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Positive shyness is thought to be an approach-dominant form of shyness, whereas non-positive shyness is thought to be an avoidance-dominant form of shyness. This study examined electrocortical and behavioral correlates of motivation and emotion in relation to these shy subtypes in 67 children (Mage = 10.41 years, SD = 3.23). Using resting state electroencephalography, findings revealed that positive shy and low shy children had greater relative left frontal alpha asymmetry compared to non-positive shy children, and positive shy children had a higher frontal delta-beta correlation compared to other groups. Non-positive shy children scored highest on parent-reported school avoidance. These findings converge with previous work reporting distinct correlates in positive and non-positive shyness, extending this to two brain measures of motivation and emotion.

There is considerable variability regarding the convergence between behavioral and biological aspects of distress responses in toddlerhood, and little research has investigated the convergence of these measures in high distress. The aim of the current study was to describe patterns of distress responses to vaccinations as indexed by both pain-related behavioral distress and heart rate (HR) at 12 and 18 months. Caregiver-toddler dyads were part of an ongoing longitudinal cohort observed during 12- (N = 158) and 18-month (N = 122) well-baby vaccinations. Parallel-process growth mixture models discerned two distinct groups at 12 months and three distinct groups at 18 months. All groups had comparable pain-related behavioral distress and HR responses post-vaccination, with most participants displaying high arousal and regulation to baseline levels following the vaccination. However, at 18 months, an important minority had a blunted response or did not regulate to a low level of distress by 3 min post-needle. Post hoc analyses revealed that higher baseline pain-related behavioral distress predicted membership in the majority groups at 12 and 18 months. These results highlight the developmental differences and variability in behavioral and cardiac indicators of distress regulation across the second year of life.

Background Despite ample clinical evidence that gaining excess weight in pregnancy results in negative health outcomes for women and infants, more than half of women in Western industrialized nations gain in excess of national guidelines. The influence of socio-demographic factors and weight gain is well-established but not causal; the influence of psychological factors may explain some of this variation. Methods This is the qualitative portion of an explanatory sequential mixed-methods study designed to identify predictive psychological factors of excess gestational weight gain (QUAN) and then explain the relevance of those factors (qual). For this portion of the study, we used a qualitative descriptive approach to elicit 39 pregnant women’s perspectives of gestational weight gain, specifically inquiring about factors determined as relevant to excess gestational weight gain by our previous predictive study. Women were interviewed in the latter half of their third trimester. Data were analyzed using a combination of unconstrained deductive content analysis to describe the findings relevant to the predictive factors and a staged inductive content analytic approach to examine the data without a focus on the predictive factors. Results Very few participants consistently made deliberate choices relevant to weight gain; most behaviour relevant to weight gain happened with in-the-moment decisions. These in-the-moment decisions were influenced by priorities, hunger, a consideration of the consequence of the decision, and accommodation of pregnancy-related discomfort. They were informed by the foundational information a woman had available to her, including previous experience and interactions with health care providers. The foundational information women used to make these decisions was often incomplete. While women were aware of the guidelines related to gestational weight gain, they consistently mis-applied them due to incorrect understanding of their own BMI. Only one woman was aware that weight gain was linked to maternal and infant health outcomes. Conclusions There is an important role for prenatal providers to provide the foundational information to positively influence in-the-moment decisions. Understanding how weight gain guidelines apply to one’s own pre-pregnancy BMI and comprehending the well-established link between gestational weight gain and health outcomes may help women prioritize healthy weight gain amongst many competing factors.

Objective To develop and validate a prediction model for excess pregnancy weight gain using early pregnancy factors. Design Prospective cohort study Setting We recruited from 12 obstetrical, family medicine, and midwifery centers in Ontario, Canada Participants We recruited English-speaking women with singleton pregnancies between 8+0–20+6 weeks. Of 1296 women approached, 1050 were recruited (81%). Of those, 970 women had complete data (970/1050, 92%) and were recruited at a mean of 14.8 weeks. Primary outcome measure We collected data on psychological, physical, and social factors and used stepwise logistic regression analysis to develop a multivariable model predicting our primary outcome of excess pregnancy weight gain, with random selection of 2/3 of women for training data and 1/3 for testing data. Results Nine variables were included in the final model to predict excess pregnancy weight gain. These included nulliparity, being overweight, planning excessive gain, eating in front of a screen, low self-efficacy regarding pregnancy weight gain, thinking family or friends believe pregnant women should eat twice as much as before pregnancy, being agreeable, and having emotion control difficulties. Training and testing data yielded areas under the receiver operating characteristic curve of 0.76 (95% confidence interval, 0.72 to 0.80) and 0.62 (95% confidence interval 0.56 to 0.68), respectively. Conclusions In this first validated prediction model in early pregnancy, we found that nine psychological, physical, and social factors moderately predicted excess pregnancy weight gain in the final model. This research highlights the importance of several predictors, including relatively easily modifiable ones such as appropriate weight gain plans and mindfulness during eating, and lays an important methodological foundation for other future prediction models.

This study examined the link between two biological markers of stress vulnerability at 22–26 years of age and telomere length at 30–35 among extremely low birth weight (ELBW; 2500 g) control participants. Sixteen ELBW and 22 NBW participants provided baseline afternoon salivary cortisol samples and resting frontal electroencephalogram (EEG) alpha asymmetry data at 22–26 years. Buccal cells were assayed for telomere length at 30–35 years. Analyses controlled for sex, postnatal steroid exposure, childhood socioeconomic status, time of cortisol sample collection, and body mass index at 22–26 years. Salivary cortisol and frontal asymmetry at age 22–26 independently predicted telomere length at age 30–35, such that relatively higher cortisol and greater relative right frontal asymmetry at rest predicted telomere shortening among NBW controls, but not among ELBW survivors. However, similar associations were not noted in ELBW survivors, suggesting that ELBW survivors may have different mechanisms of stress coping as a result of their early-life exposures. These findings offer preliminary evidence in support of the role of stress in the genesis of cellular senescence at least among those born at NBW, but that these links may differ in those born preterm.

Selective mutism (SM) is an anxiety disorder in which a child fails to speak in some situations (e.g., school) despite the ability to speak in other situations (e.g., home). Some work has conceptualized SM as a variant of social anxiety disorder (SAD) characterized by higher levels of social anxiety. Here, we empirically tested this hypothesis to see whether there were differences in social anxiety (SA) between SM and SAD across behavioral, psychophysiological, self-, parent-, and teacher-report measures. Participants included 158 children (M

Very preterm survivors born in the early neonatal intensive care era are now in their middle adulthood. The literature from cohort studies and population-linked registries indicate that extreme prematurity is associated with lower educational attainment and income, higher need for social assistance, and lower rates of marriage/partnership and reproduction. In addition, with increasing age, many general and system-specific adverse health outcomes, such as psychiatric problems, hypertension, and cardio-metabolic disorders have emerged, resulting in high cumulative health care costs across the life-span. Yet, a significant majority of adults born preterm are leading productive lives and contributing to society. Although this information may not be directly applicable to survivors of modern neonatal intensive care, there is much to learn from these findings to inform and guide us into designing effective strategies to improve the health and well-being of future very premature infants. The longer-term outcome of more recent survivors remains to be determined.

The aim of this study was to examine the concurrent and predictive relations between healthy toddlers' pain behavior and cardiac indicators (ie, heart rate [HR] and respiratory sinus arrhythmia [RSA]) during routine vaccinations. Caregiver-infant dyads were part of a longitudinal cohort observed during their 12- and 18-month vaccinations. Behavioral and cardiac data were simultaneously collected for 1-minute preneedle and 3-minutes postneedle. Videotapes were coded for pain behaviors (FLACC; Merkel et al., 1997), and cardiac data were analyzed (HR, RSA) during sequential 30-second epochs. Four separate cross-lagged path models were estimated using data from the 12- (n = 147) and 18-month (n = 122) vaccinations. Across 12- and 18-month vaccinations, predictive within-measure relations were consistent for FLACC, HR, and RSA, reflecting good stability of these pain indicators. Behavioral indicators predicted subsequent HR and RSA within the immediate postneedle period. Both baseline behavior and HR/RSA predicted future pain scores. Concurrent residual relations between behavioral and cardiac indicators were inconsistent across time and indicators. Results suggest that behavioral and cardiac indicators reflect unique aspects of the nociceptive response. As such, multimodal assessment tools should be used and contextualized by child age, cardiac indicator, baseline behavior/physiology, and pain phase.

Shyness can manifest as inhibition, fear, and avoidance in the context of social novelty and situations of perceived social evaluation. In the present study, 130 children (Mage = 7.6 years, SD = 1.8) participated in a videotaped self-presentation task across three separate visits spanning approximately 3 years in early and middle childhood. Children’s observed shyness was best characterized by two trajectories, including a high-stable class (19%) and a low-stable class (81%). Girls were more likely than boys to follow a pattern of high-stable observed shyness. Further, children in the high-stable observed shyness class were rated by parents and teachers as more socially anxious relative to children in the low-stable class, and boys in the high-stable observed shyness class were rated by their teachers as displaying more depressive symptoms relative to girls. These findings suggest that a subset of children display stable behavioral shyness, and this is correlated with psychosocial functioning.

The contemporary study of phenomena in the psychological sciences can be usually traced to a rich historical past. The study of behavioral inhibition and temperamental shyness is no exception. In this chapter, we review the study of behavioral inhibition and temperamental shyness as viewed across four academic generations (Generation I, Jerome Kagan; Generation II, Nathan Fox; Generation III, Louis Schmidt; Generation IV, Kristie Poole), spanning over seven decades and representing multiple student-mentor relationships. We suggest that the transactional nature of student-mentor relationships is one key mechanism through which the establishment and transmission of knowledge anchors us to the past, informs contemporary inquiry, and spawns new directions for future research and academic generations.

One common perception is that shyness is an inherently problematic trait that lays the developmental foundation of psychosocial maladjustment. However, not all shy individuals are alike, nor are all shy individuals at risk for poor developmental outcomes. In the current chapter, we discuss heterogeneous subtypes of shyness. We place a particular emphasis on the adaptive subtype of positive shyness, which is characterized by the expression of shy behavior (e.g., gaze aversion, avoidance) in conjunction with positive affect (e.g., smiling). We review theoretical and empirical evidence suggesting that positive shyness may be an adaptive phenotype that helps the shy individual modulate arousal in social situations and helps to facilitate social approach through signaling of social interest, interpersonal trust, and appeasement, which ultimately may protect the shy individual from psychosocial maladjustment. We then propose a hypothetical model to describe the development and maintenance of adaptive and nonadaptive subtypes of shyness. We conclude with suggestions for future research that may help to further our understanding of different shyness subtypes and how they may relate to adaptive and nonadaptive outcomes across development.

Contrary to popular belief, the personality traits of shyness and sociability are not merely opposite ends of the same dimension. Over three decades ago, Cheek and Buss (Shyness and sociability. Journal of Personality and Social Psychology, 41, 330–339, 1981) noted that shyness and sociability were conceptually and empirically independent traits. Since then, a number of studies have replicated their initial findings and shown that shyness and sociability are indeed independent personality traits, each with distinct correlates across development. In this chapter, we provide an overview of the conceptual model proposed by Cheek and Buss (1981) and illustrate how shyness and sociability act as a heuristic for assessing avoidance and approach motivation, respectively. Given the relative independence of shyness and sociability, we can examine their interaction to yield four distinct social profiles: sociable (low shyness, high sociability), unsociable (low shyness, low sociability), avoidant shy (high shyness, low sociability), and conflicted shy (high shyness, high sociability). We then review empirical work since the original model proposed by Cheek and Buss that has illustrated distinct behavioral, physiological, and cognitive correlates of these resulting subtypes, as well as the developmental trajectories of shyness and sociability and comment on some of the benefits of shyness and costs of sociability. Considering shyness and sociability as independent traits may further our understanding of the different reasons for multiple types of social withdrawal observed across the lifespan and the adaptive and maladaptive outcomes associated with each trait.

Objective Although individual differences in personality are known to influence quality of life in individuals with schizophrenia, relatively few studies have attempted to identify putative links underlying this relation. Methods Here, we examined associations among temperamental shyness, hormones (ie baseline salivary cortisol and testosterone), and quality of life (QoL) measured in 42 stable outpatient adults with schizophrenia. Results We found that baseline cortisol, but not testosterone, moderated the relation between shyness and QoL (s = 1.09, p = 0.004). Among individuals with relatively low baseline cortisol, higher shyness was associated with lower Intrapsychic Foundations QoL. Individuals with relatively higher baseline cortisol reported similar QoL scores irrespective of level of shyness. Conclusion These preliminary results suggest that relatively lower baseline cortisol may be helpful to understanding the relation between temperament and Intrapsychic Foundations QoL in schizophrenia. The present findings are consistent with previous studies implicating relatively lower baseline cortisol levels in nonclinical samples of people who are shy and the negative downstream effects resulting from HPA axis dysregulation, and extends these prior findings to people with schizophrenia who are also shy.

Extremely low birth weight (ELBW;1000 g) survivors are exposed to significant perinatal adversity. In many cases, mothers of these infants receive antenatal corticosteroids (ACS), which reduce offspring neonatal mortality but may have lasting neuropsychiatric effects. However, the long-term neurophysiological effects of being born at ELBW and exposed to ACS are unknown.We compared resting frontal electroencephalogram (EEG) alpha asymmetry in ELBW survivors (n = 51), some of whom were exposed to antenatal corticosteroids (ELBW-S; n = 23) versus non-exposed (ELBW-NS; n = 28), and normal birth weight controls (NBW; n = 66) in adulthood (mELBW survivors exhibited greater relative right frontal EEG alpha (11.5 to 13.5 Hz) asymmetry at rest relative to NBW controls. A linear relation was observed between increased exposure to perinatal adversity (NBW vs. ELBW-NS vs. ELBW-S) and greater relative right frontal asymmetry. Relative right frontal asymmetry was also linked to contemporaneous psychopathology in all individuals.In the fourth decade of life, exposure to perinatal adversity was associated with patterns of frontal brain activity that reflect risk for psychopathology. Exposure to additional physiological stresses such as antenatal corticosteroids may amplify these effects.The mental health of ELBW survivors, particularly those exposed to antenatal corticosteroids, should be monitored into adulthood.

OBJECTIVE To systematically review and meta-analyze studies assessing the effectiveness of audiovisual (AV) interventions aimed at reducing anxiety in parents whose children are undergoing elective surgery. METHODS A comprehensive search of multiple electronic databases was performed. A narrative synthesis of findings and random-effects meta-analyses were used to summarize the results. Our primary outcome was parental anxiety. Secondary outcomes included children's preoperative anxiety and postoperative outcomes; parental satisfaction, knowledge, and need for anesthesia information. Risk of bias was appraised within and across studies. RESULTS Our search yielded 723 studies and 11 were included. A Standardized Mean Difference (SMD) of -0.53 (95% CI [-0.91, -0.15], p < .01) was found between parental anxiety scores in AV interventions and control groups. In terms of children's preoperative anxiety, there was a SMD of -0.59 (95% CI [-1.11, -0.07], p < .05) between children's anxiety scores in AV intervention and nonintervention participants. Furthermore, AV interventions were shown to shorten the recovery time for children undergoing surgery (SMD = -0.21; 95% CI [-0.39, -0.02], p = .03) but did not lead to improvements on other postoperative outcomes. CONCLUSIONS These findings suggest that AV interventions have modest, positive effects on both parental and children's preoperative anxiety. Although a statistically significant medium size effect was detected, the clinical significance of this finding requires further exploration. Further research aimed at developing better AV interventions to help guide future practice is warranted. (PsycINFO Database Record

Despite the burgeoning use of respiratory sinus arrhythmia (RSA), heart period (HP), and blood pressure (BP) to study individual differences in autonomic regulatory processes in young adults, few studies have examined the short-term reliability of such autonomic measures in emerging adulthood. If resting autonomic measures indeed reflect “trait-like” individual differences, they should have acceptable levels of test-retest reliability. We examined the 1-month test-retest reliability of resting measures of RSA as well as HP, systolic (SBP) and diastolic blood pressure (DBP) in a sample of 41 healthy young adults. Test-retest reliability of all four measures was good-to-excellent across the 1-month period. However, uncontrolled mean RSA declined from Time 1 to Time 2, suggesting that while individual differences in RSA were stable, mean RSA appeared to be sensitive to condition effects. Even with random variation, all of these measures were stable across one month, demonstrating acceptable short-term test-retest reliability in emerging adulthood.

Although inhibitory control (IC) is associated with children's positive adjustment, we know relatively little about factors underlying its development. We examined whether baseline and on-task respiratory sinus arrhythmia [(RSA); a physiological measure of self-regulation] and private speech (a behavioral measure of self-regulation) interacted to confer differences on directly observed IC in 52 typically developing 4-year olds. We found that baseline RSA moderated the association between private speech and IC, such that private speech positively predicted IC in children with relatively higher baseline RSA, but was unrelated to IC in children with relatively lower RSA. We also found that children with a concordant physiological-behavioral pattern (i.e., high RSA and high private speech; low RSA and low private speech) had higher IC, higher effortful control, and lower negative emotionality than those with a discordant physiological-behavioral pattern (i.e., high RSA and low private speech; low RSA and high private speech). Individual differences in physiological and behavioral self-regulation indices may represent distinct regulation pathways that interact to confer differences in IC during the preschool years.

Although shyness is a ubiquitous phenomenon and long viewed as a maladaptive characteristic, we know relatively little about the possible brain mechanism(s) underlying and maintaining shyness. Using a prospective longitudinal study, we examined frontal brain maturation in shy children. We collected measures of resting regional EEG spectral power approximately every six months for two years in young school-age children and characterized frontal brain maturation using a growth curve analysis of proportion of spectral power in relative faster-to-slower EEG frequencies. We found that children classified as low in shyness exhibited a significant linear growth in the proportion of overall frontal alpha power relative to delta power across assessments relative to children classified as high in shyness. High shy children displayed no growth in the proportion of overall frontal alpha power relative to delta power across assessments. These preliminary results indicate that high shy children exhibited delayed frontal brain maturation compared to low shy children. We interpret these findings within the context of a proximate explanation, suggesting links between delayed frontal maturation and emotion dysregulatory processes related to an approach-avoidance conflict. We also speculate on an ultimate explanation in which delayed frontal brain maturation may reflect neoteny (i.e., the prolongation and extension of childhood), which may have supported an adaptive function of shyness across human evolution.

Although emotion regulatory processes and affective experiences have been explored among extremely low birth weight (ELBW

Child maltreatment is linked to distinct neurophysiological patterns and social-emotional vulnerability. Relations among maltreatment, relative resting frontal alpha asymmetry, shyness, and psychopathology were examined prospectively. Adolescent girls (age 14-16) who experienced child maltreatment (N = 55) were compared to nonmaltreated controls (N = 25), and returned for 6- and 12-month follow-ups. Among participants exhibiting relative right frontal asymmetry, maltreated adolescents reported higher shyness than controls at Time 1. Low-stable and high-stable shyness trajectories were observed for maltreated participants. Compared to low shy, participants in high-shy trajectory reported at Time 3: higher neuroticism and generalized anxiety; and lower extraversion if they also exhibited relative right frontal asymmetry. Thus, right frontal brain activity and shyness are involved in social-emotional vulnerability of adolescents who experienced child maltreatment. [ABSTRACT FROM AUTHOR]

We propose three practical suggestions that might be used in tandem to help address enduring replication challenges: (1) a methodology checklist to increase awareness of potentially overlooked variables and scaffold the design of replication attempts, (2) a means of facilitating visual side-by-side comparisons of reference and replication methodologies to increase replication fidelity, and (3) a broader methodology fidelity rating system to capture the nuance associated with direct replication. Incorporating these suggestions into replication efforts could facilitate improved coordination of multi-site replication attempts and offer a standardized means of assessing methodological fidelity for replication submissions and data review.

Although shyness has been found to be a concurrent constraint on young children’s empathy and instrumental helping, there is limited evidence to suggest that this temperamental profile has longitudinal effects on prosocial behaviors. Here, we examined the concurrent and longitudinal relations between children’s shyness and prosocial behaviors, as well as the intervening impact of instrumental helping behavior on later empathic response in typically developing children (N = 86; 45 female). Shyness was coded from direct observations and reported by parents at Time 1 (Mage = 54.3 months, SD = 2.9), Time 2 (Mage = 66.5 months, SD = 2.8), and Time 3 (Mage = 77.9 months, SD = 2.8), helping behavior was assessed at Time 2, and data on cognitive and affective empathy were collected at Time 3. Increases in shyness resulted in longitudinal reductions of affective empathy but not cognitive empathy or instrumental helping. As well, Time 2 helping behavior mediated the relation between Time 1 shyness and Time 3 affective empathy and, to some extent, the relation between Time 2 shyness and Time 3 affective empathy. These findings suggest that shyness concurrently impedes early helping behaviors, and that this withdrawal may contribute to reductions in shy children's prosocial learning opportunities that inform later empathic responses.

Although excessive avoidance has been implicated in mental health problems and socioemotional difficulties, relatively little is known about dynamic changes of avoidance behaviors. We used a latent class growth analysis to examine the temporal course of avoidance behaviors in real time and determined whether the derived classes were distinguishable on temperament and physiological markers of regulation and reactivity (N = 153; Mage = 4.20 years). A three-class solution was found and identified a low, medium, and high increasing avoidance group. The high and increasing avoidance group had the highest physiological reactivity (cortisol reactivity) and shyness, and the lowest physiological regulation (i.e., respiratory sinus arrythmia suppression). High and increasing avoidance may therefore be associated with temperamental and physiological indices of risk implicated in maladjustment and highlight the value of data-driven, group-based approaches for examining dynamic patterns of behavior.

The present study examined the moderating role of extraversion in explaining the relation between shyness and anxiety in a non-clinical early adolescent sample (N = 119, nfemale = 75; Mage = 12.93 years, SDage = 2.23 years) and a clinical adult sample from an outpatient anxiety disorders clinic (N = 100, nfemale = 77; Mage = 34.97 years, SDage = 12.66 years). We found evidence for the protective role of relatively high levels of extraversion in both samples, such that shyness was positively associated with anxiety in the context of relatively low levels of extraversion. Our results provide support for the protective role of extraversion in the presence of high levels of shyness.

Few studies have examined the interactive effect of intra- and extra-individual vulnerability factors on the trajectory of social anxiety in children. In this study, we examined the joint influence of familial vulnerability (i.e., parental social anxiety) and child biological stress vulnerability (i.e., cortisol reactivity) on trajectories of social anxiety. Children (N = 112 (57 males), M age = 8.14 years, S.D. = 2.25) were followed over three visits spanning approximately three years. Parental social anxiety was assessed using the Social Phobia and Anxiety Inventory, children’s behavior and salivary cortisol reactivity were measured in response to a speech task, and children’s social anxiety was assessed at all three visits using the Screen for Child Related Emotional Disorders (SCARED; Parent-report). A growth curve analysis was used to examine trajectories of child social anxiety as predicted by children’s cortisol reactivity and parental social anxiety, adjusting for covariates. We found a significant interaction between parental social anxiety and child cortisol reactivity in predicting child social anxiety across time. Having a socially anxious parent coupled with heightened cortisol reactivity predicted the highest levels of child social anxiety, with scores that remained above clinically significant levels for social anxiety across all visits. Children with familial risk for social anxiety and who also exhibit high stress-reactivity appear to be at risk for persistent, clinically significant social anxiety. This highlights the importance of considering the interaction between both biological and contextual factors when considering the development, maintenance, and treatment of social anxiety in children across time.

Perinatal and later postnatal adversities have been shown to adversely affect socioeconomic trajectories, while enhanced early cognitive abilities improve them. However, little is known about the combined influence of these exposures on social mobility. In this study, we examined if childhood IQ moderated the association between four different types of postnatal adversity (childhood socioeconomic disadvantage, childhood sexual abuse, lifetime psychiatric disorder, and trait neuroticism) and annual earnings at 30–35 years of age in a sample of 88 extremely low birth weight survivors. Our results suggested that higher childhood IQ was associated with greater personal income at age 30–35. Extremely low birth weight survivors who did not face psychological adversities and who had higher childhood IQ reported higher income in adulthood. However, those who faced psychological adversity and had higher childhood IQ generally reported lower income in adulthood. Our findings suggest that cognitive reserve may not protect preterm survivors against the complex web of risk factors affecting their later socioeconomic attainment.

Resting frontal electroencephalogram (EEG) alpha asymmetry patterns reflecting different affective and motivational tendencies have been proposed as a putative mechanism underlying resilience among maltreated youth. This 2-year prospective study examined whether developmental stability of resting frontal alpha asymmetry moderated the relation between child maltreatment severity and psychopathology in female adolescents (n = 43; ages 12-16) recruited from child protection agencies. Results identified two trajectories of resting frontal asymmetry: 60.5% displayed stable right and 39.5% displayed stable left frontal alpha asymmetry. Although individuals with these alpha asymmetry profiles experienced comparable childhood trauma severity, adolescents with stable left alpha asymmetry and lower levels of trauma were less likely to present symptoms or an episode of posttraumatic stress disorder (PTSD) and depression over 2 years than those with stable right alpha asymmetry and lower levels of trauma. These findings suggest that developmental patterns of resting left frontal brain activity may buffer against psychopathology in maltreated female youth.

Fifty-seven percent of children with poor language skills are affected by socio-emotional problems. Despite the importance of language skills to interpersonal functioning and school performance, relatively little is known about how they affect self-esteem in adolescence. Data on youth at high risk for language problems (e.g. those born extremely low birth weight (ELBW; 2500 grams) ( N = 111). Participants’ language skills were assessed using the Verbal Scale of the Wechsler Intelligence Scale for Children-Revised and the Token Test at age 8. In adolescence, participants completed the Harter Self-Perception Profile for Adolescents. Birth weight status was found to moderate associations between childhood language and adolescent global self-esteem (Token Test ( p = .006), Verbal Intelligence Quotient ( p = .033)) such that better language skills were associated with higher self-esteem in adolescent ELBW survivors, but not in NBW participants. Language skills may play a protective role in the development and maintenance of self-esteem in ELBW youth and could be an important target for optimizing their functioning, particularly before transitioning to the critical adolescent period.

Background Preterm birth is associated with an increased risk of depression and anxiety, but it is not known if this is due to greater exposure to risk, or if perinatal adversity amplifies the impact of traditional risk factors. This study sought to determine if exposure to perinatal adversity modifies associations between traditional risk and resilience factors and depression and anxiety in adulthood. Methods A sample of 142 extremely low-birth-weight (ELBW

Background Early life experiences may alter personality outcomes across the lifespan. Extremely low birth weight (ELBW) survivors appear to have a particular personality ‘type’ marked by increased levels of cautiousness and social conformity. It is, however, unclear if the experience of child sexual abuse (CSA) can alter this outcome. Methods We utilized data from a prospective, longitudinal, birth cohort of ELBW survivors to examine the personality characteristics in the third and fourth decades of life of those exposed to CSA versus those who were not. Results At age 22–26 years, ELBW survivors who had experienced CSA were less likely to display social conformity (p Conclusions ELBW survivors who have experienced CSA appear less likely to socially conform, are less cautious, and may experience higher levels of neuroticism in their 20s and 30s than those who were not exposed. These findings support the possibility that significant childhood experiences may lead to stable alterations in personality through the fourth decade of life.

Background Extremely low birth weight (ELBW

Objective:The current study examined the impact of an activity-based mindfulness treatment on EEG indices of attention in youth with ADHD aged 11 to 17 years compared with a waitlist control group. Method: Pre- and post-treatment, EEG was recorded as participants completed a single-point focus rest task and two active attention tasks. Theta power, beta power, and theta/beta ratio (TBR) were calculated during each task. Results: A significant group by time by task interaction was found that indicated significant improvement in attentional ability, indexed by decreased TBR, for the treatment group but not controls. Conclusion: Findings support the benefit of mindfulness treatment for enhancing attentional control in youth with ADHD and extend the literature by providing evidence of these gains at a neural level. Findings also offer methodological support for the use of active attention tasks when examining mindfulness-related attentional gains in youth with ADHD. Directions for future research are discussed.

Shyness has been linked to several distinct behavioral antecedents and biological correlates across development, including early behavioral inhibition and neuroendocrine dysregulation. In the present study, we examined whether self-reported history of childhood behavioral inhibition, concurrent cortisol output, and sex affected shyness levels in adults. Results revealed that a history of childhood social behavioral inhibition predicted higher shyness among female adults with high levels of cortisol output. Among women with low cortisol levels, there was no relation between childhood social behavioral inhibition and shyness levels. These associations were not consistent when examining a history of non social behavioral inhibition, or among adult males. These findings highlight the importance of differentiating social versus nonsocial behavioral inhibition when examining relations between childhood temperament and adult shyness. Further, these findings raise the possibility that neuroendocrine dysregulation may have a unique role in predicting and maintaining social behaviors such as shyness depending on sex and individual differences in temperament.

Objectives To examine the feasibility, acceptability, and effects of a novel tablet-based application, Story-Telling Medicine (STM), in reducing children's preoperative anxiety. Methods Children (N = 100) aged 7 to 13 years who were undergoing outpatient surgery were recruited from a local children's hospital. This study comprised 3 waves: Waves 1 (n = 30) and 2 (n = 30) examined feasibility, and Wave 3 (n = 40) examined the acceptability of STM and compared its effect on preoperative anxiety to Usual Care (UC). In Wave 3, children were randomly allocated to receive STM+UC or UC. A change in preoperative anxiety was measured using the Children's Perioperative Multidimensional Anxiety Scale (CPMAS) 7 to 14 days before surgery (T1), on the day of surgery (T2), and 1 month postoperatively (T3). Results Wave 1 demonstrated the feasibility of participant recruitment and data collection procedures but identified challenges with attrition at T2 and T3. Wave 2 piloted a modified protocol that addressed attrition and increased the feasibility of follow-up. In Wave 3, children in the STM+UC demonstrated greater reductions in CPMAS compared with the UC group (ΔM = 119.90, SE = 46.36, t(27) = 2.59, p = .015; 95% confidence interval = 24.78-215.02). Conclusion This pilot study provides preliminary evidence that STM is a feasible and acceptable intervention for reducing children's preoperative anxiety in a busy pediatric operative setting and supports the investigation of a full-scale randomized controlled trial.

We explored the relation between shyness and social anxiety disorder (SAD) by investigating the role of sociability in this association. Using a multicomponent approach, we found that sociability moderated the association between shyness and SAD in adults, such that individuals who experience conflicted shyness (i.e., scoring high on shyness and sociability) displayed the greatest disturbance across cognitive, behavioral, and somatic components of SAD. Our findings lend support to the notion that shyness is a broad, heterogeneous construct, and that not all highly shy individuals meet diagnostic criteria for SAD. Adults with a conflicted shyness phenotype represent a subgroup of shy individuals who may be at particular risk for SAD symptoms. This finding provides empirical support that an approach–avoidance conflict may be a motivational underpinning in the development of SAD.

Emerging evidence suggests that conflicted shyness (combination of shyness and sociability) places individuals at risk for maladjustment in childhood, adolescence, and emerging adulthood. However, it is not known (1) if this risk for maladjustment persists into adulthood, (2) the extent to which it is generalizable to a broad range of adaptive domains, and (3) if there are mechanisms that might underlie the link between the conflicted shyness phenotype and domains of functioning. Here, we find that the combination of shyness and sociability (i.e., conflicted shyness) places individuals in their thirties at the greatest risk for poor functioning across demographic, health, interpersonal, and psychological domains above and beyond shyness alone. We also report that attention and loneliness may be factors that underlie the risk for poor mental health in individuals characterized by conflicted shyness. Our findings extend work on conflicted shyness by considering several domains of functioning beyond emerging...

Although childhood shyness is presumed to predict mental health problems in adulthood, no prospective studies have examined these outcomes beyond emerging adulthood. As well, existing studies have been limited by retrospective and cross-sectional designs and/or have examined shyness as a dichotomous construct. The present prospective longitudinal study (N = 160; 55 males, 105 females) examined shyness trajectories from childhood to the fourth decade of life and mental health outcomes. Shyness was assessed using parent- and self-rated measures from childhood to adulthood, once every decade at ages 8, 12-16, 22-26, and 30-35. At age 30-35, participants completed a structured psychiatric interview and an experimental task examining attentional biases to facial emotions. We found 3 trajectories of shyness, including a low-stable trajectory (59.4%), an increasing shy trajectory from adolescence to adulthood (23.1%), and a decreasing shy trajectory from childhood to adulthood (17.5%). Relative to the low-stable trajectory, the increasing, but not the decreasing, trajectory was at higher risk for clinical social anxiety, mood, and substance-use disorders and was hypervigilant to angry faces. We found that the development of emotional problems in adulthood among the increasing shy trajectory might be explained in part by adverse peer and social influences during adolescence. Our findings suggest different pathways for early and later developing shyness and that not all shy children grow up to have psychiatric and emotional problems, nor do they all continue to be shy.

Although individuals born at extremely low birth weight (ELBW; < 1,000 g) are the most vulnerable of all preterm survivors, their risk for mental health problems across the life span has not been systematically reviewed. The primary objective of this systematic review and meta-analysis was to ascertain whether the risk for mental health problems is greater for ELBW survivors than their normal birth weight (NBW) peers in childhood, adolescence, and adulthood. Forty-one studies assessing 2,712 ELBW children, adolescents, and adults and 11,127 NBW controls were reviewed. Group differences in mental health outcomes were assessed using random effects meta-analyses. The impacts of birthplace, birth era, and neurosensory impairment on mental health outcomes were assessed in subgroup analyses. Children born at ELBW were reported by parents and teachers to be at significantly greater risk than NBW controls for inattention and hyperactivity, internalizing, and externalizing symptoms. ELBW children were also at greater risk for conduct and oppositional disorders, autistic symptoms, and social difficulties. Risks for parent-reported inattention and hyperactivity, internalizing, and social problems were greater in adolescents born at ELBW. In contrast, ELBW teens self-reported lower inattention, hyperactivity, and oppositional behavior levels than their NBW peers. Depression, anxiety, and social difficulties were elevated in ELBW survivors in adulthood. Group differences were robust to region of birth, era of birth, and the presence of neurosensory impairments. The complex needs faced by children born at ELBW continue throughout development, with long-term consequences for psychological and social well-being. (PsycINFO Database Record

Introduction Perinatal and later postnatal adversity (e.g., child sexual abuse) are predictors of psychopathology across the lifespan. However, little is known about the impact of the joint effects of perinatal and postnatal adversity on the longitudinal trajectories of mental health problems from adolescence through adulthood. Method We utilized data from a prospective, longitudinal birth cohort of extremely low birth weight (ELBW; 2500 g) control participants. Self-report data on internalizing (depression, anxiety) and externalizing (antisocial) problems were collected at 12–16, 22–26, and 30–35 years of age. Results A birth weight by child sexual abuse (CSA) interaction was observed such that ELBW survivors exposed to CSA had higher levels of internalizing problems from adolescence through adulthood than NBW participants exposed to CSA. Differences remained significant after adjustment for covariates. Likewise, ELBW survivors exposed to CSA had higher levels of internalizing problems from adolescence through adulthood than ELBW participants who were not exposed to CSA. Limitations Findings are limited by sample attrition due to the longitudinal nature of the study spanning over 30 years as well as the retrospective nature of child sexual abuse reporting. Conclusions Exposure to both perinatal and later postnatal adversity leads to persistently higher internalizing problems than exposure to either adversity alone over more than two decades. These findings suggest that individuals exposed to perinatal adversity may be especially vulnerable to, and persistently affected by, childhood adversity, particularly in the form of depression and anxiety.

* Abbreviation: EP — : extremely premature In this issue of Pediatrics , O’Reilly et al1 report on neuropsychological outcomes at 19 years of age after extremely preterm (EP) birth using the 1995 EPICure birth cohort of infants born EP (50% loss to follow-up, O’Reilly et al1 provide compelling evidence for persistent effects of general cognitive impairments in their impressive longitudinal studies of EP birth to emerging adulthood. These findings are generally consistent with … Address correspondence to Louis A. Schmidt, PhD, Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, ON L8S 4K1, Canada. E-mail: schmidtl{at}mcmaster.ca

Being born at extremely low birth weight (ELBW; ≤1,000 g) is associated with enduring visual impairments. We tested for long-term, higher order visual processing problems in the oldest known prospectively followed cohort of ELBW survivors. Configural processing (spacing among features of an object) was examined in 62 adults born at ELBW (Mage = 31.9 years) and 82 adults born at normal birth weight (NBW; ≥2,500 g: Mage = 32.5 years). Pairs of human faces, monkey faces, or houses were presented in a delayed match-to-sample task, where non-matching stimuli differed only in the spacing of their features. Discrimination accuracy for each stimulus type was compared between birth weight groups, adjusting for neurosensory impairment, visual acuity, binocular fusion ability, IQ, and sex. Both groups were better able to discriminate human faces than monkey faces (p

Early theoretical work by Buss (1986a, 1986b) posited that there is an early-developing fearful shyness that emerges during toddlerhood, and a later-developing self-conscious shyness that emerges during early childhood. It has been theorized that early-developing shyness is related to fear, rooted in inherited biases, and manifests in contexts of social novelty, whereas later-developing shyness is related to self-conscious emotions, may result from social ridicule or poor social skills, and manifests in contexts of social exposure. Despite the hypothesized correlates of these shyness subtypes, this theory has not been empirically tested in children. We tested 96 children aged 5 to 10 years old and classified them into three groups: early-developing shyness (n = 28; MAgeOnset = 2.4 years), later-developing shyness (n = 19; MAgeOnset = 4.8 years), and non-shy (n = 49). Findings revealed that children with later-developing shyness had the highest relative cortisol responses in the context of self-presentation, highest levels of embarrassment, and lowest social skills relative to the other groups, while children with early-developing shyness displayed the highest relative resting right frontal brain asymmetry (a neural correlate of fear) relative to the other groups. These preliminary findings provide partial empirical support for the previously theorized correlates and distinction of early-developing and later-developing shyness in childhood.

Abstract. There has been an unprecedented increase in the number of research studies employing event-related potential (ERP) techniques to examine dynamic and rapidly occurring neural processes with children during the preschool and early childhood years. Despite this, there has been relatively little discussion of the methodological and procedural differences that exist for studies of young children versus older children and adults. That is, reviewers, editors, and consumers of this work often expect developmental studies to simply apply adult techniques and procedures to younger samples. Procedurally, this creates unrealistic expectations for research paradigms, data collection, and data reduction and analyses. Scientifically, this leads to inappropriate measures and methods that hinder drawing conclusions and advancing theory. Based on ERP work with preschoolers and young children from 10 laboratories across North America, we present a summary of the most common ERP components under study in the area of emotion and cognition in young children along with 13 realistic expectations for data collection and loss, laboratory procedures and paradigms, data processing, ERP averaging, and typical challenges for conducting this type of work. This work is intended to supplement previous guidelines for work with adults and offer insights to aid researchers, reviewers, and editors in the design and evaluation of developmental research using ERPs. Here we make recommendations for researchers who plan to conduct or who are conducting ERP studies in children between ages 2 and 12 years, focusing on studies of toddlers and preschoolers. Recommendations are based on both data and our cumulative experience and include guidelines for laboratory setup, equipment and recording settings, task design, and data processing.

Key Points Question Is temperament associated with preoperative anxiety in young patients undergoing surgery? Findings In this systematic review of 23 studies including 4527 participants aged 1 to 18 years and meta-analysis of 12 studies including 1064 participants, certain temperament styles were associated with patients’ preoperative anxiety. Specifically, emotionality, intensity of reaction, and withdrawal were associated with increased preoperative anxiety, whereas activity level was associated with reduced anxiety. Meaning Knowledge of temperamental propensity to preoperative anxiety in pediatric patients may help to guide the design of future detection, prevention, and/or individualized management strategies (eg, improving emotional regulation and coping skills) aimed at reducing the adverse effects of preoperative anxiety., This systemic review and meta-analysis evaluates the associations of temperament with preoperative anxiety in pediatric patients aged 18 years and younger undergoing surgery., Importance Preoperative anxiety is associated with poor behavioral adherence during anesthetic induction and adverse postoperative outcomes. Research suggests that temperament can affect preoperative anxiety and influence its short- and long-term effects, but these associations have not been systematically examined. Objective To examine the associations of temperament with preoperative anxiety in young patients undergoing surgery. Data Sources Studies from MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and the Cochrane Central Register of Controlled Trials databases were searched from database inception to June 2018. Study Selection All prospective studies reporting associations of temperament with preoperative anxiety were included. Overall, 43 of 5451 identified studies met selection criteria. Data Extraction and Synthesis Using the PRISMA guidelines, reviewers independently read 43 full-text articles, extracted data on eligible studies, and assessed the quality of each study. Data were pooled using the Lipsey and Wilson random-effects model. Main Outcomes and Measures Primary outcome was the association of temperament with preoperative anxiety in patients undergoing surgery. Results A total of 23 studies, with 4527 participants aged 1 to 18 years, were included in this review. Meta-analysis of 12 studies including 1064 participants revealed that emotionality (r = 0.11; 95% CI, 0.04 to 0.19), intensity of reaction (r = 0.29; 95% CI, 0.11 to 0.46), and withdrawal (r = 0.40; 95% CI, 0.23 to 0.55) were positively associated with preoperative anxiety, whereas activity level (r = −0.23; 95% CI, −0.31 to −0.16) was negatively correlated with preoperative anxiety. Impulsivity was not significantly associated with preoperative anxiety. Conclusions and Relevance This systematic review and meta-analysis provided evidence suggesting that temperament may help identify pediatric patients at risk of preoperative anxiety and guide the design of prevention and intervention strategies. Future studies should continue to explore temperament and other factors influencing preoperative anxiety and their transactional effects to guide the development of precision treatment approaches and to optimize perioperative care.

Although resting right frontal electroencephalogram (EEG) asymmetry has been linked to avoidance and withdrawal-related behaviors such as shyness in previous cross-sectional studies, relatively little research has examined the influence of frontal brain electrical activity on the development of shyness in children using a prospective, longitudinal study design. Here, we tested whether resting frontal EEG asymmetry predicted the trajectory of children’s shyness across five assessments. Children were enrolled in the study during the summer prior to grade 1 (N = 37; Mage = 6.39 years, S.D. = 0.15 years), at which time resting frontal EEG activity and maternal report of children’s shyness were collected. Mothers then reported on their child’s shyness over another four follow-up assessments, spanning 2 years (winter of grade 1, summer prior to grade 2 entry, winter of grade 2, and summer prior to grade 3). Growth curve analysis revealed that children displaying greater relative right frontal EEG activity had lower levels of shyness relative to children exhibiting greater relative left frontal EEG activity at study enrollment (i.e., age 6), but displayed statistically significant linear increases in shyness across time, with the highest levels of shyness by the summer prior to grade 3 (i.e., age 8). There was, however, no relation between left frontal EEG asymmetry and change in shyness across time. These preliminary findings suggest that right frontal EEG asymmetry may reflect a biological diathesis for the growth of shyness during the early school years.

Relatively little is known about the psychophysiological processes underlying the development of socioemotional vulnerabilities that are common among adolescents exposed to child maltreatment. Using a prospective, longitudinal design, we investigated whether trajectories of resting heart period (HP; a physiological correlate of stress vulnerability) across three visits (separated by 6 months) was associated with shyness (a type of socioemotional vulnerability) in adolescent females exposed to child maltreatment ( N = 55; Mage = 14.07 years). Adolescents’ resting HP across visits was best characterized by two latent trajectories: a stable high class (25.5%) and a stable low class (74.5%). The stable low HP trajectory was associated with higher shyness at Time 1 (T1), and HP trajectory moderated the association between T1 and Time 3 (T3) shyness. Females in the stable low HP trajectory demonstrated stability of shyness from T1 to T3, whereas T1 and T3 shyness were unrelated for females in the stable high HP trajectory. We also found that shyness at T1 and T3 was associated with greater levels of anxiety at T3. These findings illustrate heterogeneity in the developmental patterns of resting autonomic activity in adolescent females exposed to child maltreatment; such differences may influence the continuity of some traits linked with socioemotional vulnerability such as shyness.