Severe Life Events and Chronic Adversities as Antecedents to Anxiety in Children: A Matched Control Study

The present study compared the number of severe life events and chronic adversities as reported retrospectively by mothers of children with an anxiety disorder (n = 39) prior to the onset of their most recent episode, with controls (n = 39) matched for age and sex. The parent version of the Psychosocial Assessment of Childhood Experiences (PACE) was used to assess chronic adversities (long-term experiences with negative impact on child) and severe life events (discrete life events with high long-term threat). A significantly greater number of severe life events and chronic adversities were assessed prior to onset for anxious children compared to controls. The finding for severe life events held regardless of whether impact ratings were assigned by mothers or a panel of independent raters, suggesting the findings reflect actual as opposed to perceived differences. Results suggest that both discrete and chronic stressors may constitute risk for future episodes of anxiety in childre

Maternal Modeling and the Acquisition of Fear and Avoidance in Toddlers: Influence of Stimulus Preparedness and Child Temperament

The aim of the present study was to investigate the influence of maternal modeling on the acquisition of fear and avoidance towards fear-relevant and fear-irrelevant, novel stimuli in a sample of 71 toddlers. Children were shown a rubber snake or spider (fear-relevant objects) and a rubber mushroom or flower (fear-irrelevant objects), which were alternately paired with either negative or positive expression by their mothers. Both stimuli were presented again after a 1- and a 10-min delay, while mothers maintained a neutral expression. The toddlers showed increased fear and avoidance of the objects following negative reaction from their mothers than following positive maternal expression. This was similarly true for both fear-relevant and fear-irrelevant stimuli. In addition, no association was found between child temperament and behavioral responses and a weak association emerged between child temperament and emotional responses. The results demonstrate that young children can rapidly form conditioned emotional and behavioral responses via maternal reactions regardless of stimulus preparedness or child temperament. It is suggested that early maternal modeling may be relevant to a broad spectrum of fearful reaction

Ew gross! Recognition of Expressions of Disgust by Children With Obsessive-Compulsive Disorder

There is evidence suggesting that obsessive-compulsive disorder (OCD) in adults may be associated with an impaired ability to recognise the facial expression of disgust (Sprengelmeyer et al., 1997a; Woody, Corcoran, & Tolin, in press). It has been suggested that this impairment begins in childhood when the recognition of emotional expressions is being learnt (see Spengelmeyer et al., 1997a). This study compared the recognition of facial affect in children aged around 11 years with a diagnosis of obsessive-compulsive disorder (OCD; n = 11), other anxiety disorders (n = 20), and nonclinical children (n = 19), adapting the methodology of Sprengelmeyer et al. Disgust was most commonly misclassified as anger by children in all three groups. However, children with OCD did not show any evidence of a recognition deficit for disgust in comparison to either control group. Unexpectedly, however, children with OCD recognised expressions of surprise more accurately than nonclinical children. Recognition of disgust or any other emotion was not related to child self-reported anxiety symptoms. Given the observed differences in some studies with adults, future research may benefit by examining older adolescents and young adults to determine when these effects may first be notice

Representations of the Self in Social Phobia: Vulnerability to Social Threat

A revised Stroop color-naming task was used to test hypotheses derived from Beck’s cognitive theory of anxiety disorders which proposes that social phobics are hypervigilant to social-evaluative threat cues. Color-naming latencies for social and physical threat words were compared to matched neutral words for both social phobics and individuals with panic disorder. As predicted, social phobics showed longer latencies for social threat words, and panickers had longer latencies for physical threat words. Latency for color-naming social threat words correlated with self-reported avoidance among social phobics. These results are consistent with Beck’s notion of self-schemata which facilitate the processing of threat cues. Methodological issues and clinical implications are discussed

The Validity of the Social Avoidance and Distress Scale and the Fear of Negative Evaluation Scale with Social Phobic Patients

Turner, McCanna and Beidel’s (1987) recent evaluation of the Social Avoidance and Distress Scale (SADS) and the Fear of Negative Evaluation Scale (FNE) with anxiety disordered patients concluded that the SADS and FNE lacked discriminant validity and may be inappropriate for subject selection or outcome evaluation in studies of social phobia . This paper raises some concerns with the interpretation of the data presented by Turner et al. (1987) and presents additional data from studies in our laboratories that may qualify their conclusions. It is asserted that (a) the SADS and FNE are not appropriate for diagnostic screening of social phobic patients, (b) Turner et al.’s findings may have been the result of clinically meaningful social anxiety in several of the anxiety disorders, (c) significant differences among the anxiety disorders may have been hidden by heterogeneity among patients who receive the diagnosis of social phobia. and (d) the distribution of FNE scores in Turner et al.’s sample may have been unusually depressed

Enhanced effects of combined cognitive bias modification and computerised cognitive behaviour therapy on social anxiety

This study examines whether combined cognitive bias modification for interpretative biases (CBM-I) and computerised cognitive behaviour therapy (C-CBT) can produce enhanced positive effects on interpretation biases and social anxiety. Forty socially anxious students were randomly assigned into two conditions, an intervention group (positive CBM-I + C-CBT) or an active control (neutral CBM-I + C-CBT). At pre-test, participants completed measures of social anxiety, interpretative bias, cognitive distortions, and social and work adjustment. They were exposed to 6 × 30 min sessions of web-based interventions including three sessions of either positive or neutral CBM-I and three sessions of C-CBT, one session per day. At post-test and two-week follow-up, participants completed the baseline measures. A combined positive CBM-I + C-CBT produced less negative interpretations of ambiguous situations than neutral CBM-I + C-CBT. The results also showed that both positive CBM-I + C-CBT and neutral CBM-I + C-CBT reduced social anxiety and cognitive distortions as well as improving work and social adjustment. However, greater effect sizes were observed in the positive CBM-I + C-CBT condition than the control. This indicates that adding positive CBM-I to C-CBT enhanced the training effects on social anxiety, cognitive distortions, and social and work adjustment compared to the neutral CBM-I + C-CBT condition

Managing anxiety disorders in adults

The GP has a key role in identifying patients presenting with anxiety symptoms and ensuring appropriate acute and long-term management. There are two key messages for GPs to follow: once you have made a diagnosis of an anxiety disorder, tell the patient you have a treatment for it. Second, do not let your anxiety lead you to prescribe inappropriately or overinvestigate for all possible differential diagnoses

Fear of negative evaluation biases social evaluation inference:evidence from a probabilistic learning task

Fear of negative evaluation (FNE) defines social anxiety yet the process of inferring social evaluation, and its potential role in maintaining social anxiety, is poorly understood. We developed an instrumental learning task to model social evaluation learning, predicting that FNE would specifically bias learning about the self but not others.During six test blocks (3 self-referential, 3 other-referential), participants (n = 100) met six personas and selected a word from a positive/negative pair to finish their social evaluation sentences "I think [you are / George is]…". Feedback contingencies corresponded to 3 rules, liked, neutral and disliked, with P[positive word correct] = 0.8, 0.5 and 0.2, respectively.As FNE increased participants selected fewer positive words (β = -0.4, 95% CI -0.7, -0.2, p = 0.001), which was strongest in the self-referential condition (FNE × condition 0.28, 95% CI 0.01, 0.54, p = 0.04), and the neutral and dislike rules (FNE × condition × rule, p = 0.07). At low FNE the proportion of positive words selected for self-neutral and self-disliked greatly exceeded the feedback contingency, indicating poor learning, which improved as FNE increased.FNE is associated with differences in processing social-evaluative information specifically about the self. At low FNE this manifests as insensitivity to learning negative self-referential evaluation. High FNE individuals are equally sensitive to learning positive or negative evaluation, which although objectively more accurate, may have detrimental effects on mental health