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Background The frequency and severity of mental health problems in student populations have been a growing cause for concern worldwide, and studies have identified measures of a number of mental health symptoms that have been steadily increasing in frequency and intensity over the past 20–25 years. Methods In two studies we investigate the levels and domains of pathological worrying in university student participants. Study 1 is a retrospective study of Penn State Worry Questionnaire (PSWQ) data collected between 2001 and 2019. Study 2 describes the development of the Student Worry Questionnaire, a short and easily delivered measure of student worrying that identifies both frequency of worry as well as the student-relevant domains across which worrying occurs. Results Study 1 revealed a steady increase in student worry scores of around 20% between 2001 and 2019, with a significant positive correlation between year of data collection and mean PSWQ score. The domain scores in Study 2 indicated that academic work was a significantly higher worry than any of the other domains, and worries about intimate relationships and ‘what people think of me’ were also worries that scored higher than either financial or health worries. Conclusions The present studies indicate that pathological worrying can be added to the list of anxiety- and stress-related symptoms that have been shown to be on the increase in student populations in recent decades, and we discuss whether these increases represent a greater willingness to report symptoms or a genuine increase in experienced symptoms over time.

People with synaesthesia have often been reported to possess enhanced memory relative to the general population and, in some cases, exceptional memory ability. However, there are also inconsistencies in this literature and it is unclear whether this reflects sampling error (exacerbated by low Ns) or more meaningful differences that arise because synaesthesia relates to some aspects of memory more than others. To this end, a multi-level meta-analysis was conducted. Synaesthetes have enhanced episodic memory with a medium population effect size estimate (d ̂ = 0.61), whereas the effects on working memory were significantly smaller (d ̂ = 0.36) but still exceeded that of controls. Moderation analyses suggested that, aside from the division between long term versus working memory, the effects of synaesthesia are pervasive i.e. they extend to all kinds of stimuli, and extend to all kinds of test formats. This pattern is hard to reconcile with the view that synaesthetic experiences directly support memory ability: for instance, digit span (where synaesthesia could be helpful) showed a small effect whereas episodic memory for abstract images (where synaesthesia is irrelevant) yielded larger effects. Synaesthesia may be the only known neurodevelopmental condition linked to a pervasive enhancement of long-term memory.

Background: Attention processes may play a central role in shaping trajectories of socioemotional development. Individuals who are clinically anxious or have high levels of trait anxiety sometimes show attention biases to threat. There is emerging evidence that young children also demonstrate a link between attention bias to salient stimuli and broad socioemotional profiles. However, we do not have a systematic and comprehensive assessment of how attention biases, and associated neural and behavioral correlates, emerge and change from infancy through toddlerhood. This paper describes the Longitudinal Attention and Temperament study (LAnTs), which is designed to target these open questions.Method: The current study examines core components of attention across the first 2 years of life, as well as measures of temperament, parental psychosocial functioning, and biological markers of emotion regulation and anxiety risk. The demographically diverse sample (N = 357) was recruited from the area surrounding State College, PA, Harrisburg, PA, and Newark, NJ. Infants and parents are assessed at 4, 8, 12, 18, and 24 months. Assessments include repeated measures of attention bias (via eye-tracking) in both infants and parents, and measures of temperament (reactivity, negative affect), parental traits (e.g., anxiety and depression), biological markers (electrophysiology, EEG, and respiratory sinus arrythmia, RSA), and the environment (geocoding, neighborhood characteristics, perceived stress). Outcomes include temperamental behavioral inhibition, social behavior, early symptom profiles, and cellular aging (e.g., telomere length).Discussion: This multi-method study aims to identify biomarkers and behavioral indicators of attentional and socioemotional trajectories. The current study brought together innovative measurement techniques to capture the earliest mechanisms that may be causally linked to a pervasive set of problem behaviors. The analyses the emerge from the study will address important questions of socioemotional development and help shape future research. Analyses systematically assessing attention bias patterns, as well as socioemotional profiles, will allow us to delineate the time course of any emerging interrelations. Finally, this study is the first to directly assess competing models of the role attention may play in socioemotional development in the first years of life.

Collecting data with infants is notoriously difficult. As a result, many of our studies consist of small samples, with only a single measure, in a single age group, at a single time point. With renewed calls for greater academic rigor in data collection practices, using multiple outcome measures in infant research is one way to increase rigor, and at the same time, enable us to more accurately interpret our data. Here, we illustrate the importance of using multiple measures in psychological research with examples from our own work on rapid threat detection, and from the broader infancy literature. First, we describe our initial studies using a single outcome measure, and how this strategy caused us to nearly miss a rich and complex story about attention biases for threat and their development. We demonstrate how using converging measures can help researchers make inferences about infant behavior, and how using additional measures allows us to more deeply examine the mechanisms that drive developmental change. Finally, we provide practical and statistical recommendations for how researchers can use multiple measures in future work.

The transition from primary to secondary education is a critical period in early adolescence which is related to increased anxiety and stress, increased prevalence of mental health issues, and decreased maths performance, suggesting it is an important period to investigate maths attainment. Previous research has focused on anxiety and working memory as predictors of maths, without investigating any long-term effects around the education transition. This study examined working memory and internalizing symptoms as predictors of children's maths attainment trajectories (age 7–16) across the transition to secondary education using secondary longitudinal analysis of the Avon Longitudinal Study of Parents and Children (ALSPAC). This study found statistically significant, but very weak evidence for the effect of internalizing symptoms and working memory on maths attainment. Greater parental education was the strongest predictor, suggesting that children of parents with a degree (compared with those with a CSE) gain the equivalent of almost a year's schooling in maths. However, due to methodological limitations, the effects of working memory and internalizing symptoms on attainment cannot be fully understood with the current study. Additional research is needed to further uncover this relationship, using more time-appropriate measures.

This study tested the theory that anxious fathers pose a quantitatively different environmental influence on childhood anxiety than anxious mothers. The analysed sample contained 502 linked adoption units from the Early Growth and Development Study (EGDS), a longitudinal multisite study that follows 561 adopted children (57.2% boys) and their adoptive and birth parents, who were recruited through US adoption agencies. A Bayesian latent growth model predicted child anxiety symptoms between 18 months and 4.5 years from inherited (birth parent anxiety) and rearing parent anxiety. This model revealed little evidence for a difference in the influence of maternal and paternal rearing parent anxiety on child anxiety symptoms. Contrary to theoretical predictions, anxiety in the rearing father is likely to have an equivalent influence to that of the mother on both child anxiety symptoms at 18 months old and their developmental trajectory over the preschool years.

Although an abundant literature documents preliterate children's word learning success from shared storybook reading, a full synthesis of the factors which moderate these word learning effects has been largely neglected. This meta-analysis included 38 studies with 2,455 children, reflecting 110 effect sizes, investigating how reading styles, story repetitions, tokens and related factors moderate children's word comprehension, while adjusting for the number of target words. Dialogic reading styles, tokens, and the number of words tested all moderated word learning effects. Children's age, who read the story, and time between story and test were not moderators. We identify story repetition and word types as topics which merit further research. These results provide information to guide researchers and educators alike to the factors with the greatest impact on improving word learning from shared storybook reading. (PsycINFO Database Record

This paper reviews and offers tutorials on robust statistical methods relevant to clinical and experimental psychopathology researchers. We review the assumptions of one of the most commonly applied models in this journal (the general linear model, GLM) and the effects of violating them. We then present evidence that psychological data are more likely than not to violate these assumptions. Next, we overview some methods for correcting for violations of model assumptions. The final part of the paper presents 8 tutorials of robust statistical methods using R that cover a range of variants of the GLM (t-tests, ANOVA, multiple regression, multilevel models, latent growth models). We conclude with recommendations that set the expectations for what methods researchers submitting to the journal should apply and what they should report.

Research has shown that pet loss can be a devastating and complex experience for some human survivors, yet this loss may not be fully recognized by friends, partners, or acquaintances as a signific...

Research demonstrates that children exposed to domestic violence experience a myriad of internalising and externalising symptoms. The current study examines this pathway within a Cambodian sample, specifically determining if the effect of witnessing domestic violence on the child’s tendency to bully or to be bullied is mediated by symptoms of posttraumatic stress disorder (PTSD). The PTSD Checklist – Civilian Version, a revised version of a12-item bullying and victimisation questionnaire, and the Revised Conflict Tactics Scale were administered to 206 high school students in Phnom Penh. A significant mediational effect of PTSD symptoms was found for victimisation (being bullied); no such mediational model was supported for bullying as the outcome variable. However, controlling for emotional, physical, and sexual child abuse resulted in the mediation effect being non-significant. Implications and directions for future research are discussed.

In non-Western societies, two-way communication between the bereaved and deceased is important in distinguishing adaptive versus maladaptive continuing bonds (CBs). We examined CBs expressed in dreams among Cambodian survivors during the Pol Pot era. Participants completed measures addressing dreams of the deceased, complicated grief (CG), and post-traumatic stress disorder (PTSD) symptoms. Participants who reported distressing dreams were more likely to have witnessed violent deaths of loved ones during the Pol Pot era and reported more severe CG and PTSD symptoms relative to those reporting other types of dreams. Distressing visitation dreams were shown to mediate the effect of violent loss on CG but not on PTSD.

The current study examined Posttraumatic Growth (PTG) experienced by bereaved pet owners in the United States, French-Canada, Japan, and Hong Kong following the death of their pet. Using qualitative methodology, we analyzed responses of participants who answered “yes” to a question about experiencing PTG and explored to what extent the cross-cultural responses mapped onto the five factors of the Posttraumatic Growth Inventory (PTGI). For the U.S. sample, 58% of responses mapped onto the PTGI. For French-Canada, 72% of responses mapped onto the PTGI. For Japan, 50% of responses mapped onto the PTGI and for Hong Kong, 39% of responses mapped onto the PTGI. We also explored emergent categories related to PTG for individuals who have lost a pet and discerned the unique aspects for PTG across cultures.

The impact of chronic trauma can be longstanding, affecting survivor affect regulation, consciousness, interpersonal functioning, perceptions of self and others, self-regulation, and somatic experience. There is a growing consensus that multimodal and staged approaches to treatment are necessary to promote healing. However, empirical investigations of such treatments are still needed. The current study used a naturalistic design to examine the impact of a brief, yet intensive, outpatient program on complex PTSD symptoms and attachment classification among women with histories of chronic trauma. Fifty-four women were assessed and followed over an 8-week intervention and six-month follow-up. Significant improvement over time was found for PTSD symptoms, dissociation, emotion regulation, interpersonal problems, sexual problems, alexithymia, and posttraumatic growth. Nearly, all women met criteria for PTSD at baseline, a third of the women who completed the measures no longer had PTSD post-treatment, and 60% showed a clinically significant reduction in PTSD symptoms. Finally, thirty-six women were classified as unresolved on the Adult Attachment Projective. Post-treatment, nine of 26 women who provided follow-up data were no longer classified as unresolved. Notably, those women whose attachment category changed also showed the greatest improvement in all other outcomes. Altogether, these findings suggest that an intensive, stage 1, and multimodal treatment program can benefit women with histories of chronic traumatization.

This study examined the relationship among projective drawings and mental health symptomatology to determine if projective drawings provide clinical utility in pet bereavement. Projective drawings, standardized questionnaires, and clinical interview results were collected from 33 adults grieving the loss of a pet. Drawings were coded into a psychosocial adjustment score based on formal artistic elements, specific indicators (e.g., placement of figure), subject portrayal, and use of space. Results showed that those with greater severity of grief and/or somatization displayed poorer psychosocial adjustment. In conjunction with behavioral observations and verbal reflections, projective drawings add clinical utility by introducing a nonverbal form of expression helpful in understanding the severity of grief and in opening up shared communication with those experiencing loss.

There is equivocal evidence on how being a child in a Black, Asian and Minority Ethnic (BAME) immigrant family affects internalizing symptoms such as anxiety. This cross-sectional study examined the relationships between peer friendships and anxiety/depression symptoms in BAME immigrant adolescents (IA) and white native adolescents (WNA). Method: Sixty-two adolescents from the UK (IA = 26, WNA = 36, mean age = 14 years) were assessed on close friendship, social competence, social anxiety, and depression. Immigrant family parents (n = 23) were also assessed on cultural orientation. There were no significant differences in anxiety and depression between groups. Bayes factors supported the conclusion that the groups did not differ. However, IA and WNA groups had different patterns of associations between close friendship/social competence and anxiety and depression symptoms. Close friendships were more strongly associated with lower anxiety/depression in IAs than WNAs, and social competence was more strongly associated with lower anxiety/depression in WNAs than IAs. Moderation analyses indicated that the relationship between close friendship and social and separation anxiety was significantly moderated by ethnic group, as was the relationship between social competence and generalized anxiety. The findings suggest that social and separation anxiety are more strongly associated with close friendships for BAME immigrant children than for non-immigrant adolescents. As such, activities that help BAME immigrant children to foster close relationships may have positive effects on their well-being.

Pregnancy, birth and adjusting to a new baby is a potentially stressful time that can negatively affect the health of women. There is some evidence that expressive writing can have positive effects on psychological and physical health, particularly during stressful periods. The current study aimed to evaluate whether expressive writing would improve women’s postpartum health. A randomized controlled trial was conducted with three conditions: expressive writing (n = 188), a control writing task (n = 213), or normal care (n = 163). Measures of psychological health, physical health and quality of life were measured at baseline (6–12 weeks postpartum), 1 and 6 months later. Ratings of stress were taken before and after the expressive writing task. Intent-to-treat analyses showed no significant differences between women in the expressive writing, control writing and normal care groups on measures of physical health, anxiety, depression, mood or quality of life at 1 and 6 months. Uptake and adherence to the writing tasks was low. However, women in the expressive writing group rated their stress as significantly reduced after completing the task. Cost analysis suggest women who did expressive writing had the lowest costs in terms of healthcare service use and lowest cost per unit of improvement in quality of life. Results suggest expressive writing is not effective as a universal intervention for all women 6–12 weeks postpartum. Future research should examine expressive writing as a targeted intervention for women in high-risk groups, such as those with mild or moderate depression, and further examine cost-effectiveness.Clinical trial registration number ISRCTN58399513 www.isrctn.com

The transition from primary to secondary education is one of the most stressful events in a young person’s life (Zeedyk et al., 2003) and can have a negative impact on psychological wellbeing and academic achievement. One explanation for these negative impacts is that the transition coincides with early adolescence, a period during which certain psychological disorders (i.e., anxiety disorders) become more salient (Kessler et al., 2005) and marked social, biological, and psychological development occurs (Anderson, Jacobs, Schramm, & Splittgerber, 2000). This review evaluates the existing literature on the psychological and academic impacts of the transition to secondary education on young adolescents. We examine the factors that plausibly increase or mitigate the risk of developing mental health issues and/or a decline in academic performance during the transition to secondary education. We also review the interplay between psychological health and academic achievement across and beyond the transition. We conclude with a summary of what schools and parents can learn from these findings to support children in a successful transition into secondary education.

Children of anxious parents are at high risk of anxiety disorders themselves. The evidence suggests that this is due to environmental rather than genetic factors. However, we currently do little to reduce this risk of transmission. There is evidence that supporting parenting in those with mental health difficulties can ameliorate this risk. Therefore, the objective of this study was to test the feasibility of a new one-session, group-based, preventive parenting intervention for parents with anxiety disorders.Feasibility Randomized Controlled Trial.A total of 100 parents with anxiety disorders, recruited from adult mental health services in England (and child aged 3-9 years), were randomized to receive the new intervention (a 1-day, group workshop), or to treatment as usual. Children's anxiety disorder and anxiety symptoms were assessed to 12 months by outcome assessors who were blind to group allocation. Exploratory analyses were conducted on an intention to treat basis, as far as possible.A total of 51 participants were randomized to the intervention condition and 49 to the control condition (82% and 80% followed to 12 months, respectively). The attendance rate was 59%, and the intervention was highly acceptable to parents who received it. The RCT was feasible, and 12-month follow-up attrition rates were low. Children whose parents were in the control condition were 16.5% more likely to have an anxiety disorder at follow-up than those in the intervention group. No adverse events were reported.An inexpensive, light-touch, psycho-educational intervention may be useful in breaking the intergenerational cycle of transmission of anxiety disorders. A substantive trial is warranted.Anxiety disorders run in families, but we currently do little to help anxious parents to raise confident children. A brief group workshop was highly acceptable to such parents and was very inexpensive to run. Children of parents who took part in the brief intervention were 16.5% less likely to have an anxiety disorder, 1 year later, than children whose parents were in the control group. This was a feasibility study, and while it showed that both the intervention and the research were feasible, the study needs replicating with a much larger sample. Many parents faced barriers to attending the workshop, and future efforts should focus on widening accessibility. We were unable to obtain sufficient self-report data from children, so the outcomes are based on parent report only.

Vicarious fear learning refers to the acquisition of fear via observation of the fearful responses of others. The present study aims to extend current knowledge by exploring whether second-order vicarious fear learning can be demonstrated in children. That is, whether vicariously learnt fear responses for one stimulus can be elicited in a second stimulus associated with that initial stimulus. Results demonstrated that children's (5-11 years) fear responses for marsupials and caterpillars increased when they were seen with fearful faces compared to no faces. Additionally, the results indicated a second-order effect in which fear-related learning occurred for other animals seen together with the fear-paired animal, even though the animals were never observed with fearful faces themselves. Overall, the findings indicate that for children in this age group vicariously learnt fear-related responses for one stimulus can subsequently be observed for a second stimulus without it being experienced in a fear-related vicarious learning event. These findings may help to explain why some individuals do not recall involvement of a traumatic learning episode in the development of their fear of a specific stimulus.

Despite a general perception that violent or scary television creates anxiety in children, the research literature is small and disparate. A meta-analysis quantifies the impact of scary television and film on children's internalizing emotions (fear, anxiety, sadness, and sleep problems). Scary television has a relatively small impact on children's internalizing emotions (r = .18) overall, and this association was not significantly moderated by whether the televised material was factual (e.g., news) or fictional or contained violence. Children under 10 were more susceptible to scary TV. The overall result contrasts with the dramatic effects found for individual children within studies, suggesting that research is needed to unpick the factors that moderate the effect that scary television has on children.

Fear and anxiety symptoms can be acquired through (1) a direct traumatic experience, (2) the transmission of verbal information, and (3) vicarious (observational) learning. All three pathways have gained empirical support, and all appear to conform to predictions made by theories of Pavlovian associative learning. Consequently, a number of integrated models of fear learning based on associative learning principles have been proposed. Field and Purkis’ (Anxiety disorders in children and adolescents: Research, assessment and intervention, 2011) model suggests that learning experiences evoke links between a neutral stimulus (CS) and threat-related US. Therefore, a single mechanism underlies all three fear learning pathways, and thus the pathways can have additive and multiplicative effects on the strength of the CS-US link. Crucially, the model acknowledges the role of individual differences in learning. This chapter will discuss the evidence demonstrating the influence of two temperamental constructs, behavioral inhibition (the tendency to react to a novel or unfamiliar situation with excessive apprehension and avoidance) and the behavioral inhibition system (a neurological system, which is linked to behavioral inhibition, that controls the experience of anxiety in response to anxiety-relevant cues). In particular, the chapter will explore the effect of behavioral inhibition and the behavioral inhibition system on both the strength of the CS-US link formed during a learning episode, as well as post-learning processes. Taken together, it is clear that behavioral inhibition interacts with the associative learning of fear to facilitate fear learning.

Objective: Maternal verbal threat information influences fear acquisition during childhood. This study investigates whether child attachment moderates the impact of maternal verbal threat information on children’s fear beliefs and behavioral avoidance.Design: Mothers of 60 children provided verbal threat information about one of two unfamiliar Australian animals. Change in children’s fear beliefs was measured with a questionnaire, and their behavioral avoidance was observed. Attachment anxiety and attachment avoidance were measured using children’s self-report.Results: The impact of verbal threat information on fear beliefs was not moderated by attachment. However, attachment anxiety enhanced the effect of maternal verbal threat information on child behavioral avoidance.Conclusion: These results provide insight into complex processes that explain the impact of parent-child relationships on child fear acquisition through maternal verbal threat information.

The current study examined Posttraumatic Growth (PTG) experienced by bereaved pet owners in the United States, French-Canada, Japan, and Hong Kong following the death of their pet. Using qualitative methodology, we analyzed responses of participants who answered "yes" to a question about experiencing PTG and explored to what extent the cross-cultural responses mapped onto the five factors of the Posttraumatic Growth Inventory (PTGI). For the U.S. sample, 58% of responses mapped onto the PTGI. For French-Canada, 72% of responses mapped onto the PTGI. For Japan, 50% of responses mapped onto the PTGI and for Hong Kong, 39% of responses mapped onto the PTGI. We also explored emergent categories related to PTG for individuals who have lost a pet and discerned the unique aspects for PTG across cultures.

Research with children has shown that vicarious learning can result in changes to 2 of Lang's (1968) 3 anxiety response systems: subjective report and behavioral avoidance. The current study extended this research by exploring the effect of vicarious learning on physiological responses (Lang's final response system) and attentional bias. The study used Askew and Field's (2007) vicarious learning procedure and demonstrated fear-related increases in children's cognitive, behavioral, and physiological responses. Cognitive and behavioral changes were retested 1 week and 1 month later, and remained elevated. In addition, a visual search task demonstrated that fear-related vicarious learning creates an attentional bias for novel animals, which is moderated by increases in fear beliefs during learning. The findings demonstrate that vicarious learning leads to lasting changes in all 3 of Lang's anxiety response systems and is sufficient to create attentional bias to threat in children.

This study examined quality of attachment to the mother and child-mother communication in adolescents' adjustment to the death of a father. Forty-eight Cambodian adolescents whose father had died within the previous 3 years completed a set of measures that included attachment, communication, grief, and self-esteem. Results showed that quality of attachment to the mother and whether the adolescent communicated with the mother about the father and found this to be helpful were positively related to adaptive grief and self-esteem. Moreover, support was shown for an indirect effect of quality of attachment to the mother on adaptive grief as mediated by communication. Implications of the findings for quality of attachment in adjustment to bereavement in a non-Western cultural context are discussed.

Several researchers have proposed a causal relation between biased attention to threat and the development and maintenance of anxiety disorders in both children and adults. However, despite the widely documented correlation between attention bias to threat and anxiety, developmental research in this domain is limited. In this review, we highlight the importance of taking a developmental approach to studying attention biases to threat and anxiety. First, we discuss how recent developmental work on attention to threat fits into existing theoretical frameworks for the development of anxiety and how attention biases might interact with other risk factors across development. Then we review the developmental literature on attention bias to threat and anxiety and describe how classic methodologies can be modified to study attention biases in even the youngest infants. Finally, we discuss limitations and future directions in this domain, emphasizing the need for future longitudinal research beginning in early infancy that tracks concurrent developments in both biased attention and anxiety. Altogether, we hope that by highlighting the importance of development in the study of attention bias to threat and anxiety, we can provide a road map for how researchers might implement developmental approaches to studying a potential core mechanism in anxiety.

Background: Previous meta-analyses of cognitive-behavioural therapy (CBT) for children and young people with anxiety disorders have not considered the efficacy of transdiagnostic CBT for the remission of childhood anxiety. Aim: To provide a meta-analysis on the efficacy of transdiagnostic CBT for children and young people with anxiety disorders. Methods: The analysis included randomized controlled trials using transdiagnostic CBT for children and young people formally diagnosed with an anxiety disorder. An electronic search was conducted using the following databases: ASSIA, Cochrane Controlled Trials Register, Current Controlled Trials, Medline, PsycArticles, PsychInfo, and Web of Knowledge. The search terms included “anxiety disorder(s)”, “anxi*”, “cognitive behavio*, “CBT”, “child*”, “children”, “paediatric”, “adolescent(s)”, “adolescence”, “youth” and “young pe*”. The studies identified from this search were screened against the inclusion and exclusion criteria, and 20 studies were identified as appropriate for inclusion in the current meta-analysis. Pre- and posttreatment (or control period) data were used for analysis. Results: Findings indicated significantly greater odds of anxiety remission from pre- to posttreatment for those engaged in the transdiagnostic CBT intervention compared with those in the control group, with children in the treatment condition 9.15 times more likely to recover from their anxiety diagnosis than children in the control group. Risk of bias was not correlated with study effect sizes. Conclusions: Transdiagnostic CBT seems effective in reducing symptoms of anxiety in children and young people. Further research is required to investigate the efficacy of CBT for children under the age of 6.

This study investigated type of continuing bonds (CB) expression and its comforting versus distressing nature in relation to psychosocial adjustment among bereaved mothers. Twenty-eight mothers whose child had died within the previous five years participated in a CB interview in which they rated the extent they used each of 11 different types of CB expression during the past month and the degree to which they experienced each of the CB expressions as comforting and distressing. CB expressions involving illusions and hallucinations of the deceased child were predictive of greater distress whereas those involving belief that the deceased child was aware of the mother or communicating with her through dreams were not associated with symptoms, but instead linked to greater spirituality. Furthermore, mothers who reported CB as more comforting than distressing had lower symptom ratings. The implications of the findings for the attachment theory perspective on unresolved loss are discussed.

The authors investigated the importance of dreams of the deceased in the experiencing of prolonged grief (PG) and posttraumatic stress disorder (PTSD) among Cambodian refugees who survived the Pol Pot genocide (1975-1979). Such dreams were frequent in the last month (52% of those surveyed), and most often involved a relative who died in the Pol Pot period. Past month frequency was correlated with PG severity (r = .59) and PTSD severity (r = .52). The dreams were almost always deeply upsetting because the dreams indicated the deceased to be in a difficult spiritual state. Dreams of the deceased as a central component of PG and PTSD among Cambodian refugees is discussed.

We report a meta- and primary data-analysis investigating the efficacy of cognitive therapy (CT) for pathological worry in adults with GAD that includes an analysis of primary data not reported in previous meta-analyses. Eligible studies included those whose participants met the criteria for a diagnosis of GAD and those that used the PSWQ as an outcome measure. All eligible studies used a randomized controlled design. Analyses included a random-effects meta-analysis of between-study effect sizes and hierarchical linear models of both within study change over time and primary recovery data. The results show that CT was effective in reducing pathological worry when compared with non-therapy controls (d=1.81), and gains were largely maintained at follow-up. The magnitude of effects reported was larger than previously found, suggesting an increased efficacy of newer forms of CT. However, we found weaker evidence to suggest that CT for pathological worry was superior to non-CT treatment controls (d=0.63). Analysis of primary recovery data revealed that 57% of participants were classed as recovered at 12 months following CT, and CT had significantly better recovery rates than all other comparison treatments at post-treatment and 12-month follow-up. These findings support the increasing efficacy of CT as a treatment for GAD. However, CT interventions still need further refinement to help a greater proportion of sufferers achieve recovery.

The present study examined the effects of attachment style and continuing bonds, defined as the extent to which a bereaved individual feels that the deceased remains a part of his/her life, on postbereavement adjustment among 71 conjugally bereaved individuals. It was shown that bereaved individuals with an anxious attachment style tended to show more externalized continuing bonds as well as more grief symptoms. An anxious attachment style played a direct and significant role in postbereavement adjustment over and above the contribution of externalized continuing bonds. Interventions to facilitate restoration tasks and to reduce externalized continuing bonds would be discussed.

Cognitive models of vulnerability to anxiety propose that information processing biases such as interpretation bias play a part in the etiology and maintenance of anxiety disorders. However, at present little is known about the role of memory in information processing accounts of child anxiety. The current study investigates the relationships between interpretation biases, memory and fear responses when learning about new stimuli. Children (aged 8-11 years) were presented with ambiguous information regarding a novel animal, and their fear, interpretation bias, and memory for the information was measured. The main findings were: (1) trait anxiety and interpretation bias significantly predicted acquired fear; (2) interpretation bias did not significantly mediate the relationship between trait anxiety and acquired fear; (3) interpretation bias appeared to be a more important predictor of acquired fear than trait anxiety per se; and (4) the relationship between interpretation bias and acquired fear was not mediated by the number of negative memories but was mediated by the number of positive and false-positive memories. The findings suggest that information processing models of child anxiety need to explain the role of positive memory in the formation of fear responses. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Two experiments are described that explore the effects of verbal information and direct conditioning in the acquisition and extinction of fear responses. Participants were given verbal threat information about novel animals before conditioning trials in which the animals were presented alongside an aversive outcome (Experiment 1), or positive information about the animals before extinction trials (Experiment 2). Fear was measured using self-reported fear beliefs, expectancy of the unconditioned stimulus (US) and event-related brain potential (ERP). The results showed a direct effect of verbal information on acquisition (Experiment 1) and extinction (Experiment 2). There was a P2 peak latency shift at acquisition (Experiment 1) and P1 mean amplitude response at extinction (Experiment 2) based on the interaction between verbal information and US-contingency. However, the P2 response showed little evidence for an enhanced conditioned response (CR) when verbal threat information and direct conditioning combined: earlier P2 responses were found for all animals that had been associated with either threat information or the aversive US. Additionally, increase in P1 mean amplitude response (Experiment 2) seemed to stem from the conflict between verbal information and contingency information, rather than the predicted decrease in response where positive information and extinction training were combined. Future studies are suggested that might explore whether attention/arousal modulate the P1 response as a result of such expectation violations.

Cognitive bias modification (CBM) procedures follow from the view that interpretive biases play an important role in the development and maintenance of anxiety. As such, understanding the link between interpretive biases and anxiety in youth at risk for anxiety (e.g., behaviorally inhibited children) could elucidate the mechanisms involved in the development of pediatric anxiety. However, to date, the majority of CBM-I work only studies adult populations. The present article presents the results of a CBM study examining effects of positive interpretive bias modification on mood, stress vulnerability, and threat-related attention bias in a group of behaviorally inhibited children (n = 45). Despite successful modification of interpretive bias in the at-risk youth, minimal effects on stress vulnerability or threat-related attention bias were found. The current findings highlight the need for continued research on cognitive biases in anxiety.

Background Prader-Willi syndrome (PWS), a complex multisystem genetic disorder, is characterised by developmental abnormalities leading to somatic and psychological symptoms. Symptoms of PWS include infantile hypotonia and failure-to-thrive, followed by life-long hyperphagia, developmental delays and moderate-to-severe behavioural problems and several physical problems that impact health. This study examined the effects of caring for a child diagnosed with PWS on the mothers and unaffected siblings. We assessed overall family functioning, the mothers' psychological health, the psychosocial and behavioural functioning of siblings, and the quality of life of siblings. Methods Participants included 12 mothers and 13 siblings of a child with genetically confirmed PWS. Self-report measures administered to the mothers evaluated overall family functioning (PedsQL - Family Impact Module), the mothers' psychological health (Brief Symptom Inventory), and the mothers' perception of the sibling's quality of life (PedsQL - Parent Proxy). Self-report measures administered to the siblings evaluated their perceived quality of life (PedsQL) and symptoms of post-traumatic stress disorder (PTSD) (UCLA PTSD Index). Results Families/mothers/siblings with children with PWS showed poorer perceived quality of life compared with general inpatient and outpatient samples of children with complex health conditions. Families/mothers/siblings with children with PWS reported difficulties in family functioning, communication problems, and an increased number of conflicts. They appeared to be experiencing significant behavioural distress symptoms, with higher than average levels of depression and feelings of isolation, anger and worry. Ninety-two per cent of the siblings indicated moderate-to-severe symptoms of PTSD. Compared with normative populations, siblings demonstrated poorer quality of life, with mothers perceiving more significant deficits in the sibling. Conclusion This study reaffirms that PWS affects the entire family system. Mothers and siblings would benefit from psychosocial support due to the multiple challenges of living with and caring for a child/young adult with PWS.