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Objective: To investigate whether mindfulness-based childbirth and parenting (MBCP) or enhanced care as usual (ECAU) for expectant couples decreases fear of childbirth (FOC) and nonurgent obstetric interventions during labor and improves newborn outcomes. Design: Randomized controlled trial. Setting: Midwifery settings, the Netherlands, April 2014-July 2017. Population: Pregnant women with high FOC (n = 141) and partners. Methods: Allocation to MBCP or ECAU. Hierarchical multilevel and intention-to-treat (ITT) and per-protocol (PP) analyses. Main outcome measures: Primary: pre-/postintervention FOC, labor anxiety disorder, labor pain (catastrophizing and acceptance), and preferences for nonurgent obstetric interventions. Secondary: rates of epidural analgesia (EA), self-requested cesarean birth (sCB), unmedicated childbirth, and 1- and 5-minute newborn's Apgar scores. Results: MBCP was significantly superior to ECAU in decreasing FOC, catastrophizing of labor pain, preference for nonurgent obstetric interventions, and increasing acceptance of labor pain. MBCP participants were 36% less likely to undergo EA (RR 0.64, 95% CI [0.43-0.96]), 51% less likely to undergo sCB (RR 0.49, 95% CI [0.36-0.67]), and twice as likely to have unmedicated childbirth relative to ECAU (RR 2.00, 95% CI [1.23-3.20]). Newborn's 1-minute Apgar scores were higher in MBCP (DM −0.39, 95% CI [−0.74 to −0.03]). After correction for multiple testing, results remained significant in ITT and PP analyses, except EA in ITT analyses and 1-minute Apgar. Conclusions: MBCP for pregnant couples reduces mothers’ fear of childbirth, nonurgent obstetric interventions during childbirth and may improve childbirth outcomes. MBCP adapted for pregnant women with high FOC and their partners appears an acceptable and effective intervention for midwifery care.

Objectives We evaluated the effects of the family mindfulness-based intervention (MBI) “MYmind” for children with ADHD and their parents, and examined child and parent predictors of child outcome. Methods Using a pragmatic quasi-experimental waitlist design, children aged 7–19 years (n = 167), clinically referred with a DSM-IV ADHD diagnosis, and both their parents completed waitlist (average waiting time was 8 weeks), pre-test, post-test, 8-week, and 1-year follow-up measurements. MYmind consisted of eight weekly 1.5-h mindfulness-based group sessions for children and parallel for parents, and a follow-up session. We assessed children’s and both parents’ ADHD symptoms and other psychopathology, child executive function, parental stress, parental overreactivity, and mindful parenting. Results Multilevel analyses revealed medium-to-large effect-sized reduced child ADHD symptoms between pre- and post-test, becoming stronger at follow-ups, while no waitlist effects occurred. Parents above the ADHD threshold improved on adult ADHD symptoms with similar sized effects. Children’s and parents’ other psychopathology, child executive function, parental overreactivity, and mindful parenting improved, whereas parental stress only improved at 1-year follow-up. Child age, child gender, ADHD medication, parental ADHD, and parent participation did not predict child outcome. Parent gender however interacted with parental ADHD to predict child outcome; children of fathers (but not mothers) above the ADHD threshold improved more than children of fathers below the ADHD threshold at post-test and at 8-week follow-up. Reduced paternal ADHD from pre- to post-test mediated this effect. Conclusions Family MBI (MYmind) may reduce childhood ADHD and improve parental functioning. Fathers with ADHD symptoms appear important in helping offspring with ADHD.

Objectives Adolescents with autism often experience comorbid internalizing disorders such as anxiety disorders or depression but the available evidence-based treatments to support the mental health of adolescents with autism are limited. The aim of this study was to investigate if and how MYmind, a mindfulness-based program (MBP) for youth with autism, could benefit adolescents with comorbid internalizing disorder(s). Methods A person-centered approach with a multiple baseline design was used to investigate the effects of MYmind. Five adolescents with autism and an internalizing disorder took part in the 9-week MYmind program. The adolescents and their parents completed a daily questionnaire on their personal goals during a baseline phase, the intervention, a 2-month follow-up phase, and a 1-year follow-up phase. We analyzed the effects on their personal goals using visual inspection and statistical analysis for single-case designs. Also, we investigated potential processes of change by analyzing how changes were related over time. Results Findings indicated that most, but not all, adolescents benefitted from the MBP. Four out of five adolescents showed medium-sized improvement in some of their personal goals. However, one adolescent reported a deterioration during the intervention and 2-month follow-up phase. Decreased worry preceded behavioral improvements in two adolescents, whereas other potential mechanisms of change showed inconclusive results. Conclusion The findings indicated that most of the adolescents with autism and a comorbid internalizing disorder partially benefitted from the MBP.

Objectives Childhood psoriasis and eczema negatively impact the well-being of children and their parents. Identifying variables that protect against, or reduce, the negative impact of these skin conditions could greatly improve the lives of children with these skin conditions and their parents. We therefore aimed to investigate whether higher levels of parental dispositional mindfulness are associated with lower levels of psychological distress and better quality of life in children with psoriasis or eczema and their parents. Methods Children with psoriasis or eczema (n = 180, M age = 10.22, females = 108) and their parents (n = 210, M age = 39.97, females = 183) were recruited from social media and NHS dermatology clinics in the UK. Parents completed questionnaires assessing dispositional mindfulness, parental stress, psychological distress (depression, anxiety, general stress), and quality of life related to their child’s skin condition. Children completed questionnaires assessing quality of life related to their skin condition and pruritus (itch intensity). Results Parental dispositional mindfulness explained significant amounts of variance in parental stress, parent depression, parent anxiety, parent general stress, and both parent and child quality of life. These relationships were not moderated by skin condition. Conclusion Parental dispositional mindfulness is associated with better well-being in parents of children with psoriasis or eczema, and their children. Mindfulness-based interventions for parents may be beneficial for improving well-being in both children with skin conditions and their parents. Trial Registration: https://aspredicted.org/xf429.pdf (see Supplementary Materials A).

Objectives Although the effectiveness of mindfulness-based intervention for various populations is well-documented, research examining these effects for police officers is limited. This study aimed to increase knowledge on (1) the effects of a mindfulness-based intervention in police officers and (2) potential mechanisms of change by relating changes in facets of mindful awareness to changes in stress. Methods In the present study, we investigated the effects of a 6-session group-based mindfulness-based intervention in police officers (n = 82) on self-report measures, using a quasi-experimental design consisting of a within-group 6-week baseline period; pre-test, 6-week intervention; and post-test, 6-week follow-up. Multilevel analyses were used to test intervention effects. Using structural equation modeling, we analyzed whether changes in facets of mindfulness were associated with changes in various types of stress. Results After the intervention, police officers significantly and substantially improved on stress (primary outcome), facets of mindful awareness (explanatory variables), and related secondary outcomes including somatic complaints, sleep disturbances, positive affect, happiness, and work ability, while in baseline period, outcome measures did not change. Effects remained significant or improved further during the follow-up period. Further, we found that increases in particularly the facets of mindful awareness of acting with awareness and non-judging were associated with reductions in stress. Conclusions Mindfulness-based intervention appears beneficial for police officers. Further, increases in both attention and acceptance skills such as acting with awareness and non-judging seem to be most important in explaining reductions of stress in police officers.

Mindful parenting (MP) as a group-based training for parents of clinically referred children with psychopathology has shown to effectively reduce child and parent mental health problems. This study investigated the effects of MP as a “preventive” intervention for parents who experienced parental stress or problems in parenting (non-clinical setting) compared to MP as a “curative” intervention (clinical setting). Parents from a non-clinical setting (n = 98, 18% fathers) and a clinical setting (n = 87, 21% fathers) completed questionnaires about themselves, their partner relationship, and their child at waitlist (non-clinical setting only), pre-test, post-test, and 8-week follow-up. Before the intervention, the children of parents in the non-clinical setting, as expected, showed higher well-being and lower behavior problems, but parental stress levels, parental overreactivity, mindful parenting, partner relationship, and parental well-being were no different in the clinical and preventive group pre-intervention. No improvement was observed at waitlist, except for parental well-being, while improvement on parent and child functioning measures did occur after MP. No differences in MP effects in both settings were found in improved parental functioning (parental stress, overreactivity, mindful parenting, partner relationship, and well-being [small to medium effect size improvements]) and child functioning (well-being and behavior problems, small effect size improvements). Improvements in child functioning were associated with improved mindful parenting. Results suggest that MP training may be an effective intervention not only for families of children referred to mental health care because of child mental disorders but also for parents who experience parental stress or parenting problems as it is.

This study investigated the feasibility and preliminary effectiveness of a concurrent mindfulness program (MYmind) on Chinese adolescents with autism spectrum disorder and their parents in Hong Kong, China using a randomized controlled trial with a waitlist control group. Results showed the study had 80% compliance rate, 0% dropout rate, and 89% response rate. Between-group comparisons showed mindfulness had trend effects on parent’s rumination (g = 1.16), mindful parenting (d = 0.6), parenting style (d = 0.59), and parenting stress (d = 0.5). The study demonstrated the feasibility of the MYmind program in the Chinese context. A larger trial with longer follow-up period is suggested to better examine the effect of mindfulness on adolescents with ASD and their parents.

Early behavioural inhibition, a temperamental characteristic defined by fearful, overly-sensitive, avoidant, or withdrawn reactions to the unknown, is a predictor of later social anxiety. However, not all behaviourally inhibited children develop anxiety problems, and attentional bias to threat has been proposed to moderate the relation between behavioural inhibition and anxiety. The current study aimed to further specify the relation between early behavioural inhibition and later social anxiety by testing this potentially moderating role of childhood attentional bias to threat. Behavioural inhibition was assessed during toddlerhood (age 2.5 years) using laboratory observations of children's behaviours in response to unknown objects and situations. When children were 7.5 years old, attentional bias was measured in 86 children (46 girls) using both a visual probe task and a visual search task with angry and happy faces. Child social anxiety was measured using questionnaires completed by the child and both parents, and clinical interviews conducted with both parents. Our results showed that while early behavioural inhibition was related to later social anxiety, there was no evidence for a moderation of this relation by attentional bias, suggesting that the relation between early fearful temperament and later social anxiety holds across children, independent of their attentional biases.

ObjectivesMindful parenting (MP) interventions show promising results, but they mostly target parents (of children) with mental health problems. This study examined an online MP intervention for mothers with toddlers in a population-based sample. Aims were to assess acceptability and effectiveness of the intervention for mothers with and without parental stress, and examine their predetermined personal goals.MethodsThe study included 157 mothers with toddlers from the general population of whom 73 reported parental stress. The mothers participated in an 8-week online MP training. Questionnaires were completed at waitlist, pretest, posttest, and follow-up.ResultsMothers rated the training positively, although only 23.1% completed the training. Personal goals were analyzed qualitatively, establishing four different themes: attention, well-being, patience, and balance. Significant improvements in personal goals posttest and follow-up were found (large and very large effect size, respectively). We found no significant improvements from waitlist to pretest for all outcome variables, except personal goals (medium effect size). Mixed-linear model analyses showed significant improvements posttest and follow-up as compared to pretest regarding Self-compassion, Parental over-reactivity and Symptoms of anxiety and depression (small to medium effect sizes). There was an effect at posttest for Parenting problems, and for Parental role restriction at follow-up (small effect sizes). Levels of parental stress and theme of personal goal did not influence the effectiveness of the intervention.ConclusionsThe current study provides initial evidence that an online MP training could be an easily accessible, inexpensive, and valuable intervention for parents without an indication for a therapist-assisted intervention.Trial RegistrationDutch Trial Register (NTR7401)

Background: Self-conscious emotional reactivity and its physiological marker—blushing, has been proposed to be an etiological mechanism of social anxiety disorder (SAD), but so far, untested in longitudinal designs. This study tested, for the first time, if self-conscious emotional reactivity (indexed as physiological blushing) contributes to the development of SAD symptoms over and above social behavioral inhibition (BI), which has been identified as the strongest predictor of SAD development in early childhood. Methods: One-hundred-fifteen children (45% boys) and their mothers and fathers participated at ages 2.5, 4.5, and 7.5 years. Social BI was observed at all time points in a Stranger-approach task and physiological blushing (blood volume, blood pulse amplitude, and temperature increases) was measured during a public performance (singing) and watching-back the performance at ages 4.5 and 7.5. Child early social anxiety was reported by both parents at 4.5 years and SAD symptoms were diagnosed by clinicians and reported by both parents at 7.5 years. Results: Higher social BI at 2.5 and 4.5 years predicted greater social anxiety at 4.5 years, which, in turn, predicted SAD symptoms at 7.5 years. Blushing (temperature increase) at 4.5 years predicted SAD symptoms at 7.5 years over and above the influence of social BI and early social anxiety. Conclusions: That blushing uniquely contributes to the development of SAD symptoms over and above social BI suggests two pathways to childhood SAD: one that entails early high social BI and an early onset of social anxiety symptoms, and the other that consists of heightened self-conscious emotional reactivity (i.e., blushing) in early childhood.

Objectives Insomnia is highly prevalent among adolescents, with severe consequences for daily life, including mental disorders. Cognitive behavioral therapy for insomnia (CBTI) can be effective in internet-delivered and face-to-face modalities. However, it is yet unclear what the contribution is of mindfulness-based techniques to the effectiveness of traditional CBTI. The present study investigated whether use of a body scan mindfulness meditation influenced the effectiveness of CBTI for adolescents. Methods Adolescents who had received 6 weeks of internet CBTI were divided into a group who had practiced a body scan meditation (N = 26, age M = 15.33 years, SD = 1.42, 77% girls) and a group who had not (N = 28, age M = 15.64 years, SD = 1.80, 82% girls). Differences between the groups were analyzed for subjective and objective sleep outcomes from baseline to post-treatment and to 2-month follow-up. Results Moderate to large effect size improvements appeared for sleep parameters from 7-day actigraphy and sleep logs, and large effect size decreases of self-reported symptoms of insomnia and chronic sleep reduction, at post-treatment for both groups. Improvements were maintained at follow-up. However, where the non-body scan group showed no significant change of wake after sleep onset from actigraphy, and self-reported shortness of sleep and irritation, there were medium effect size improvements of these outcomes in the body scan group. Conclusions These results indicate that the use of a body scan mindfulness meditation in CBTI may have an additional positive effect on sleep, above and beyond traditional CBTI techniques.

Objective: Children with autism spectrum disorder (ASD) show atypical attention. Mindfulness-based programs (MBPs), with self-regulation of attention as a basic component, could benefit these children. Method: We investigated how 49 children with ASD differed from 51 typically developing (TD) children in their attention systems; and whether their attention systems were improved by an MBP for children and their parents (MYmind), using a cognitive measure of attention, the Attention Network Test. Results: Children with ASD did not differ from TD children in the speed of the attention systems, but were somewhat less accurate in their orienting and executive attention. Also, MYmind did not significantly improve attention, although trend effects indicated improved orienting and executive attention. Robustness checks supported these improvements. Conclusion: Trend effects of the MBP on the attention systems of children with ASD were revealed, as well as minor differences between children with ASD and TD children in their attention systems.

Parent-to-child transmission of information processing biases to threat is a potential causal mechanism in the family aggregation of anxiety symptoms and traits. This study is the first to investigate the link between infants’ and parents’ attention bias to dynamic threat-relevant (versus happy) emotional expressions. Moreover, the associations between infant attention and anxiety dispositions in infants and parents were explored. Using a cross-sectional design, we tested 211 infants in three age groups: 5-to-7-month-olds (n = 71), 11-to-13-month-olds (n = 73), and 17-to-19-month-olds (n = 67), and 216 parents (153 mothers). Infant and parental dwell times to angry and fearful versus happy facial expressions were measured via eye-tracking. The parents also reported on their anxiety and stress. Ratings of infant temperamental fear and distress were averaged across both parents. Parents and infants tended to show an attention bias for fearful faces with marginally longer dwell times to fearful versus happy faces. Parents dwelled longer on angry versus happy faces, whereas infants showed an avoidant pattern with longer dwell times to happy versus angry expressions. There was a significant positive association between infant and parent attention to emotional expressions. Parental anxiety dispositions were not related to their own or their infant’s attention bias. No significant link emerged between infants’ temperament and attention bias. We conclude that an association between parental and infant attention may already be evident in the early years of life, whereas a link between anxiety dispositions and attention biases may not hold in community samples.

Organizations are confronted with a constant need for efficiency, which affects the working atmosphere, often typified by velocity, time pressure, competition, job insecurity, and information overload, which may lead to stress, burnout, work-life disbalance, and lowered work functioning. This study evaluated an 8-week, 1.5 h-per-week group-based standardized mindfulness program (“Finding peace in a frantic world”), applied on-site in a large multinational company. In a naturalistic longitudinal design self-selected employees (n = 150) completed measurements at wait-list, pre-test, post-test, and 2 and 6 months follow-up. Nearly all participants followed at least five out of eight sessions, were highly satisfied with the training (8.3 out 10), and almost 90% intended to continue with mindfulness practices. Primary outcomes were stress and risk for dropout from work. Using multilevel analyses, mean pre-test scores were compared to the other measurement occasions, and the rate of change in the training period (M = 67 days; SD = 12) was compared to the rate of change in the wait-list period (M = 29 days; SD = 8). Direct and long-term positive effects on risk for dropout from work (p p p

ObjectivesMindfulness-based programs could support children with autism spectrum disorder (ASD) and their parents to cope with autism spectrum symptoms and reduce comorbid mental health problems. In this study, we aimed to explore which change processes are involved in a mindfulness-based program for children with ASD and their parents (MYmind), according to a qualitative analysis of the families’ experiences.MethodFourteen children aged 9–17 years and 31 parents (18 mothers, 11 fathers, 2 caring relatives) participated in an interview 2 to 5 months after the 9-week MYmind training, about their experiences with the training, experienced changes, and how mindfulness works for them. We used constructivist grounded theory methodology to develop a theory of the key change processes and their relations.ResultsEight main change processes resulted from the analysis, namely connecting with peers, pausing, being aware, being in the here and now, letting be, determining a strategy, being and responding calm, and attuning to others. We proposed a model reflecting the interdependency and direction of these change processes.ConclusionThe findings deepen our understanding of how multiple change processes are involved in the MYmind program for children with ASD and their parents. Theoretical and research implications are discussed.

BACKGROUND AND OBJECTIVES: In two experiments, we investigated the effects of Attentional Bias Modification (ABM) on emotion regulation, i.e. the manner in which people influence emotional experiences. We hypothesized that decreases in attentional bias to threat would impair upregulation and improve downregulation of negative emotions, while increases in attentional bias to threat would improve upregulation and impair downregulation of negative emotions.METHODS: Using the emotion-in-motion paradigm (Experiment 1, N = 60) and the visual search task (Experiment 2, N = 58), we trained participants to attend to either threatening or positive stimuli and we assessed emotion intensity while observing, upregulating, and downregulating emotions in response to grids of mixed emotional pictures.RESULTS: In Experiment 1, the attend positive group reported more positive emotions while merely watching grids of training pictures and the attend threat group showed impaired upregulation of negative affect. In Experiment 2, the attend threat group reported intensified negative emotions for all three instructions, while the attend positive group remained largely stable over time.LIMITATIONS: We cannot unequivocally attribute these changes in emotion regulation to changes in attentional bias, as neither of the experiments yielded significant changes in attentional bias to threat.CONCLUSIONS: By showing that attentional bias modification procedures affect the manner in which people deal with emotions, we add empirical weight to the conceptual overlap between attentional bias modification and emotion regulation.

Questionnaire measures offer a time and cost-effective alternative to full diagnostic assessments for identifying and differentiating between potential anxiety disorders and are commonly used in clinical practice. Little is known, however, about the capacity of questionnaire measures to detect specific anxiety disorders in clinically anxious preadolescent children. This study aimed to establish the ability of the Spence Children's Anxiety Scale (SCAS) subscales to identify children with specific anxiety disorders in a large clinic-referred sample (N = 1,438) of children aged 7 to 12 years. We examined the capacity of the Separation Anxiety, Social Phobia, Generalized Anxiety, and Physical Injury Fears (phobias) subscales to discriminate between children with and without the target disorder. We also identified optimal cutoff scores on subscales for accurate identification of children with the corresponding disorder, and examined the contribution of child, mother, and father reports. The Separation Anxiety subscale was able to accurately identify children with separation anxiety disorder, and this was replicated across all 3 reporters. Mother- and father-reported Social Phobia subscales also accurately identified children with social anxiety disorder, although child report was only able to accurately detect social anxiety disorder in girls. Using 2 or more reporters improved the sensitivity of the Separation Anxiety and Social Phobia subscales but reduced specificity. The Generalized Anxiety and Physical Injury Fears subscales failed to accurately identify children with the corresponding disorders. These findings have implications for the potential use of mother-, father-, and child-report SCAS subscales to detect specific disorders in preadolescent children in clinical settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Purpose of review: To review mechanisms of blushing and fear of blushing from physiological, neuropharmacological and psychological viewpoints, and to evaluate current forms of treatment for blushing-related fear. Recent findings: Blushing appears to be driven primarily by sympathetic adrenomedullary and neural vasodilator discharge, possibly in association with secondary neurovascular inflammation. Psychological risk factors for fear of blushing include social anxiety, coupled with heightened self-focused attention and inflated beliefs about the likelihood and social costs of blushing. In addition, schemas of emotional inhibition, social isolation and alienation may underlie blushing-related fears. Established psychological treatments for fear of blushing include task concentration training; exposure; cognitive therapy; social skills training; and applied relaxation. More novel approaches include mindfulness and mindful self-compassion, video feedback and imagery rescripting. There are no established pharmacological treatments specifically for fear of blushing. However, selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are effective treatments for social anxiety disorder and may thus help some patients manage their fear of blushing. Summary: A reactive sympathetic nervous system may interact with psychological predispositions to intensify fear of blushing. These physiological and psychological risk factors could be promising targets for treatment.

OBJECTIVE: Integrative data analysis was used to combine existing data from nine trials of cognitive-behavioral therapy (CBT) for anxious youth (N = 832) and identify trajectories of symptom change and predictors of trajectories.METHOD: Youth- and parent-reported anxiety symptoms were combined using item-response theory models. Growth mixture modeling assessed for trajectories of treatment response across pre-, mid-, and posttreatment and 1-year follow-up. Pretreatment client demographic and clinical traits and treatment modality (individual- and family-based CBT) were examined as predictors of trajectory classes.RESULTS: Growth mixture modeling supported three trajectory classes based on parent-reported symptoms: steady responders, rapid responders, and delayed improvement. A 4-class model was supported for youth-reported symptoms: steady responders, rapid responders, delayed improvement, and low-symptom responders. Delayed improvement classes were predicted by higher number of diagnoses (parent and youth report). Receiving family CBT predicted membership in the delayed improvement class compared to all other classes and membership in the steady responder class compared with rapid responders (youth report). Rapid responders were predicted by older age (parent report) and higher number of diagnoses (parent report). Low-symptom responders were more likely to be male (youth report).CONCLUSIONS: Integrative data analysis identified distinct patterns of symptom change. Diagnostic complexity, age, gender, and treatment modality differentiated response classes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Background and objectivesExtensive research investigated maternal parenting behaviors of children with anxiety disorders (ADs). No research has compared parenting behaviors of children with anxiety disorders (ADs) and ADHD, which is important to understand the common or specific role of parenting in both disorders, and also to inform interventions including parents.MethodsWe compared the presence of paternal and maternal behaviors of autonomy granting, control, and rejection in youths with AD (n = 16; Mage = 11.63, SD = 2.96) to the presence of these behaviors in youth with ADHD (n = 14; Mage = 10.64, SD = 2.65) and in community sample (CS) youths (n = 24; Mage = 11.4, SD = 2.64) using aggregated child, parent-about-self, and parent-about-partner report. Parental anxiety was also assessed.ResultsFathers of youths with ADs were less controlling than fathers of youths with ADHD and CS fathers. Fathers of youths with ADHD were more rejecting of their children than fathers of children with ADs and CS fathers. With respect to maternal behaviors, no differences between the three groups occurred. No group differences were found in parental anxiety.ConclusionResults provide little evidence for the assumed controlling and lack of autonomy encouragement style of parents of children with ADs. This study points to the importance of involving fathers in the treatment of youth ADHD. Irrespective of whether paternal dysfunctional behaviors are involved in the development of ADHD or are a consequence of ADHD, it is likely that such behaviors negatively contribute to the therapy course and pace and should be targeted during treatment.

Item does not contain fulltext Background and objectives: Cognitive theories of fear suggest that biases in interpretation are content-specific: Fearful children should only interpret materials negatively if they are specifically related to the content of their fear. So far, there are only a few studies available that report on this postulated content-specificity of interpretation processes in childhood fear. The goal of this study was to examine interpretation bias and its content-specificity in children with varying levels of Generalized Anxiety Disorder (GAD) symptoms. Methods: In an Auditory Interpretation Task (AIT), two words that differ by one phoneme are acoustically blended so that one can hear only one of the words. In the current AIT, we included GAD-related blends, negatively-valenced fear-related blends and positive blends. Multiple-choice (n = 371) or open-ended (n = 295) responses were collected from 666 nonclinical children between 7 and 13 years of age. Results: Children with higher levels of self-reported GAD showed significantly more negative interpretations of ambiguous GAD-related blends in the multiple-choice version than children with lower levels of GAD. There were no differences when interpreting the other ambiguous blends. This result was not found with the open-ended version. Limitations: Effects were relatively small, some GAD-stimuli were sub-optimal, and the task was administered in a classroom setting. Even though we ensured that all children were able to hear all words clearly, this may have impacted the results. Conclusions: The findings only partly support the idea that fearful children display cognitive biases specific for fear-relevant stimuli, and more research is needed to replicate the results and test the usability of the AIT. 7 p.

Contains fulltext : 196717.pdf (Publisher’s version ) (Open Access) We investigated the role of self-reports and behavioral measures of interpretation biases and their content-specificity in children with varying levels of spider fear and/or social anxiety. In total, 141 selected children from a community sample completed an interpretation bias task with scenarios that were related to either spider threat or social threat. Specific interpretation biases were found; only spider-related interpretation bias and self-reported spider fear predicted unique variance in avoidance behavior on the Behavior Avoidance Task for spiders. Likewise, only social-threat related interpretation bias and self-reported social anxiety predicted anxiety during the Social Speech Task. These findings support the hypothesis that fearful children display cognitive biases that are specific to particular fear-relevant stimuli. Clinically, this insight might be used to improve treatments for anxious children by targeting content-specific interpretation biases related to individual disorders. 9 p.

Blushing is an involuntary reddening of the face that typically occurs when people are concerned about making negative impressions on others. Although people typically blush for their mishaps or misdeeds, Darwin observed that some people, and especially children, also blush when they are lavished with praise. We theorize that socially anxious children blush when praised in inflated ways because they believe they do not match the inflated image others hold of them. Such praise-induced blushing might be particularly common in late childhood, when children's worries about their social image escalate. In this randomized experiment, 105 children (ages 8–12, 85% Caucasian) sang in front of an audience. Afterwards, children received inflated praise (“You sang incredibly well!”), noninflated praise (“You sang well!”), or no praise. Children's physiological blushing was assessed through photoplethysmography and a temperature sensor. As predicted, inflated praise—but not non-inflated praise—increased blushing in socially anxious children. This emerged for blood pulse amplitude changes (AC reactivity) and self-reported blushing, not for blood volume (DC reactivity) and temperature changes. Socially anxious children may blush to “apologize” in advance for not being as incredible as others think they are. Thus, blushing may be elicited in situations that seem benign but actually evoke the fear of being evaluated negatively.

Adolescent insomnia can be treated effectively with cognitive behavioural therapy for insomnia (CBTI). However, little is known about effects of CBTI on psychopathology in adolescents. This study aimed to investigate whether (a) CBTI improves psychopathology in Internet- (IT) and face-to-face group treatment (GT) compared to waitlist (WL), (b) improvement in psychopathology can be attributed to reduced insomnia, (c) improvement in psychopathology remains stable for up to 1 year. One hundred and sixteen participants (age = 15.6 years, 25% males) with DSM-5 insomnia, were randomly assigned to IT, GT or WL. http://www.controlledtrials.com (ISRCTN33922163). Assessments of psychopathology, insomnia and objectively and subjectively measured sleep occurred at baseline, post-treatment, and at 2-, 6- and 12-month follow-up. Multilevel and mediation analyses were run to test hypotheses. The CBTI protocol, 'Sleeping Smart' for both IT and GT consisted of six weekly sessions and a booster session after 2 months. Psychopathology symptoms, insomnia and sleep problems as measured by actigraphy and sleep logs decreased substantially in IT and GT compared with WL at 2-month follow-up with medium to large effect sizes (ESs). Psychopathology symptoms remained stable or further improved for up to 12-month follow-up. ESs at 12-month follow-up for IT and GT were respectively: affective (d = -0.87 and -0.97), anxiety (d = -0.81 for IT), somatic (d = -0.38 and d = -0.52), oppositional (d = -0.42 for GT) and attention deficit hyperactivity disorder (ADHD) problems (d = -0.47 and -0.46). Mediation analyses indicated that reduction of insomnia symptoms after CBTI fully mediated the effects of CBTI on affective and anxiety problems, and partially mediated the effect on ADHD problems. This is the first study demonstrating that Internet and face-to-face CBT for insomnia achieves long-term reduction in adolescent psychopathology and does so by improving insomnia. This finding can have profound implications for youth mental health care.

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

A combined mindfulness-based program for children and their parents (MYmind) was beneficial for adolescents with autism spectrum disorder (ASD). In this study, we investigated whether this program is also beneficial for younger children with ASD, whether effects last on the long-term, and whether it reduces common comorbid problems. Forty-five children referred with ASD aged 8 until 19 years old, and their parents participated. Repeated measures of children’s and parents’ social communication problems, emotional and behavioral functioning, mindful awareness, and of parenting were conducted pre-intervention, post intervention, 2-month follow-up, and 1-year follow-up. While children did not report significant changes in mindful awareness, their social communication problems decreased, and their emotional and behavioral functioning improved. Results were not consistent at each occasion; improvements reported by children were most substantial at a 2-month follow-up and only partly remained at a 1-year follow-up, while all children’s improvements as reported by parents were present on all occasions. Parents themselves reported improved emotional and behavioral functioning, improved parenting, and increased mindful awareness on all occasions. Parents’ social communication problems reduced only directly after the intervention. Most improvements were supported by the qualitative investigation of children’s and parents’ experienced change as reported on open-ended questions. This study suggests that children, including adolescents, with ASD and their parents can benefit from a mindfulness-based program with parallel sessions for children and parents.

Children’s early onset of social anxiety may be associated with their social understanding, and their ability to express emotions adaptively. We examined whether social anxiety in 48-month-old children (N = 110; 54 boys) was related to: a) a lower level of theory of mind (ToM); b) a lower proclivity to express shyness in a positive way (adaptive); and c) a higher tendency to express shyness in a negative way (non-adaptive). In addition, we investigated to what extent children’s level of social anxiety was predicted by the interaction between ToM and expressions of shyness. Children’s positive and negative expressions of shyness were observed during a performance task. ToM was measured with a validated battery, and social anxiety was assessed using both parents’ reports on questionnaires. Socially anxious children had a lower level of ToM, and displayed more negative and less positive shy expressions. However, children with a lower level of ToM who expressed more positive shyness were less socially anxious. Additional results show that children who displayed shyness only in a negative manner were more socially anxious than children who expressed shyness only in a positive way and children who did not display any shyness. Moreover, children who displayed both positive and negative expressions of shyness were more socially anxious than children who displayed shyness only in a positive way. These findings highlight the importance of ToM development and socio-emotional strategies, and their interaction, on the early development of social anxiety.

Generalized anxiety disorder (GAD) runs in families. Building on recent theoretical approaches, this review focuses on potential environmental pathways for parent-to-child transmission of GAD. First, we address child acquisition of a generalized pattern of fearful/anxious and avoidant responding to potential threat from parents via verbal information and via modeling. Next, we address how parenting behaviors may contribute to maintenance of fearful/anxious and avoidant reactions in children. Finally, we consider intergenerational transmission of worries as a way of coping with experiential avoidance of strong negative emotions and with intolerance of uncertainty. We conclude that parents with GAD may bias their children's processing of potential threats in the environment by conveying the message that the world is not safe, that uncertainty is intolerable, that strong emotions should be avoided, and that worry helps to cope with uncertainty, thereby transmitting cognitive styles that characterize GAD. Our review highlights the need for research on specific pathways for parent-to-child transmission of GAD.El trastorno de ansiedad generalizada (TAG) ocurre en familias. De acuerdo con aproximaciones teóricas recientes, esta revisión se centra en las potenciales vías ambientales de transmisión del TAG desde los padres a los hijos. Primero, nos enfocamos en la adquisición del niño de un patrón generalizado de respuestas ansioso/ temerosas y de evitación frente a potenciales amenazas de los padres, a través de información verbal y mediante el modelado. Luego, analizamos cómo las conductas parentales pueden contribuir al mantenimiento de reacciones ansioso/temerosas y evitativas en los niños. Por último, consideramos la transmisión intergeneracional de preocupaciones como una forma de adaptación a la evitación experiencial de emociones negativas intensas y a la intolerancia a la incertidumbre. Concluimos que los padres con TAG pueden sesgar en sus hijos el procesamiento de potenciales amenazas ambientales, transmitiendo el mensaje que el mundo no es seguro, que la incertidumbre no es tolerable, que las emociones intensas deben ser evitadas y que las preocupaciones ayudan a adaptarse a la incertidumbre, con lo que se transmiten estilos cognitivos que caracterizan al TAG. Nuestra revisión destaca la necesidad de una investigación orientada a vías específicas de la transmisión del TAG desde los padres a los hijos.Les troubles de l'anxiété généralisée (TAG) sont familiaux. S'appuyant sur des approches théoriques récentes, cet article s'attache aux voies environnementales potentielles de la transmission des TAG des parents aux enfants. Tout d'abord, nous nous intéressons à l'acquisition par l'enfant d'un schéma généralisé de réponse craintive/anxieuse et évitante à une menace potentielle transmise par les parents via une information verbale et une modélisation. Puis nous abordons la façon dont les comportements parentaux peuvent contribuer au maintien des réactions craintives/anxieuses et évitantes chez les enfants. Enfin, nous analysons la transmission intergénérationnelle de l'inquiétude comme une façon de s'adapter à l'évitement des émotions négatives fortes et à l'intolérance à l'incertitude. Nous concluons que les parents ayant un TAG peuvent influer sur les processus de menaces potentiels de l'environnement pour leurs enfants en transmettant que le monde n'est pas sûr, que l'incertitude est intolérable, que les émotions fortes doivent être évitées et que l'inquiétude aide à supporter l'incertitude, transmettant ainsi les schémas cognitifs qui caractérisent les TAG. Notre article souligne le besoin de recherche sur les voies spécifiques de transmission des TAG des parents aux enfants.

Background Many children and adolescents suffer from problematic levels of anxiety, but the multitude of these children do not receive an intervention. It is of importance to increase the accessibility and availability of child anxiety interventions, as to identify and treat anxious children early and successfully. Online platforms that include information, assessments and intervention can contribute to this goal. Interventions for child anxiety are frequently based on Cognitive Behavioral Therapy, because of its strong theoretical and empirical basis. However, the working mechanisms of Cognitive Behavioral Therapy in children are poorly studied. To our knowledge, mediation studies on child anxiety are non-existent regarding online Cognitive Behavioral Therapy. Methods We will aim at children aged 8–13 years with problematic anxiety. We recruit these children via the community setting, and refer them to our online platform ‘Learn to Dare!’ (in Dutch: ‘Leer te Durven!’), https://leertedurven.ou.nl, where information about child anxiety and our research is freely accessible. After an active informed consent procedure, the participants can access the screening procedure, which will select the children with problematic anxiety levels. Thereafter, these children will be randomized to an online intervention based on Cognitive Behavioral Therapy (n = 120) or to a waitlist control (WL, n = 120). The intervention consists of 8 sessions with minimal therapist support and contains psycho-education, exposure (based on inhibitory learning), cognitive restructuring and relapse prevention. Child anxiety symptoms and diagnoses, cognitions, avoidance behavior and level of abstract reasoning are measured. Assessments are the same for both groups and are performed before and after the proposed working mechanisms are offered during the intervention. A follow-up assessment takes place 3 months after the final session, after which children in the waitlist control group are offered to take part in the intervention. Discussion This protocol paper describes the development of the online platform ‘Learn to Dare!’, which includes information about child anxiety, the screening procedure, anxiety assessments, and the online intervention. We describe the development of the online intervention. Offering easy accessible interventions and providing insight into the working mechanisms of Cognitive Behavioral Therapy contributes to optimizing Cognitive Behavioral Therapy for anxious youth.

Although attentional bias (AB) is considered a key characteristic of anxiety problems, the psychometric properties of most AB measures are either problematic or unknown. We conducted two experiments in which we addressed the reliability, convergent validity, and concurrent validity of different AB measures in unselected student samples. In Experiment 1 (N = 66), the visual probe task and the emotional flanker task yielded unreliable estimates of AB. Both the relevant and irrelevant feature visual search task yielded better reliability estimates, yet AB scores did not correlate significantly with each other nor with self-reported social anxiety. In Experiment 2 (N = 60), we retained only the visual search tasks. The relevant feature visual search task was again highly reliable, but it did not correlate significantly with anxiety measures. The irrelevant feature visual search task yielded only small reliability estimates, yet one of the scores was significantly correlated with implicit (but not self-reported or physiological) measures of social anxiety. Together, our results advocate the use of variants of visual search tasks to measure AB and they underline the importance of fundamental psychometric testing in AB research.

Objective: This study was the first attempt to explore the efficacy of a mindfulness protocol for children with attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD), and their parents. Method: Fifty male children with ADHD and ODD diagnosis, aged 8 to 12, were randomly assigned to the mindfulness intervention (n = 25) or the wait-list (n = 25) group. Outcome measures included children, parents’, and teachers’ reports and objective measures of attention. Results: Children from the intervention group had a greater reduction in hyperactive behaviors in the school context (effect size [ES] = 0.59) and a greater improvement in visual sustained attention (ES = 0.77) and in Avoidance and Fusion Questionnaire scores (ES = 0.43) than those in the wait-list control group. No significant effect of the intervention on aggressive behaviors was revealed. Conclusion: A mindfulness intervention for children and their parents showed partial beneficial effects in children with ADHD + ODD.

This study examined changes in mothers' and fathers' rejection and psychological control during parent-child interactions after cognitive-behavioral therapy (CBT) for children's anxiety disorders. We studied whether family CBT reduced rejection (vs. warmth) and psychological control (vs. autonomy-granting) more than child CBT, and whether parents own anxiety disorders resulted in smaller decreases in these parenting behaviors. Participants were 128 clinically referred children and adolescents (52 boys; Mage = 12.4, SDage = 2.7) with anxiety disorders and their parents, randomly assigned to either family CBT (n = 64) or child CBT (n = 64). The Anxiety Disorders Interview Schedule was used to assess children's and parents' anxiety disorders. Before and after treatment, parents' rejection and psychological control toward their child was rated during conflict and anxiety discussions of mother-child dyads, father-child dyads, and mother-father-child triads. As expected, during dyadic and triadic interactions, mothers' and fathers' rejection toward their child decreased after child and family CBT. Unexpectedly, during triadic conflict interactions, mothers, after child CBT and family CBT, as well as fathers, after child CBT, displayed increased psychological control. During triadic anxiety interactions, only mothers, after child CBT, showed increased psychological control. Changes in parenting did not depend on whether or not parents had anxiety disorders themselves. Thus, CBT for anxiety-disordered children can successfully reduce parents' rejection. The unexpected findings of increased psychological control after treatment, particularly by mothers in the presence of the father, suggests potential benefits of mothers' psychological control with anxious children. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

BackgroundMindful2Work is a 6-week program combining physical activity, yoga and mindfulness meditations, targeting (work-related) stress complaints from a body-mind perspective.Materials and methodsWe combined a top-down approach (researcher-driven outcome measures) with a bottom-up approach (personal goals and interview data) to investigate the effects on 98 employees with at least moderate (work-related) stress. Effects on personal goals, well-being (stress, anxiety, depression, sleep, affect, happiness), functioning at work (dropout, mental and physical workability, work satisfaction), and training-specific aspects (mindful awareness, self-compassion, emotion regulation strategies) were assessed.ResultsNearly all measures showed no change during the wait-list period, with only negative affect and physical workability showing small statistically significant improvements. Medium to large effect size improvements directly after training and at all follow-ups were found on primary outcomes stress (0.62–1.17), and risk for dropout from work (0.55–1.00), and largest effects occurred on personal goals (0.98–1.46). Improvements in well-being and functioning at work were medium directly after training, and at follow-up 1 (six weeks later) and 2 (six months later), and large at follow-up 3 (one year later). The training-specific measures showed small to medium effects after training and at follow-up 1. Further, from the interviews (n = 9), two main categories of effects emerged: well-being and acquired insights.ConclusionMindful2Work showed substantial and long-lasting improvements according to researcher-driven measures as well as participants’ own reports.

Objectives: The prevalence of maternal stress in early years of parenting can negatively impact child development. Therefore, there is a need for an early intervention that is easily accessible and low in costs. The current study examined the effectiveness of an 8-session online mindful parenting training for mothers with elevated levels of parental stress.Methods: A total of 76 mothers were randomized into an intervention (n = 43) or a waitlist control group (n = 33). The intervention group completed pretest assessment prior to the online intervention. Participants completed a post intervention assessment after the 10 weeks intervention and a follow-up assessment 10 weeks later. The waitlist group completed waitlist assessment, followed by a 10-week waitlist period. After these 10 weeks, a pretest assessment took place, after which the waitlist group participants also started the intervention, followed by the posttest assessment. Participating mothers completed questionnaires on parental stress (parent-child interaction problems, parenting problems, parental role restriction) and other maternal (over-reactive parenting discipline, self-compassion, symptoms of depression and anxiety) and child outcomes (aggressive behavior and emotional reactivity) while the non-participating parents (father or another mother) were asked to also report on child outcomes.Results: The online mindful parenting intervention was shown to be significantly more effective at a 95% level than a waitlist period with regard to over-reactive parenting discipline and symptoms of depression and anxiety (small and medium effect sizes), and significantly more effective at a 90% level with regard to self-compassion, and mother-rated child aggressive behavior and child emotional reactivity (small effect sizes). The primary outcome, parental stress, was found to have a 95% significant within-group effect only for the subscale parental role restriction (delayed small effect size improvement at follow-up). No significant improvements on child outcomes were found for the non-participating parent.Conclusion: To conclude, the results provide first evidence that an online mindful parenting training may be an easily accessible and valuable intervention for mothers with elevated levels of parental stress.

Mental illness is highly prevalent and runs in families. Mental disorders are considered to enhance the risk for the development of psychopathology in the offspring. This heightened risk is related to the separate and joint effects of inherited genetic vulnerabilities for psychopathology and environmental influences. The early years of life are suggested to be a key developmental phase in the intergenerational psychopathology transmission. Available evidence supports the idea that early exposure to parental psychopathology, during the pregnancy and first postpartum year, may be related to child psychological functioning beyond the postpartum period, up to adulthood years. This not only highlights the importance of intervening early to break the chain of intergenerational transmission of psychopathology but also raises the question of whether early interventions targeting parental mental disorders in this period may alleviate these prolonged adverse effects in the infant offspring. The current article focuses on the specific risk of psychopathology conveyed from mentally ill parents to the offspring during the pregnancy and first postpartum year. We first present a summary of the available evidence on the associations of parental perinatal mental illness with infant psychological outcomes at the behavioral, biological, and neurophysiological levels. Next, we address the effects of early interventions and discuss whether these may mitigate the early intergenerational transmission of risk for psychopathology. The summarized evidence supports the idea that psychopathology-related changes in parents’ behavior and physiology in the perinatal period are related to behavioral, biological, and neurophysiological correlates of infant psychological functioning in this period. These alterations may constitute risk for later development of child and/or adult forms of psychopathology and thus for intergenerational transmission. Targeting psychopathology or mother-infant interactions in isolation in the postnatal period may not be sufficient to improve outcomes, whereas interventions targeting both maternal psychopathology and mother-infant interactions seem promising in alleviating the risk of early transmission.

Major depressive disorder and the anxiety disorders are highly prevalent, disabling and moderately heritable. Depression and anxiety are also highly comorbid and have a strong genetic correlation (rg ≈ 1). Cognitive behavioural therapy is a leading evidence-based treatment but has variable outcomes. Currently, there are no strong predictors of outcome. Therapygenetics research aims to identify genetic predictors of prognosis following therapy. We performed genome-wide association meta-analyses of symptoms following cognitive behavioural therapy in adults with anxiety disorders (n = 972), adults with major depressive disorder (n = 832) and children with anxiety disorders (n = 920; meta-analysis n = 2724). We estimated the variance in therapy outcomes that could be explained by common genetic variants (h2SNP) and polygenic scoring was used to examine genetic associations between therapy outcomes and psychopathology, personality and learning. No single nucleotide polymorphisms were strongly associated with treatment outcomes. No significant estimate of h2SNP could be obtained, suggesting the heritability of therapy outcome is smaller than our analysis was powered to detect. Polygenic scoring failed to detect genetic overlap between therapy outcome and psychopathology, personality or learning. This study is the largest therapygenetics study to date. Results are consistent with previous, similarly powered genome-wide association studies of complex traits.

Studies on the effectiveness of mindful parenting interventions predominantly focused on self-report measures of parenting, whereas observational assessments of change are lacking. The present study examined whether the Mindful with your baby/toddler training leads to observed changes in maternal behavior and mother-child interaction quality. Mindful with your baby/toddler is a 8- or 9-week mindful parenting training for clinically referred mothers of young children (aged 0-48 months), who experience parental stress, mother-child interaction problems, and/or whose children experience regulation problems. The study involved a quasi-experimental non-random design including a sample of 50 mothers who were diagnosed with a mood disorder (n = 21, 42%), an anxiety disorder (n = 7, 14%), post-traumatic stress disorder (n = 6, 12%), or other disorder (n = 7, 14%). Mothers completed a parental stress questionnaire and participated in home observations with their babies (n = 36) or toddlers (n = 14) during a waitlist, pretest, and posttest assessment. Maternal sensitivity, acceptance, and mind-mindedness were coded from free-play interactions and dyadic synchrony was coded from face-to-face interactions. Sensitivity and acceptance were coded with the Ainsworth's maternal sensitivity scales. Mind-mindedness was assessed by calculating frequency and proportions of appropriate and nonattuned mind-related comments. Dyadic synchrony was operationalized by co-occurrences of gazes and positive facial expressions and maternal and child responsiveness in vocal interaction within the dyad. Coders were blind to the measurement moment. From waitlist to pretest, no significant improvements were observed. At posttest, mothers reported less parenting stress, and were observed to show more accepting behavior and make less nonattuned comments than at pretest, and children showed higher levels of responsiveness. The outcomes suggest that the Mindful with your baby/toddler training affects not only maternal stress, but also maternal behavior, particularly (over)reactive parenting behaviors, which resulted in more acceptance, better attunement to child's mental world, and more "space" for children to respond to their mothers during interactions. Mindful with your baby/toddler may be a suitable intervention for mothers of young children with (a combination of) maternal psychopathology, parental stress, and problems in the parent-child interaction and child regulation problems.

Parental mind-mindedness, the parent’s propensity to treat the child as an intentional agent, has repeatedly shown to promote children’s development of social understanding and secure attachment. Less is known about whether the impact of maternal and paternal mind-mindedness extends to children’s social and behavior problems. We investigated the combined effect of mothers’ and fathers’ (N = 104) mind-mindedness at 4, 12, and 30 months on children’s social competence and externalizing and internalizing behavior problems at 4.5 years. Besides, we examined the stability, continuity, parental concordance, and inter-parental differences in the use of mind-related comments. Appropriate mind-mindedness (i.e., correct interpretations of the child’s mental states) and nonattuned mind-mindedness (i.e., misinterpretations of the child’s mental states) were observed during parent-child free-play interactions. Social competence, internalizing and externalizing behavior problems were assessed using both parents’ reports. Hierarchical multiple regression analyses showed that, at 30 months, infrequent use of appropriate mind-related comments of both parents predicted children’s externalizing problems, while their frequent use of nonattuned comments predicted children’s low social competence. Furthermore, mothers’ frequent use of nonattuned comments at 12 and 30 months and fathers’ nonattuned comments at 30 months predicted children’s externalizing behavior. The findings suggest that both parents’ low use of mind-related comments, and frequent misinterpretations of their child’s mind, may act as risk factors for later social and behavior problems of their child.

Objective: To examine whether the Wijma Delivery Expectation Questionnaire (W-DEQ-A) and the one-item Fear of Childbirth-Postpartum-Visual Analogue Scale (FOCP-VAS) - measuring high FOC - are useful tools in predicting requested and received non-urgent obstetric interventions in pregnant women. Design: A prospective cohort study. Population and setting: Self-selected pregnant women from midwifery care settings (n=401). Methods: W-DEQ-A and FOCP-VAS were assessed at two timepoints in pregnancy. Measures of non-urgent obstetric interventions which were derived from medical files were: induction of labour, epidural analgesia, augmentation with oxytocin due to failure to progress and self-requested caesarean section. Hierarchical logistics regression models were used. Main outcome measures: The change in the Nagelkerke R2 was examined for three models predicting two outcome measures: (1) explicitly requested non-urgent obstetric interventions during pregnancy and (2) received non-urgent obstetric interventions during labour. The first model only included participants’ characteristics, the second model also included FOCP-VAS ≥5, and in the third model the W-DEQ-A ≥66 was added. Results: High FOC measured with FOCP-VAS≥5 predicted requested (pseudo-R2=0.33, X2=59.82, PR2=0.19, X2=32.81, PConclusion: This study is the first evaluating self-reported FOC and postpartum based on VAS (subjective outcome)in relation to actual pregnancy and childbirth outcomes derived from medical files (objective outcome). Nonurgent obstetric interventions could already be predicted in the first half of pregnancy by means of a simple FOC assessment with the one-item FOCP-VAS. Implementing this easy to use one-item screening tool in midwifery care is suggested.

Cultivating empathy is a presumed benefit of mindfulness, but this possibility has rarely been investigated experimentally. We examined whether a five-minute mindfulness exercise would cultivate empathy relative to two equally brief control exercises: relaxation and mind-wandering. We further examined whether mindfulness would be especially beneficial for people with autistic or narcissistic traits. Results showed no effect of mindfulness relative to both control conditions on mind reading, empathic responding, or prosocial behavior. Mindfulness effects were independent of autistic traits. Unexpectedly, people higher in autistic traits did show increased prosocial behavior across conditions. Intriguingly, mindfulness improved mind reading in non-narcissistic people, but reduced it in narcissistic people. These findings question whether a brief mindfulness exercise is sufficient for building empathy.

With DSM‐5, the American Psychiatric Association encourages complementing categorical diagnoses with dimensional severity ratings. We therefore examined the psychometric properties of the DSM‐5 Dimensional Anxiety Scales, a set of brief dimensional scales that are consistent in content and structure and assess DSM‐5‐based core features of anxiety disorders. Participants (285 males, 255 females) completed the DSM‐5 Dimensional Anxiety Scales for social anxiety disorder, generalized anxiety disorder, specific phobia, agoraphobia, and panic disorder that were included in previous studies on the scales, and also for separation anxiety disorder, which is included in the DSM‐5 chapter on anxiety disorders. Moreover, they completed the Screen for Child Anxiety Related Emotional Disorders Adult version (SCARED‐A). The DSM‐5 Dimensional Anxiety Scales demonstrated high internal consistency, and the scales correlated significantly and substantially with corresponding SCARED‐A subscales, supporting convergent validity. Separation anxiety appeared present among adults, supporting the DSM‐5 recognition of separation anxiety as an anxiety disorder across the life span. To conclude, the DSM‐5 Dimensional Anxiety Scales are a valuable tool to screen for specific adult anxiety disorders, including separation anxiety. Research in more diverse and clinical samples with anxiety disorders is needed. © 2016 The Authors International Journal of Methods in Psychiatric Research Published by John Wiley & Sons Ltd.

Work-related stress and associated illness and burnout is rising in western society, with now as much as almost a quarter of European and half of USA’s employees estimated to be at the point of burnout. Mindfulness meditation, yoga, and physical exercise have all shown beneficial effects for work-related stress and illness. This proof of concept study assessed the feasibility, acceptability, and preliminary effects of the newly developed Mindful2Work training, a combination of physical exercise, restorative yoga, and mindfulness meditations, delivered in six weekly group sessions plus a follow-up session. Participants (n = 26, four males), referred by company doctors with (work-related) stress and burnout complaints, completed measurements pre and post the intervention, as well as at 6-week (FU1) and 6-month (FU2) follow-up. Results showed very high feasibility and acceptability of the Mindful2Work training. The training and trainers were rated with an 8.1 and 8.4 on a 1–10 scale, respectively, and training dropout rate was zero. Significant improvements with (very) large effect sizes were demonstrated for the primary outcome measures of physical and mental workability, and for anxiety, depression, stress, sleep quality, positive and negative affect, which remained (very) large and mostly increased further over time. Risk for long-term dropout from work (checklist individual strength [CIS]) was 92 % at pre-test, reduced to 67 % at post-test, to 44 % at FU1, and 35 % at FU2, whereas employees worked (RTWI) 65 % of their contract hours per week at pre-test, which increased to 73 % at post-test, 81 % at FU1 and 93 % at FU2. Intensity of home practice or number of attended sessions were not related to training effects. To conclude, the newly developed Mindful2Work training seems very feasible, and acceptable, and although no control group was included, the large effects of Mindful2Work are highly promising.

Mindful parenting training is an application of mindfulness-based interventions that allows parents to perceive their children with unbiased and open attention without prejudgment and become more attentive and less reactive in their parenting. This study examined the effectiveness of mindful parenting training in a clinical setting on child and parental psychopathology and of mindfulness as a predictor of these outcomes. Seventy parents of 70 children (mean age=8.7) who were referred to a mental health care clinic because of their children's psychopathology participated in an 8-week mindful parenting training. Parents completed questionnaires at pre-test, post-test and 8-week follow-up. A significant decrease was found in children's and parents' psychopathology and a significant increase in mindful parenting and in general mindful awareness. Improvement in general mindful awareness, but not mindful parenting, was found to predict a reduction in parental psychopathology, whereas improvement in mindful parenting, but not general mindful awareness, predicted the reduction of child psychopathology. This study adds to the emerging body of evidence indicating that mindful parenting training is effective for parents themselves and, indirectly, for their children suffering from psychopathology. As parents' increasedmindful parenting, but not increased general mindfulness, is found to predict child psychopathology, mindful parenting training rather than general mindfulness training appears to be the training of choice. However, RCTs comparing mindful parenting to general mindfulness training and to parent management training are needed in order to shed more light on the effects of mindful parenting and mechanisms of change.

Earlier evidence has revealed a bi‐directional causal relationship between anxiety and attention biases in adults and children. This study investigated the prospective and concurrent relations between anxiety and attentional bias in a sample of 89 families (mothers, fathers, and first‐born children). Parents’ and children's attentional bias was measured when children were 7.5 years old, using both a visual probe task and visual search task with angry versus happy facial expressions. Generalized and social anxiety symptoms in parents and children were measured when children were 4.5 and 7.5 years old. Anxiety in parents and children was prospectively (but not concurrently) related to their respective attentional biases to threat: All participants showed a larger attentional bias to threat in the visual search (but not in the visual probe) task if they were more anxious at the 4.5 (but not at the 7.5) year measurement. Moreover, parents’ anxiety levels were prospectively predictive of the visual search attentional bias of their children after controlling for child anxiety. More anxiety in mothers at 4.5 years was related to a faster detection of angry among happy faces, while more anxiety in fathers predicted a faster detection of happy among angry faces in chil‐dren at 7.5 years. We found no direct association between parental and child attentional biases. Our study contributes to the recently emerging literature on attentional biases as a potential mechanism in the intergenerational transmission of anxiety by showing that parents’ anxiety rather than parents’ attentional bias contributes to the intergenerational transmission of risk for child anxiety.

To get additional insight into the phenotype of attentional problems, we examined to what extent genetic and environmental factors explain covariation between lack of dispositional mindfulness and attention-deficit/hyperactivity disorder (ADHD) traits in youth, and explored the incremental validity of these constructs in predicting life satisfaction. We used data from a UK population-representative sample of adolescent twins (N = 1092 pairs) on lack of dispositional mindfulness [Mindful Attention Awareness Scale (MAAS)], ADHD traits [Conners’ Parent Rating Scale-Revised (CPRS-R): inattentive (INATT) and hyperactivity/impulsivity (HYP/IMP) symptom dimensions] and life satisfaction (Students’ Life Satisfaction Scale). Twin model fitting analyses were conducted. Phenotypic correlations (rp) between MAAS and CPRS-R (INATT: rp = 0.18, HYP/IMP: rp = 0.13) were small, but significant and largely explained by shared genes for INATT (% rp INATT–MAAS due to genes: 93%, genetic correlation rA = 0.37) and HYP/IMP (% rp HYP/IMP–MAAS due to genes: 81%; genetic correlation rA = 0.21) with no significant contribution of environmental factors. MAAS, INATT and HYP/IMP significantly and independently predicted life satisfaction. Lack of dispositional mindfulness, assessed as self-reported perceived lapses of attention (MAAS), taps into an aspect of attentional functioning that is phenotypically and genetically distinct from parent-rated ADHD traits. The clinically relevant incremental validity of both scales implicates that MAAS could be used to explore the underlying mechanisms of an aspect of attentional functioning that uniquely affects life satisfaction and is not captured by DSM-based ADHD scales. Further future research could identify if lack of dispositional mindfulness and high ADHD traits can be targeted by different therapeutic approaches resulting in different effects on life satisfaction. Electronic supplementary material The online version of this article (10.1007/s00787-019-01279-8) contains supplementary material, which is available to authorized users.

Why are some children more socially anxious than others? One theory holds that socially anxious children are poor mindreaders, which hampers their social interactions; another that socially anxious children are advanced mindreaders leading to heightened self-consciousness in social situations. To test these theories simultaneously, this study (N = 105, ages 8–12) assessed children’s mindreading (accuracy in detecting mental states from the eye region), self-consciousness (indexed as physiological blushing during public performance), and social anxiety levels. Results support both theories, showing a quadratic relation between mindreading and social anxiety. Low mindreading was related to clinical levels of social anxiety. High mindreading was related to subclinical levels of social anxiety through blushing. Our findings suggest two social-cognitive pathways to heightened social anxiety.

Emerging evidence supports the positive effects of mindful parenting as a clinical intervention in the context of child psychopathology; however, previous studies have not considered the specific parenting predictors of improvements in child outcomes. Parents accessing a child and youth secondary mental health care center participated in an 8-week mindful parenting training (n = 89). The effects of the mindful parenting training were assessed on parent-reported child’s psychopathology, parents’ own psychopathology, mindfulness, and parenting factors from pre- to post-intervention, 8-week and 1-year follow-up. Multi-level analyses indicated immediate and delayed improvements in most child and parent outcomes. Changes in experiential avoidance in parenting partially predicted improvements in child internalizing problems. In combination with mindful parenting, experiential avoidance in parenting fully accounted for improvements in child attention problems. Changes in parental over-reactivity fully accounted for improvements in child externalizing problems. The mindful parenting training successfully improved the targeted (mindful) parenting factors, which in turn predicted improvements across different child outcomes.

The parents of children with psychopathology are at increased risk for psychiatric symptoms. To investigate which parents are mostly at risk, we assessed in a clinical sample of families with children with psychopathology, whether parental symptom scores can be predicted by offspring psychiatric diagnoses and other child, parent and family characteristics. Parental depressive, anxiety, avoidant personality, attention-deficit/hyperactivity (ADHD), and antisocial personality symptoms were measured with the Adult Self Report in 1805 mothers and 1361 fathers of 1866 children with a psychiatric diagnosis as assessed in a child and adolescent psychiatric outpatient clinic. In a multivariate model, including all parental symptom scores as outcome variables, all offspring psychiatric diagnoses, offspring comorbidity and age, parental age, parental educational attainment, employment, and relationship status were simultaneously tested as predictors. Both 35.7% of mothers and 32.8% of fathers scored (sub)clinical for at least one symptom domain, mainly depressive symptoms, ADHD symptoms or, only in fathers, avoidant personality symptoms. Parental psychiatric symptoms were predicted by unemployment. Parental depressive and ADHD symptoms were further predicted by offspring depression and offspring ADHD, respectively, as well as by not living together with the other parent. Finally, parental avoidant personality symptoms were also predicted by offspring autism spectrum disorders. In families with children referred to child and adolescent psychiatric outpatient clinics, parental symptom scores are associated with adverse circumstances and with similar psychopathology in their offspring. This signifies, without implying causality, that some families are particularly vulnerable, with multiple family members affected and living in adverse circumstances. Electronic supplementary material The online version of this article (10.1007/s00787-018-1156-6) contains supplementary material, which is available to authorized users.

IntroductionMindfulness is one of the potential alternative interventions for children with attention-deficit hyperactivity disorder (ADHD). Some evidence suggests that mindfulness is related to changes in brain regions associated with ADHD. The potential benefits of mindfulness on children with ADHD, as well as the feasibility of this intervention approach, are warranted through prior local and foreign studies. This study aims to evaluate the effect of mindfulness-based group intervention for children with ADHD and their respective parents through a robust research design.Methods and analysisThis study will adopt a randomised controlled trial design including 140 children aged 8–12 years with ADHD together with one of their parents (n=140). These families will be randomised into intervention group (n=70) who will be offered the MYmind programme delivered by trained healthcare professionals, and an active control group (n=70) who will be offered the CBT programme. The intervention includes 8 weekly 90 min group sessions for children with ADHD (aged 8–12 years) and their respective parents. The primary and secondary outcomes will include children’s attention, ADHD-related symptoms, behaviours, executive function and mindfulness levels measured by validated objective measures and parent’s reported instruments. Parents’ parental stress, parenting styles, ADHD related symptoms, well-being, rumination level and mindfulness levels will also be measured. Analysis is by intention to treat. The effects of intervention will be evaluated by comparing outcomes between the two arms, as well as comparing outcomes within subject through comparing measurements at baseline (T0), immediately after the 8 week intervention (T1) and at 3 (T2) and 6 (T3) months postintervention.Ethics and disseminationEthics approval has been granted by the Joint Chinese University of Hong Kong – New Territories East Cluster Clinical Research Ethics Committee (The Joint CUHK-NTEC CREC). Participants will be required to sign informed consent form from both parents and children. Findings will be reported in conferences and peer-reviewed publications in accordance with recommendations of Consolidated Standards of Reporting Trials.Trial registration numberChiCTR1800014741; Pre-results.

Recent theories propose that (especially fathers’) challenging parenting behavior (CPB) serves to reduce offspring's anxiety development, and that fearful children are more susceptible to parenting. Using a longitudinal design we explored whether more CPB (and less overprotection) of both parents, (1) separately, (2) relatively, and (3) jointly predicts less anxiety in early childhood, and (4) whether child fearful temperament moderates these relations. Participants were 132 couples with their first-born child. Child fearful temperament was observed at 4 months and 1 year, and parents’ CPB and overprotection at 1 and 2.5 years. Child anxiety symptoms were assessed at 2.5 and 4.5 years. Multilevel analyses showed that more CPB and, unexpectedly, more overprotection predicted less child anxiety. Relatively, fathers’ CPB and mothers’ overprotection predicted less anxiety. An interaction showed that if one parent shows low CPB, the other parent's higher CPB predicts less child anxiety. A trend interaction suggested that fathers’ CPB predicts less anxiety most strongly for fearful children. Thus, fathers’ CPB appears to play a protective role in anxiety development, possibly in particular for children most vulnerable to develop anxiety problems. Parents can compensate for a less challenging partner. The finding that maternal overprotection mitigates child anxiety requires further investigation.