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This study combined the family investment theory and family stress model to explore the relationship between parental educational involvement (PEI) and social anxiety (SA) among Chinese middle school students, as well as the mediating role of psychological Suzhi and the moderating role of family socioeconomic status (SES). Participants consisted of 596 middle school students from two middle schools in Guizhou and Sichuan who completed a survey that included the simplified version of the Psychological Suzhi Scale for Middle School Students and the Social Avoidance and Distress Scale. Students' parents completed sections regarding family SES and PEI. The students then returned the completed surveys to the researchers. The results showed that (1) PEI predicted SA among middle school students; (2) psychological Suzhi partially mediated the relationship between PEI and SA; and (3) family SES played a moderating role in the direct relationship between PEI and SA. Low family SES may hinder the direct inhibitory effect of PEI on their offspring's SA due to parents' poor educational quality., Author(s): Jia Chen [sup.1] [sup.2] , Jiajia Huang [sup.1] , Wenwen Zhao [sup.1] [sup.2] , Feiling Du [sup.1] [sup.2] , Gang Cheng [sup.1] [sup.2] Author Affiliations: (1) grid.443395.c, 0000 0000 [...]

Prior research demonstrates that stress and coping strategies have a significant influence on development and wellbeing, however few studies focus on the impact of daily stressors and coping strategies on anxiety and resiliency in preadolescents living in Mexico. The current study aim is to determine the impact of coping strategies and daily stressors on anxiety and resilience. Daily stressors, coping strategy use, anxiety symptoms, and resilience were assessed in a sample of 98 students (age 9-13) from two schools serving similar socioeconomic areas in Ciudad Juarez, Mexico. The relationship was analyzed using structural equation modeling (SEM) to better account for the influence of coping daily stressors, gender, and age on both anxiety and resilience. The proposed model had excellent indices of model fit and revealed a positive relationship between daily stressors and levels of anxiety. Non-productive coping strategies were also associated with higher levels of anxiety while the relying on others strategy associated with less anxiety. Productive coping and non-productive coping strategies were associated with greater resiliency. Our findings parallel other findings from the literature, however, in a sample from Mexico. The findings suggest that preadolescents use different coping strategies to effectively manage daily stressors, and that anxiety may influence resiliency., Author(s): Verónica Portillo-Reyes [sup.1] , John W. Capps [sup.2] , Yolanda Loya-Mèndez [sup.3] , Gilberto Reyes-Leal [sup.4] , Juan Quiñones-Soto [sup.5] Author Affiliations: (1) grid.441213.1, 0000 0001 1526 9481, Department [...]

DSM-5 classifies Selective Mutism (SM) among anxiety disorders, and a majority of children with SM comply with symptomatology of Social Anxiety Disorder (SAD). It is still discussed whether SM constitutes a discrete disorder entity or merely an extreme form of SAD. Past research that compared anxiety levels in both disorders resulted in conflicting conclusions, which might be due to the adoption of questionnaire measures or experimental designs that comprised in vivo situations. In vivo situations contain the possibility to avoid the feared situations for children with SM by remaining silent, which is not true for children with SAD. Participants aged eight to 18 years (M = 13.30 years, SD = 3.26) with above cut-off symptomatology in SM (n = 52), SAD (n = 18), and typical development (n = 41) participated in an online-based study. They evaluated 21 videos with neutral, embarrassing, or speech-demanding situations with respect to their anxiety elicitation. There was no general difference in anxiety levels between participants with elevated SM and SAD symptomatology, and both groups rated embarrassing situations similarly. However, only children with SM features experienced speech-demanding situations as anxiety eliciting, as embarrassing situations and more so than participants in both other groups. Results of the present study indicate that SM is an anxiety disorder with a specific anxiety pattern rather than an extreme form of SAD. In addition to typical social phobic situations, interventions for children with SM should also address situations involving speech demands., Author(s): Christina Schwenck [sup.1] , Angelika Gensthaler [sup.2] , Felix Vogel [sup.1] Author Affiliations: (1) grid.8664.c, 0000 0001 2165 8627, Department of Special Needs Educational and Clinical Child and Adolescent [...]

The aim of the present study was to examine the association between emotional and behavioral problems in preschool children and maternal attitudes. The predictor variables were parental attitudes, maternal depression and anxiety symptoms. Our sample consisted of the mothers of 204 preschool children attending different preschools in Ankara, Turkey. Mothers were asked to complete the parental attitude research instrument, the beck depression inventory, the trait anxiety inventory, and the child-behavior checklist. Hierarchical regression analysis revealed that when considered jointly, maternal anxiety but not maternal depression explained variability in preschool children internalizing and externalizing their problems. Mothers rejecting attitudes towards family life and child-raising styles were also found to be closely associated with the emotional and behavioral problems in their children. The findings demonstrate that the importance of maternal anxiety is above and beyond the importance of rejecting the maternal role when it comes to preschool problems in children. Keywords Maternal depression * Maternal anxiety * Parenting styles * Preschool children * Internalizing problems * Externalizing problems, Introduction The influence of various factors regarding child behavior problems has received considerable interest in literature. Usually these factors consist of child-related (e.g., age, gender, temperament, physical well-being, etc.), parental [...]

This study further investigated the construct of courage in children. Children aged 8-13 years (n = 51) were interviewed about the most courageous action that they had ever performed during their life, and to retrospectively rate their level of fear and courage experienced during that event. On a separate occasion, children also completed the Courage Measure for Children (CM-C) as an index of children's general level of personal courage, as well as scales for assessing anxiety symptoms and sensation seeking. Results indicated that almost all children (i.e., 94%) indicated that they had carried out a courageous action at some point during their life, although the levels of fear and courage associated with these acts varied considerably. Further, there was no relation between fear and courage reported for the courageous action, but these variables were significantly correlated with respectively anxiety symptoms and personal courage as indexed by the CM-C. Finally, a significant positive correlation was observed between sensation seeking and personal courage, indicating that children who are more thrill and adventure seeking are generally also more courageous. It is concluded that fear and courage in children are largely unrelated and not just two sides of the same coin. The implications of these results for the etiology and treatment of childhood anxiety problems are discussed. Keywords Fear * Courage * Anxiety * Sensation seeking * Children

We examined trends in publications on childhood anxiety disorders over the past 25 years. A PsycINFO search was carried out to find relevant research articles published between 1982 and 2006. Results indicated a gradual and significant rise in the frequency of publications on childhood anxiety disorders during the past 25 years, and this increase was particularly strong for post-traumatic stress disorder, obsessive--compulsive disorder, social phobia, and multiple anxiety disorders. Most studies concerned the phenomenology of childhood anxiety disorders (i.e., >50%). Considerable less research has been conducted on the etiology, intervention, and assessment of these disorders in youths. Nevertheless, the conclusion seems warranted that the research on childhood anxiety disorders has made significant advancements during the past decades. This notion is supported by a selective review of the literature, which highlights important developments in this field of study. Keywords Childhood anxiety disorders * Publication trends * Review

The use of functional magnetic resonance imaging in investigating pediatric anxiety disorders is studied. Functional magnetic resonance imaging can be utilized in demonstrating parallels between the neural architecture of difference in anxiety of humans and the neural architecture of attention-orienting behavior in nonhuman primates or rodents. Implications for anxiety disorder treatments are discussed.

The present study extended our understanding of cognitive biases in childhood social anxiety. A non-clinical sample of 1l-13-year olds completed social anxiety and depression scales and were presented with scenarios depicting positive and mildly negative social events. Social anxiety was associated with tendencies to interpret positive social events in a discounting fashion, to catastrophize in response to mildly negative social events, and to anticipate more negative emotional reactions to the negative events. Implications for understanding and treating social anxiety are discussed. Keywords: Social anxiety Cognitive bias Interpretation Judgmental bias Children

A study to examine the association between childhood separation anxiety disorder (SAD) and the risk of developing of psychopathology during young adulthood is conducted. Results show that SAD contributed to the risk for the development of internalizing disorders, which are panic and depression, but decreased risk for externalizing disorders, which are alcoholism and substance abuse.

Verbal information has long been assumed to be an indirect pathway to fear. Children (aged 6-8 or 12-13 years) were exposed to threat, positive, or no information about 3 novel animals to see the long-term impact on their fear cognitions and the immediate impact on avoidance behavior. Their directly (self-report) and indirectly (implicit association task) measured attitudes toward the animals changed congruent with the information provided, and the changes persisted up to 6 months later. Verbal threat information also induced behavioral avoidance of the animal. Younger children formed stronger animal-threat and animal--safe associations because of threat and positive verbal information than older children, but there were negligible age effects on self-reported fear beliefs and avoidance behaviors. These results support theories of fear acquisition that suppose that verbal information affects components of the fear emotion. Keywords: childhood fear, anxiety, conditioning

This study examined the developmental trajectory of anxiety symptoms among 290 boys and evaluated the association of trajectory groups with child and family risk factors and children's internalizing disorders. Anxiety symptoms were measured using maternal reports from the Child Behavior Check-list (T. M. Achenbach, 1991, 1992) for boys between the ages of 2 and 10. A group-based trajectory analysis revealed 4 distinct trajectories in the development of anxiety symptoms: low, low increasing, high declining, and high-increasing trajectories. Child shy temperament tended to differentiate between initial high and low groups, whereas maternal negative control and maternal depression were associated with increasing trajectories and elevated anxiety symptoms in middle childhood. Follow-up analyses to diagnoses of preadolescent depression and/or anxiety disorders revealed different patterns on the basis of trajectory group membership. The results are discussed in terms of the mechanisms of risk factors and implications for early identification and prevention. Keywords: childhood anxiety, temperament, emotion regulation, parent-child interaction, maternal depression

The present study examined threat interpretation biases in children 7-12 years of age with separation, social and generalised anxiety disorders (N = 15), non-anxious offspring at risk due to parental anxiety (N = 16) and non-anxious controls of non-anxious parents (N = 14). Children provided interpretations of ambiguous situations to assess cognitive, emotional and behavioural responses. In comparison with non-anxious control children and at-risk children who did not differ from each other, anxious children reported stronger negative emotion and less ability to influence ambiguous situations. These results suggest that threat interpretation bias may be a cognitive factor associated with ongoing childhood anxiety but not a vulnerability factor associated with parental anxiety. Keywords: Threat interpretation bias; Childhood anxiety disorders; At-risk offspring

Recent research has shown that the verbal information pathway to fear creates long-term fear cognitions and can create cognitive biases and avoidance in children. However, the interaction between the verbal information pathway to fear and other pathways is untested. This experiment exposed children (aged 6-8) to threat information about a novel animal to see the impact on a measure of avoidance after a subsequent simulated direct negative encounter with that animal. Results showed that a direct negative experience (without prior information) or threat information (without a subsequent negative experience) produced similar effects, but in combination (verbal threat information followed by a direct negative experience) the effect was significantly magnified. These results support theories of fear acquisition that suppose that verbal information impacts on the strength of associations formed in subsequent conditioning episodes, and suggest that pathways to fear have interactive effects. Keywords: Childhood anxiety: Verbal Information: Fears: Information processing

The relationship between a history of lifetime psychiatric disorders of parents with selective mutism (SM) in their children is examined. The results support earlier findings of a familial relationship between generalized social phobia and SM.

The present study investigated developmental patterns in children's interpretation of anxiety-related physical symptoms and emotional reasoning, and to what extent these phenomena are influenced by children's level of cognitive development. A large sample of 4-13-year-old children (N = 358) were exposed to vignettes in which the presence and absence of physical symptoms was systematically varied. In addition, children completed a series of conservation tasks and a theory-of-mind-test. Results demonstrated that from the age of 7, children were increasingly able to link physical symptoms to anxiety. Furthermore, cognitive development appeared to enhance children's ability to interpret physical symptoms as a sign of anxiety. Further, children's tendency to infer danger from vignettes with physical symptoms (i.e., emotional reasoning) was already prominent in 4-6-year-olds. The implications for physical symptom-based theories of childhood anxiety are briefly discussed. Keywords: Children; Interpretation of anxiety-related physical symptoms; Emotional reasoning; Cognitive development; Theory-of-mind

The current study investigated whether physical anxiety sensitivity (AS) is associated with selective attentional biases to affective stimuli in children. The dot-probe paradigm was used to examine the deployment of attention towards words pertaining to anxiety symptomatology, socially threatening words, and positive words, in samples of 8-10-year-old children. Word pairs were presented under both masked and unmasked conditions. Irrespective of masking, children high in physical AS displayed an attentional vigilance for emotional words relative to neutral words, whereas those low in physical AS displayed a relative avoidance of such material. The results of this study are interesting as they not only suggest the presence of automatic AS-related biases in childhood, but that this is a general emotionality bias rather than one related to specific anxiety-related stimuli. Keywords: Anxiety sensitivity; Selective attention; Dot-probe paradigm; Children

It has been hypothesized that anxiety in children is associated with attentional bias in the early stages of information processing. Bias towards threat indicates the tendency of an individual to direct attention towards threatening information. The aim of the present study was to investigate whether high test-anxiety in a sample of nonreferred children is associated with attentional bias towards threat pictures, and if low test-anxiety is associated with attentional bias away from threat pictures. A probe-detection task was used with 44 10- to 13-yr.-old children. The overall analyses indicated the presence of an attentional bias away from threatening pictures in these nonreferred children. However, in relation to anxiety, the study did not confirm that high anxious children show an attentional bias towards threatening pictures or that low anxious children show an attentional bias away from threatening pictures. Yet, higher anxiety did seem to be associated with longer mean response times. These longer response times might originate from the interpretation of the nature of a stimulus as too threatening, compared to the actual threatening content, in the first stage of information processing. This finding could be useful to improve treatment methods aimed at anxiety symptoms during childhood.

The behavioral inhibition system (BIS) is the neurological substrate of trait anxiety and is linked to the development of anxiety disorders. Three experiments are reported that investigate the moderating influence of the BIS on 1 pathway to fear: threat information. In all studies, children were given verbal information about a set of novel animals, and their BIS sensitivity was measured. The results suggest that BIS sensitivity (a) facilitates attentional biases to stimuli associated with threat information and (b) facilitates behavioral avoidance of novel stimuli associated with threat information. This suggests a possible mechanism through which the BIS may promote the acquisition of animal fears. Keywords: fear, anxiety, behavioral inhibition system, children

Separation anxiety and social phobia are intertwined to a considerable degree, and high comorbidity rates have been reported. The present study used latent class analysis (LCA) to investigate if classes of children and adolescents with--simultaneously high rates of separation anxiety and low rates of social anxiety symptoms, or vice versa, could be identified. Eight- to 18-year-olds from a large general population (n = 1000) and referred sample (n = 735) were assessed with the Multidimensional Anxiety Scale for Children (MASC). With LCA, a separate class of referred 8-11-year-old children with high separation anxiety scores, and simultaneously lower social anxiety scores was identified, next to a class of children with high scores on separation anxiety and social anxiety. In the other groups (referred 12-18-year-olds and children and adolescents from the general population), a class with individuals who specifically scored high on separation anxiety could not be revealed. The results indicated that separation anxiety represents a different construct than social anxiety in referred children (but not in referred adolescents or in the general population). It can be concluded that, in referred children, research regarding etiology and treatment outcome of anxiety symptoms should be aimed specifically at separation anxiety and social anxiety, instead of just investigating a broader anxiety dimension. Keywords: Children; Adolescents; Anxiety; Taxonomy; MASC

Supplementing bibliotherapy with therapist-client communication has been shown to be an effective way of providing services to under-resourced and isolated communities. The current study examined the efficacy of supplementing bibliotherapy for child anxiety disorders with therapist-initiated telephone or email sessions, or with client-initiated contact in a randomised trial using a waitlist control. Participants were 100 anxiety-disordered children and their parents from rural and remote communities. All treatment conditions resulted in improvement on self-report measures and clinician rated severity. Telephone sessions produced superior outcomes with 79% of children being anxiety disorder free posttreatment compared with 33% of email and 31% of client-initiated participants. The results suggest that therapist supplemented bibliotherapy could provide an efficacious treatment option for families isolated from traditional treatment services. Keywords: Child; Anxiety; Treatment outcome; Bibliotherapy; Rural

Seventy-two clinically anxious children, aged 7 to 14 years, were randomly allocated to clinic-based, cognitive-behavior therapy, the same treatment partially delivered via the Internet, or a wait-list control (WL). Children in the clinic and clinic-plus-Internet conditions showed significantly greater reductions in anxiety from pre-to posttreatment and were more likely to be free of their anxiety diagnoses, compared with the WL group. Improvements were maintained at 12-month follow-up for both therapy conditions, with minimal difference in outcomes between interventions. The Internet treatment content was highly acceptable to families, with minimal dropout and a high level of therapy compliance. Keywords: Internet, computer, online therapy, cognitive-behavior therapy, child anxiety

The current trial examined the value of modifying empirically validated treatment for childhood anxiety for application via written materials for parents of anxious children. Two hundred sixty-seven clinically anxious children ages 6-12 years and their parents were randomly allocated to standard group treatment, waitlist, or a bibliotherapy version of treatment for childhood anxiety. In general, parent bibliotherapy demonstrated benefit for children relative to waitlist but was not as efficacious as standard group treatment. Relative to waitlist, use of written materials for parents with no therapist contact resulted in around 15% more children being free of an anxiety disorder diagnosis after 12 and 24 weeks. These results have implications for the dissemination and efficient delivery of empirically validated treatment for childhood anxiety. Keywords: child anxiety, anxiety disorders, childhood, treatment, self-help

This study investigated DSM-defined anxiety symptoms in South African youths. Children and adolescents (N = 701) from various cultural groups completed the SCARED and a questionnaire measuring perceived parental rearing behaviors. Results indicated that the psychometric properties of the SCARED were satisfactory in the total sample of South African youths, and acceptable in colored and black children and adolescents. Further, colored and black youths displayed higher SCARED scores than white youths, and there were also differences in the perceived parental rearing behaviors of the cultural groups. White youths generally rated their parents' rearing behaviors as less anxious, overprotective, and rejective, but more emotionally warm than colored and black youths. Finally, positive correlations were found between anxious rearing, overprotection, and rejection and anxiety symptoms. The clinical and research implications of these findings are briefly discussed. Keywords: Anxiety; Screen for child anxiety related emotional disorders; Perceived parental rearing behaviors; South Africa; Children and adolescents

This study tested the effect of reductions in children's anxiety over time on improvements in school performance and social functioning in the context of participation in a cognitive-behavioral intervention program. Participants included 40 children with high anxiety (6 13 years of age). Independent evaluators, children, and parents rated child anxiety: parents rated school performance: and children and parents rated social functioning. Measures were completed at pre-intervention, midintervention, and postintervention. Fixed-effects regression analyses and random-effects regression analyses indicated that decreased anxiety was predictive of improved school performance and social functioning over the course of the intervention. These findings suggest that changes in anxiety influence trajectories of children's scholastic and social functioning. Keywords: anxiety, school performance, social adjustment, longitudinal studies

This study examined the planning performance of children with attention deficits, and also investigated the possible interactions between inattention and anxiety in the performance of executive function tasks. A group of 98 children (grades 4 and 6), derived from an initial group of 550, were assigned to an attention difficulties group (AD) and a control group (n = 49 each) based on their scores on a variety of cognitive attention measures and teacher scales of attention and hyperactivity. The two groups were matched on age, gender, parental education, non-verbal and verbal ability. They were compared on Crack-the-Code (C-t-C) action-planning task, embedded and ambiguous figures and Theory of Mind tasks. Analyses indicated that the failure of AD children on cognitive performance measures is linked to planning impairments. The co-occurrence of anxiety, in turn, did not interact with inattention to affect planning performance differentially. Implications of these findings for the current discussion about the cognitive and emotional processes underlying impaired performance among children with attention deficits on executive control tasks are discussed. KEY WORDS: attention deficit; planning; theory of mind; anxiety.

Reactivity and habituation patterns were examined in the offspring of anxious and non-anxious parents. Although no differences emerged for magnitude of response to either fear-relevant visual or auditory stimuli, offspring of anxious parents displayed significantly more electrodermal activity during resting baseline and during the inter-trial intervals of these stimulus presentations. Differences also were observed for the number of children per group achieving habituation to the fear-relevant visual and auditory stimuli, where offspring of anxious parents were less likely to habituate to either stimuli. The same pattern of group differences emerged after excluding children diagnosed with an anxiety disorder, indicating that even offspring of anxious parents who did not have an anxiety disorder differ from offspring of normal controls with respect to their pattern of psychophysiological reactivity. It is hypothesized that these features might serve as an indication of anxiety proneness and risk for the development of anxiety disorders. Keywords: Offspring; Anxious parents; Reactivity; Habituation; Anxiety-proneness

This study reports the results of a 3-year follow-up assessment of children and adolescents diagnosed with social anxiety disorder (social phobia) and treated with Social Effectiveness Therapy for Children (SET-C), a comprehensive behavioral treatment program combining social skills training, peer generalization, and individualized exposure. Among 32 children initially treated with the protocol, 29 completed the follow-up assessment and were evaluated with a multidimensional assessment strategy, including self-report, parental report, clinician ratings, and behavioral assessment. Results indicated that the majority of posttreatment gains were maintained at 3-year follow-up, and 72% of treated children continued to be free of a social phobia diagnosis 3 years later. These findings support the long-term efficacy of SET-C for children and adolescents suffering from social phobia. Keywords: social phobia, children, behavior therapy, Social Effectiveness Therapy for Children, treatment follow-up

This research examined whether a parent's non-disclosure of his or her homosexual or bisexual orientation within the family unit negatively affects self-esteem and anxiety in children, as measured in adulthood. Thirty-six subjects indicated that they had not known of their parent's sexual orientation until an average age of sixteen for the children of lesbian or bisexual mothers, and twenty-two for the children of gay or bisexual fathers. This group's scores on the Rosenberg Sell-Esteem Scale, the Marlowe Crowne Social Desirabilty Scale and the State-Trait Anxiety Scale were compared to scores obtained by sixty-three participants who did not have a homosexual/bisexual parent. The number of years a secretive environment surrounded the child was measured, as were participants' attitudes about the secret sexual identity. Although the study did not find that adults previously raised with a closeted parent had significantly higher levels of anxiety or lower levels of self-esteem, results indicated that those who had been raised as children with non-disclosed lesbian mothers showed a significantly higher level of self-esteem than participants with heterosexual parents. Implications of the findings for the targeted population are discussed. KEYWORDS. Closeted parents, self esteem, anxiety, lesbian, gay, sexual orientation

Whether an attentional bias toward fear-related pictures can be found in nonselected children (n=105) and adults (n=47) and whether a sample of clinically anxious children (n=23) displayed an attentional bias for fear-related pictures over and above that expected for nonselected children is investigated. Both adults and children have showed a stronger attentional bias toward fear-related pictures than toward pleasant pictures.

Ratings of child involvement in manual-based cognitive-behavioral treatment for anxiety were associated with the absence of primary anxiety diagnosis and reductions in impairment ratings at posttreatment for 59 children with anxiety (ages 8-14 years). Good-to-excellent interrater reliability was established for the independent ratings of 237 therapy sessions, and strong psychometrics were established for the involvement measure. Child involvement at midtreatment, just prior to in vivo exposures, was positively associated with treatment gains but earlier involvement was not. Increased involvement during therapy (positive involvement shifts) may provide a useful index of change and may also predict outcomes. Involvement was not associated with client demographics or diagnostic category. Implications for treatment and measurement of psychotherapy process within manual-based treatments are discussed.

Research suggests that the sequelae of childhood anxiety disorders, if left untreated, can include chronic anxiety, depression, and substance abuse. The current study evaluated the maintenance of outcomes of children who received a 16-week cognitive-behavioral treatment for primary anxiety disorders (generalized, separation, and social anxiety disorders) an average of 7.4 years earlier. The 86 participants (ages 15 to 22 years; 91% of the original sample) and their parents completed diagnostic interviews and self-and parent-report measures. According to the diagnostic interviews, a meaningful percentage of participants maintained significant improvements in anxiety at long-term follow-up. With regard to sequelae, positive responders to anxiety treatment, as compared with less positive responders, had a reduced amount of substance use involvement and related problems at long-term follow-up. The findings are discussed with regard to child anxiety and some of its sequelae.

Results of past factor analytic studies of the Childhood Anxiety Sensitivity Index and Anxiety Sensitivity Index were used to formulate hypotheses about factor models of anxiety sensitivity. Using a nonclinical sample of 767 children and adolescents and confirmatory factor analysis, hypothesized models with 2, 3, and 4 lower order factors (facets) were tested. Goodness-of-fit criteria indicated that a model with 4 facets fits these data well. Support was found for factorial invariance of the 4 facets across age and gender, using nonclinical and clinical samples. Results support a hierarchical factor model in that there was a strong general factor, explaining 71% of the variance. Findings are discussed in the context of anxiety sensitivity theory and research with children and adolescents.