability to successfully recruit cognitive processes involved in the regulation of negative reactivity. However, separate cognitive processes may differentially moderate the association between BI and later anxiety problems. The goal of the current study was to examine how two cognitive processes-attention shifting and inhibitory control-laboratory assessed at 48 months of age moderated the association between 24-month BI and anxiety symptoms in the preschool years. Results revealed that high levels of attention shifting decreased the risk for anxiety problems in children with high levels of BI, whereas high levels of inhibitory control increased this risk for anxiety symptoms. These findings suggest that different cognitive processes may influence relative levels of risk or adaptation depending upon a child's temperamental reactivity.

Longitudinal stability of temperamental exuberance and social-emotional outcomes in early childhood

The goals of the current study were to investigate the stability of temperamental exuberance across infancy and toddlerhood and to examine the associations between exuberance and social-emotional outcomes in early childhood. The sample consisted of 291 4-month-olds followed at 9, 24, and 36 months and again at 5 years of age. Behavioral measures of exuberance were collected at 9, 24, and 36 months. At 36 months, frontal electroencephalogram (EEG) asymmetry was assessed. At 5 years, maternal reports of temperament and behavior problems were collected, as were observational measures of social behavior during an interaction with an unfamiliar peer in the laboratory. Latent profile analysis revealed a high, stable exuberance profile that was associated with greater ratings of 5-year externalizing behavior and surgency, as well as observed disruptive behavior and social competence with unfamiliar peers. These associations were particularly true for children who displayed left frontal EEG asymmetry. Multiple factors supported an approach bias for exuberant temperament but did not differentiate between adaptive and maladaptive social-emotional outcomes at 5 years of age.