The Effectiveness of Anxiety Interventions for Young Children: A Meta-Analytic Review.

Anxiety symptoms and disorders are prevalent and impairing in young children and these symptoms often persist and worsen over time, indicating the need for efficacious interventions for this age group. The purpose of this study was to evaluate the effectiveness of psychosocial interventions targeting anxiety in younger children and to assess the potential moderators of outcome. The effect sizes from 24 trials were assessed based on a random effect model. The mean weighted effect size was found to be significant and moderate in magnitude. Moderators, including level of intervention, intervention approach, rater, and level of training of the provider/program facilitator, are assessed and discussed. Overall, the findings indicate that anxiety interventions are effective in reducing anxiety in young children, and targeted trials show particularly strong promise.

Validation of the Interpretation of Intrusions Inventory for the Mexican Population: Cross-Cultural Discrepancies.

To facilitate research on the cognitive model of obsessive-compulsive disorder (OCD), leaders in the field of OCD (Obsessive-Compulsive Cognitions Working Group [OCCWG]) developed and validated the Interpretation of Intrusions Inventory-31 (III-31). The current sought to adapt and validate this important measure for the Mexican population using a large sample of emerging adults (N = 457). Specifically, we evaluated the factor structure and convergent validity of the III-31 for the Mexican population. Based on a series of confirmatory factor analyses, previously established one-, two-, and three-factor models were found to be a poor fit with current data. However, an exploratory factor analysis yielded a two-factor solution, with one factor assessing the harmfulness and danger of intrusive thoughts (Harmfulness/Danger), and the other assessing exaggerated responsibility and efforts to control intrusions (Responsibility/Control). Satisfactory convergent validity was found with the severity of dysfunctional beliefs and OCD symptoms. Implications and limitations of study results are discussed.

The Relevance of Mindfulness and Thought Suppression to Scrupulosity.

The purpose of this study was to examine the relevance of the mindfulness and thought suppression to scrupulosity, or religious obsessions. It was hypothesized that scrupulosity would be negatively associated trait mindfulness and positively associated with thought suppression. It was also hypothesized that thought suppression and mindfulness would mediate the association between scrupulosity and symptoms of obsessive-compulsive disorder (OCD). A survey-based study was conducted to test these hypotheses in a large, nonreferred sample. In particular, undergraduate university students completed a number of self-report measures, including the Pennsylvania Inventory of Scrupulosity (PIOS), the Five Facet Mindfulness Questionnaire- Short Form (FFMQ-SF), and the White Bear Suppression Inventory (WBSI) in exchange for extra credit. As anticipated, mindfulness was significantly associated with scrupulosity, with a particularly strong and negative association found between the PIOS and the nonjudging subscale of the FFMQ-SF. Further, thought suppression was found to be significantly and positively associated scores on the PIOS, with correlations in the moderate to strong range. Further, as anticipated, mindfulness and thought suppression mediated the relation between scrupulosity and thought suppression. Overall, the findings provide insight into the cognitive processes related to persistent and disruptive levels of scrupulosity.

Rumination and the mood-as-input hypothesis: Does congruence matter?

BACKGROUND AND OBJECTIVES: The mood-as-input hypothesis (MAIH), which emphasizes the role of mood and stop rules on perseverative thinking, has been extensively studied in relation to worry (Meeten & Davey, 2011). However, relatively few studies have focused on the applicability of the MAIH to depressive rumination. Consequently, two studies were conducted to further examine the potential relevance of the MAIH to depressive rumination. METHODS: In the first study, a sample of undergraduate students completed a rumination interview under one of four conditions, including mood (positive vs. negative) and stop rule (as-many-as can (AMA) and feel like stopping (FL)). It was anticipated that participants in the negative mood/AMA and the positive mood/FL conditions would exhibit the most persistence in the rumination interview. A second, follow-up study was conducted in which a positive rumination condition was added to examine the role of congruence between mood induction and task valence on interview performance. RESULTS: In the first study, support for predictions of the MAIH was found in the negative mood conditions but not the positive mood conditions. In the second study, as predicted, under conditions of mood congruence, the original predictions of the MAIH were supported. However, under conditions of mood incongruence, participants appeared to default to the assigned stop rule. LIMITATIONS: Although the findings are promising, it is noteworthy that the sample was non-clinical. Further, this approach to studying depressive rumination may have somewhat limited ecological validity, as the research was conducted in a controlled laboratory setting. CONCLUSIONS: Overall, the current findings provide insight into the conditions under which depressive rumination is most likely to occur.

The Development and Evaluation of the Psychometric Properties of the Negative Beliefs about Post-Event Processing Scale.

BACKGROUND: Although negative beliefs have been found to be associated with worry symptoms and depressive rumination, negative beliefs have yet to be examined in relation to post-event processing and social anxiety symptoms. AIMS: The purpose of the current study was to examine the psychometric properties of the Negative Beliefs about Post-Event Processing Questionnaire (NB-PEPQ). METHOD: A large, non-referred undergraduate sample completed the NB-PEPQ along with validation measures, including a measure of post-event processing and social anxiety symptoms. RESULTS: Based on factor analysis, a single-factor model was obtained, and the NB-PEPQ was found to exhibit good validity, including positive associations with measures of post-event processing and social anxiety symptoms. CONCLUSIONS: These findings add to the literature on the metacognitive variables that may lead to the development and maintenance of post-event processing and social anxiety symptoms, and have relevant clinical applications.

Examination of the Contribution of Ruminative Thinking and Maladaptive Self-Beliefs to Social Anxiety.

The purpose of this study was to examine the relative contribution of 3 components of the Clark and Wells (1995) model to social anxiety symptoms. In particular, based on theory and previous research, it was hypothesized that the association between post-event processing and social anxiety and between anticipatory anxiety and social anxiety would be mediated by maladaptive self-beliefs. To test this hypothesis, a large, nonclinical sample of young adults completed a measure of anticipatory processing, post-event processing, maladaptive self-beliefs, and social anxiety. Based on a structural equation modeling approach, full mediation was found between post-event processing and social anxiety, and partial mediation was found between anticipatory processing and social anxiety. Overall, the results contribute to the literature by elucidating cognitive processes that may lead to the development and maintenance of social anxiety symptoms.

Meta-worry in adolescents: examination of the psychometric properties of the meta-worry questionnaire in an adolescent sample.

BACKGROUND: Meta-worry is considered a central component of the Metacognitive Model of Generalized Anxiety Disorder. Although initial research provides support for the applicability of this model to adolescent samples, the construct of meta-worry has yet to be examined in adolescents. AIMS: The purpose of this study was to examine the psychometric properties of the Meta-Worry Questionnaire (MWQ), a measure designed to assess negative beliefs about worry, in an adolescent sample, and to examine the degree to which meta-worry is associated with pathological worry in adolescents. METHOD: A non-referred sample of 175 adolescents completed a modified version of the MWQ along with the Meta-Cognitions Questionnaire-Children (MCQ-C) and the Penn State Worry Questionnaire for Children (PSWQ-C). RESULTS: The MWQ was found to exhibit strong psychometric properties. Most noteworthy, the MWQ was found to be a particularly robust predictor of scores on the PSWQ-C, and incremental validity was also demonstrated. CONCLUSIONS: Overall, the current findings provide support for the reliability and validity of the MWQ in adolescents and support for meta-worry as a predictor of worry symptoms in adolescents.

What do parents worry about? Examination of the construct of parent worry and the relation to parent and child anxiety.

BACKGROUND: Previous research has indicated that parent cognition, including anxious beliefs and expectations, are associated with both parent and child anxiety symptoms and may be transferred from parent to child. However, the content and frequency of parent worry in relation to their children has yet to be examined as a potential form of anxious parent cognition, and little is known about normative parent worry. AIMS: The purpose of the current study is to extend the research on parent cognition and child anxiety by focusing on parent worry (i.e. parent worry in relation to their children) as a potential predictor of child anxiety. METHOD: A comprehensive self-report measure of parent worry was developed and administered to a community-based sample of parents. RESULTS: An exploratory factor analysis yielded a single factor solution. Parent worry was found to be a more robust predictor of child anxiety than parent anxiety symptoms, and parent worry mediated the association between parent anxiety symptoms and child anxiety. Most common worries reported by parents fell within the domains of life success and physical well-being. CONCLUSION: Overall, this study adds to the literature on parent cognitive biases and has the potential to inform parent-based interventions for the treatment of child anxiety. Further, this study provides initial data on normative parent worry.

The relation between parental influence, body image, and eating behaviors in a nonclinical female sample.

The purpose of the current study is to create a comprehensive composite measure of parental influence based on previously developed measures to clarify the underlying dimensions of parental influence and to determine the degree to which parental influence relates to body image and dysfunctional weight concerns. Previously published literature was reviewed for measures of parental influence, and items from 22 measures were condensed and combined into a single questionnaire, which was completed by 367 female undergraduate psychology students. Two dimensions emerged from a principle components analysis: Direct Influence, which includes weight and eating related comments, and Modeling, which includes parental modeling of dieting and related behavior. Direct Influence and Modeling were significantly related to eating disturbance, such as drive for thinness and bulimic symptomatology. Overall, the results integrate the previous literature and clarify the underlying dimensions of parental influence. Further, this study provides directions for future research related to the development and maintenance of body image and eating disturbance.

The prevention of child and adolescent anxiety: a meta-analytic review.

The purpose of this study was to provide a comprehensive review of the effectiveness of child and adolescent anxiety prevention programs. Mean weighted effect sizes were calculated, and studies were encoded for potential moderator variables. A statistically significant effect size of .18 was obtained at post-intervention, which is consistent with effect sizes reported in reviews of depression, eating disorder, and substance abuse prevention programs. However, the effect sizes obtained at follow-up yielded mixed results. Significant moderators of program effectiveness were found including provider type (professional versus lay provider) and the use of the FRIENDS program. In contrast, program duration, participant age, gender, and program type (universal versus targeted) were not found to moderate program effectiveness. Clinical implications and directions for future research are discussed, including the need for more long-term follow-up, early prevention programs, and studies that systematically examine the impact of parent involvement on program effectiveness.

Validation of the food thought suppression inventory.

The Food Thought Suppression Inventory (FTSI) was designed as a domain-specific measure of food-related thought suppression, and the FTSI has been found to be associated with eating pathology, including binge eating. Although initial research in this area is promising, as it may provide understanding of the cognitive processes related to the development of eating pathology and obesity, little is known about the psychometric properties of the FTSI. In the current study, the validity of the FTSI was examined, and the FTSI was found to be a valid, reliable, single factor measure of food thought suppression.

Reexamination of the MASC factor structure and discriminant ability in a mixed clinical outpatient sample.

Anxiety problems in youth are common, suggesting the need for developmentally appropriate and psychometrically sound measures in this area. The Multidimensional Anxiety Scale for Children (MASC) was created with this goal in mind, but has yet to be examined with samples representative of youth typically seen in clinical settings. Two hundred and sixty-two outpatient youth with mixed clinical presentations completed the MASC, a measure that includes a total anxiety score, as well as subscale scores for social anxiety, harm avoidance, separation anxiety/panic, and physical symptoms of anxiety. Internal consistency, means, and factor structure were comparable to that reported previously. Model invariance was supported across gender, diagnosis, and age. The MASC total score significantly differentiated children who received anxiety disorder diagnoses from those who did not. The social anxiety subscale significantly predicted social phobia and the harm avoidance subscale significantly predicted generalized anxiety disorder. Further support was found for the MASC. However, caution should be exercised given mixed discriminant ability findings. That is, the MASC seems best suited as a screening instrument for anxiety and when used in conjunction with a multiple method/informant assessment approach.

Personality information: does it influence attractiveness ratings of various body sizes?

In the present study, the influence of personality information on attractiveness ratings of different body sizes was examined. Specifically, participants were presented with either no personality information, negative information, or positive information about a hypothetical female target and asked to rate the smallest and largest figure that they would consider attractive for her using a figure rating scale. Consistent with the study hypotheses: (1) participants chose a wider range of figures as attractive for a female described to have a positive personality when compared to the range chosen when no personality information was provided; (2) females selected wider attractive ranges than males; and (3) other participant characteristics (i.e., physical appearance anxiety and body mass) were found to predict attractive ranges selected by participants. These findings may have implications for the treatment of body-image disturbance, as the findings suggest that personality, rather than appearance alone, may be a factor in perceptions of attractiveness of various body sizes.

Parental modeling, reinforcement, and information transfer: risk factors in the development of child anxiety?

The purpose of this article is to provide a comprehensive review and a conceptual integration of research examining the potential role of learning from parents in the development of child anxiety. Specifically, research in this area is discussed within the framework of three specific mechanisms: parental modeling, information transfer, and parental reinforcement of anxious/avoidant behavior. Implications of the research in this area are discussed, as well as limitations and directions for future research.