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This large, international dataset contains survey responses from N = 12,570 students from 100 universities in 35 countries, collected in 21 languages. We measured anxieties (statistics, mathematics, test, trait, social interaction, performance, creativity, intolerance of uncertainty, and fear of negative evaluation), self-efficacy, persistence, and the cognitive reflection test, and collected demographics, previous mathematics grades, self-reported and official statistics grades, and statistics module details. Data reuse potential is broad, including testing links between anxieties and statistics/mathematics education factors, and examining instruments’ psychometric properties across different languages and contexts. Data and metadata are stored on the Open Science Framework website [https://osf.io/mhg94/].

This study examined patterns of attention toward affective stimuli in a longitudinal sample of typically developing infants (N = 357, 147 females, 50% White, 22% Latinx, 16% African American/Black, 3% Asian, 8% mixed race, 1% not reported) using two eye-tracking tasks that measure vigilance to (rapid detection), engagement with (total looking toward), and disengagement from (latency to looking away) emotional facial configurations. Infants completed each task at 4, 8, 12, 18, and 24 months of age from 2016 to 2020. Multilevel growth models demonstrate that, over the first 2 years of life, infants became faster at detecting and spent more time engaging with angry over neutral faces. These results have implications for our understanding of the development of affect-biased attention.

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.

Maths attainment is essential for a wide range of outcomes relating to further education, careers, health and the wider economy. Research suggests a significant proportion of adults and adolescents are underachieving in maths within the UK, making this a key area for research. This study investigates the role of children's perceptions of the school climate (children's affect towards school and student–teacher relationships), their attitudes towards maths and teacher characteristics as predictors of maths attainment trajectories, taking the transition from primary to secondary education into consideration. Two growth models were fit using secondary data analysis of the Avon Longitudinal Study of Parents and Children (ALSPAC). The first model, which looked at predictors of maths attainment in primary education, found significant associations only between positive maths attitudes and increased maths attainment. The second model, which looked at predictors of maths attainment in secondary education, found significant associations between increased maths attainment and positive maths attitudes, decreased school belonging, positive student–teacher relationships and increased teacher fairness. The findings suggest that the secondary education school environment is particularly important for maths attainment.

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.

The primary- to secondary-education transition is a substantive life event for many children. The transition can be associated with changes in the developmental trajectories of both emotional health and academic achievement. The current study looked at whether the trajectory of mathematical attainment and emotional health (anxiety) across this transition predicted later maths anxiety. A secondary analysis of data from the Twin Early Development Study (TEDS) was performed. The statistical models were fit on the 753 participants (one from each twin pair) for which there were measures of mathematical performance across the primary- to secondary-education transition and maths anxiety at age 18. Two multi-level growth models were fit predicting mathematical attainment and anxiety over the primary- to secondary-education transition. The intercepts and slopes for each child were extracted from these models and used as predictors of subsequent maths anxiety at age 18. These effects were adjusted for biological sex, socio-economic status, verbal cognitive ability and general anxiety. Maths anxiety at age 18 was significantly predicted by both pre-transition levels of anxiety and mathematical attainment and their rate of change across the primary- to secondary-education transition. However, the effects were small, suggesting that theories of maths anxiety may have overplayed the role of prior mathematical attainment and general anxiety.

The discovery that prolonged administration of interferon-alpha (a pro-inflammatory cytokine) readily precipitates depressive symptoms has played a key role in development of the inflammation theory of major depressive disorder (MDD). However, it remains unclear whether the clinical phenotype of patients with inflammation-associated depression significantly overlaps with, or can be distinguished from that of patients with ‘idiopathic’ depression. Here we explored the Hamilton depression scale factor structure of 172 patients undergoing interferon-alpha treatment for hepatitis-C at the point of transition to a depressive episode of DSM IV defined major depression severity. The resulting factor structure was first compared with a model derived from 6 previous studies of ‘idiopathic’ MDD (Cole et al., 2004). This confirmatory factor analysis revealed that the factor structure of HAMD scores in our interferon-alpha treated cohort did not plausibly fit that previously described for ‘idiopathic’ MDD. Instead, subsequent exploratory factor analysis revealed a distinct four factor model with a novel primary factor grouping cognitive symptoms of depression and anxiety (HAMD items 1, 2, 9, 10, 11, 15). The second sleep disorder factor (items 4, 5, 6) replicated previous findings in ‘idiopathic’ depression. A third and unique factor grouped somatic symptoms and function (items 7, 12, 13, 14 and item 1). The final factor (also common in idiopathic depression studies), grouped gastrointestinal symptoms and weight loss (items 12 and 16). Severe depression items (3, 8, and 17) were excluded from analysis due to very low variance. At transition, interferon-alpha induced major depressive episodes therefore appears to have more associated anxiety features that covary with depressed mood than classical or ‘idiopathic’ MDD and a low likelihood of severe features such as suicidal ideation. Identification of this clinical phenotype may help identify patients with an inflammatory depression etiology and support the development of more effective and personalized therapies.

At least 40% of people with psychosis have persistent distressing symptoms despite optimal medication treatment. Cognitive behaviour therapy for psychosis (CBTp) is the only NICE-recommended individual therapy for psychosis, with effects on symptoms, distress and quality of life. Yet10% of service-users receive it and 94% of trusts struggle to provide it. Of those offered it, 22-43% refuse or do not attend. We have developed a new pre-CBTp informed choice intervention to address knowledge and attitudes that influence uptake and implementation and now want to test it in a feasibility trial.The design is a two-arm, feasibility randomised controlled trial (RCT), with 1:1 randomisation, stratified by participant group and site. Participants are 40 psychosis patients and 40 clinicians, who are ambivalent towards uptake or implementation of CBTp. Sites are community and inpatient services in Sussex and London. The intervention is a pre-CBT digital psychoeducation intervention designed to address identified knowledge and attitudinal barriers to uptake and implementation of CBTp, incorporating behaviour change mechanisms, and supported by animated introductory, patient and clinician stories. The comparator is the NHS choices website for CBT. The primary aim is to assess clinical feasibility (recruitment, randomisation, acceptability, use, delivery, outcome measurement, retention). A secondary aim is a preliminary evaluation of efficacy. Outcomes will be assessed at baseline, post intervention, and one-month follow-up (blind to treatment arm). The primary efficacy outcome is likelihood of offering/taking up CBTp. Secondary outcomes include knowledge and attitudes towards CBTp, illness perceptions, empowerment, psychological wellbeing (patients only) and CBTp implementation (clinicians only). Use of the intervention and CBT behaviours during the follow-up period will be recorded and captured in a feedback questionnaire. Use, acceptability and experience of outcome assessment will be explored in qualitative interviews with participants (n = 6 per group). The efficacy evaluation will report descriptive data, key model parameters and 95% highest probability density intervals in a Bayesian growth model.This is the first feasibility trial of a digital 'informed choice' decision aid for the implementation of CBTp. If the trial proves feasible and demonstrates preliminary evidence of efficacy, a large multi-site trial will be warranted.ISRCTN registry, ISRCTN53107879 . Registered prospectively on 2 August 2017.

Background At least 40% of people with psychosis have persistent distressing symptoms despite optimal medication treatment. Cognitive behaviour therapy for psychosis (CBTp) is the only NICE-recommended individual therapy for psychosis, with effects on symptoms, distress and quality of life. Yet

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.

Background: Pregnancy, birth and adjusting to a new baby is a potentially stressful time that can negatively affect\ud women’s mental and physical health. Expressive writing, where people write about a stressful event for at least\ud 15 min on three consecutive days, has been associated with improved health in some groups but it is not clear\ud whether it is feasible and acceptable for use with postpartum women. This study therefore examined the feasibility and acceptability of expressive writing for postpartum women as part of a randomised controlled trial (RCT).\ud Methods: The Health After Birth Trial (HABiT) was an RCT evaluating expressive writing for postpartum women\ud which included measures of feasibility and acceptability. At 6 to 12 weeks after birth 854 women were randomised\ud to expressive writing, a control writing task or normal care, and outcome measures of health were measured at\ud baseline, one month later and six months later. Feasibility was measured by recruitment, attrition, and adherence to\ud the intervention. Quantitative and qualitative measures of acceptability of the materials and the task were\ud completed six months after the intervention.\ud Results: Recruitment was low (10.7% of those invited to participate) and the recruited sample was from a restricted\ud sociodemographic range. Attrition was high, increased as the study progressed (35.8% at baseline, 57.5% at one\ud month, and 68.1% at six months) and was higher in the writing groups than in the normal care group. Women\ud complied with instructions to write expressively or not, but adherence to the instruction to write for 15 min per\ud day for three days was low (Expressive writing: 29.3%; Control writing: 23.5%). Acceptability measures showed that\ud women who wrote expressively rated the materials/task both more positively and more negatively than those in\ud the control writing group, and qualitative comments revealed that women enjoyed the writing and/or found it\ud helpful even when it was upsetting.\ud Conclusions: The feasibility of offering expressive writing as a universal self-help intervention to all postpartum\ud women 6 to 12 weeks after birth in the HABiT trial was low, but the expressive writing intervention was acceptable\ud to the majority of women who completed it.\ud Trial registration: ISRCTN58399513, 10/09/2013.\ud Keywords: Feasibility, Acceptability, Expressive writing, Postpartum, Postnatal, Maternal

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.

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.

Judge Field rode his lawmaster reluctantly back into Mega-Silly One; he was not a health psychologist, but when it came to statistics he was the law. Reports from Judges Peters, de Bruin and Crutze...

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.

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.

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.

One of the challenges to conditioning models of fear acquisition is to explain how different individuals can experience similar learning events and only some of them subsequently develop fear. Understanding factors moderating the impact of learning events on fear acquisition is key to understanding the etiology and prevention of fear in childhood. This study investigates these moderators in the context of vicarious (observational) learning. Two experiments tested predictions that the acquisition or inhibition of fear via vicarious learning is driven by associative learning mechanisms similar to direct conditioning. In Experiment 1, 3 groups of children aged 7 to 9 years received 1 of 3 inhibitive information interventions—psychoeducation, factual information, or no information (control)—prior to taking part in a vicarious fear learning procedure. In Experiment 2, 3 groups of children aged 7 to 10 years received 1 of 3 observational learning interventions—positive modeling (immunization), observational familiarity (latent inhibition), or no prevention (control)—before vicarious fear learning. Results indicated that observationally delivered manipulations inhibited vicarious fear learning, while preventions presented via written information did not. These findings confirm that vicarious learning shares some of the characteristics of direct conditioning and can explain why not all individuals will develop fear following a vicarious learning event. They also suggest that the modality of inhibitive learning is important and should match the fear learning pathway for increased chances of inhibition. Finally, the results demonstrate that positive modeling is likely to be a particularly effective method for preventing fear-related observational learning in children., The studies demonstrate that positive modeling and prior exposure to a stimulus are effective methods to prevent vicarious fear learning in 7 to 10-year-olds. This confirms that positive modeling is a useful part of prevention programs and that associative learning mechanisms underpin its effectiveness. The findings also explain why not everyone develops fear following a negative vicarious learning event.

Cognitive biases are known to play an important role in anxiety. In this study we investigate whether maternal anxiety is associated with biases in interpretation, attention, and catastrophic processing about self-referent stimuli that may signal potential threat in the mother's own environment. We also investigate whether maternal anxiety is associated with biases about stimuli that their own child may encounter or to child-related stimuli more broadly. Three hundred mothers with a child aged 6 to 10 years participated. All participants completed a trait anxiety measure and an ambiguous sentences task to assess interpretation bias for self- and child-referent situations. A subset of the sample completed a catastrophizing interview about a self- (n = 194) or child-referent (n = 99) worry topic and an attentional dot-probe task (n = 99) with general threat and child threat stimuli. Maternal anxiety was not significantly associated with an attentional bias for general or child threat stimuli but was significantly associated with a bias for threat interpretations of both self and child-referent situations. Higher maternal anxiety was also significantly associated with generating more catastrophic outcomes to both a self-referent and child-referent hypothetical worry situation. We consider whether maternal cognitive biases, which extend to influence how mothers process potential threats in their child's world, may be an important mechanism through which intergenerational transmission of anxiety could occur.

The present study examined (a) processing biases for emotional facial stimuli in a sample of 355 4- to 12-year-old non-clinical children, (b) developmental patterns of such biases, and (c) to what extent biases were related to social anxiety and the temperamental trait of behavioral inhibition in children of various ages. Processing biases were assessed with a dot probe task and a dynamic emotion recognition paradigm (i.e., morph task), whereas children's levels of social anxiety and behavioral inhibition were measured by means of parent-report. Results showed that on the morph task children were generally faster in detecting happy faces compared to angry faces, and this effect was not qualified by age, social anxiety, or behavioral inhibition. Further analyses revealed no significant effect of age on bias scores. However, analyses did reveal two classes in the data with one class mainly consisting of younger children and the other class predominantly composed of older children: Younger children were in general slower, less accurate, and displayed more variance in their scores on the processing biases tasks than older children. Results of this study underline the need of the development and use of more age-appropriate, non-reaction time-based tasks for measuring processing bias in younger children.

We examined the effects of training to approach or avoid novel animals on fear-related responses in children. Ninety-nine primary school children (9-12 years old) were instructed to repeatedly move a manikin toward or away from pictures of novel animals. The training produced more positive self-reported attitudes for the animal that was repeatedly approached and more negative attitudes for the animal that was repeatedly avoided. After the training, children reported more fear of the avoided animal than of the approached animal. Interestingly, children showed a training-congruent confirmation bias effect on an information-seeking task. That is, they displayed a tendency to seek more positive information about the approached animal, whereas they were inclined to search for more negative information about the avoided animal. No significant training effects were observed on implicit attitudes. The finding that a simple approach-avoidance training influences children's fear-related responses and leads to biased information-seeking behaviors lends support to general theories of fear acquisition in children as well as to models that try to explain the intergenerational transmission of anxiety.

Using an experimental bias modification task, an interpretation bias towards or away from threat was induced about animal or social situations in a sample of 103 children split into a young (7-10 years) and old age group (11-15 years). Children rapidly learned to select outcomes of ambiguous situations which were congruent with their assigned modification condition. Following positive modification, children's threat interpretation biases significantly decreased, while threat biases increased (non-significantly) after negative modification. Bias modification effects also varied as a function of age with children appearing particularly vulnerable to acquiring biases about stimuli that were congruent with the normative fears for their age group. Weak age-related modification-congruent effects on younger but not older children's anxiety vulnerability in response to a behavioral task were also observed. However, no consistent effects of bias modification on avoidance behavior were found.

A Multilevel model is a statistical tool for analysing data that has a hierarchical data structure (in other words, data are nested within contexts). This paper describes what a multilevel model is, how it is described mathematically, the advantages of using this data analysis technique, and some practical issues to consider. We then move on to describe the application of multilevel models using two scenarios pertinent to researchers interested in clinical trial analysis and experimental psychopathology research. We describe how to use the software R to run these analyses.

Psychologists estimate the precision of their statistics both to conduct hypothesis tests and to construct confidence intervals. The methods traditionally used for this are available only for a small set of statistics (e.g., the mean and transformations of it) and often make unrealistic assumptions about the variables' distributions. These assumptions are often particularly unrealistic in data derived from clinical samples, or when looking at groups responding at the extreme end of clinical constructs. Bootstrap estimation is a computer intensive procedure that offers a flexible and automatic alternative. The computer takes thousands of bootstrap samples from the observed data and from these bootstrap samples estimates the precision of the statistic. High-speed personal computers make the bootstrap a viable and appealing technique throughout the sciences. This article offers a tutorial on the theory and practice of applying bootstrap estimation to data from clinical samples and measures relevant to experimental psychopathology.

This study investigated the effect of filmed peer modeling on fear beliefs and approach–avoidance behaviors towards animals in 8- to 10-year-old typically developing children. Ninety-seven children randomly received either a positive or negative modeling film in which they saw peers interact with a novel animal. Before and after this film, children’s fear beliefs and avoidance tendencies towards the modeled and non-modeled control animal were measured. A behavioral approach task was also administered post-modeling. Following positive peer modeling, children’s fear beliefs and avoidance tendencies towards the modeled but also towards the non-modeled animal decreased significantly. After negative modeling, children’s fear beliefs towards the modeled animal increased significantly, but did not change for the non-modeled animal. Negative modeling did not change avoidance tendencies for the modeled animal, while it decreased children’s avoidance of the non-modeled animal. No significant effects were observed on the behavioral approach task. These results support Rachman’s indirect pathway of modeling/vicarious learning as a plausible mechanism by which children can acquire fears of novel stimuli and stresses the important fear-reducing effects of positive peer modeling. Clinical implications and directions for future research are discussed.

This study investigated the effects of experimentally modifying interpretation biases for children's cognitions, avoidance behavior, anxiety vulnerability, and physiological responding. Sixty-seven children (6-11 years) were randomly assigned to receive a positive or negative interpretation bias modification procedure to induce interpretation biases toward or away from threat about ambiguous situations involving Australian marsupials. Children rapidly learned to select outcomes of ambiguous situations, which were congruent with their assigned condition. Furthermore, following positive modification, children's threat biases about novel ambiguous situations significantly decreased, whereas threat biases significantly increased after negative modification. In response to a stress-evoking behavioral avoidance test, positive modification attenuated behavioral avoidance compared to negative modification. However, no significant effects of bias modification on anxiety vulnerability or physiological responses to this stress-evoking Behavioral Avoidance Task were observed.

Meta-analysis is a statistical tool for estimating the mean and variance of underlying population effects from a collection of empirical studies addressing ostensibly the same research question. Meta-analysis has become an increasing popular and valuable tool in psychological research, and major review articles typically employ these methods. This article describes the process of conducting meta-analysis: selecting articles, developing inclusion criteria, calculating effect sizes, conducting the actual analysis (including information on how to do the analysis on popular computer packages such as IBM SPSS and R) and estimating the effects of publication bias. Guidance is also given on how to write up a meta-analysis.

Interpretation of ambiguity is consistently associated with anxiety in children, however, the temporal relationship between interpretation and anxiety remains unclear as do the developmental origins of interpretative biases. This study set out to test a model of the development of interpretative biases in a prospective study of 110 children aged 5–9 years of age. Children and their parents were assessed three times, annually, on measures of anxiety and interpretation of ambiguous scenarios (including, for parents, both their own interpretations and their expectations regarding their child). Three models were constructed to assess associations between parent and child anxiety and threat and distress cognitions and expectancies. The three models were all a reasonable fit of the data, and supported conclusions that: (i) children’s threat and distress cognitions were stable over time and were significantly associated with anxiety, (ii) parents’ threat and distress cognitions and expectancies significantly predicted child threat cognitions at some time points, and (iii) parental anxiety significantly predicted parents cognitions, which predicted parental expectancies at some time points. Parental expectancies were also significantly predicted by child cognitions. The findings varied depending on assessment time point and whether threat or distress cognitions were being considered. The findings support the notion that child and parent cognitive processes, in particular parental expectations, may be a useful target in the treatment or prevention of anxiety disorders in children.

There is increasing research on posttraumatic growth after life-threatening illnesses such as cancer and HIV/AIDS, although it is unclear whether growth confers any psychological or physical benefits in such samples. Consequently, this meta-analysis explored the relationship between posttraumatic growth and psychological and physical wellbeing in adults diagnosed with cancer or HIV/AIDS and examined potential moderators of these relationships. Analysis of 38 studies (N = 7927) of posttraumatic growth after cancer or HIV/AIDS revealed that growth was related to increased positive mental health, reduced negative mental health and better subjective physical health. Moderators of these relationships included time since the event, age, ethnicity, and type of negative mental health outcome. It is hoped that this synthesis will encourage further examination of the potentially complex relationship between posttraumatic growth and adjustment in individuals living with life-threatening medical conditions.