Emotional Control Mediates the Association Between Dimensions of Perfectionism and Worry in Children

Previous research has shown that perfectionism predicts for increased worry in children. Theoretically, children with high levels of perfectionism may show a decreased ability to control their emotions during times of perceived failure. Children may then worry as a maladaptive attempt to cope with intense emotions. The current study sought to test the mediating role of emotional control on the relation between perfectionism dimensions and worry in children. Participants were 66 parent–child dyads. Children were 7–13 years (50 % male; 77.3 % Caucasian, 9.1 % African American). Overall the model fit the data well. Results indicated that perfectionism domains predicted for emotional control deficits and increased worry. Emotional control also partially mediated the relation between perfectionism dimensions and worry. These results suggest that emotional control may be one mechanism through which perfectionism exerts its effect on worry and perfectionistic children may worry due to difficulty controlling their emotional responses.     

Risk-Taking Propensity in Older Adolescents: Internalizing Symptoms,Gender, and Negative Reinforcement

Objective: Engagement in risk behaviors, including substance use, risky sex, and violence, tends to increase throughout adolescence into young adulthood. One motivational process that may underlie risk behaviors during adolescence is negative reinforcement. Moreover, gender and internalizing symptoms (e.g., depression and anxiety) may both convey risk for negative reinforcement–based risk taking. Along these lines, the aims of the current study were to (a) examine gender differences in negative reinforcement–based risk-taking propensity and (b) examine internalizing symptoms as a moderator of the relationship between gender and negative reinforcement–based risk-taking propensity. Method: Participants included 103 youth between the ages of 18 and 21 (50.49% female, age M(SD) = 19.41(1.06)) who were recruited from a large Mid-Atlantic university between September 2013 and November 2014. Participants completed self-report assessments of internalizing symptomatology and a computerized behavioral analog assessment of negative reinforcement–based risk-taking propensity. Results: Results indicated that, overall, female older adolescents were riskier under conditions of negative reinforcement than male older adolescents. In addition, internalizing symptoms significantly moderated the relationship between gender and negative reinforcement–based risk-taking propensity such that the relationship between gender and negative reinforcement–based risk-taking propensity was nonsignificant at high levels of internalizing symptoms, and female gender was significantly positively predictive of heightened negative reinforcement–based risk-taking propensity at low levels of internalizing symptoms. Conclusions: Thus, although female youth overall were riskier, the predictive utility of gender for negative reinforcement–based risk taking may be most relevant at low levels of internalizing symptoms. Results are discussed in terms of implications for future prevention and intervention.     

Language of perfectionistic parents predicting child anxiety diagnostic status

Previous research has identified parental perfectionism as a risk factor for child anxiety. Yet few studies investigated why parental perfectionism may play such a role. Based on research suggesting parental verbal information and language use are associated with increased child fear beliefs and anxiety, the current study investigated the linguistic style of perfectionistic mothers and its relation to child anxiety. Participants were 71 mother–child dyads. Children were 3–12 years old, 57.7% female, and 30 were diagnosed with an anxiety disorder. Analyses showed that parental perfectionism was associated with increased second person pronouns, decreased adverbs, negative emotion words, and anger words. Second person pronouns and negative emotion words predicted child anxiety diagnostic status and mediated the relation between maternal perfectionism and child anxiety. These findings suggest that parental perfectionism may be associated with a specific language style that is related to child anxiety. Implications and future directions are discussed.     

A Multi-level Longitudinal Model of Risk Factors for Generalized and Separation Anxiety Symptoms in a Community Sample of 6-year-olds

The current longitudinal study examined the relations between variables in four domains—contextual (SES, family conflict, stress), parent (caretaker depression), parenting (support hostility, autonomy granting), and child (negative affect, effortful control, sensory regulation, attachment)—and both the presence of generalized and separation anxiety symptoms at age 6 in a community sample of 796 children and the change in these anxiety symptoms from ages 4 to 6. Anxiety was highly stable over time. Specific results revealed both direct and indirect pathways between age 4 and age 5 variables, and age 6 anxiety. Caretaker depression and the child variables of attachment, effortful control, negative affect, and sensory regulation were directly related to anxiety symptoms at age 6. Contextual variables (SES) at age 4 were indirectly related to age 6 anxiety through parent depression at age 5. Parent depression was indirectly related to age 6 anxiety through age 5 child negative affect. Child negative affect at age 4 was indirectly related to age 6 anxiety through age 5 effortful control and age 4 effortful control was indirectly related to age 6 anxiety through age 5 negative affect. With the exception of attachment, there was a reduction in the impact of other variables when initial levels of anxiety symptoms were included in the model. Implications of results for early intervention and further study are discussed.

     

Temperament,Peer Victimization,and Nurturing Parenting in Child Anxiety: A Moderated Mediation Model

Research has linked fearful temperament and childhood anxiety. Yet there remain numerous factors that moderate and mediate this relation. Two specific factors, identified in separate lines of research, are peer victimization and parenting. The current study tested a moderated mediational model to investigate the respective effects of peer victimization and nurturing parenting on the relation between fearful temperament and child anxiety. Participants were 124 parent–child dyads recruited from the community. Children were between the ages of 7 and 12 (56.5 % male, 93.5 % Caucasian) and most parents were mothers. Overall the data fit the model well. Analyses indicated that peer victimization was a mediator of the temperament to child anxiety relation, while nurturing parenting moderated this mediated effect. Nurturing parenting did not mediate the temperament to child anxiety relation directly. The findings suggest that nurturing parenting may be a specific, rather than global, protective factor for peer victimization in child anxiety.     

Predicting Depression and Anxiety from Oppositional Defiant Disorder Symptoms in Elementary School-Age Girls and Boys with Conduct Problems

This study investigated the relationship between the three DSM-5 categories of oppositional defiant disorder (ODD) symptoms (irritable mood, defiant behavior, vindictive behavior) and anxiety/depression in girls and boys with conduct problems (CP) while controlling for comorbid child psychopathology at baseline. Data were drawn from an ongoing longitudinal study of 6- to 9-year-old French-Canadian children (N = 276; 40.8 % girls) receiving special educational services for CP at school and followed for 2 years. Using linear regression analysis, the results showed that irritable mood symptoms predicted a higher level of depression and anxiety in girls and boys 2 years later, whereas the behavioral symptoms of ODD (e.g., defiant, vindictive symptoms) were linked to lower depression scores. The contribution of ODD symptoms to these predictions, while statistically significant, remained modest. The usefulness of ODD irritable symptoms as a marker for identifying girls and boys with CP who are more vulnerable to developing internalizing problems is discussed.     

The neglected relationship between social interaction anxiety and hedonic deficits: differentiation from depressive symptoms

Depressive symptoms are associated with both the presence of negative subjective experiences and relative absence of positive subjective experiences. A similar affective profile of high negative affect and low positive affect (PA) has been associated with excessive social anxiety (SA). This initial cross-sectional study evaluated the incremental effects of social interaction anxiety on hedonic deficits beyond the effects of depressive and anxiety (i.e., physiological arousal, worry) symptoms. From a sample of 97 college students, a factor analysis on self-report measures of hedonic functioning derived two domains: Positive Subjective Experiences and Curiosity. Social interaction anxiety was uniquely, negatively related to Positive Subjective Experiences and Curiosity after removing variance attributable to various depressive and anxiety symptoms. In contrast, anxious arousal and nonspecific anxiety had near-zero relationships with both domains, and depressive symptoms were negatively related to Positive Subjective Experiences. These data provide some evidence for an association between social interaction anxiety and hedonic deficits that is not attributable to covariance with other internalizing conditions.     

Obsessions and worry beliefs in an inpatient OCD population

Dysfunctional beliefs in obsessive–compulsive disorder (OCD) and worry are thought to contribute to vulnerability and maintenance of pathological anxiety. In this study, five belief domains concerning responsibility/threat estimation, perfectionism, intolerance of uncertainty, importance/control of thoughts and thought–action fusion were examined to see whether they differentially predicted worry and obsession severity in patients with severe OCD. Correlational analysis revealed that perfectionism and intolerance of uncertainty were associated with worry, whereas beliefs in the importance and control of thoughts and thought–action fusion were associated with obsession severity when obsession severity and worry, respectively, were controlled. In regression analyses, thought–action fusion and intolerance of uncertainty predicted OCD severity. The relation between dysfunctional beliefs and specific subtypes of OCD symptoms was also examined. Specific relationships were identified, including perfectionism with ordering, obsessions with control/importance of thoughts and checking and washing with threat estimation.     

The effect of maternal psychopathology on parent–child agreement of child anxiety symptoms: A hierarchical linear modeling approach

The current study examined the effects of maternal anxiety, worry, depression, child age and gender on mother and child reports of child anxiety using hierarchical linear modeling. Participants were 73 mother–child dyads with children between the ages of 7 and 10 years. Reports of child anxiety symptoms, including symptoms of specific disorders (e.g., social phobia) were obtained using concordant versions of the Screen for Anxiety and Related Emotional Disorders (SCARED). Children reported significantly higher levels of anxiety symptoms relative to their mothers. Maternal worry and depression predicted for significantly lower levels of maternal-reported child anxiety and increasing discrepant reports. Maternal anxiety predicted for higher levels of maternal-reported child anxiety and decreasing discrepant reports. Maternal depression was associated with increased child-reported child anxiety symptoms. No significant effect of child age or gender was observed. Findings may inform inconsistencies in previous studies on reporter discrepancies. Implications and future directions are discussed.     

Reliability and Validity of the Spence Children’s Anxiety Scale for Parents in Mainland Chinese Children and Adolescents

This study examined the psychometric properties of the Spence Children’s Anxiety Scale for Parents (SCAS-P) in 1943 father-mother dyads and 1785 students. Results of confirmatory factor analyses for SCAS-P were in favour of the original model with six correlated factors. The internal consistency of SCAS-P was acceptable (α = .63–.91), and the test–retest reliability was acceptable (r = .46–.72). The convergent and divergent validity of SCAS-P was supported by significant correlations with an internalizing subscale to a greater extent than with an externalizing subscale. Congruent validity was supported by significant correlations between father and mother reports (r = .60–.71) and child and parent reports (r = .25–.42). Significant differences between community and clinical samples supported the discriminant validity. Adolescents showed higher anxiety levels than children, and girls showed higher anxiety levels than boys. Our findings suggest that the SCAS-P is a suitable parent instrument to measure child anxiety symptoms in Mainland Chinese children and adolescents.     

Maternal depressive symptoms, and not anxiety symptoms, are associated with positive mother–child reporting discrepancies of internalizing problems in children: a report on the TRAILS Study

Maternal internalizing problems affect reporting of child’s problem behavior. This study addresses the relative effects of maternal depressive symptoms versus anxiety symptoms and the association with differential reporting of mother and child on child’s internalizing problems. The study sample comprised a cohort of 1,986 10- to 12-year-old children and their mothers from the Dutch general population in a cross sectional setup. Children’s internalizing problems were assessed with the DSM-IV anxiety and affective problem scales of the Child Behavior Checklist (CBCL) and the Youth Self-Report (YSR). Current maternal internalizing problems were assessed with the depressive and anxiety symptom scales of the Depression Anxiety Stress Scale (DASS), while the TRAILS Family History Interview (FHI) measured lifetime maternal depression and anxiety. Results show that current and lifetime maternal depressive symptoms were associated with positive mother–child reporting discrepancies (i.e. mothers reporting more problems than their child). Considering the small amount of variance explained, we conclude that maternal depressive symptoms do not bias maternal reporting on child’s internalizing problems to a serious degree. Studies concerning long term consequences of mother–child reporting discrepancies on child’s internalizing problems are few, but show a risk for adverse outcome. More prognostic research is needed.     

Pathways to Service Receipt: Modeling Parent Help-Seeking for Childhood Mental Health Problems

Understanding parent appraisals of child behavior problems and parental help-seeking can reduce unmet mental health needs. Research has examined individual contributors to help-seeking and service receipt, but use of structural equation modeling (SEM) is rare. SEM was used to examine parents’ appraisal of child behavior, thoughts about seeking help, and receipt of professional services in a diverse, urban sample (N = 189) recruited from women infant and children offices. Parents of children 11–60 months completed questionnaires about child behavior and development, parent well-being, help-seeking experiences, and service receipt. Child internalizing, externalizing, and dysregulation problems, language delay, and parent worry about child behavior loaded onto parent appraisal of child behavior. Parent stress and depression were positively associated with parent appraisal (and help-seeking). Parent appraisal and help-seeking were similar across child sex and age. In a final model, parent appraisals were significantly associated with parent thoughts about seeking help, which was significantly associated with service receipt.     

Child Routines and Parental Adjustment as Correlates of Internalizing and Externalizing Symptoms in Children Diagnosed with ADHD

Attention deficit hyperactivity disorder (ADHD) is one of the most common disorders of childhood, and the presence of comorbid externalizing and internalizing symptoms often result in severe negative long-term consequences. Multiple etiological factors contribute to the development of co-occurring symptoms. Family stability and consistency appear to be particularly important in effectively managing behavioral concerns. One important factor in producing consistency and stability is the use of routines. The current study examined how routines may be related to internalizing/externalizing symptoms in a clinical sample (N = 371) of children with ADHD (M age = 9.13, SD = 1.96; 77 % male). After controlling for child age, gender, and parental adjustment, routines predicted both internalizing and externalizing symptoms. Specific subtypes of routines including Household, Discipline, and Homework Routines were found to significantly predict symptomatology. A positive relation was found between parental and child adjustment problems; however, support for routines moderating the relation between parent and child adjustment was not supported.     

A study of the psychometric properties of the Obsessive Beliefs Inventory and Interpretations of Intrusions Inventory on clinical Italian individuals

Forty-three individuals with obsessive-compulsive disorder (OCD), 17 with generalized anxiety disorder (GAD) and 50 non-clinical controls (SC), completed the Italian versions of the Obsessive Beliefs Questionnaire (OBQ) and the Interpretations of Intrusions Inventory (III), along with measures of obsessive-compulsive (OC) symptoms, depression, anxiety and worry. OBQ and III showed an excellent reliability and temporal stability. The six OBQ subscales were reasonably distinct from each other, whereas the three subscales of the III were highly interrelated. The OBQ, and in less measure the III, discriminated between OCD, GAD, and normal controls. In the OCD cohort, the two instruments correlated moderately with a measure of obsessive-compulsive symptoms but also with a measure of worry. However, a linear regression analysis evidenced a specific relationship between the OBQ and obsessive-compulsive symptoms over and above worry. Overall, at least three cognitive domains (intolerance of uncertainty, excessive concern about the importance of controlling one's thoughts and perfectionism) seemed specific to OCD, whereas overimportance of thoughts and inflated responsibility barely discriminate clinically anxious individuals from non-clinical ones. It is concluded that OBQ and III are useful measures in Italian individuals and that more research is warranted to possibly refine these two instruments.     

Distinguishing Fear Versus Distress Symptomatology in Pediatric OCD

Prior research has identified OCD subtypes or “clusters” of symptoms that differentially relate to clinical features of the disorder. Given the high comorbidity between OCD and anxiety, OCD symptom clusters may more broadly associate with fear and/or distress internalizing constructs. This study examines fear and distress dimensions, including physical concerns (fear), separation anxiety (fear), perfectionism (distress), and anxious coping (distress), as predictors of previously empirically-derived OCD symptom clusters in a sample of 215 youth diagnosed with primary OCD (ages 7–17, mean age = 12.25). Self-reported separation fears predicted membership in Cluster 1 (aggressive, sexual, religious, somatic obsessions, and checking compulsions) while somatic/autonomic fears predicted membership in Cluster 2 (symmetry obsessions and ordering, counting, repeating compulsions). Results highlight the diversity of pediatric OCD symptoms and their differential association with fear, suggesting the need to carefully assess both OCD and global fear constructs that might be directly targeted in treatment.     

Child Internalizing Symptoms: Contributions of Child Temperament,Maternal Negative Affect,and Family Functioning

Research has traditionally focused on the role of genetic and environmental variables in the development and maintenance of childhood internalizing disorders. Temperament variables, such as negative affect and effortful control have gained considerable interest within the field of developmental psychopathology. Environmental factors such as mother–child interactions and family cohesion have also been linked with internalizing disorders. The current study examines the relationship between child negative affect, effortful control, maternal negative affect, family functioning, and internalizing symptoms in a sample of preschool-aged children using a path analysis approach. Sixty-five children, aged 3–5 years and their mothers completed measures on child temperament, family environment, maternal personality, and child internalizing symptoms. Results support a complex model for the influence of both direct and indirect factors on internalizing symptoms in preschool-aged children.     

Ethnic variance between Asian and European American women in a six month prospective model of eating disorder and social anxiety symptom comorbidity

ABSTRACT

Eating disorders and social anxiety are highly comorbid. Understanding this comorbidity may improve treatment outcomes, as social anxiety can impair the ability to benefit from eating disorder treatment. The primary model of social anxiety and eating disorder comorbidity includes social appearance anxiety, high standards, and maladaptive perfectionism. In the current study, we tested for ethnic invariance between Asians (n = 82) and European Americans (n = 182) in a cross-sectional and prospective comorbidity model of social anxiety and eating disorder symptoms. Differences were found across ethnicity in eating disorder and social anxiety symptom comorbidity. Maladaptive perfectionism predicted social anxiety and eating disorder symptoms in European Americans, whereas social appearance anxiety predicted social anxiety and eating disorder symptoms in Asians. Our findings suggest that interventions for social anxiety and eating disorders in Asian populations may be improved by assessing and targeting social appearance anxiety, while maladaptive perfectionism should be targeted among European Americans.     

Empathic Responses to Mother’s Emotions Predict Internalizing Problems in Children of Depressed Mothers

Recent theories posit that empathy, typically an adaptive characteristic, may be associated with internalizing problems when children are chronically exposed to mother’s depression. We tested this postulation in a sample of children (N = 82, M _age = 5 years). Children witnessed their mothers express sadness, anger, and happiness during a simulated phone conversation, and researchers rated children’s negative affective empathy, positive affective empathy, and information-seeking (cognitive empathy) in response to their mother’s emotions. The chronicity of mother’s depression during the child’s lifetime moderated associations between children’s empathy and internalizing problems. As predicted, all three empathy measures were related to greater mother-rated internalizing problems in children of chronically (i.e., 2–3 years) depressed mothers. Greater positive empathy was related to lower internalizing problems in children of nondepressed mothers. Positive empathy may contribute to adaptive processes when mothers are not depressed, and positive, negative, and cognitive empathy may contribute to maladaptive processes when mothers are chronically depressed.     

The contribution of prenatal and postnatal maternal anxiety and depression to child maladjustment

Background: The adverse effect of both pre‐ and post‐natal maternal anxiety and depression on the development of offspring is shown by a large body of research. No published studies, however, have simultaneously: (i) controlled for co‐occurring prenatal risks that may influence maternal prenatal anxiety and depression; (ii) compared the relative contributions of prenatal and postnatal maternal anxiety and depression on child functioning; and (iii) assessed a full range of child psychopathology and functioning to determine the relative effects of prenatal and postnatal anxiety and depression in the mother. Method: Using 3,298 mother–offspring pairs, the authors examined these factors in a single‐path analytic model. Measurements of maternal anxiety and depression were collected at two time points: 32 weeks prenatal and 1.5 years postnatal. Other prenatal risks were assessed between 8 and 32 weeks of gestation. Child outcomes included (a) ordered‐categorical measures of DSM‐IV externalizing and internalizing disorders, and (b) an assessment of verbal IQ. Results: In both the prenatal and postnatal periods, maternal depression had a wider impact on different types of child maladjustment than maternal anxiety, which appeared more specific to internalizing difficulties in the child. Of note, prenatal risks were prospectively associated with child externalizing difficulties and verbal IQ, beyond the effects of prenatal and postnatal maternal anxiety and depression. Conclusion: The present results suggest that addressing both maternal anxiety and depression, in the prenatal and postnatal periods—as well as associated risk factors—may be the most effective approach to prevent adverse outcomes in the offspring. Depression and Anxiety, 2011. © 2011 Wiley‐Liss, Inc.     

HIV-Related Stigma,Shame, and Avoidant Coping: Risk Factors for Internalizing Symptoms Among Youth Living with HIV?

Youth living with HIV (YLH) are at elevated risk of internalizing symptoms, although there is substantial individual variability in adjustment. We examined perceived HIV-related stigma, shame-proneness, and avoidant coping as risk factors of internalizing symptoms among YLH. Participants (N = 88; ages 12–24) completed self-report measures of these potential risk factors and three domains of internalizing symptoms (depressive, anxiety, and PTSD) during a regularly scheduled HIV clinic visit. Hierarchical regressions were conducted for each internalizing symptoms domain, examining the effects of age, gender, and maternal education (step 1), HIV-related stigma (step 2), shame- and guilt-proneness (step 3), and avoidant coping (step 4). HIV-related stigma, shame-proneness, and avoidant coping were each correlated with greater depressive, anxiety, and PTSD symptoms. Specificity was observed in that shame-proneness, but not guilt-proneness, was associated with greater internalizing symptoms. In multivariable analyses, HIV-related stigma and shame-proneness were each related to greater depressive and PTSD symptoms. Controlling for the effects of HIV-related stigma and shame-proneness, avoidant coping was associated with PTSD symptoms. The current findings highlight the potential importance of HIV-related stigma, shame, and avoidant coping on the adjustment of YLH, as interventions addressing these risk factors could lead to decreased internalizing symptoms among YLH.