Impact of Psychotherapy for Children and Adolescents with Anxiety Disorders on Global and Domain-Specific Functioning: A Systematic Review and Meta-analysis.

A substantial empirical base supports the use of psychotherapy to alleviate anxiety symptoms and diagnoses in children and adolescents. However, focusing only on symptom or diagnostic reduction provides an incomplete picture of clinically meaningful efficacy given that anxiety disorders in this age group are integrally associated with problems in functioning. A systematic review and meta-analysis (N studies = 40, N participants = 3094) evaluating the impacts of psychotherapy for anxiety was conducted on the following outcomes: global functioning, social functioning, academic functioning, and school attendance. Randomised controlled trials with a passive control condition, a child and/or adolescent sample (7-17 years) with a primary anxiety diagnosis, and receiving anxiety-focused psychotherapy were eligible for inclusion if they reported suitable outcome data. Results from the meta-analysis indicated that from pre- to post-treatment, psychotherapy led to significant improvements in global functioning according to clinician (d = 1.55), parent (d = 0.67), and child (d = 0.31) reports and on social functioning according to parent (d = 0.51), but not child (d = 0.31) reports. The qualitative review provided preliminary support psychotherapy's efficacy in increasing family functioning and school attendance, but not so much in enhancing academic performance. These results indicate that psychotherapy improves daily functioning in anxious children and adolescents. The study also highlighted the limited attention paid to measures of functioning in the empirical literature on treatment of childhood anxiety.Trial Registry: This study is registered with PROSPERO under the identification number CRD42021246565.

Children's understanding of habitual behaviour.

Research into the development of Theory of Mind (ToM) has shown how children from a very early age infer other people's goals. However, human behaviour is sometimes driven not by plans to achieve goals, but by habits, which are formed over long periods of reinforcement. Habitual and goal-directed behaviours are often aligned with one another but can diverge when the optimal behavioural policy changes without being directly reinforced (thus specifically hobbling the habitual learning strategy). Unlike the flexibility of goal-directed behaviour, rigid habits can cause agents to persist in behaviour that is no longer adaptive. In the current study, all children predict agents will tend to behave consistently with their goals, but between the ages of 5 and 10, children showed an increasing understanding of how habits can cause agents to persistently take suboptimal actions. These findings stand out from the typical way the development of social reasoning is examined, which instead focuses on children's increasing appreciation of how others' beliefs or expectations affect how they will act in service of their goals. The current findings show that children also learn that under certain circumstances, people's actions are suboptimal despite potentially 'knowing better.'

Gender-differentiated effects of theory of mind, emotion understanding, and social preference on prosocial behavior development: A longitudinal study.

Although key differences have been found in boys' and girls' prosocial behavior toward peers, few studies have systematically examined gender differences in how intrinsic perspective-taking abilities-theory of mind (ToM) and emotion understanding (EU)-and the extrinsic peer environment relate to prosocial behavior. In this prospective longitudinal study, we studied gender differences in the relations between children's observed prosocial behavior and their ToM, EU, and social preference ratings in 114 children (58 boys and 56 girls). We used conventional ToM and EU tasks at 5 and 7years of age. Observed prosocial behavior in triadic peer interactions was assessed at both time points. Controlling for gender, age, verbal ability, and earlier prosocial behavior, ToM at 5years was found to predict prosocial behavior at 7years. Results also revealed gender-differentiated associations at 7years, whereby only girls' prosocial behavior was positively associated with EU. Results are discussed in terms of gender-differentiated patterns of socialization.

Blood volume pulse (BVP) derived vagal tone (VT) between 5 and 7 years of age: a methodological investigation of measurement and longitudinal stability.

The present study evaluated the possibility of collecting cardiac vagal tone data using a photoplethysmograph, and its stability and continuity in a longitudinal sample of early-school aged children. A method for the optical (i.e., blood volume pulse) estimation of heart rate was established in a pilot study. Then the longitudinal stability and continuity in photoplethysmograph-derived vagal tone was assessed in 114 children (56 girls) at three sessions between 5 and 7 years of age. Results indicate that this method possesses substantial measurement reliability and individual stability, as children report low intra-individual variation over time. Children also report a mean decrease in vagal tone from 5 to 7 years of age, consistent with increased attentional capacity. Overall, this suggests blood volume pulse estimation of vagal tone is both accurate and appropriate for naturalistic developmental research.

Oxytocin increases heart rate variability in humans at rest: implications for social approach-related motivation and capacity for social engagement.

CONTEXT: Oxytocin (OT) plays a key regulatory role in human social behaviour. While prior studies have examined the effects of OT on observable social behaviours, studies have seldom examined the effects of OT on psychophysiological markers such as heart rate variability (HRV), which provides an index of individual's motivation for social behaviour. Furthermore, no studies have examined the impact of OT on HRV under resting conditions, which provides an index of maximal capacity for social engagement. OBJECTIVE: To examine the effects of OT on HRV measures in healthy male participants while at rest. OT was hypothesised to increase HRV, compared to placebo, and that the effects would be greatest for a non-linear measure of HRV (the detrended fluctuation scaling exponent). METHODS: Twenty-one male participants were recruited for this study. Participants were non-smokers, not on any medications and reported no history of psychiatric illness, neurological disorder, or any other serious medical condition (e.g. diabetes, cardiovascular disease). The study employed a randomised, placebo-controlled, within-subject, crossover, experimental design. MAIN OUTCOME MEASURES: HRV was calculated from electrocardiography under a standardized, 10-minute, resting state condition. RESULTS: As hypothesised, OT increased HRV and these effects were largest using the detrended fluctuation scaling exponent, a non-linear measure. These changes were observed in the absence of any change in state mood, as measured by the profile of mood states. Importantly, participants were unable to correctly guess which treatment they had been assigned at either of the two assessments. CONCLUSIONS: Together with the broader literature on OT and HRV, findings suggest that acute administration of OT may facilitate a fundamental psychophysiological feature of social behaviour, increasing capacity for social engagement. Findings also suggest that HRV changes may provide a novel biomarker of response to OT nasal spray that can be incorporated into research on response to treatment.