Exclusion Expected? Cardiac Slowing Upon Peer Exclusion Links Preschool Parent Representations to School-Age Peer Relationships.

Attachment theory proposes that children's representations of interactions with caregivers guide information-processing about others, bridging interpersonal domains. In a longitudinal study (N = 165), preschoolers (Mage  = 5.19 years) completed the MacArthur Story Stem Battery to assess parent representations. At school-age (Mage  = 8.42 years), children played a virtual ballgame with peers who eventually excluded them to track event-related cardiac slowing, a physiological correlate of rejection, especially when unexpected. At both ages, parents and teachers reported on peer and emotional problems. During exclusion versus inclusion-related events, cardiac slowing was associated with greater positive parent representations and fewer emerging peer problems. Cardiac slowing served as a mediator between positive parent representations and peer problems, supporting a potential psychophysiological mechanism underlying the generalization of attachment-related representations to peer relationships.

Latent trajectories of internalizing symptoms from preschool to school age: A multi-informant study in a high-risk sample.

Recent proposals suggest early adversity sets in motion particularly chronic and neurobiologically distinct trajectories of internalizing symptoms. However, few prospective studies in high-risk samples delineate distinct trajectories of internalizing symptoms from preschool age onward. We examined trajectories in a high-risk cohort, oversampled for internalizing symptoms, several preschool risk/maintenance factors, and school-age outcomes. Parents of 325 children completed the Strengths and Difficulties Questionnaire on up to four waves of data collection from preschool (3-5 years) to school age (8-9 years) and Preschool Age Psychiatric Assessment interviews at both ages. Multi-informant data were collected on risk factors and symptoms. Growth mixture modelling identified four trajectory classes of internalizing symptoms with stable low, rising low-to-moderate, stable moderate, and stable high symptoms. Children in the stable high symptom trajectory manifested clinically relevant internalizing symptoms, mainly diagnosed with anxiety disorders/depression at preschool and school age. Trajectories differed regarding loss/separation experience, maltreatment, maternal psychopathology, temperament, and stress-hormone regulation with loss/separation, temperament, maternal psychopathology, and stress-hormone regulation (trend) significantly contributing to explained variance. At school age, trajectories continued to differ on symptoms, disorders, and impairment. Our study is among the first to show that severe early adversity may trigger a chronic and neurobiologically distinct internalizing trajectory from preschool age onward.

Putting Ostracism into Perspective: Young Children Tell More Mentalistic Stories after Exclusion, But Not When Anxious.

Much is known about when children acquire an understanding of mental states, but few, if any, experiments identify social contexts in which children tend to use this capacity and dispositions that influence its usage. Social exclusion is a common situation that compels us to reconnect with new parties, which may crucially involve attending to those parties' mental states. Across two studies, this line of inquiry was extended to typically developing preschoolers (Study 1) and young children with and without anxiety disorder (AD) (Study 2). Children played the virtual game of toss "Cyberball" ostensibly over the Internet with two peers who first played fair (inclusion), but eventually threw very few balls to the child (exclusion). Before and after Cyberball, children in both studies completed stories about peer-scenarios. For Study 1, 36 typically developing 5-year-olds were randomly assigned to regular exclusion (for no apparent reason) or accidental exclusion (due to an alleged computer malfunction). Compared to accidental exclusion, regular exclusion led children to portray story-characters more strongly as intentional agents (intentionality), with use of more mental state language (MSL), and more between-character affiliation in post-Cyberball stories. For Study 2, 20 clinically referred 4 to 8-year-olds with AD and 15 age- and gender-matched non-anxious controls completed stories before and after regular exclusion. While we replicated the post regular-exclusion increase of intentional and MSL portrayals of story-characters among non-anxious controls, anxious children exhibited a decline on both dimensions after regular exclusion. We conclude that exclusion typically induces young children to mentalize, enabling more effective reconnection with others. However, excessive anxiety may impair controlled mentalizing, which may, in turn, hamper effective reconnection with others after exclusion.

FKBP5 polymorphisms moderate the influence of adverse life events on the risk of anxiety and depressive disorders in preschool children.

FKBP5 is thought to be involved in the pathogenesis of stress-related disorders. Studies have shown that FKBP5 genotypes moderate the risk of post-traumatic stress disorder and depression in traumatized adults. We aimed to replicate this finding in a sample of preschool children. Parents of preschoolers (N = 186) were interviewed using the Preschool Age Psychiatric Assessment (PAPA) to evaluate the presence of anxiety and depressive disorders and to quantify the child's exposure to adverse events. All FKBP5 polymorphisms showed significant interactions with mild to moderate life events, but not with severe life events, in predicting the risk of anxiety and/or depressive disorders (p = 0.003-0.019). Children who experienced a high number of mild to moderate life events had a higher risk of developing an anxiety and/or depressive disorder if they were carriers of the minor allele compared to major allele homozygotes. Results indicate that genetic variation in FKBP5 influences the risk of anxiety and/or depressive disorders in preschool age by altering the sensitivity to the deleterious effects of mild to moderate adverse events. In case of severe life events, the FKBP5 genotype does not seem to play a role, suggesting that severe life events might influence directly the risk of anxiety and/or depressive disorders independent of an FKBP5 genotype-dependent vulnerability.

[Self-reported Anxiety and Regulation Strategies in Primary School-age Children]. / Selbstberichtete Ängste und Strategien zu deren Regulation bei Kindern im Grundschulalter.

We examined the self-reported anxiety in different situations (social anxiety, cognitive fears, fears of injury) and the use of regulation strategies (problem orientation, problem avoidance and seeking social support) in a sample of N=175 primary school children (mean age 8 years 4 months). At time of recruitment we oversampled for children with internalizing symptoms. In addition, mothers rated the overall anxiety of their children. According to their mothers 14.3% of the children showed anxiety symptoms in an abnormal range which is comparable to prevalence rates of children from population samples. 19.4% of the children described themselves as being anxious in an abnormal range. The correlations between different measures of children's self-reported anxieties were low to moderate. We found no significant correlations between mothers' and children's reports. The higher children's self-reported overall and cognitive anxiety, the more frequently they reported seeking social support in frightening situations. Girls reported more frequently pm cognitive fears than boys. Regarding regulation strategies we found that boys reported more problem orientation than girls whereas girls reported more social support seeking than boys. The results are discussed and practical implications are outlined.

Maternal stress and internalizing symptoms in preschoolers: the moderating role of narrative coherence.

In the present study, we examined whether maternal psychosocial stress and children's coherence in story-stem narratives are associated with preschool children's internalizing symptoms and disorders, and whether narrative coherence moderates the association between maternal stress and children's internalizing symptoms and disorders. The sample consists of 236 preschool children (129 girls, 107 boys; Mage = 5.15 years) and their mothers. Mothers completed questionnaires on their psychosocial stress burden and on child symptoms. A diagnostic interview (the Preschool Age Psychiatric Assessment; Egger & Angold, 2004) was conducted with one of the parents to assess children's psychiatric diagnoses. Children completed 8 story stems of the MacArthur Story Stem Battery (Bretherton & Oppenheim, 2003). Story-stem narratives were coded for narrative coherence. Multivariate analyses were controlled for children's age, gender, verbal performance, and externalizing symptoms. Results showed that maternal psychosocial stress was significantly associated with child internalizing symptoms and disorders. Neither maternal stress nor children's internalizing symptoms or disorders were associated with narrative coherence. However, narrative coherence moderated the association between maternal stress and child internalizing symptoms. For children with more incoherent narratives, the association between maternal psychosocial stress and children's internalizing symptoms was significantly stronger than for children with more coherent narratives. The moderation effect of narrative coherence concerning children's internalizing disorders was found not to be significant. Our findings indicate that preschool children's cognitive-emotional organization in dealing with relational conflict themes seems to buffer their mental health when exposed to adverse circumstances in their everyday family life.

A prospective study of behavioral and emotional symptoms in preschoolers.

A substantial number of preschool children exhibit psychological symptoms that have an impact on their own and their families' lives. The aim of the current study was to investigate the prevalence, stability and increase/decrease in emotional and behavioral symptoms and the resultant impairment at two assessment points at preschool age. The sample consisted of 1,034 children drawn from the general population with a mean age of 51 months at t1 and 72 months at t2. Parents completed the Strengths and Difficulties Questionnaire extended version (Goodman, J Child Psychol Psychiatry 38(5):581-586, 1997; Goodman, J Child Psychol Psychiatry 40(5):791-799, 1999). At t1, 6.9 % of the preschoolers had a total difficulties and 6.8 % a total impact score within the abnormal range. At t2, these scores were 5.7 and 6.2 %, respectively. We found moderate stability of symptoms. From t1 to t2, emotional symptoms and prosocial behavior significantly increased, while hyperactivity, conduct problems, peer problems and total difficulties decreased. The mean total impact score did not change. Boys showed higher levels of symptoms (except emotional symptoms) and impact, and lower prosocial behavior, than girls. Moreover, there was a significant time × gender interaction, with girls showing a larger decrease in hyperactivity/inattention and in total difficulties than boys. The stepwise multiple regression analysis revealed that the total impact score at baseline, male gender, conduct problems, hyperactivity and peer problems significantly contributed to the explained variance of the total impact score at follow-up. This is one of very few studies to examine the stability and change of psychological symptoms in a large community sample of preschoolers, assessed twice during preschool age.

[Sadness, worries and fears: depression and anxiety disorders in preschool age--results of relevance, symptoms and impairment]. / Traurig, besorgt und ängstlich: Depression und Angststörungen im Vorschulalter--Befunde zu Relevanz, Symptomatik und Beeinträchtigungen.

The aim of the present study was to examine the current strain and impairment of children with depressive and anxiety disorders in terms of their development and family environment compared to children without mental disorders. Conclusions for dealing with clinical disorders in preschool are to be derived. Internalizing symptoms/disorders were measured dimensionally with the Strengths and Difficulties Questionnaire (SDQ; multi-informant approach) and categorially with the Preschool Age Psychiatric Assessment (PAPA). The sample consisted of n = 93 children with pure anxiety disorders, n = 20 children with depressive and anxiety disorders, n = 42 children with subclinical symptoms of depression and anxiety disorders, and n = 76 children without mental disorders. We assessed stability of symptoms, as well as agreement between mothers, fathers and kindergarten teachers regarding internalizing symptoms which was higher between mothers and fathers than between parents and kindergarten teachers. In comparison to kindergarten teachers parents reported more internalizing symptoms. Regarding the overall impairment, family adversity, family environment and maternal psychopathology children with depression and additional anxiety disorders showed the highest scores. There were no differences in overall impairment between children with pure anxiety disorders and without mental disorders. Finally, implications for practice are discussed.

Depressive comorbidity in preschool anxiety disorder.

BACKGROUND: The threshold for clinical relevance of preschool anxiety has recently come under increasing scrutiny in view of large variations in prevalence estimates. We studied the impact of presence/absence of additional depressive comorbidity (symptoms and/or diagnosis) on preschoolers with anxiety disorders in relation to clinical phenomenology, family, and peer problems compared to healthy controls. METHOD: A population of 1738 preschoolers were screened and oversampled for internalizing symptoms from community sites, yielding a sample of 236 children. RESULTS: Using a multi-informant approach (mother, father, teacher, child), we found evidence that children with anxiety disorders and depressive comorbidity display a greater internalizing symptom-load, more peer problems and live in families with more psychosocial impairment (poor family functioning, family adversity, maternal mental health problems). The pure anxiety group was merely dissociable from controls with regard to internalizing symptoms and family adversity. CONCLUSION: The presence of depressive comorbidity in anxiety disorders may mark the transition to a more detrimental and impairing disorder at preschool age.

Prevalence of emotional and behavioral symptoms and their impact on daily life activities in a community sample of 3 to 5-year-old children.

The aim of the study was to evaluate prevalence and impact of behavioral/emotional symptoms in preschoolers. The sample comprised 1,738 preschoolers with an age range between 37 and 63 months. Parents rated children's symptoms using the Strengths and Difficulties Questionnaire (SDQ) and the impact of perceived difficulties using the impact supplement of the SDQ. The prevalence of a total difficulties score in an abnormal/borderline range was 16.0 % that means lower than rates in schoolchildren. 8.6 % of the preschoolers were rated as symptomatic (borderline/abnormal) and their symptoms were rated as having some or considerable impact on their lives. Parents mostly reported problems of hyperactivity/inattention and their interference with learning abilities. All symptoms scales of the SDQ, except prosocial behavior, significantly explained impact of perceived difficulties. Parents of boys rated significantly higher levels of symptoms and impact. Low parental education was associated with more symptoms and higher impact.

In vitro evaluation of toothbrushing abrasion of differently bleached bovine enamel.

PURPOSE: To evaluate in vitro, the effect of different external bleaching agents on the susceptibility of enamel against toothbrushing abrasion. METHODS: 96 bovine enamel specimens were embedded in acrylic resin, polished and covered with tape except for a 1.4 x 10 mm window. The samples were divided into eight groups (A-H), 12 specimens each (A-G) were treated with seven different home-bleaching (A: Whitestrips, B: Rapid White, C: Opalescence 10%, D: Opalescence PF 15%) and in-office-bleaching agents (E: Opalescence Extra, F: Opalescence Quick, G: Opalescence Extra Boost) according to manufacturers' instructions. Before and after each individual bleaching treatment the samples were brushed 40 times in an automatic brushing machine using a slurry containing artificial saliva and fluoridated toothpaste. The control group (Group H) was not bleached, but also brushed. After each cycle the specimens were stored in artificial saliva for 24 hours. RESULTS: After 20 cycles loss of enamel was determined by profilometry, resulting in the following values (mean +/- standard deviation) which were statistically analyzed: Group A: (0.169 microm +/- 0.035), Group B (11.108 microm +/- 0.655), Group C (0.207 microm +/- 0.042), Group D (0.154 microm +/- 0.028), Group E (0.081 microm +/- 0.015), Group F (0.084 microm +/- 0.018), Group G (0.087 microm +/- 0.014), Group H (0.076 microm +/- 0.012). Group B differed significantly from the other groups (r = 0.001). Samples of Groups C, D and A showed a significant difference compared to the control H (r = 0.001). Statistical analysis revealed no significant difference between enamel loss of Groups E, F, G and the Control H. It could be proven that toothbrushing abrasion of bleached enamel may be increased depending on the bleaching agent and application form used. Nevertheless, with the exception of bleaching treatment with Rapid White, toothbrushing abrasion of bleached enamel seems to be clinically less relevant.