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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.

Behavioral Inhibition is a temperament identified in the first years of life that enhances the risk for development of anxiety during late childhood and adolescence. Amongst children characterized with this temperament, only around 40 percent go on to develop anxiety disorders, meaning that more than half of these children do not. Over the past 20 years, research has documented within-child and socio-contextual factors that support differing developmental pathways. This review provides a historical perspective on the research documenting the origins of this temperament, its biological correlates, and the factors that enhance or mitigate risk for development of anxiety. We review as well, research findings from two longitudinal cohorts that have identified moderators of behavioral inhibition in understanding pathways to anxiety. Research on these moderators has led us to develop the Detection and Dual Control (DDC) framework to understand differing developmental trajectories among behaviorally inhibited children. In this review, we use this framework to explain why and how specific cognitive and socio-contextual factors influence differential pathways to anxiety versus resilience.

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.

Emergency departments (EDs) have played a major role in the science and practice of HIV population screening. After decades of experience, EDs have demonstrated the capacity to provide testing and linkage to care to large volumes of patients, particularly those who do not otherwise engage the healthcare system. Efforts to expand ED HIV screening in the United States have been accelerated by a collaborative national network of emergency physicians and other stakeholders called EMTIDE (Emergency Medicine Transmissible Infectious Diseases and Epidemics). As the COVID-19 pandemic evolves, EDs nationwide are being tasked with diagnosing and managing COVID-19 in a myriad of capacities, adopting varied approaches based in part on know-how, local disease trends, and the supply chain. The objective of this article is to broadly summarize the lessons learned from decades of ED HIV screening and provide guidance for many analogous issues and challenges in population screening for COVID-19. Over time, and with the accumulated experience from other epidemics, ED screening should develop into an overarching discipline in which the disease in question may vary, but the efficiency of response is increased by prior knowledge and understanding.

Emergency departments (EDs) have played a major role in the science and practice of HIV population screening. After decades of experience, EDs have demonstrated the capacity to provide testing and linkage to care to large volumes of patients, particularly those who do not otherwise engage the healthcare system. Efforts to expand ED HIV screening in the United States have been accelerated by a collaborative national network of emergency physicians and other stakeholders called EMTIDE (Emergency Medicine Transmissible Infectious Diseases and Epidemics). As the COVID-19 pandemic evolves, EDs nationwide are being tasked with diagnosing and managing COVID-19 in a myriad of capacities, adopting varied approaches based in part on know-how, local disease trends, and the supply chain. The objective of this article is to broadly summarize the lessons learned from decades of ED HIV screening and provide guidance for many analogous issues and challenges in population screening for COVID-19. Over time, and with the accumulated experience from other epidemics, ED screening should develop into an overarching discipline in which the disease in question may vary, but the efficiency of response is increased by prior knowledge and understanding.

Theta oscillations (4-8 Hz) provide an organizing principle of cognitive control, allowing goal-directed behavior. In adults, theta power over medial-frontal cortex (MFC) underlies conflict/error monitoring, whereas theta connectivity between MFC and lateral-frontal regions reflects cognitive control recruitment. However, prior work has not separated theta responses that occur before and immediately after a motor response, nor explained how medial-lateral connectivity drives different kinds of control behaviors. Theta's role during adolescence, a developmental window characterized by a motivation-control mismatch also remains unclear. As social observation is known to influence motivation, this might be a particularly important context for studying adolescent theta dynamics. Here, adolescents performed a flanker task alone or under social observation. Focusing first on the nonsocial context, we parsed cognitive control into dissociable subprocesses, illustrating how theta indexes distinct components of cognitive control working together dynamically to produce goal-directed behavior. We separated theta power immediately before/after motor responses, identifying behavioral links to conflict monitoring and error monitoring, respectively. MFC connectivity was separated before/after responses and behaviorally-linked to reactive and proactive control, respectively. Finally, distinct forms of post-error control were dissociated, based on connectivity with rostral/caudal frontal cortex. Social observation was found to exclusively upregulate theta measures indexing post-response error monitoring and proactive control, as opposed to conflict monitoring and reactive control. Linking adolescent cognitive control to theta oscillations provides a bridge between non-invasive recordings in humans and mechanistic studies of neural oscillations in animal models; links to social observation provide insight into the motivation-control interactions that occur during adolescence.

Behavioral inhibition (BI), a temperament trait characterized by fear and wariness in novel situations, has been identified as a risk factor for later social reticence and avoidance of peer interactions. However, the ability to regulate fearful responses to novelty may disrupt the link between BI and socially reticent behavior. The present study examined how and whether both behaviorally-manifested and physiological indices of emotion regulation moderate the relation between BI and later social reticence. Participants in this study included 88 children followed longitudinally from ages 2 to 4. At age 2, children completed the BI Paradigm in which children's responses to novel objects and adults were observed. At age 4, children's baseline respiratory sinus arrhythmia (RSA) was assessed and mothers reported on children's negative emotionality and soothability. Social reticence at age 4 was observed during a free play session with 3 unfamiliar peers. Results from saturated path models revealed a significant two-way interaction between BI and baseline RSA and a three-way interaction between BI, negative emotionality, and baseline RSA when predicting socially reticent behavior at age 4. At high levels of baseline RSA and high levels of negative emotionality, the association between BI and social reticence was negative. The relation between BI and later social reticence was only positive and significant at low levels of baseline RSA combined with high levels of negative emotionality. The results suggest that either strong physiological regulation or low negative emotionality seems sufficient to buffer inhibited young children against later social reticence.

The ability to regulate behaviors and emotions depends in part on the ability to flexibly monitor one's own progress toward a goal. Atypical patterns of response monitoring have been reported in individuals with autism spectrum disorders (ASD). In the current study we examined the error related negativity (ERN), an electrophysiological index of response monitoring, in relation to behavioral, social cognitive, and emotional presentation in higher functioning children (8-16 years) diagnosed with autism (HFA: N = 38) and an age- and IQ-matched sample of children without autism (COM: N = 36). Both HFA and COM participants displayed larger amplitude responses to error compared to correct response trials and these amplitudes did not differ by diagnostic group. For participants with HFA, larger ERN amplitudes were associated with more parent-reported autistic symptoms and more self-reported internalizing problems. However, across the full sample, larger ERN amplitudes were associated with better performance on theory of mind tasks. The results are discussed in terms of the utility of electrophysiological measures for understanding essential moderating processes that contribute to the spectrum of behavioral expression in the development of ASD.

Children and adolescents with autism spectrum disorder (ASD) demonstrate atypical processing of, and memory for, self-referenced information, which may contribute to the heightened rates of co-occurring internalizing problems. We assessed affective and cognitive aspects of self-referential processing in verbally-fluent children with ASD (N = 79), and an age-matched comparison sample (COM, N = 73) of children without an autism diagnosis. We examined group differences in these two aspects of the self-system, and their joint contributions to individual differnces in internalizing problems. Using a self-referenced memory (SRM) task, participants indicated whether a series of positive and negative trait adjectives described themselves and a well-known fictional character. Participants were then surprised with a recognition memory test on the same adjectives. Overall, individuals with ASD showed a reduction in the extent to which they preferentially endorsed positive over negative trait adjectives about themselves, and a reduction in their preferential memory for self- over other-referenced information. Across the full sample, these two aspects of self-referential processing jointly predicted self-reported internalizing problems. Specifically, self-evaluations were strongly and inversely associated with internalizing problems but only for children with relatively high SRM. These findings suggest that the salience of the self influences the extent to which affective self-evaluations impact emotional functioning for youth both with and without ASD. Implications for basic (e.g., developmental) and translational (e.g., intervention) research are discussed. Autism Res 2017, 10: 949-960. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

ObjectiveBehavioral inhibition (BI) is a temperament identified in early childhood that is a risk factor for later social anxiety. However, mechanisms underlying the development of social anxiety remain unclear. To better understand the emergence of social anxiety, longitudinal studies investigating changes at behavioral neural levels are needed.MethodBI was assessed in the laboratory at 2 and 3 years of age (N = 268). Children returned at 12 years, and an electroencephalogram was recorded while children performed a flanker task under 2 conditions: once while believing they were being observed by peers and once while not being observed. This methodology isolated changes in error monitoring (error-related negativity) and behavior (post-error reaction time slowing) as a function of social context. At 12 years, current social anxiety symptoms and lifetime diagnoses of social anxiety were obtained.ResultsChildhood BI prospectively predicted social-specific error-related negativity increases and social anxiety symptoms in adolescence; these symptoms directly related to clinical diagnoses. Serial mediation analysis showed that social error-related negativity changes explained relations between BI and social anxiety symptoms (n = 107) and diagnosis (n = 92), but only insofar as social context also led to increased post-error reaction time slowing (a measure of error preoccupation); this model was not significantly related to generalized anxiety.ConclusionResults extend prior work on socially induced changes in error monitoring and error preoccupation. These measures could index a neurobehavioral mechanism linking BI to adolescent social anxiety symptoms and diagnosis. This mechanism could relate more strongly to social than to generalized anxiety in the peri-adolescent period.

Although prior studies have demonstrated reduced resting state EEG coherence in adults with autism spectrum disorder (ASD), no studies have explored the nature of EEG coherence during joint attention. We examined the EEG coherence of the joint attention network in adolescents with and without ASD during congruent and incongruent joint attention perception and an eyes-open resting condition. Across conditions, adolescents with ASD showed reduced right hemisphere temporal-central alpha coherence compared to typically developing adolescents. Greater right temporal-central alpha coherence during joint attention was positively associated with social cognitive performance in typical development but not in ASD. These results suggest that, in addition to a resting state, EEG coherence during joint attention perception is reduced in ASD.

Higher-functioning participants with and without autism spectrum disorder (ASD) viewed a series of face stimuli, made decisions regarding the affect of each face, and indicated their confidence in each decision. Confidence significantly predicted accuracy across all participants, but this relation was stronger for participants with typical development than participants with ASD. In the hierarchical linear modeling analysis, there were no differences in face processing accuracy between participants with and without ASD, but participants with ASD were more confident in their decisions. These results suggest that individuals with ASD have metacognitive impairments and are overconfident in face processing. Additionally, greater metacognitive awareness was predictive of better face processing accuracy, suggesting that metacognition may be a pivotal skill to teach in interventions.

This study tested the spectrum hypothesis, which posits that children and adolescents with high functioning autism (HFA) differ quantitatively but not qualitatively from typically developing peers on self-reported temperament. Temperament refers to early-appearing, relatively stable behavioral and emotional tendencies, which relate to maladaptive behaviors across clinical populations. Quantitatively, participants with HFA (N = 104, aged 10-16) self-reported less surgency and more negative affect but did not differ from comparison participants (N = 94, aged 10-16) on effortful control or affiliation. Qualitatively, groups demonstrated comparable reliability of self-reported temperament and associations between temperament and parent-reported behavior problems. These findings support the spectrum hypothesis, highlighting the utility of self-report temperament measures for understanding individual differences in comorbid behavior problems among children and adolescents with HFA.

Individual differences in the expression of autism complicate research on the nature and treatment of this disorder. In the Modifier Model of Autism (Mundy et al. 2007), we proposed that individual differences in autism may result not only from syndrome specific causal processes, but also from variability in generic, non-syndrome specific modifier processes that affect the social and emotional development of all people. One study supporting this model found that measures of resting anterior EEG asymmetry, a measure reflecting complex brain processes associated with generic individual differences in approach and avoidance motivation, may help explain differences in the expression of autism in children without intellectual disabilities (Sutton et al. 2005). In the current study, we partially replicated the observation that children with autism who exhibited a pattern of left frontal EEG asymmetry tended to display milder levels of social symptoms, although in the current sample this pattern applied only to HFA children with relatively lower verbal IQs. New observations indicated that left frontal EEG asymmetry was also associated with retrospective parent reports of significantly later age of onset of symptoms, but also higher levels of self-reported outward expressions of anger as well as symptoms of obsessive compulsive disorder in school-age higher functioning children with ASD. Therefore, the results of this study provide a new and fully independent set of observations, which indicate that individual differences in anterior EEG asymmetry may significantly moderate the expression and developmental course of autism. This observation may have clinical implications for identifying meaningful diagnostic sub-groups among children with autism.

Individual differences in the expression of autism complicate research on the nature and treatment of this disorder. In the Modifier Model of Autism (Mundy et al. 2007), we proposed that individual differences in autism may result not only from syndrome specific causal processes, but also from variability in generic, non-syndrome specific modifier processes that affect the social and emotional development of all people. One study supporting this model found that measures of resting anterior EEG asymmetry, a measure reflecting complex brain processes associated with generic individual differences in approach and avoidance motivation, may help explain differences in the expression of autism in children without intellectual disabilities (Sutton et al. 2005). In the current study, we partially replicated the observation that children with autism who exhibited a pattern of left frontal EEG asymmetry tended to display milder levels of social symptoms, although in the current sample this pattern applied only to HFA children with relatively lower verbal IQs. New observations indicated that left frontal EEG asymmetry was also associated with retrospective parent reports of significantly later age of onset of symptoms, but also higher levels of self-reported outward expressions of anger as well as symptoms of obsessive compulsive disorder in school-age higher functioning children with ASD. Therefore, the results of this study provide a new and fully independent set of observations, which indicate that individual differences in anterior EEG asymmetry may significantly moderate the expression and developmental course of autism. This observation may have clinical implications for identifying meaningful diagnostic sub-groups among children with autism.

This report highlights the testimonies of perseverance and hope presented by the students at the hearing. These students share not only the formidable obstacles facing undocumented students but also the hope that comprehensive immigration reform will change their lives and allow them to fully contribute to American society. In an effort to make more information available to the public about the California and federal Dream Acts as well as the broader policy issues involving immigrant youth and higher education, the UCLA Center for Labor Research and Education will release a student publication in the summer of 2007.

This report highlights the testimonies of perseverance and hope presented by the students at the hearing. These students share not only the formidable obstacles facing undocumented students but also the hope that comprehensive immigration reform will change their lives and allow them to fully contribute to American society. In an effort to make more information available to the public about the California and federal Dream Acts as well as the broader policy issues involving immigrant youth and higher education, the UCLA Center for Labor Research and Education will release a student publication in the summer of 2007.