Maladaptive schemas and psychopathology in adolescence: on the utility of Young's schema theory in youth

The present article reports on two studies that investigated the utility of Young's cognitive theory Young et al. (Schema therapy: A practitioner's guide, Guilford Publications, New York, 2003) in adolescents. Study 1 focused on the factorial validity of the Young Schema Questionnaire (YSQ) in youth. In Study 2, the dimensionality of Young's schemas and their (content-specific) association with psychopathology were investigated. In Study 1, 635 adolescents were asked to complete the YSQ. In Study 2, participants were 112 non-referred and 104 referred adolescents. They were interviewed with the Structured Clinical Interview for DSM-IV-Child edition and completed the YSQ and the Youth Self Report. Their parents were asked to fill out the Child Behavior Checklist. It was demonstrated that Young's theoretically proposed taxonomy of schemas and domains can be retrieved in adolescents. Referred youth displayed a higher severity of maladaptive schemas as compared with non-referred adolescents. A content-specific association of schemas and psychopathology was established. Young's schema theory might constitute a valuable framework to understand psychopathology in youth

Self-compassion improves parental well-being in response to challenging parenting events

Shame and guilt are common during the course of parenting and can reflect feelings of “bad self “and “bad behaviour” in relation to parenting events. Self-compassion is known to be beneficial for well-being by reducing negative emotions, yet there is little research examining whether self-compassion might reduce parental guilt and shame. The current study examined the effects of dispositional and induced self-compassion on guilt and shame in a sample of 167 parents (Mage = 37.23, SD = 6.73, 83.1% female) of children 12 years and under recruited online. After completing baseline measures, parents were randomly assigned to recall a guilt versus shame provoking parenting event, and randomly allocated to either a self-compassion prompt versus a control condition. Analyses confirmed that those who received the self-compassion prompt reported higher levels of self-compassion, and reduced feelings of guilt and shame compared to the control group. Effects did not differ as a function of the guilt versus shame instructions. Multivariate analyses revealed that, when controlling for dispositional self-compassion, and baseline guilt and shame, differences between conditions were maintained for post-manipulation guilt and shame. Findings extend our understanding of the role of self-compassion for improving well-being when dealing with the challenges of parenting

The structure of challenging parenting behavior and associations with anxiety in Dutch and Australian children

Objective: Challenging parenting behavior (CPB), a novel construct involving active physical and verbal behaviors that encourage children to push their limits, has been identified as a potential buffer against child anxiety. This study aimed to 1) evaluate the measurement invariance of the Challenging Parenting Behavior Questionnaire (CPBQ4-6) across Dutch and Australian mothers and fathers of preschoolers; 2) examine differences in levels of CPB across mothers and fathers, and across countries; 3) examine whether parents’ CPB predicts less child anxiety symptoms and disorders. Methods: Participants were 312 families, 146 Dutch and 166 Australian, with their 3 to 4-year-old child (55.8% girls). Fathers’ and mothers’ CPB was measured using the CPBQ4-6, child anxiety symptoms and presence of anxiety disorders were assessed using maternal reports. Results: Multigroup confirmatory factor analyses revealed equivalence of factor structure and factor loadings (all significant) of the CPBQ4-6 across mothers and fathers, and countries. Evidence of partial scalar invariance indicated that the groups differed on some subscales of the CPBQ4-6. Australian mothers scored lower on the CPB factor than Australian fathers and Dutch parents. Structural equation models showed that CPB predicted fewer child anxiety symptoms and anxiety disorders for all groups. Conclusion: The study confirms that the CPBQ4-6 is appropriate for use with Dutch and Australian parents of pre-school aged children, and identifies CPB as a multifaceted and coherent construct. The negative relations between CPB and child anxiety suggest that CPB has a protective role in childhood anxiety, and is important to examine in future research and interventions

Pupil responses to dynamic negative facial expressions of emotion in infants and parents

Observing others' emotions triggers physiological arousal in infants as well as in adults, reflected in dilated pupil sizes. This study is the first to examine parents' and infants' pupil responses to dynamic negative emotional facial expressions. Moreover, the links between pupil responses and negative emotional dispositions were explored among infants and parents. Infants' and one of their parent's pupil responses to negative versus neutral faces were measured via eye tracking in 222 infants (5- to 7-month-olds, n = 77, 11- to 13-month-olds, n = 78, and 17- to 19-month-olds, n = 67) and 229 parents. One parent contributed to the pupil data, whereas both parents were invited to fill in questionnaires on their own and their infant's negative emotional dispositions. Infants did not differentially respond to negative expressions, while parents showed stronger pupil responses to negative versus neutral expressions. There was a positive association between infants' and their parent's mean pupil responses and significant links between mothers' and fathers' stress levels and their infants' pupil responses. We conclude that a direct association between pupil responses in parents and offspring is observable already in infancy in typical development. Stress in parents is related to their infants' pupillary arousal to negative emotions.Action Contro

Predicting outcomes following cognitive behavior therapy in child anxiety disorders: the influence of genetic, demographic and clinical information

Background. Within a therapeutic gene by environment (GxE) framework, we recently demonstrated that variation in the Serotonin Transporter Promoter Polymorphism; 5HTTLPR and marker rs6330 in Nerve Growth Factor gene; NGF is associated with poorer outcomes following cognitive behaviour therapy (CBT) for child anxiety disorders. The aim of this study was to explore one potential means of extending the translational reach of G×E data in a way that may be clinically informative. We describe a ‘risk-index’ approach combining genetic, demographic and clinical data and test its ability to predict diagnostic outcome following CBT in anxious children. Method. DNA and clinical data were collected from 384 children with a primary anxiety disorder undergoing CBT. We tested our risk model in five cross-validation training sets. Results. In predicting treatment outcome, six variables had a minimum mean beta value of 0.5: 5HTTLPR, NGF rs6330, gender, primary anxiety severity, comorbid mood disorder and comorbid externalising disorder. A risk index (range 0-8) constructed from these variables had moderate predictive ability (AUC = .62-.69) in this study. Children scoring high on this index (5-8) were approximately three times as likely to retain their primary anxiety disorder at follow-up as compared to those children scoring 2 or less. Conclusion. Significant genetic, demographic and clinical predictors of outcome following CBT for anxiety-disordered children were identified. Combining these predictors within a risk-index could be used to identify which children are less likely to be diagnosis free following CBT alone or thus require longer or enhanced treatment. The ‘risk-index’ approach represents one means of harnessing the translational potential of G×E data

Just as they expected: How parents' expectations about their unborn child's characteristics provide a context for early transactions between parenting and child temperament

Prenatal expectations about what children will be like after birth may provide a context for how parents perceive their infant's actual temperament. We examined how these expectations and perceptions are associated and together predict early parenting behavior, with parenting behavior in turn predicting changes in temperament. Reports of 125 families (N = 122 fathers; N = 123 mothers; sample 1) about their expectations of their unborn child's temperament (negative affectivity, surgency, regulation, T1), their infant's temperament at 4 and 12 months post-partum (T2 and T3), and their hostile, responsive, warm, and overprotective parenting (T2) were included. We also included data from an independent sample of 168 mothers (sample 2), with the same measures, except that mothers reported on Big Five personality traits at T1. Results indicated that in both samples, parents' expectations were positively associated with perceptions of infant temperament. Prenatal expectations and newborn temperament independently predicted parenting behavior, and maternal and paternal parenting in turn predicted infant temperament at T3, controlling for infant temperament at T2. Although overall findings indicated associations between (expectations of) a more difficult temperament and more negative/less positive parenting, significant combinations of specific traits and parenting behaviors were sample-specific—indicating that more research is necessary to draw a conclusion about specific links. Both maternal and paternal expectations about their unborn child's temperament appear to carry over into the postpartum reality and provide a context for shaping early interactions between caregivers and their children, which may further shape the developing temperament of the child

Interpretation of ambiguous situations: evidence for a dissociation between social and physical threat in Williams syndrome

There is increasing evidence that Williams syndrome (WS) is associated with elevated anxiety that is non-social in nature, including generalised anxiety and fears. To date very little research has examined the cognitive processes associated with this anxiety. In the present research, attentional bias for non-social threatening images in WS was examined using a dot-probe paradigm. Participants were 16 individuals with WS aged between 13 and 34 years and two groups of typically developing controls matched to the WS group on chronological age and attentional control ability respectively. The WS group exhibited a significant attention bias towards threatening images. In contrast, no bias was found for group matched on attentional control and a slight bias away from threat was found in the chronological age matched group. The results are contrasted with recent findings suggesting that individuals with WS do not show an attention bias for threatening faces and discussed in relation to neuroimaging research showing elevated amygdala activation in response to threatening non-social scenes in WS

Starting to develop self-help for social anxiety associated with vitiligo: using clinical significance to measure the potential effectiveness of enhanced psychological self-help

Background Vitiligo can be associated with high levels of distress, yet there are currently no self-help interventions available. Objectives To describe the initial development of a psychosocial self-help intervention designed to reduce social anxiety associated with vitiligo. Also to examine whether including a planning exercise, aimed at increasing use of the intervention (termed implementation intentions), has the potential to achieve a clinically significant reduction in distress. Methods Participants (n = 75) were randomized to one of three groups: cognitive behavioural self-help (CBSH), CBSH augmented with implementation intentions (CBSH+), or no intervention. Participants were assessed at baseline and after 8 weeks on measures of social anxiety, anxiety and depression, and appearance-related concern. The two intervention groups also completed a questionnaire evaluating their use of, and satisfaction with, the intervention. Results High levels of social anxiety and concern over appearance were reported. Twenty-four per cent of participants in the CBSH+ group experienced clinically significant change on the measure of social anxiety compared with 8% in the CBSH group and 0% in the control group. In addition, 58% of the control group deteriorated during the study period. There were no significant differences between the conditions on the other outcome measures. Participants reported that the self-help leaflets were helpful. Conclusions The findings demonstrate that augmented CBSH provides a relatively simple and accessible intervention that can result in a clinically significant reduction in social anxiety. The augmented intervention has potential and might be further developed and evaluated in subsequent trials

Genetic variation in the endocannabinoid system and response to cognitive behavioural therapy for child anxiety disorders

Extinction learning is an important mechanism in the successful psychological treatment of anxiety. Individual differences in response and relapse following Cognitive Behavior Therapy may in part be explained by variability in the ease with which fears are extinguished or the vulnerability of these fears to re-emerge. Given the role of the endocannabinoid system in fear extinction, this study investigates whether genetic variation in the endocannabinoid system explains individual differences in response to CBT. Children (N = 1,309) with a primary anxiety disorder diagnosis were recruited. We investigated the relationship between variation in the CNR1, CNR2, and FAAH genes and change in primary anxiety disorder severity between pre- and post-treatment and during the follow-up period in the full sample and a subset with fear-based anxiety disorder diagnoses. Change in symptom severity during active treatment was nominally associated (P < 0.05) with two SNPs. During the follow-up period, five SNPs were nominally associated with a poorer treatment response (rs806365 [CNR1]; rs2501431 [CNR2]; rs2070956 [CNR2]; rs7769940 [CNR1]; rs2209172 [FAAH]) and one with a more favorable response (rs6928813 [CNR1]). Within the fear-based subset, the effect of rs806365 survived multiple testing corrections (P < 0.0016). We found very limited evidence for an association between variants in endocannabinoid system genes and treatment response once multiple testing corrections were applied. Larger, more homogenous cohorts are needed to allow the identification of variants of small but statistically significant effect and to estimate effect sizes for these variants with greater precision in order to determine their potential clinical utility