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Background There is increasing recognition of the importance of children’s play from a public health perspective, given the links between play and children’s physical and mental health. The present research aimed to develop and evaluate a new parent-report questionnaire that measures the time children spend playing across a range of places and includes a supplement to evaluate how adventurously children play. Methods The questionnaire was developed with input from a diverse group of parents and experts in children’s play. It was designed to yield a range of metrics including time spent playing per year, time spent playing outside, time spent playing in nature and level of adventurous play. The reliability of the questionnaire was then evaluated with 245 parents (149 mothers, 96 fathers) of 154 children aged 5–11 years. All participants completed the measure at time 1. At time 2, an average of 20 days later, 184 parents (111 mothers and 73 fathers) of 99 children completed the measure again. Results Cross-informant agreement, evaluated using Concordance Correlation Coefficients (CCCs), ranged from 0.36 to 0.51. These fall in the poor to moderate range and are largely comparable to cross-informant agreement on other measures. Test-retest reliability for mothers was good (range 0.67–0.76) for time spent playing metrics. For fathers, test-retest reliability was lower (range 0.39–0.63). For both parents the average level of adventurous play variable had relatively poor test retest reliability (mothers = 0.49, fathers = 0.42). This variable also showed a significant increase from time 1 to time 2. This instability over time may be due to the timing of the research in relation to the Covid-19 lockdown and associated shifts in risk perception. Conclusions The measure will be of value in future research focusing on the public health benefits and correlates of children’s play as well as researchers interested in children’s outdoor play and play in nature specifically. The development of the measure in collaboration with parents and experts in children’s play is a significant strength. It will be of value for future research to further validate the measure against play diaries or activity monitors.

It is theorised that adventurous play offers learning opportunities that help to prevent mental health problems in children. In this study, data from two samples is used to examine associations between the time that children aged 5–11 years spent playing adventurously and their mental health. For comparison, time spent playing unadventurously and time spent playing outdoors are also examined. Study 1 includes a sample of 417 parents, Study 2 includes data from a nationally representative sample of 1919 parents. Small, significant associations between adventurous play and internalising problems, as well as positive affect during the first UK-wide Covid-19 lockdown, were found; children who spend more time playing adventurously had fewer internalising problems and more positive affect during the Covid-19 lockdown. Study 2 showed that these associations were stronger for children from lower income families than for children from higher income families. The results align with theoretical hypotheses about adventurous play.

Individuals who score high in Intolerance of Uncertainty (IU) have a tendency to find uncertainty and the unknown aversive. However, there is a dearth of literature on the extent to which the known vs. the unknown during threatening contexts induce fear and anxiety in individuals with high IU. In the following registered report we attempted to address this question by manipulating the known and unknown in the threat of predictable and unpredictable aversive events task. Throughout the task, we measured a variety of self-report (ratings of valence and arousal) and physiological indices (skin conductance, pupil dilation, orbicularis oculi, corrugator supercilii). We collected data from 93 participants. Higher IU, relative to lower IU was associated with: (1) less discriminatory orbicularis oculi activity between cue and interstimulus interval periods across conditions, and (2) larger corrugator supercilii activity to the known predictable shock condition and smaller corrugator supercilii activity to the known unpredictable shock condition, compared to the other conditions. These findings provide evidence that IU-related biases manifest differently depending on the physiological marker of fear and anxiety and the type of known-unknown threat i.e. orbicularis oculi activity was related to generalisation across conditions, whilse corrugator supercilii activity reflected distress/relief during conditions with known threat. Ultimately, this research will inform future models of IU in relation to anxiety and stress disorders.

Temporary goals modulate attention to threat. We examined whether attentional bias to angry faces differs depending on whether a temporary background goal is neutral, or threat related, whilst also measuring social anxiety. Participants performed a dot probe task combined with a separate task that induced a temporary goal. Depending on the phase in this goal task, the goal made angry faces or neutral stimuli (i.e., houses) relevant. The dot probe task measured attention to combinations of angry faces, neutral but goal-relevant stimuli (i.e., houses), and neutral control stimuli. Attention was allocated to angry faces when an angry goal was active. This was more pronounced for people scoring high on social phobia. The neutral goal attenuated attention to angry faces and effects of social phobia were no longer apparent. These findings suggest that individual differences in social anxiety interact with current and temporary goals to affect attentional processes.

Background Difficulty updating threat associations to safe associations has been observed in individuals who score high in self-reported Intolerance of Uncertainty (IU). Here we sought to determine whether an instruction based on fundamental principles of Cognitive Behavioural Therapy could promote safety learning in individuals with higher levels of IU, whilst controlling for self-reported trait anxiety (STICSA). Methods We measured skin conductance response, pupil dilation and expectancy ratings during an associative threat learning task in which participants either received a cognitive behavioural instruction or no instruction prior to threat extinction (n = 92). Results Analyses revealed that both self-reported IU and STICSA similarly predicted differences in skin conductance response. Only individuals with lower IU/STICSA in the cognitive behavioural instruction condition displayed successful safety learning via skin conductance response. Conclusions These initial results provide some insight into how simple cognitive behavioural instructions combined with exposure are applied differently in individuals with varying levels of self-reported anxiety. The results further our understanding of the role of basic cognitive behavioural principles and self-reported anxiety in safety learning.

Adventurous play, defined as exciting, thrilling play where children are able to take age-appropriate risks has been associated with a wide range of positive outcomes. Despite this, it remains unclear what factors might aid or hinder schools in offering adventurous play opportu-nities. The purpose of this systematic review is to synthesise findings from qualitative studies on the perceived barriers and facilitators of adventurous play in schools. A total of nine studies were included in the final synthesis. The review used two synthesis strategies: a meta-aggregative syn-thesis and narrative synthesis. Findings were similar across the two syntheses, highlighting that key barriers and facilitators were: adults’ perceptions of children; adults’ attitudes and beliefs about adventurous play and concerns pertaining to health; and, safety and concerns about legis-lation. Based on the findings of the review, recommendations for policy and practice as provided to support adventurous play in schools.

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The current systematic review and meta-analyses examined the efficacy of psychological interventions targeting behavioural inhibition and anxiety in preschool-aged children, evaluated within randomised controlled trials. Web of Science, MEDLINE, PsycINFO and CINAHL were systematically searched from inception to March 2021. Ten studies (N = 1475 children, aged 3 - 7 years) were included in the current review. Separate analyses were conducted for behavioural inhibition, anxiety symptoms, and anxiety diagnosis as reported by parents, teachers, and observer-ratings. Pooled outcomes ranged from post-intervention to 12-month follow-up due to the limited number of studies. Meta-analyses revealed that intervention did not reduce behavioural inhibition as assessed by independent observers (SMD = -0.13, 95% CI = -0.63 to.38), but did reduce behavioural inhibition as reported by parents (SMC = -0.64, 95% CI = -1.00 to -0.27) and teachers (SMD = -0.69, 95% CI = -1.02 to -0.36). Additionally, intervention appeared to reduce the risk of anxiety disorders (RR =0.75, 95% CI =0.62 to.90), and parent-report anxiety symptoms (SMC = -0.47, 95% CI = -0.83 to -0.12) in preschool-aged children. Intervention may be efficacious in reducing anxiety in preschool-aged behaviourally inhibited children. It is less clear whether intervention leads to change in BI.

This longitudinal study examined a multitude of early childhood predictors of anxiety symptoms and disorders over an 8-year period. The purpose of the study was to identify early life predictors of anxiety across childhood and early adolescence in a sample of at-risk children. The sample included 202 preschool children initially identified as behaviorally inhibited or uninhibited between the ages of 3 years 2 months and 4 years 5 months. Temperament and familial environment variables were assessed using observation and parent report at baseline. Anxiety symptoms and disorders were assessed using questionnaires and diagnostic interviews at baseline (age 4), and at age 6, 9 and 12 years. In line with our hypotheses, the findings showed that preschool children were more likely to experience anxiety symptoms and disorders over time i) when the child was inhibited, ii) when there was a history of maternal anxiety disorders or iii) when mothers displayed high levels of overinvolvement. Further, the study identified a significant interaction effect between temperament and maternal overvinvolvement such that behaviorally inhibited preschoolers had higher anxiety symptoms at age 12, only in the presence of maternal overinvolvement at age 4. The increased risk of anxiety in inhibited children was mitigated when mothers demonstrated low levels of overinvolvement at age 4. This study provides evidence of both additive and interactive effects of temperament and family environment on the development of anxiety and provides important information for the identification of families who will most likely benefit from targeted early intervention.

In this conceptual article, we draw upon the literature regarding cognitive and behavioural factors that underpin childhood anxiety to outline how a range of these risk markers might be targeted through adventurous play. When children play in an adventurous way, climbing trees, riding their bikes fast downhill and jumping from rocks, they experience feelings of fear and excitement, thrill and adrenaline. We propose that the positive, thrilling and playful emotions associated with this type of child-led play facilitate exposure to fear-provoking situations and, in doing so, provide opportunities for children to learn about physiological arousal, uncertainty and coping. We hypothesise that these learning opportunities will, over time, reduce children’s risk for elevated anxiety by increasing children’s expectations and ability to cope with anxiety, decreasing intolerance of uncertainty and preventing catastrophic misinterpretations of physiological arousal. If our conceptual model is correct, then ensuring that children have the physical and psychological space required to play in an adventurous way may help to decrease their risk for elevated or clinical anxiety.

The British Children’s Play Survey was conducted in April 2020 with a nationally representative sample of 1919 parents/caregivers with a child aged 5–11 years. Respondents completed a range of measures focused on children’s play, independent mobility and adult tolerance of and attitudes towards risk in play. The results show that, averaged across the year, children play for around 3 h per day, with around half of children’s play happening outdoors. Away from home, the most common places for children to play are playgrounds and green spaces. The most adventurous places for play were green spaces and indoor play centres. A significant difference was found between the age that children were reported to be allowed out alone (10.74 years, SD = 2.20 years) and the age that their parents/caregivers reported they had been allowed out alone (8.91 years, SD = 2.31 years). A range of socio-demographic factors were associated with children’s play. There was little evidence that geographical location predicted children’s play, but it was more important for independent mobility. Further, when parents/caregivers had more positive attitudes around children’s risk-taking in play, children spent more time playing and were allowed to be out of the house independently at a younger age.

Background and Objectives\ud Intolerance of Uncertainty (IU) may be important for the development and maintenance of anxiety disorders but research with preadolescent children has relied entirely on questionnaire measures to assess IU. Here we aimed to develop a behavioural measure of IU that was appropriate for preadolescent children by adapting the beads task (Jacoby, Abramowitz, Buck, & Fabricant, 2014). \ud Methods\ud Participants were 51 typically developing children (26 female; 7 to 11 years). We examined first whether preadolescent participants could understand and complete the task, then how participants responded to varying levels of uncertainty. We also conducted exploratory analyses regarding associations between task measures and questionnaire measures of IU, anxiety and worry. \ud Results\ud Overall, the adapted Beads Task appears suitable for preadolescent children and is able to capture reactions to uncertainty. At least some of these reactions are related to questionnaire measures of IU and anxiety. Implications and areas for future research are discussed to provide insights into how behavioral tasks examining responses to uncertainty can improve our understanding of IU.\ud Limitations\ud The sample size was relatively small. There was no control task or condition without uncertainty. \ud Conclusions\ud Overall, the adapted Beads Task appears suitable for preadolescent children and is able to capture reactions to uncertainty. This type of behavioral task would be appropriate for use in future research that aims to improve our understanding of IU in children.

(1) Background: There is evidence of an attention bias&ndash, anxiety relationship in children, but lack of appropriate methods has limited the number of studies with children younger than eight years old. This study used eye tracking as a measure of overt attention in young children. The aim of this study was to assess anxiety-related attention bias in children aged four to eight years. Age was considered a moderator, and the influence of effortful control was investigated. (2) Method: A community sample of 104 children was shown pairs of happy&ndash, neutral and angry&ndash, neutral faces. Growth curve analyses were used to examine patterns of gaze over time. (3) Results: Analyses revealed moderation by age and anxiety, with distinct patterns of anxiety-related biases seen in different age groups in the angry&ndash, neutral face trials. Effortful control did not account for age-related effects. (4) Conclusions: The results support a moderation model of the development of anxiety in children.

Extensive research has examined attention bias to threat in the context of anxiety in adults, but little is understood about this association in young children, and there is a dearth of longitudinal research examining whether attention bias to threat predicts anxiety over time in childhood. In the current study, a sample of 180 children participated in a longitudinal study, first as preschoolers and again as they transitioned to formal schooling. At baseline, children aged 3-4 years completed a free-viewing eye-tracking task with angry-neutral and happy-neutral face pairs and an assessment of behavioral inhibition (BI). At follow-up, parents provided daily reports of their child's state anxiety over a 2-week period as their child started school and completed a measure of their child's anxiety symptoms. Results indicated that, on average, preschool-aged children exhibit a bias for emotional faces that is stronger for angry than happy faces. There was little evidence that this bias was associated with anxiety symptoms. However, BI interacted with dwell bias for angry faces to predict trajectories of anxiety over the transition to school. An unexpected interaction between BI and dwell bias for happy faces was also found, with dwell for happy faces associated with lower anxiety for children higher in BI. The findings are consistent with recent developmental models of the BI-anxiety relationship and indicate that attention bias modification may not be suitable for young children, for whom attention bias to threat may be normative. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Publisher's version (útgefin grein), Background Childhood Social Anxiety Disorder (SAD) is common and impairing. The recommended treatment is a disorder specific form of cognitive behavioural therapy (CBT) that includes social skills training and, whilst they appear to be more effective than more general treatments, it is not clear whether social skills training is the critical component involved in improved outcomes, particularly given that evidence for the relationship between social anxiety and social skills deficits in children is inconsistent. This may be partly due to an overlap in their observable features, and because the nature of the association may vary in different contexts (e.g. according to child age). An alternative approach is to examine the association between social anxiety and the social cognitive capacities that underpin social skills. This paper aims to examine the association between social anxiety and social cognition in children and adolescents, and examine conceptual and methodological moderators of this relationship. Methods Papers published between 1980 and 2019 were screened systematically. Fifty studies were identified from which an effect size could be calculated for the relationship between social anxiety and social cognition, including 15,411 children and adolescents. Results An overall significant, but moderate effect (r = -.15) was identified, where increased social anxiety was associated with lower social cognitive ability. Moderation analyses revealed specific associations within studies examining social anxiety among participants with and without ASD who were older than 7 years old, and studies assessing the relationship between social anxiety and specific aspects of Theory of Mind (ToM). No significant association was identified between social anxiety and emotion recognition. Conclusions Significant associations between social anxiety and social cognitive abilities appear to be accounted for by elevated social anxiety among children with ASD, and those with difficulties in specific aspects of ToM but not broader social skills, such as emotion recognition. This reinforces the importance of accurately identifying and treating social anxiety within ASD populations. In addition, treatments for social anxiety among neurotypical populations may benefit from targeting particular aspects of ToM rather than emotion recognition and other broad social skills., National Institute for Health Research (NIHR) Grant Number: NIHR-RP-2014-04-018 University of Reading, "Peer Reviewed"

Individuals who score high in self-reported Intolerance of Uncertainty (IU) display difficulties updating threat associations to safe associations. Here we sought to determine whether individuals who score high in IU can learn and retain new safety associations if given more exposure. We recorded skin conductance response, pupil dilation and expectancy ratings during an associative threat learning task with acquisition, same-day extinction and next-day extinction phases. Participants (n = 144) were assigned to either a regular exposure (32 trials of same-day and next-day extinction) or extended exposure condition (48 trials of same-day and next-day extinction). We failed to replicate previous work showing that IU is associated with poorer safety-learning indexed via SCR, although the results were at trend and in the expected direction. We found preliminary evidence for promoted safety-retention in individuals with higher Inhibitory IU in the extended exposure condition, relative to individuals with higher Inhibitory IU in the regular exposure condition, indexed via SCR. These findings further our current understanding of the role of IU in safety-learning and -retention, informing models of IU and exposure-based treatments.

Objective Children with a behaviorally inhibited temperament during early childhood have been shown to have an increased risk for developing anxiety disorders. This study evaluated the efficacy of an anxiety prevention program aimed at reducing the risk of anxiety in behaviorally inhibited preschool children. Method Participants were 86 children aged 41–57 months and their mothers. Children were selected if their mothers reported high levels of child behavioral inhibition on a screening measure. Participants were randomly allocated to a nine-session intervention or a waitlist control condition. Mothers and children both participated in the intervention. Results. At follow-up, the intervention group had significantly fewer clinician-rated child anxiety disorders and fewer mother-reported child anxiety symptoms than at baseline but this change was not significantly different to the change seen in the waitlist control group. Conclusions On average, across the course of the study, anxiety decreased in all children irrespective of group. A number of potential reasons for this are discussed along with implications for research and clinical practice.

Extinction-resistant threat is regarded as a central hallmark of pathological anxiety. However, it remains relatively under-studied in social anxiety. Here we sought to determine whether self-reported trait social anxiety is associated with compromised threat extinction learning and retention. We tested this hypothesis within two separate, socially relevant conditioning studies. In the first experiment, a Selective Extinction Through Cognitive Evaluation (SECE) paradigm was used, which included a cognitive component during the extinction phase, while experiment 2 used a traditional threat extinction paradigm. Skin conductance responses and subjective ratings of anxiety (experiment 1 and 2) and expectancy (experiment 2) were collected across both experiments. The findings of both studies demonstrated no effect of social anxiety on extinction learning or retention. Instead, results from experiment 1 indicated that individual differences in Intolerance of Uncertainty (IU) were associated with the ability to use contextual cues to decrease a conditioned response during SECE. However, during extinction retention, high IU predicted greater generalisation across context cues. Findings of experiment 2 revealed that higher IU was associated with impaired extinction learning and retention. The results from both studies suggest that compromised threat extinction is likely to be a characteristic of high levels of IU and not social anxiety.

Individuals who score high in intolerance of uncertainty (IU) display reduced threat extinction. Recently, it was shown that replacing threat associations with novel associations during extinction learning (i.e., presenting a novel tone 100% of the time) can promote threat extinction retention in individuals with high IU. This novelty facilitated extinction (NFE) effect could be driven by the tone's novelty or reliability. Here, we sought to address this question by adjusting the reliability of the novel tone (i.e., the reinforcement rate) during NFE. We measured skin conductance response during an associative learning task in which participants (n = 92) were assigned to one of three experimental groups: standard extinction, NFE 100% reinforcement, or NFE 50% reinforcement. For standard extinction, compared to NFE 100% and 50% reinforcement groups, we observed a trend for greater recovery of the conditioned response during extinction retention. Individuals with high IU relative to low IU in the standard extinction group demonstrated a larger recovery of the conditioned response during extinction retention. These findings tentatively suggest that NFE effects are driven by the novelty rather than the reliability of the new stimulus. The implications of these findings for translational and clinical research in anxiety disorder pathology are discussed.

Intolerance of Uncertainty (IU) is a dispositional tendency to react negatively to uncertainty. The Intolerance of Uncertainty Scale for Children (IUS-C) is designed to measure IU in children but there has been limited investigation into the psychometric properties of this scale. Using data from 227 preadolescent children and 204 parents, we examined (a) readability and whether any items were difficult to understand for children and parents, (b) factor structure, (c) test-retest reliability, and (d) the agreement between child and parent forms of the IUS-C. Results revealed that the reading age of the IUS-C may be too high for preadolescent children and that both children and parents found some items difficult to understand. Model fit with the full IUS-C was not adequate for either parent or child forms. For both forms, selecting items aligned with the IUS-12 led to adequate model fit. For both child-report and parent-report, a one-factor model was supported. Test-retest reliability of total score for all versions was high over a 2-week period (child form: ICC = .82 for 27 item and ICC = .73 for 12 items; parent form: ICC = .87 for 27 item and ICC = .86 for 12 item) but agreement between child and parent forms was consistently poor (r = .24 for 27 item and r = .29 for 12 item). Overall, the results suggest that IUS-C-12 is most appropriate for preadolescent children and their parents. The reading age remains slightly high for preadolescent children so it may be beneficial for future research to consider developing a child-report version with lower reading age.

Food fussiness is the rejection of familiar and novel foods leading to consumption that is insufficient and/or inadequately varied. Its importance to children's nutrition and the development of food preferences means it has been the focus of extensive research. To measure food fussiness, research has predominantly relied on parent-report, though parents' reporting of their child's eating behaviour can be reliable, responses may also be subject to bias. Utilising data from video-recordings of sixty-seven mother-child dyads during a meal in the home environment, this study aimed to validate the most widely used parent-report questionnaire measuring food fussiness against independent observations of children's eating behaviour and, in so doing, determine its accuracy. Maternal reported food fussiness, assessed using the Food Fussiness subscale of the Children's Eating Behaviour Questionnaire (CEBQ; Wardle, Guthrie, Sanderson, & Rapoport, 2001) was compared to children's observed food rejection and acceptance behaviours. Bootstrapped Pearson's correlations revealed that maternal reports of food fussiness were significantly positively related to food rejection behaviours and significantly negatively related to food acceptance behaviours. Maternal reports of food fussiness were also found to be significantly negatively related to the proportion of familiar/appealing of familiar foods consumed by the child. There was no significant association between maternal reported food fussiness and the proportion of familiar/unappealing, unfamiliar/appealing and unfamiliar/unappealing foods consumed by the child or the meal duration. These findings support the CEBQ FF as a valid measure of food fussiness.

This study examined the effect of anonymous computer mediated communication (CMC) on state anxiety, specifically focusing on whether the valence of the interaction affected state anxiety prior to completing an anxiety-inducing task. To investigate this, 62 female participants aged 18-25 were randomly assigned to one of three conditions: positive CMC, negative CMC and writing a blog. Self-report measures of state anxiety were taken at: baseline; after participants had been given instructions about the anxiety-inducing task; after ten minutes of CMC/blog writing; and after the anxiety-inducing task had been completed. Results showed that participants in the positive CMC condition showed a significant and moderate decrease in anxiety following the CMC whereas those in the negative CMC condition showed a non-significant but moderate increase in anxiety following the CMC. Anxiety remained relatively unaffected by the blog condition. After completing the anxiety-inducing task there were no differences in anxiety scores between groups. The findings show that CMC can be beneficial for relieving state anxiety but that the valence of the communication is crucial. This has implications for advice and training given to those participating in and supporting CMC where mental health issues might be discussed.

Background Cognitive Behaviour Therapy (CBT) is an effective treatment for childhood anxiety disorders, yet a significant proportion of children do not benefit from it. CBT for child anxiety disorders typically includes a range of strategies that may not all be applicable for all affected children. This study explored whether there are distinct subgroups of children with anxiety disorders who are characterized by their responses to measures of the key mechanisms that are targeted in CBT (i.e. interpretation bias, perceived control, avoidance, physiological arousal, and social communication). Methods 379 clinically anxious children (7–12 years) provided indices of threat interpretation, perceived control, expected negative emotions and avoidance and measures of heart rate recovery following a speech task. Parents also reported on their children's social communication difficulties using the Social Communication Questionnaire (SCQ). Results Latent profile analysis identified three groups, reflecting (i) ‘Typically anxious’ (the majority of the sample and more likely to have Generalized anxiety disorder); (ii) ‘social difficulties’ (characterized by high SCQ and more likely to have social anxiety disorder and be male); (iii) ‘Avoidant’ (characterized by low threat interpretation but high avoidance and low perceived control). Limitations Some measures may have been influenced by confounding variables (e.g. physical variability in heart rate recovery). Sample characteristics of the group may limit the generalizability of the results. Conclusions Clinically anxious children appear to fall in to subgroups that might benefit from more targeted treatments that focus on specific maintenance factors. Treatment studies are now required to establish whether this approach would lead to more effective and efficient treatments., Highlights • Latent profile analysis suggested clinically anxious children represented three groups. • The groups differed on putative maintenance mechanisms often targeted in CBT. • The groups were categorised as “Typically anxious”, “Social Difficulties” and “Avoidant”. • Groups did not neatly align with existing diagnostic categories for child anxiety disorders.

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

Excessive avoidance and safety behaviours are a hallmark feature of social anxiety disorder. However, the conditioning and extinction of avoidance behaviour in social anxiety is understudied. Here, we examined the effect of individual differences in social anxiety on low-cost operant avoidance conditioning and extinction in 80 female participants. We employed an avoidance conditioning and extinction paradigm and measured skin conductance response, threat expectancy ratings and avoidance behaviour throughout the task. Findings demonstrated that elevated levels of social anxiety predicted the generalisation of conditioned avoidance responses across to safety cues during avoidance conditioning. When the opportunity to avoid was returned after extinction learning, elevated social anxiety was associated with increased avoidance behaviour to both threat and safety cues. The results suggest that compromised extinction of avoidance behaviour is a characteristic of social anxiety and supports the strategy of minimising avoidance and safety behaviours during exposure therapy for the treatment of social anxiety disorder. Future research should utilise the avoidance conditioning and extinction paradigm as a laboratory model for clinical research to investigate how, and under what circumstances, the extinction of avoidance and safety behaviours can be improved for individuals high in social anxiety.

Verbal information transfer, one of Rachman’s three pathways to fear, may be one way in which vulnerability for anxiety may be transmitted from parents to children. A community sample of mothers and their preschool-aged children (N = 65) completed observational tasks relating to the child starting school. Mothers were asked to tell their child about social aspects of school; then children completed a brief play assessment involving ambiguous, school-based social scenarios. Mothers completed self-report questionnaires on social anxiety symptoms, general anxiety and depressive symptoms as well as a questionnaire on child anxiety symptoms and indicated whether they were personally worried about their child starting school. There was a significant difference in the information given to children about school between mothers who stated they were worried and those who stated they were not, with mothers who were worried more likely to mention unresolved threat, use at least one anxiety-related word, and show clear/consistent negativity (all ps

Task relevance affects emotional attention in healthy individuals. Here, we investigate whether the association between anxiety and attention bias is affected by the task relevance of emotion during an attention task. Participants completed two visual search tasks. In the emotion-irrelevant task, participants were asked to indicate whether a discrepant face in a crowd of neutral, middle-aged faces was old or young. Irrelevant to the task, target faces displayed angry, happy, or neutral expressions. In the emotion-relevant task, participants were asked to indicate whether a discrepant face in a crowd of middle-aged neutral faces was happy or angry (target faces also varied in age). Trait anxiety was not associated with attention in the emotion-relevant task. However, in the emotion-irrelevant task, trait anxiety was associated with a bias for angry over happy faces. These findings demonstrate that the task relevance of emotional information affects conclusions about the presence of an anxiety-linked attention bias.

There is convincing evidence that anxious children and adolescents are biased to interpret ambiguity in a negative way (Stuijfzand, Creswell, Field, Pearcey, & Dodd, 2017). However, little research examines interpretation bias in children under eight years. This is due to existing measures of interpretation bias being inappropriate for young children. Consequently, we aimed to develop a new interpretation bias task for young children using tones. Children learnt to associate high tones with a ‘happy alien’ and low tones with an ‘angry alien’. They were then asked to classify tones from the middle of the frequency range (ambiguous tones) as ‘happy’ or ‘angry’. Corrugator muscle activity was recorded alongside behavioural responses. A community sample of 110 children aged 4–8 years, split into high and low anxious groups, completed the task. High anxious children were more likely to interpret the ambiguous tones as negative but this effect was small and only apparent after controlling for developmental factors. Corrugator activity aligned with behavioural responses for trained but not ambiguous tones. This is the first study to assess interpretation bias in young children using behavioural and physiological measures. Results indicate the task is developmentally appropriate and has potential utility for future research.

An association between interpretation of ambiguity and anxiety may exist in children, but findings have been equivocal. The present research utilized the Interpretation Generation Questionnaire for Children (IGQ-C), a novel measure that breaks down the processing of ambiguity into three steps: the generation of possible interpretations, the selection of the most likely interpretation and the anticipated emotional response to the ambiguous situation. The IGQ-C was completed by 103 children aged 11–12 years, 28 of whom had a clinical anxiety disorder. There was some evidence for an association between anxiety and: (1) the generation of initial negative interpretations; (2) the generation of a greater number of negative interpretations overall; and (3) the selection of negative responses. These findings were not consistent across measures of anxiety. A more convincing association was found between child anxiety and anticipated emotional response to the ambiguous scenarios, with anxious children anticipating more negative emotion.

The temperament style Behavioural Inhibition (BI) has been implicated as a risk factor for the development of internalising disorders such as anxiety. Of interest is what factors influence the developmental trajectories of both inhibited and disinhibited children and the development of psychopathology. One such factor is risk-taking behaviour. Using the computer based Balloon Analogue Risk Task, we assessed risk taking behaviour in behaviourally inhibited (n = 27) and behaviourally disinhibited (n = 43) children. This is the first study to examine the relationship between BI, executive functioning and risk-taking. The results indicated Behavioural Inhibition was not related to risk-taking but that inhibitory control predicted reward focused results. These findings illustrate how inhibitory control affects risk-taking and risk avoidance in both inhibited and disinhibited children.

This study investigated the psychometric properties of the Social Worries Anxiety Index for Young children (SWAIY), adapted from the Social Worries Questionnaire—Parent version (SWQ-P; Spence, 1995), as a measure of social anxiety in young children. 169 parents of children aged four to eight years from a community sample completed the SWAIY and a standardized measure of anxiety; the SWAIY was completed again two weeks later. Parents deemed the items appropriate and relevant to children of this age. The SWAIY demonstrated excellent ( > 0.80) internal consistency and a one-factor model. Test-retest reliability was strong (r = 0.87) and evidence of convergent validity (r > .50) was found. The study provides initial evidence for the validation of SWAIY as a measure of social anxiety in children aged four to eight years old. This questionnaire is ideal for investigating social anxiety over early childhood and the relationship between early social worries and later anxiety disorders.

Intolerance of uncertainty (IU) has been implicated in the development and maintenance of worry and anxiety in adults and there is an increasing interest in the role that IU may play in anxiety and worry in children and adolescents.We conducted a systematic review and meta-analysis to summarize existing research on IU with regard to anxiety and worry in young people, and to provide a context for considering future directions in this area of research. The systematic review yielded 31 studies that investigated the association of IU with either anxiety or worry in children and adolescents.The meta-analysis showed that IU accounted for 36.00% of the variance in anxiety and 39.69% in worry. Due to the low number of studies and methodological factors, examination of potential moderators was limited; and of those we were able to examine, none were significant moderators of either association. Most studies relied on questionnaire measures of IU, anxiety, and worry; all studies except one were cross-sectional and the majority of the studies were with community samples.The inclusion of eligible studies was limited to studies published in English that focus on typically developing children.There is a strong association between IU and both anxiety and worry in young people therefore IU may be a relevant construct to target in treatment. To extend the existing literature, future research should incorporate longitudinal and experimental designs, and include samples of young people who have a range of anxiety disorders.

The number of students in special schools has increased at a rapid rate in some Australian states, due in part to increased enrolment under the categories of emotional disturbance (ED) and behaviour disorder (BD). Nonetheless, diagnostic distinctions between ED and BD are unclear. Moreover, despite international findings that students with particular backgrounds are over-represented in special schools, little is known about the backgrounds of students entering such settings in Australia. This study examined the government school enrolment data from New South Wales, the most populous of the Australian states. Linear and quadratic trends were used to describe the numbers and ages of students enrolled in special schools in the ED and BD categories. Changes between 1997 and 2007 were observed. Results showed an over-representation of boys that increased across the decade and a different pattern across age for boys and girls. Consistent with international findings, these results indicate that trends in special school placements are unrelated to disability prevalence in the population. Rather, it is suggested that schools act to preserve time and resources for others by removing their more challenging students: most typically, boys.

The current study investigated the longitudinal relationships among behavioral inhibition (BI), life events, and anxiety in a sample of 102 BI children and 100 behaviorally uninhibited (BUI) children aged 3 to 4 years. Children's parents completed questionnaires on BI, stressful life events, and anxiety symptoms, and were administered a diagnostic interview three times in a 5-year period. In line with our hypotheses, negative life events, particularly negative behavior-dependent life events (i.e., life events that are related to the children's own behaviors), and the impact of negative life events were predictive of increases in subsequent anxiety symptoms, the likelihood of having an anxiety disorder, and increased number of anxiety diagnoses over the 5-year follow-up period. Experiencing more positive, behavior-independent life events decreased the risk of being diagnosed with an anxiety disorder. Furthermore, differences were found in life events between BI and BUI children. That is, BI children experienced fewer positive and specifically positive behavior-dependent life events, and the impact of these positive life events was also lower in BI children than in BUI children. However, BI did not interact with life events in the prediction of anxiety problems as hypothesized. Therefore, this study seems to indicate that BI and life events act as additive risk factors in the development of anxiety problems.

Individuals with Williams syndrome (WS) often experience significant anxiety. A promising approach to anxiety intervention has emerged from cognitive studies of attention bias to threat. To investigate the utility of this intervention in WS, this study examined attention bias to happy and angry faces in individuals with WS (N = 46). Results showed a significant difference in attention bias patterns as a function of IQ and anxiety. Individuals with higher IQ or higher anxiety showed a significant bias toward angry, but not happy faces, whereas individuals with lower IQ or lower anxiety showed the opposite pattern. These results suggest that attention bias interventions to modify a threat bias may be most effectively targeted to anxious individuals with WS with relatively high IQ.

BACKGROUND: This research investigates the relationship between challenging parenting behaviour and childhood anxiety disorders proposed by Bögels and Phares (2008). Challenging parenting behaviour involves the playful encouragement of children to go beyond their own limits, and may decrease children's risk for anxiety (Bögels and Phares, 2008).METHOD: Parents (n=164 mothers and 144 fathers) of 164 children aged between 3.4 and 4.8 years participated in the current study. A multi-method, multi-informant assessment of anxiety was used, incorporating data from diagnostic interviews as well as questionnaire measures. Parents completed self-report measures of their parenting behaviour (n=147 mothers and 138 fathers) and anxiety (n=154 mothers and 143 fathers). Mothers reported on their child's anxiety via questionnaire as well as diagnostic interview (n=156 and 164 respectively). Of these children, 74 met criteria for an anxiety disorder and 90 did not.RESULTS: Fathers engaged in challenging parenting behaviour more often than mothers. Both mothers' and fathers' challenging parenting behaviour was associated with lower report of child anxiety symptoms. However, only mothers' challenging parenting behaviour was found to predict child clinical anxiety diagnosis.LIMITATIONS: Shared method variance from mothers confined the interpretation of these results. Moreover, due to study design, it is not possible to delineate cause and effect.CONCLUSIONS: The finding with respect to maternal challenging parenting behaviour was not anticipated, prompting replication of these results. Future research should investigate the role of challenging parenting behaviour by both caregivers as this may have implications for parenting interventions for anxious children.

This study investigated whether close friends affect each other’s fear responses (fear beliefs and avoidance) when they discuss fear-related issues together. Children (N = 242) aged 7 to 10 years were first presented with ambiguous and threatening information about two novel animals respectively, after which their fear responses towards each animal were assessed (T1). Next, dyads of close friends had a discussion about their feelings regarding the animals, and their fear responses were measured again (T2). Results showed that children influenced each other’s cognitions following the discussion; from T1 to T2 their fear responses became more similar and close friends’ fear responses at T1 significantly predicted children’s fear responses at T2. Gender pair type predicted change in children’s fear responses over time. Children in boy-boy pairs showed a significant increase in fear responses following the discussion; their fear level became more in line with that of other gender pairs at T2, while those in girl-girl pairs showed a significant decrease in their fear beliefs, at least when threatening information was given. Differences in anxiety level between close friends did not affect change in fear responses over time. Altogether, the results indicate that children may affect each other’s fears.

Cognitive theories emphasise the role of dysfunctional beliefs about sleep in the development and maintenance of sleep-related problems (SRPs). The present research examines how parents’ dysfunctional beliefs about children’s sleep and child dysfunctional beliefs about sleep are related to each other and to children’s subjective and objective sleep. Participants were 45 children aged 11–12 years and their parents. Self-report measures of dysfunctional beliefs about sleep and child sleep were completed by children, mothers and fathers. Objective measures of child sleep were taken using actigraphy. The results showed that child dysfunctional beliefs about sleep were correlated with father (r = 0.43, p < 0.05) and mother (r = 0.43, p < 0.05) reported child SRPs, and with Sleep Onset Latency (r = 0.34, p < 0.05). Maternal dysfunctional beliefs about child sleep were related to child SRPs as reported by mothers (r = 0.44, p < 0.05), and to child dysfunctional beliefs about sleep (r = 0.37, p < 0.05). Some initial evidence was found for a mediation pathway in which child dyfunctional beliefs mediate the relationship between parent dysfunctional beliefs and child sleep. The results support the cognitive model of SRPs and contribute to the literature by providing the first evidence of familial aggregation of dysfunctional beliefs about sleep.

A story-stem paradigm was used to assess interpretation bias in preschool children. Data were available for 131 children. Interpretation bias, behavioral inhibition (BI), and anxiety were assessed when children were aged between 3 years 2 months and 4 years 5 months. Anxiety was subsequently assessed 12 months, 2 years, and 5 years later. A significant difference in interpretation bias was found between participants who met criteria for an anxiety diagnosis at baseline, with clinically anxious participants more likely to complete the ambiguous story-stems in a threat-related way. Threat interpretations significantly predicted anxiety symptoms at 12-month follow-up, after controlling for baseline symptoms, but did not predict anxiety symptoms or diagnoses at either 2-year or 5-year follow-up. There was little evidence for a relationship between BI and interpretation bias. Overall, the pattern of results was not consistent with the hypothesis that interpretation bias plays a role in the development of anxiety. Instead, some evidence for a role in the maintenance of anxiety over relatively short periods of time was found. The use of a story-stem methodology to assess interpretation bias in young children is discussed along with the theoretical and clinical implications of the findings.