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The human gut microbiome influence on brain function and mental health is an emerging area of intensive research. Animal and human research indicates adolescence as a sensitive period when the gut-brain axis is fine-tuned, where dietary interventions to change the microbiome may have long-lasting consequences for mental health. This study reports a systematic review and meta-analysis of microbiota-targeted (psychobiotics) interventions on anxiety in youth, with discussion of a consultation on the acceptability of psychobiotic interventions for mental health management amongst youth with lived experience. Six databases were searched for controlled trials in human samples (age range: 10–24 years) seeking to reduce anxiety. Post intervention outcomes were extracted as standard mean differences (SMDs) and pooled based on a random-effects model. 5416 studies were identified: 14 eligible for systematic review and 10 eligible for meta-analysis (total of 324 experimental and 293 control subjects). The meta-analysis found heterogeneity I2 was 12% and the pooled SMD was −0.03 (95% CI: −0.21, 0.14), indicating an absence of effect. One study presented with low bias risk, 5 with high, and 4 with uncertain risk. Accounting for risk, sensitivities analysis revealed a SMD of −0.16 (95% CI: −0.38, 0.07), indicative of minimal efficacy of psychobiotics for anxiety treatment in humans. There is currently limited evidence for use of psychobiotics to treat anxiety in youth. However, future progress will require a multidisciplinary research approach, which gives priority to specifying mechanisms in the human models, providing causal understanding, and addressing the wider context, and would be welcomed by anxious youths.

Depression and anxiety are highly prevalent and comorbid in adolescents, and this co-occurrence leads to worse prognosis and additional difficulties. The relationship between depression and anxiety must be delineated to, in turn, reduce and prevent the comorbidity, however our knowledge is still limited. We used network analysis to investigate bridge symptoms; symptoms that connect individual depression and anxiety symptoms and thus can help explain the comorbidity. We also examined the role of relevant risk and protective factors in explaining these symptom-level associations between these disorders. We analyzed data from the Avon Longitudinal Study of Children and Parents (n = 3670). Depression and anxiety symptoms, peer victimization, bullying, peer relational problems, prosocial behavior, and parental monitoring were assessed at a single time point around age 13 years. Stressful life events (SLEs) were assessed at age 11 years. We identified the most prominent bridge symptoms among depression (“feeling unhappy”, “feeling lonely”) and anxiety symptoms (“worrying about past”, “worrying about future”). Peer relational difficulties and SLEs were strongly associated with several depression and anxiety symptoms, such that these two risk factors created a link between individual depression and anxiety symptoms. Prosocial behavior had several negative associations with symptoms of both disorders, suggesting it can be an important protective factor. Supplementary Information The online version contains supplementary material available at 10.1007/s10862-021-09880-5.

Purpose This systematic review aims to synthesise the evidence on behavioural and attitudinal patterns as well as barriers and enablers in Filipino formal help-seeking. Methods Using PRISMA framework, 15 studies conducted in 7 countries on Filipino help-seeking were appraised through narrative synthesis. Results Filipinos across the world have general reluctance and unfavourable attitude towards formal help-seeking despite high rates of psychological distress. They prefer seeking help from close family and friends. Barriers cited by Filipinos living in the Philippines include financial constraints and inaccessibility of services, whereas overseas Filipinos were hampered by immigration status, lack of health insurance, language difficulty, experience of discrimination and lack of acculturation to host culture. Both groups were hindered by self and social stigma attached to mental disorder, and by concern for loss of face, sense of shame, and adherence to Asian values of conformity to norms where mental illness is considered unacceptable. Filipinos are also prevented from seeking help by their sense of resilience and self-reliance, but this is explored only in qualitative studies. They utilize special mental health care only as the last resort or when problems become severe. Other prominent facilitators include perception of distress, influence of social support, financial capacity and previous positive experience in formal help. Conclusion We confirmed the low utilization of mental health services among Filipinos regardless of their locations, with mental health stigma as primary barrier, while resilience and self-reliance as coping strategies were cited in qualitative studies. Social support and problem severity were cited as prominent facilitators.

Background Theories suggest that interpretation biases play a role in the aetiology of a range of psychopathology including depression, anxiety and psychosis. We evaluate the psychometric properties of an adapted version of an ambiguous scenario task (i.e., Interpretation Bias Task [IBT]) that assesses benign and negative interpretations in four domains: immediate bodily injury; long-term illness; social rejection; and, performance failure. Methods The factor structure of the IBT was evaluated in a student sample (N = 237) in Study 1, and subsequently confirmed in a community sample with a wider age range (N = 1103) in Study 2. Correlations between interpretation biases and health and social anxiety symptoms were tested in both studies. Results The four IBT domains were differentiable and each was represented by two factors (i.e., benign vs. negative). In Study 1, higher health anxiety was characterised by fewer benign interpretations for injury- and illness-related scenarios, whereas higher social anxiety was associated with more negative and fewer benign interpretations for social rejection and performance failure scenarios. Correlational results were replicated in Study 2 for social anxiety, but not health anxiety. Conclusions The IBT is suitable for measuring interpretation biases in Asian adults. The content specificity of interpretation biases was partially supported.

Purpose of Review Adolescent depression is a major public health concern associated with severe outcomes. A lack of efficacious interventions has triggered an increase in cognitive neuropsychology research to identify relevant treatment targets for new interventions. This review summarises key neurocognitive findings in adolescent depression and explores the potential of neurocognitive markers as treatment targets in new interventions. Recent Findings Studies support difficulties in the voluntary deployment of attention towards and away from emotional stimuli, negative interpretation biases and overgeneralised autobiographical memories in adolescent depression; however, little evidence is given to a general decline in executive function. There is consistent evidence for abnormalities in several distributed neural networks in adolescent depression, including dysfunction in and between the amygdala, medial prefrontal cortex and ventral striatum. Summary The relationships between different cognitive biases and abnormalities in specific neural networks remain unclear. Several new experimental interventions targeting these neurocognitive markers await evaluation.

Purpose The purpose of this study was to examine group and individual differences in attentional bias toward and away from socially threatening facial stimuli among adolescents who stutter and age- and sex-matched typically fluent controls. Method Participants included 86 adolescents (43 stuttering, 43 controls) ranging in age from 13 to 19 years. They completed a computerized dot-probe task, which was modified to allow for separate measurement of attentional engagement with and attentional disengagement from facial stimuli (angry, fearful, neutral expressions). Their response time on this task was the dependent variable. Participants also completed the Social Anxiety Scale for Adolescents (SAS-A) and provided a speech sample for analysis of stuttering-like behaviors. Results The adolescents who stutter were more likely to engage quickly with threatening faces than to maintain attention on neutral faces, and they were also more likely to disengage quickly from threatening faces than to maintain attention on those faces. The typically fluent controls did not show any attentional preference for the threatening faces over the neutral faces in either the engagement or disengagement conditions. The two groups demonstrated equivalent levels of social anxiety that were both, on average, very close to the clinical cutoff score for high social anxiety, although degree of social anxiety did not influence performance in either condition. Stuttering severity did not influence performance among the adolescents who stutter. Conclusion This study provides preliminary evidence for a vigilance–avoidance pattern of attentional allocation to threatening social stimuli among adolescents who stutter.

Group decision-making is required in early life in educational settings and central to a well-functioning society. However, there is little research on group decision-making in adolescence, despite the significant neuro-cognitive changes during this period. Researchers have studied adolescent decision-making in ‘static’ social contexts, such as risk-taking in the presence of peers, and largely deemed adolescent decision-making ‘sub-optimal.’ It is not clear whether these findings generalise to more dynamic social contexts, such as the discussions required to reach a group decision. Here we test the optimality of group decision-making at different stages of adolescence. Pairs of male pre-to-early adolescents (8 to 13 years of age) and mid-to-late adolescents (14 to 17 years of age) together performed a low-level, perceptual decision-making task. Whenever their individual decisions differed, they were required to negotiate a joint decision. While there were developmental differences in individual performance, the joint performance of both adolescent groups was at adult levels (data obtained from a previous study). Both adolescent groups achieved a level of joint performance expected under optimal integration of their individual information into a joint decision. Young adolescents’ joint, but not individual, performance deteriorated over time. The results are consistent with recent findings attesting to the competencies, rather than the shortcomings, of adolescent social behaviour.

Aberrant interoceptive accuracy could contribute to the co-occurrence of anxiety and premonitory urge in chronic tic disorders (CTD). If it can be manipulated through intervention, it would offer a transdiagnostic treatment target for tics and anxiety. Interoceptive accuracy was first assessed consistent with previous protocols and then re-assessed following an instruction attempting to experimentally enhance awareness. The CTD group demonstrated lower interoceptive accuracy than controls but, importantly, this group difference was no longer significant following instruction. In the CTD group, better interoceptive accuracy was associated with higher anxiety and lower quality of life, but not with premonitory urge. Aberrant interoceptive accuracy may represent an underlying trait in CTD that can be manipulated, and relates to anxiety and quality of life.

Research studies applying cognitive bias modification of attention (CBM-A) and interpretations (CBM-I) training to reduce adolescent anxiety by targeting associated cognitive biases have found mixed results. This study presents a new multi-session, combined bias CBM package, which uses a mix of training techniques and stimuli to enhance user-engagement. We present preliminary data on its viability, acceptability and effectiveness on reducing symptoms and biases using an A–B case series design. 19 adolescents with elevated social anxiety reported on their social anxiety, real-life social behaviours, general anxiety, depression, and cognitive biases at pre/post time-points during a 2-week baseline phase and a 2-week intervention phase. Retention rate was high. Adolescents also reported finding the CBM training helpful, particularly CBM-I. Greater reductions in social anxiety, negative social behaviour, and general anxiety and depression, characterised the intervention but not baseline phase. There was a significant correlation between interpretation bias change and social anxiety symptom change. Our enhanced multi-session CBM programme delivered in a school-setting appeared viable and acceptable. Training-associated improvements in social anxiety will require further verification in a study with an active control condition/group. Medical Research Council

The proclivity to construe ambiguous information in a negative way is known as interpretation bias, which has been implicated in the onset and/or maintenance of social anxiety. The purpose of this study was to examine group and individual differences in interpretation bias among young people who stutter and their typically fluent peers during the adolescent years when social fears and worries tend to escalate.A total of 99 adolescents (13 to 19 years old) participated, including 48 adolescents who stutter (67% male) and 51 typically fluent controls (68% male). They completed a computerized vignette-based interpretation bias task in which they first read 14 short ambiguous social scenarios (half including a verbal interaction, half including a non-verbal interaction). They were then presented with four possible interpretations of each scenario including two negative interpretations (one target, one foil) and two positive interpretations (one target, one foil). Participants used a 4-point Likert scale to rate how similar in meaning each interpretation was to the original scenario. Participants also completed self-report measures of social and general anxiety, and provided a speech sample for stuttering analysis.There was no effect of stuttering on interpretations; the adolescents who stutter rated interpretations across both verbal and non-verbal scenarios comparably to the controls, and stuttering severity did not affect interpretation ratings. However, across groups, there was a significant effect of social anxiety such that higher social anxiety was associated with more negative interpretations, and lower social anxiety was associated with more positive interpretations.This study provides preliminary evidence that social anxiety may affect how adolescents interpret ambiguous social cues in verbal and non-verbal scenarios more than stuttering, although more research into how people who stutter process social information is warranted.

Background Emerging evidence suggests that cognitive bias modification of interpretations (CBM‐I) is effective in altering interpretation biases and reducing anxiety in adults. Less is known about the impact of CBM‐I in young people, but some recent findings, including a meta‐analysis of combined cognitive bias modification of interpretation and attention techniques, have cast doubt on its clinical utility. Given the current debate, this meta‐analysis sought to establish the independent effects of CBM‐I on interpretations biases and anxiety in youth. Methods Studies were identified through a systematic literature search of PsycINFO, Ovid MEDLINE, PsycARTICLES, Web of Science and EMBASE between January 1992 and March 2017. Eligible studies aimed to target interpretation biases; did not combine CBM‐I with another intervention; included a control condition; randomly allocated participants to conditions; assessed interpretation bias and/or anxiety as an outcome; included individuals up to age 18; and did not present previously reported data. Reference lists of included articles were checked for further eligible studies, and authors were contacted for unpublished data. Results We identified 26 studies meeting eligibility criteria that included in the meta‐analysis. CBM‐I had moderate effects on negative and positive interpretations (g = −0.70 and g = −0.52, respectively) and a small but significant effect on anxiety assessed after training (g = −0.17) and after a stressor (g = −0.34). No significant moderators were identified. Conclusions In contrast to previous meta‐analytic findings, our results indicate that CBM‐I has potential but weak anxiolytic effects in youth. Our findings suggest that it may be premature to disregard the potential value of CBM‐I research and further research in this field is warranted.

Pathological social withdrawal (PSW) refers to a set of socially-avoidant behaviours including low social engagement. Because social disconnectedness is associated with loneliness, which in turn is linked with psychiatric conditions, investigating loneliness in PSW is important for understanding the societal burden of PSW. Here, we investigated relationships between PSW, disconnectedness from other social groups, loneliness and psychiatric disturbances in Taiwan. Individuals with PSW showed greater perceived disconnection with their peers and more loneliness than those without PSW. Duration of being socially-withdrawn and the degree of disconnection with peers were each associated with loneliness. A positive correlation between loneliness and psychiatric disturbances also emerged. As poorer perceived closeness with friends may explain loneliness and psychiatric symptoms amongst individuals with PSW, future treatment should focus on social skills or nurturing social interactions with peers, beyond family members.

Group decision-making is required in early life in educational settings and central to a well-functioning society. However, there is little research on group decision-making in adolescence, despite the significant neuro-cognitive changes during this period. Researchers have studied adolescent decision-making in ‘static’ social contexts, such as risk-taking in the presence of peers, and largely deemed adolescent decision-making ‘sub-optimal’. It is not clear whether these findings generalise to more dynamic social contexts, such as the discussions required to reach a group decision. Here we test the optimality of group decision-making at different stages of adolescence. Pairs of male pre-to-early adolescents (8 to 13 years of age) and mid-to-late adolescents (14 to 17 years of age) together performed a low-level, perceptual decision-making task. Whenever their individual decisions differed, they were required to negotiate a joint decision. While there were developmental differences in individual performance, the joint performance of both adolescent groups was at adult levels (data obtained from a previous study). Both adolescent groups achieved a level of joint performance expected under optimal integration of their individual information into a joint decision. Young adolescents’ joint, but not individual, performance deteriorated over time. The results are consistent with recent findings attesting to the competencies, rather than the shortcomings, of adolescent social behaviour.

Interpretation training programs have proven effective in altering anxiety-related cognitive biases in children and adults. The current study examined the effects of interpretation training on subsequent anticipatory processing of an anxiety-provoking event. A nonclinical sample of 89 children (10–12 years) was trained to interpret ambiguous social scenarios in either a benign or a negative way. After a single session of training, participants were also asked to engage in anticipatory processing and rated their state anxiety at various points during the experiment. The results indicate that the training was effective in inducing the intended group differences in interpretative bias. Moreover, participants who had previously been trained to make benign interpretations showed attenuated levels of state anxiety after engaging in anticipatory processing of the stressful event, whereas participants trained to make negative interpretations maintained their heightened anxiety levels during this period. These res...

Adolescent anxiety is common and impairing and often persists into adulthood. There is growing evidence that adult anxiety is characterized by abnormal fear responses to threat and safety cues, along with perturbations in fear-related neural circuits. Although some of this work has been extended to adolescents, with promising results, it is not yet clear whether changes in these circuits across developmental age varies between anxious and non-anxious adolescents. Here we used fMRI to examine how age modulates neural responses as adolescents are exposed to threat and safety cues. Participants were 15 anxious and 11 non-anxious adolescents (age 12-17) who completed a fear conditioning paradigm. The paradigm incorporated a threat cue comprising a neutral face which was paired with a fearful, screaming face, a safety cue comprising a different neutral face, and a control stimulus. Across the whole sample, neural activation to the threat cue (relative to the control cue) correlated positively with age in a number of regions, including the dorsal anterior cingulate and bilateral dorsolateral prefrontal cortex (PFC). However, neural activation to the safety cue (relative to the control cue) was modulated differently by age in the two groups: a more positive association between activation and age was observed in the control group compared to the anxious group in various regions including medial and dorsolateral PFC, anterior insula, and amygdala. These findings suggest that maturation of the neural substrates of fear responses to safety cues may be perturbed in anxious adolescents, potentially contributing to the emergence and maintenance of anxiety disorders in adulthood.

Highlights • Late childhood and adolescence are a sensitive juncture for social anxiety onset. • Cognitive biases linked to social anxiety manifest in differences in functional brain response. • Normative socio-affective developments may exacerbate biased processing. • Increased plasticity/learning may make adolescence an ideal time to intervene. • Modifying processing biases through cognitive training and neurofeedback represent two possible age-appropriate interventions., Social anxiety disorder represents a debilitating condition that has large adverse effects on the quality of social connections, educational achievement and wellbeing. Age-of-onset data suggests that early adolescence is a developmentally sensitive juncture for the onset of social anxiety. In this review, we highlight the potential of using a developmental cognitive neuroscience approach to understand (i) why there are normative increases in social worries in adolescence and (ii) how adolescence-associated changes may ‘bring out’ neuro-cognitive risk factors for social anxiety in a subset of individuals during this developmental period. We also speculate on how changes that occur in learning and plasticity may allow for optimal acquisition of more adaptive neurocognitive strategies through external interventions. Hence, for the minority of individuals who require external interventions to target their social fears, this enhanced flexibility could result in more powerful and longer-lasting therapeutic effects. We will review two novel interventions that target information-processing biases and their neural substrates via cognitive training and visual feedback of neural activity measured through functional magnetic resonance imaging.

Despite the apparent effectiveness of cognitive-behavioral therapy (CBT) in the treatment of anxiety disorders, more can be done to predict individual variability in the effectiveness of CBT. One potentially useful predictor involves individual differences in fear inhibition and extinction as similar learning processes are thought to be involved in CBT. Waters and Pine (this issue) present an investigation of the relationship between pretreatment indices of fear extinction and responsiveness to CBT among children with anxiety disorders. We discuss these findings and place them within the context of supporting evidence from neurobiological and genetic research. Various novel ways in which different elements of fear inhibition and extinction can be quantified are then outlined, and the potential utility of this approach for clinicians and researchers particularly in developmental samples is discussed.

BACKGROUND: Depression is the most common psychiatric disorder in adolescence, and is characterised by an inability to down-regulate negative emotional responses to stress. Adult studies suggest this may be associated with reduced functional connectivity between prefrontal and subcortical regions, yet the neurological mechanisms in adolescence remain unclear. METHODS: We developed a novel, age-appropriate, reappraisal paradigm to investigate functional connectivity during reappraisal of a real-life source of stress in 15 depressed and 15 non-depressed adolescents. During fMRI, participants i) attended to, and ii) implemented reappraisal techniques (learnt prior to fMRI) in response to, rejection. RESULTS: Reappraisal reduced negative mood and belief in negative thoughts in both groups alike, however during reappraisal (versus attend) trials, depressed adolescents showed greater connectivity between the right frontal pole and numerous subcortical and cortical regions than non-depressed adolescents. CONCLUSIONS: These findings tentatively suggest that, when instructed, depressed adolescents do have the ability to engage neural networks involved in emotion regulation, possibly because adolescence reflects a period of heightened plasticity. These data support the value of cognitive reappraisal as a treatment tool, identify neural markers that could be used to optimise current therapies, and lay the foundations for developing novel neuroscientific techniques for the treatment of adolescent depression. Language: en

Negative biases in the interpretation of social information are associated with anxious symptoms in adolescents. Previous studies have attempted to modify interpretive biases to alleviate anxious mood responses but the longevity of such training effects has not been established. A cognitive bias modification of interpretations (CBM-I) paradigm was administered to sixty-nine 15–17 year-olds. Participants were either trained to interpret ambiguous social situations positively, or received control training that contained no emotional content. Participants showed significantly weaker endorsement of negative interpretations of novel ambiguous information following positive training than following control. Positive CBM-I training effects on interpretation did not differ between a group tested immediately following training and one tested 24 h later. Results provided no evidence of differential changes in state anxiety as a direct result of CBM-I training. The persistence of training effects of suppressing negative biases for ambiguous social information is encouraging for future work that might use bias-training methods in adolescents as buffers against negative emotional responses.

OBJECTIVES: This systematic review and meta-analysis examined the effects of psychological therapies for management of chronic pain in children. METHODS: Randomized controlled trials of psychological interventions treating children (

The last decade has cognitive bias modification (CBM) training paradigms, emerging first as an experimental test of the causal role of information-processing biases on mood and anxiety symptoms, and then, as the clinical implications of these findings were realised, as a potential clinical 'vaccine' that could be used to modify biases and reduce symptoms. CBM is an umbrella term for methods designed to modify cognitive factors that maintain psychiatric conditions such as anxiety and depression through simple repetitive learning. Two biases that have most often been targeted by these training programs are the tendency to orient attention towards threat and distortions in the interpretation of ambiguous situations. This commentary reflects on an accompanying meta-analysis by Crsitea et al., which pooled effect sizes from over 20 statistical comparisons between a CBM group and a control group on post-training measures of mental health (mostly anxiety and depression). Cristea et al. reported that any CBM training-associated difference on measures of anxiety and depression were weak and non-significant (although training effects were generally evident on measures of cognitive biases). Heterogeneity across studies was high, but with exception to the setting in which CBM was delivered (home, school, laboratory or mental health facility), there was no persuasive evidence for significant moderation of training effects by other key variables. In their conclusions the authors suggested that CBM had little clinical utility and that it was unclear whether positive results in any individual study arose from experimenter or participant bias. So if the glass is half empty, what should the next stage of CBM research usefully focus on?

Anxiety disorders in children and adolescents are common and impairing. As many patients do not benefit from - or have difficulties accessing - frontline treatments, novel, effective and easy-to-deliver interventions are needed. Cognitive Bias Modification of Interpretations (CBM-I) training has been used to treat adult anxiety disorders. CBM-I methods train individuals to endorse benign rather than negative resolutions of ambiguous cues. Developmental extensions of CBM-I are important for several reasons. First, implementing CBM-I in symptomatic children and adolescents may facilitate early preventative gains. Second, as training uses simple learning mechanisms, CBM-I may reflect a developmentally-suitable strategy for shaping adaptive processing styles. Third, as this age range involves protracted neurocognitive maturation and associated plasticity, administering CBM-I early could drive powerful, long-lasting benefits for emotional development. Finally, data from CBM-I studies could inform the cognitive mechanisms involved in the genesis of early-emerging anxiety. This paper provides the first organised review of CBM-I studies conducted in children and adolescents, and contains suggestions for future research that may help realise the therapeutic potential of early CBM-I interventions.

Mental imagery-based interventions are receiving increasing interest for the treatment of psychological disorders in adults. This is based on evidence that mental imagery potently influences the experience of emotion in non-clinical samples, and that a number of psychological disorders are marked by syndrome-specific, distressing abnormalities in mental imagery. During childhood and adolescence, neurocognitive development impacting mental imagery processes may moderate its relationship with clinically-relevant emotional symptoms at a number of potential loci. Crucially, these changes could impact vulnerability to distressing mental imagery and the efficacy of mental imagery-based clinical interventions. This review synthesises evidence pertaining to developmental changes in the role and content of mental imagery, and in the cognitive sub-processes required to generate and sustain mental images. Subsequently, we discuss implications for understanding the developmental relationship between mental imagery, emotion and psychopathology. Translational cognitive neuroscience research investigating the content, emotional impact and neurocognitive substrates of mental imagery across development may reveal insights into trajectories of vulnerability to symptoms of a number of psychological disorders. If proper consideration is given to developmental factors, techniques based on mental imagery may be valuable as part of a treatment armoury for child and adolescent clinical populations and those at risk of emotional disorders.

Adolescent anxiety is common, impairing and costly. Given the scale of adolescent anxiety and its impact, fresh innovations for therapy are in demand. Cognitive Bias Modification of Interpretations (CBM-I) studies of adults show that by training individuals to endorse benign interpretations of ambiguous situations can improve anxious mood-states particularly in response towards stress. While, these investigations have been partially extended to adolescents with success, inconsistent training effects on anxious mood-states have been found. The present study investigated whether positive versus negative CBM-I training influenced appraisals of stress, in forty-nine adolescents, aged 15-18. Data supported the plasticity of interpretational styles, with positively-trained adolescents selecting more benign resolutions of new ambiguous situations, than negatively-trained adolescents. Positively-trained adolescents also rated recent stressors as having less impact on their lives than negatively-trained adolescents. Thus, while negative styles may increase negative responses towards stress, positive styles may boost resilience. © 2013 The Author(s).

Anxiety disorders are globally prevalent, debilitating and onset in early life. Cognitive bias modification of interpretations (CBM-I) training has emerged as a targeted intervention for early emerging anxiety problems. While CBM-I can alter interpretational styles in unselected and clinical-analogue samples of adolescents, no studies have assessed its capacity to change biases in clinical samples. Here, we assessed training efficacy in ameliorating interpretation biases and anxious mood in adolescents with anxiety disorders. Twenty-eight Chinese adolescents meeting criteria for a current anxiety disorder were randomly assigned to receive positive or neutral CBM-I training. Training involved completing a word-fragment to resolve the outcomes of sixty ambiguous scenarios. During positive training, scenarios ended with benign/positive resolutions, but during neutral training, half of the scenarios were resolved positively and half negatively. Positively trained patients interpreted new ambiguous scenarios less negatively than the neutral training group although training effects were not observed on a questionnaire measure of interpretation bias. Training effects on mood were also absent. Before the clinical implications of CBM-I can be considered in adolescents, research needs to establish optimal training parameters for symptom-changes to occur. © 2012 Elsevier Ltd.

Negative attributional style has been associated with depressive symptoms in children. Yet, it is unclear whether these cognitive biases reflect inherited characteristics of the broader depressive phenotype or are a product of children's environments. While existing data in adolescents show that negative attributions reflect a genetic predisposition, elevating depressive responses to stress, other data suggest that negative attributions in children are more likely to reflect early environmental experiences on symptoms. Here, we assess the degree to which negative attributional style and depressive symptoms arise from common genetic, shared and non-shared environmental influences in childhood. Monozygotic and dizygotic twins reported on attributional style and depressive symptoms at age 8 (n = 300 pairs) and at age 10 (n = 250 pairs). Two multivariate models with varying assumptions on the nature of the relationship between negative attributions and depressive symptoms within and across time were fit to the data. The Common Pathway model provided better fit than the Cholesky decomposition. A common, latent factor influenced both attributional style and depressive symptoms at both time-points in children. The only significant influences on this factor were shared and non-shared aspects of the environment. Placing the present findings with those of adolescents suggests possible developmental differences in the relationship between attributional style and depressive symptoms.

Background: Negative biases in the interpretation of ambiguous material have been linked to anxiety and mood problems. Accumulating data from adults show that positive and negative interpretation styles can be induced through cognitive bias modification (CBM) paradigms with accompanying changes in mood. Despite the therapeutic potential of positive training effects, training paradigms have not yet been explored in adolescents. Methods: Eighty-two healthy adolescents (aged 13–17 years) were randomly allocated to either positive or negative CBM training. To assess training effects on interpretation bias, participants read ambiguous situations followed by test sentences with positive or negative interpretations of the situation. Participants rated the similarity of these sentences to the previously viewed ambiguous situations. Training effects on negative and positive affect were assessed using visual analogue scales before and after training. Results: After training, adolescents in the negative condition drew more negative and fewer positive interpretations of new ambiguous situations than adolescents in the positive condition. Within the positive condition, adolescents endorsed more positive than negative interpretations. In terms of mood changes, positive training resulted in a significant decrease in negative affect across participants, while the negative condition led to a significant decrease in positive affect among male participants only. Conclusion: This is the first study to demonstrate the plasticity of interpretation bias in adolescents. The immediate training effects on mood suggest that it may be possible to train a more positive interpretation style in youth, potentially helping to protect against anxiety and depressive symptoms.

Background: Despite theoretical and empirical support for an association between maternal control and child anxiety, few studies have examined the origins of this association. Furthermore, none use observer-ratings of maternal control within a genetically informative design. This study addressed three questions: 1) do children who experience maternal control report higher anxiety levels than those who do not?; 2) to what extent do genetic and environmental factors influence maternal control and child anxiety?; 3) to what extent do genetic and environmental factors influence the associations between child anxiety and maternal control? Method: Five hundred and thirty 8-year-old children (from 265 twin pairs) and their mothers were observed participating in an ‘etch-a-sketch’ task from which maternal control was rated. Children rated their anxiety using the Screen for Child Anxiety Related Emotional Disorders. Results: Children who experienced maternal behaviour rated as ‘extreme control’ reported higher anxiety levels than those who did not. Maternal control was highly heritable (A = .63), high self-rated anxiety less so (h2g = .36). The overlap between high child anxiety and maternal control was primarily due to shared genetic factors. Conclusions: These results suggest that maternal control is likely to have been elicited by children with high levels of anxiety.

We examined genetic and environmental influences on recognition of facial expressions in 250 pairs of 10-year-old monozygotic (83 pairs) and dizygotic (167 pairs) twins. Angry, fearful, sad, disgusted, and happy faces varying in intensity (15%-100%), head orientation, and eye gaze were presented in random order across 160 trials. Total correct recognition responses to each facial expression comprised the dependent variables. Twin data examined genetic and environmental contributions to variables and their correlations. Results support a common psychometric factor influenced primarily by additive genetic influences across expressions with discrimination of specific expressions due largely to non-shared environmental influences.

Background: Genetic risks for depression may be expressed through greater exposure towards environmental stressors (gene–environment correlation, rGE) and increased susceptibility to these stressors (gene–environment interaction, G · E). While these effects are often studied independently, evidence supports their co-occurrence on depression. Methods: Adolescent twin and sibling data was used to assess correlations and interactions between genetic risks for depressive symptoms and two putative environmental stressors: dependent negative life events and maternal punitive discipline. Results: Moderate genetic effects influenced each environmental risk factor, consistent with rGE. Genetic effects on environmental risks also contributed to depressive outcomes, implying genetic correlations between measures. Genetic effects on depressive symptoms changed across levels of negative life events and maternal punitive discipline, consistent with G · E. Finally, G · E cooccurred with rGE on depressive outcomes. Conclusions: Adolescents at genetic risk for depressive phenotypes may be exposed to increased social adversity (rGE) and more susceptible to developing symptoms in response to these risks (G · E). Keywords: Gene–environment interaction, gene–environment correlation, adolescence, depressive symptoms. Abbreviations: AIC: Akaike’s Information Criterion; DZ: Dizygotic; rGE: gene–environment correlation; G · E: gene–environment interaction; FS: full sibling; MZ: monozygotic; RMSEA: root mean square error approximation; SMFQ: short Mood and Feelings Questionnaire.

School of Psychology and Clinical Language Sciences, University of Reading, Reading, UKBackground: Cognitive Bias Modification (CBM) has been shown to change interpretation biases commonlyassociated with anxiety and depression and may help ameliorate symptoms of these disorders. However, its evidencebase for adolescents is scarce. Previous results have been hard to interpret because of methodological issues. Inparticular, many studies have used negative bias training as the control condition. This would tend to inflate anyapparent benefits of CBM compared to a neutral control. Most studies also only examined the effects of a singletraining session and lacked follow-up assessment or ecologically valid outcome measures. Method: Seventy-fouradolescents, aged 16–18 years, were randomised to two sessions of CBM training or neutral control. Interpretationbias and mood were assessed three times: at baseline, immediately post-training and 1 week post-training.A controlled experimental stressor was also used, and responses to everyday stressors were recorded for 1 week aftertraining to assess responses to psychological challenges. Feedback for the training programme was collected.Results: The CBM group reported a greater reduction in negative affect than control participants. However, otherhypothesised advantages of CBM were not demonstrated. Regardless of training group, participants reportedincreased positive interpretations, decreased negative interpretations, reduced depressive symptoms and no changein trait anxiety. The two groups did not differ in their stress reactivity. After controlling for group differences intraining performance, all the mood effects disappeared. Conclusions: When tested under stringent experimentalconditions the effects of CBM in healthy adolescents appear to be minimal. Future studies should concentrate onparticipants with elevated cognitive biases and/or mood symptoms who may be more sensitive to CBM. Keywords:Cognitive Bias Modification, interpretation, adolescence, depression, anxiety, stress reactivity.

Background: Parenting factors may be important to the development of attributional style in adolescence, which in turn relates to depression symptoms. These relationships have mainly been considered in terms of social risk mechanisms, and little is known about the role of genetic influences. Method: Self-reported measures of attributional style, depression symptoms and parental disciplinary styles were administered to over 1300 adolescent twin and sibling pairs. Model-fitting techniques were used to examine the role of genetic and environmental influences. Results: Moderate genetic influences on attributional style were demonstrated, and furthermore, its association with depression reflected considerable genetic effects. Familial factors were implicated in the association between attributional style and punitive parenting, although genetic from shared environmental causes could not be distinguished. Conclusions: Our results demonstrate that attributional style is influenced by genetic, as well as social factors. Implications for aetiological pathways integrating cognitive, genetic and social factors on adolescent depression are discussed.

The recent target article by Nakazawa and colleagues (2016) flags some important ethical issues concerning the use of real-time functional magnetic resonance neuroimaging-based neurofeedback (NF) f...

Social fears and worries in children are common and impairing. Yet, questions have been raised over the efficacy, suitability and accessibility of current frontline treatments. Here, we present data on the effectiveness of a novel parent-administered Cognitive Bias Modification of Interpretations (CBM-I) training tool. CBM-I capitalises on findings demonstrating an association between anxiety symptoms and biased interpretations, the tendency to interpret ambiguous situations negatively. Through CBM-I training, participants are exposed to benign resolutions, and reinforced for selecting these. In adults and adolescents, CBM-I training is effective at reducing symptoms and mood reactivity. In the present study, we developed a novel, child-appropriate form of CBM-I training, by presenting training materials within bedtime stories, read by a parent to the child across three consecutive evenings. Compared to a test-retest control group (n = 17), children receiving CBM-I (n = 19) reported greater endorsement of benign interpretations of ambiguous situations post-training (compared to pre-training). These participants (but not the test-retest control group) also showed a significant reduction in social anxiety symptoms. Pending replication and extensions to a clinical sample, these data may implicate a cost-effective, mechanism-driven and developmentally-appropriate resource for targeting social anxiety problems in children.

Negative attributional style has been associated with depressive symptoms in children. Yet, it is unclear whether these cognitive biases reflect inherited characteristics of the broader depressive phenotype or are a product of children's environments. While existing data in adolescents show that negative attributions reflect a genetic predisposition, elevating depressive responses to stress, other data suggest that negative attributions in children are more likely to reflect early environmental experiences on symptoms. Here, we assess the degree to which negative attributional style and depressive symptoms arise from common genetic, shared and non-shared environmental influences in childhood. Monozygotic and dizygotic twins reported on attributional style and depressive symptoms at age 8 (n = 300 pairs) and at age 10 (n = 250 pairs). Two multivariate models with varying assumptions on the nature of the relationship between negative attributions and depressive symptoms within and across time were fit to the data. The Common Pathway model provided better fit than the Cholesky decomposition. A common, latent factor influenced both attributional style and depressive symptoms at both time-points in children. The only significant influences on this factor were shared and non-shared aspects of the environment. Placing the present findings with those of adolescents suggests possible developmental differences in the relationship between attributional style and depressive symptoms.