Anxiety-related cognitions in close relationships

Etiological models of anxiety have increasingly emphasized the role of information processing biases, and there is evidence that children, as well as adults exhibit these biases. However, to date, little is known about the origins of these biases. This thesis aims to explore whether interpretation bias and fear beliefs might be acquired from significant others in close relationships (i.e., parents, friends and romantic partners). It also considers a range of developmental stages to identify potential sources of influence that may play a role in the acquisition and/or maintenance of information processing biases across development. The thesis aims are realised across four studies that explore shared anxiety-related cognitions in distinct close relationships. The main findings of this thesis are summarized as follows. First, there is some evidence that individuals in close relationships exhibit similar patterns of anxiety-related cognitions, namely in close friends in middle childhood, as well as in parents and their young adult children. Second, there is some indication that anxietyrelated cognitions might be acquired via the verbal information pathway from significant others in close relationships, such as from parents, close friends, and romantic partners. Third, factors such as the difference in anxiety levels between individuals in close relationships, relationship closeness, and attachment do not appear to moderate the transmission of anxiety-related cognitions in close relationships. Finally, results showed a significant relationship between anxiety-related cognitions and anxiety in middle childhood and young adulthood, but not in early childhood, indicating that interpretation bias may initially develop during the preschool years and may not show an association with anxiety until middle childhood. Taken together, these results indicate that anxiety-related cognitions can be transmitted within close relationships, and that verbal information appears to be a viable pathway in which such cognitions may be transmitted

Behavioural Inhibition and Childhood Anxiety: Interventions and the Role of Peer Relationships

Background: Behavioural inhibition (BI), a temperament style characterised by shy, quiet, or restrained behaviours when exposed to novel situations, has consistently been identified as a key risk factor for the development of anxiety disorders. This thesis aims to examine whether psychological interventions targeting BI are efficacious in reducing BI and anxiety (symptoms and diagnosis) in preschool-aged children. It also aims to examine the longitudinal relationship between BI, peer relationship difficulties, and anxiety in a cohort of young children over an 8-year period. Method: The efficacy of interventions targeting BI in preschool-aged children was examined by conducting a systematic review and meta-analysis consisting of 10 studies (N = 1475 children, aged 3 – 7 years). The empirical study included a cohort of 202 preschool-aged children initially assessed as behaviourally inhibited (n = 102) and behaviourally uninhibited (BUI; n = 100) at baseline. Peer relationship difficulties were assessed at baseline, 2-year, 5-year and 8-year follow-ups. Anxiety symptoms and disorders were assessed at baseline and at 8-year follow-up. Results: Intervention significantly reduced behavioural inhibition when outcomes were reported by parents (SMD = -.42) and teachers (SMD = -.69), but not when assessed by observers (SMD = -.13). Additionally, intervention significantly reduced anxiety symptoms when reported by parents (SMD = -.35) but not for anxiety diagnosis (OR = .39). Results of the empirical study indicated that BI children generally exhibited higher levels of peer relationship difficulties than BUI children across time-points. Peer relationship difficulties across time-points were significantly associated with and predictive of anxiety disorders at age 12 generally. Finally, peer relationship difficulties moderated the longitudinal relationship between BI and anxiety diagnosis predominantly when the difficulties were reported by mothers. Conclusion: Intervention targeted at BI preschool-aged children may be effective in reducing BI and anxiety symptoms (but not disorder). Moreover, children’s peer relationship difficulties across development impacts on their anxiety diagnosis in early adolescence

Acceptance and commitment therapy (ACT) for post-stroke adjustment difficulties via telerehabilitation in a working-age man

Adjustment difficulties following a stroke are common and associated with poorer outcomes. Current systematic reviews suggest insufficient evidence for the efficacy of psychological interventions for post-stroke anxiety and/or depression. However, a recent randomised controlled trial (Majumdar and Morris, 2019) of group-based acceptance and commitment therapy (ACT) showed promise in reducing depression and increasing hopefulness and perceived health status in stroke survivors. The present case study describes the assessment, formulation, treatment and outcomes of post-stroke adjustment difficulties in a working-aged man using ACT delivered via telerehabilitation. At the end of treatment (six sessions over 2 months), the client no longer met clinical cut-off for psychological distress and depression. Furthermore, reported levels of psychological flexibility were comparable to non-clinical norms. These gains were maintained at 3- and 6-month follow-up. Outcomes from this case study support emerging evidence indicating that ACT may be an efficacious intervention for post-stroke adjustment difficulties, even when delivered via telerehabilitation. Further research investigating the mediating and moderating effects of different cognitive behavioural processes such as values and acceptance on psychological adjustment to stroke is recommended

Do you think I should be scared? The effect of peer discussion on children's fears

This study investigated whether close friends affect each other’s fear responses (fear beliefs and avoidance) when they discuss fear-related issues together. Children (N = 242) aged 7 to 10 years were first presented with ambiguous and threatening information about two novel animals respectively, after which their fear responses towards each animal were assessed (T1). Next, dyads of close friends had a discussion about their feelings regarding the animals, and their fear responses were measured again (T2). Results showed that children influenced each other’s cognitions following the discussion; from T1 to T2 their fear responses became more similar and close friends’ fear responses at T1 significantly predicted children’s fear responses at T2. Gender pair type predicted change in children’s fear responses over time. Children in boy-boy pairs showed a significant increase in fear responses following the discussion; their fear level became more in line with that of other gender pairs at T2, while those in girl-girl pairs showed a significant decrease in their fear beliefs, at least when threatening information was given. Differences in anxiety level between close friends did not affect change in fear responses over time. Altogether, the results indicate that children may affect each other’s fears

Interpersonal Functioning in Borderline Personality Disorder Traits: A Social Media Perspective

This is the first study to demonstrate interpersonal difficulties associated with borderline personality disorder (BPD) features in the domain of social media. Using crowdsourcing, we presented participants with a battery of questions about their recent social media use, and then assessed their BPD features using the short form of the Five-Factor Borderline Inventory. The results revealed that individuals with higher BPD trait scores reported posting more often on social media, as well as a higher incidence of experiencing regret after posting on social media, and of deleting or editing their posts. They also report a higher degree of importance of social media in their social behavior and daily routines. These results highlight the pervasiveness of interpersonal difficulties associated with BPD features even in the non-clinical population, and demonstrate that these difficulties are also observable in social media behavior. Our findings may provide a starting point for research using data from social media to illuminate the cognitive and emotional processes underpinning the interpersonal difficulties associated with BPD features, and to inform and assess therapeutic interventions

The efficacy of interventions for behaviourally inhibited preschool-aged children: A meta-analysis

The current systematic review and meta-analyses examined the efficacy of psychological interventions targeting behavioural inhibition and anxiety in preschool-aged children, evaluated within randomised controlled trials. Web of Science, MEDLINE, PsycINFO and CINAHL were systematically searched from inception to March 2021. Ten studies (N = 1475 children, aged 3 – 7 years) were included in the current review. Separate analyses were conducted for behavioural inhibition, anxiety symptoms, and anxiety diagnosis as reported by parents, teachers, and observer-ratings. Pooled outcomes ranged from post-intervention to 12-month follow-up due to the limited number of studies. Meta-analyses revealed that intervention did not reduce behavioural inhibition as assessed by independent observers (SMD = -.13, 95% CI = -.63 to.38), but did reduce behavioural inhibition as reported by parents (SMC = -.64, 95% CI = -1.00 to -.27) and teachers (SMD = -.69, 95% CI = -1.02 to -.36). Additionally, intervention appeared to reduce the risk of anxiety disorders (RR =.75, 95% CI =.62 to.90), and parent-report anxiety symptoms (SMC = -.47, 95% CI = -.83 to -.12) in preschool-aged children. Intervention may be efficacious in reducing anxiety in preschool-aged behaviourally inhibited children. It is less clear whether intervention leads to change in BI

Probing commitment in individuals with borderline personality disorder

Interpersonal problems are a core symptom of borderline personality disorder (BPD). In particular, patients with BPD exhibit a heightened sensitivity to cues of acceptance or rejection in their relationships. The current study investigated the psychological processes underpinning this heightened responsiveness. In a between-subjects design, we implemented a reactivity induction designed to trigger either acceptance or rejection of a partner in two separate groups, and measured the effects which this manipulation had upon 49 patients with BPD, as well as 52 control participants. The experimental paradigm required participants to repeatedly choose whether to coordinate with their partner on a decision-making task. When both players coordinate on the same option, both are rewarded. The experiment probed participants’ commitment to their partners: participants were sometimes presented with tempting opportunities to unilaterally defect from the coordination. The results show that participants in the BPD group were less committed than participants in the control group when exposed to the rejection manipulation

Shared cognition in childhood anxiety: interpretation bias in preschool children and their parents

Although interpretation bias has been associated with the development and/or maintenance of childhood anxiety, its origins remain unclear. The present study is the first to examine intergenerational transmission of this bias from parents to their preschool-aged children via the verbal information pathway. A community sample of fifty parent–child pairs was recruited. Parents completed measures of their own trait anxiety and interpretation bias, their child’s anxiety symptoms, and a written story-stem measure, to capture the way parents tell their children stories. Interpretation bias was assessed in preschool-aged children (aged between 2 years 7 months and 5 years 8 months) using an extended story-stem paradigm. Young children’s interpretation bias was not significantly associated with their own anxiety symptoms. Neither was there evidence for a significant association between parent and child interpretation bias. However, parents who reported they would tell their child one or more threatening story endings in the written story-stem task had significantly higher anxiety than those who did not include any threatening story endings. In turn, children whose parents did not include any threatening endings in their written stories had significantly lower threat interpretations on the child story-stem paradigm, compared to those with parents who included at least one threatening story ending. The results suggest that parental verbal information could play a role in the development of interpretation bias in young children

Where do fairness preferences come from? Norm transmission in a teen friendship network

We ran an experiment on transmission of fairness norms in a friendship network of 11–15 year olds. Experiment participants were able to observe a peer's allocations between two anonymous others. Observing others’ choices affected both participants’ own choices and their expressed fairness judgments. Rather than learning a new norm, participants decided which of two already known norms applied in the experimental situation. We also use the social network to examine how social influence varies with friendship status and network position