Elizabeth J. Kiel

Dysregulated fear predicts social wariness and social anxiety symptoms during kindergarten.

Fearful temperament is associated with risk for the development of social anxiety disorder in childhood; however, not all fearful children become anxious. Identifying maladaptive trajectories is thus important for clarifying which fearful children are at risk. In an unselected sample of 111 two-year-olds (55% male, 95% Caucasian), Buss (2011) identified a pattern of fearful behavior, dysregulated fear, characterized by high fear in low threat situations. This pattern of behavior predicted parent- and teacher-reported withdrawn/anxious behaviors in preschool and at kindergarten entry. The current study extended original findings and examined whether dysregulated fear predicted observed social wariness with adults and peers, and social anxiety symptoms at age 6. We also examined prosocial adjustment during kindergarten as a moderator of the link between dysregulated fear and social wariness. Consistent with predictions, children with greater dysregulated fear at age 2 were more socially wary of adults and unfamiliar peers in the laboratory, were reported as having more social anxiety symptoms, and were nearly 4 times more likely to manifest social anxiety symptoms than other children with elevated wariness in kindergarten. Results demonstrated stability in the dysregulated fear profile and increased risk for social anxiety symptom development. Dysregulated fear predicted more social wariness with unfamiliar peers only when children became less prosocial during kindergarten. Findings are discussed in relation to the utility of the dysregulated fear construct for specifying maladaptive trajectories of risk for anxiety disorder development.

Temperamental Risk Factors for Pediatric Anxiety Disorders

Fearful temperament, most often conceptualized as behavioral inhibition, has been found to be a robust predictor for the development of pediatric anxiety disorders, with most evidence suggesting a link with social anxiety disorder. In addition to a detailed review of behavioral inhibition, recent work that supports a new construct, dysregulated fear, is also reviewed in this chapter. New evidence is presented that demonstrates that dysregulated fear is conceptually and methodologically distinct from behavioral inhibition and improves the prediction of which fearful toddlers are at risk for pediatric anxiety disorders. The following review will summarize the empirical bases for these two approaches and their role in the development of anxiety disorders, as well as evidence for biomarkers, executive processes, and parenting environment that exacerbate or ameliorate this early temperament risk. Specifically, research on fearful temperament has identified multiple trajectories and outcomes for children with the same underlying temperamental biases. That is, not all young children who display fearful temperament maintain this behavioral profile or develop anxiety symptoms. Therefore, this chapter summarizes evidence for biological, regulatory, and parental processes that account for these divergent trajectories and addresses the question of which fearful children are at highest risk for developing anxiety disorders.

Allostatic and Environmental Load in Toddlers Predicts Anxiety in Preschool and Kindergarten

Psychobiological models of allostatic load have delineated the effects of multiple processes that contribute to risk for psychopathology. This approach has been fruitful, but the interactive contributions of allostatic and environmental load remain understudied in early childhood. Because this developmental period encompasses the emergence of internalizing problems and biological sensitivity to early experiences, this is an important time to examine this process. In two studies, we examined allostatic and environmental load and links to subsequent internalizing and externalizing problems. Study 1 examined relations between load indices and maladjustment, concurrently and at multiple times between age 2 and kindergarten; Study 2 added more comprehensive risk indices in a sample following a group of highly fearful toddlers from 2 to 3 years of age. Results from both studies showed that increased allostatic load related to internalizing problems as environmental risk also increased. Study 2, in addition, showed that fearfulness interacted with allostatic and environmental load indices to predict greater anxiety among the fearful children who had high levels of allostatic and environmental load. Taken together, the findings support a model of risk for internalizing characterized by the interaction of biological and environmental stressors, and demonstrate the importance of considering individual differences and environmental context in applying models of allostatic load to developmental change in early childhood.

Emotion: empirical contribution. Maternal borderline personality pathology and infant emotion regulation: examining the influence of maternal emotion-related difficulties and infant attachment.

Evidence suggests that maternal borderline personality (BP) pathology increases offspring risk. This study examined the relations between maternal BP pathology and related emotional dysfunction (including emotion regulation [ER] difficulties and emotional intensity/reactivity) and infant ER difficulties. Specifically, we examined both self-focused and caregiver-focused ER behaviors and the modulation of emotional expressions (one indicator of ER in young children) in response to fear- and anger-eliciting stimuli among 101 infants (12 to 23 months old) of mothers with and without clinically relevant BP pathology. The authors also examined the moderating role of mother-infant attachment. Findings of a series of multiple regression mediation analyses revealed an indirect effect of maternal BP pathology on infant ER difficulties through maternal emotional dysfunction, with maternal ER difficulties facilitating an indirect effect of maternal BP pathology on expressivity-related indicators of infant ER difficulties and maternal emotional intensity/reactivity linking maternal BP pathology to lower self-focused ER for infants in insecure-resistant attachment relationships.

Maternal Encouragement to Approach Novelty: A Curvilinear Relation to Change in Anxiety for Inhibited Toddlers

Various parenting behaviors (e.g., protection, intrusiveness, sensitivity) have been shown to impact young children’s anxiety development, particularly for temperamentally inhibited children. These behaviors have sometimes predicted both increases and decreases in anxiety in inhibited children, suggesting that linear relations may not adequately model their influence. In the current study, we proposed the dimension of encouragement to approach novelty to characterize parenting behavior ranging from very little encouragement (i.e., protective behavior) to very strong encouragement (i.e., intrusiveness), with gentle encouragement residing in the middle. In a sample of 110 toddlers (48 female, 62 male) and their mothers, the linear and curvilinear effects of this parenting dimension were investigated in relation to change in child separation anxiety and shyness from age 2 to age 3. Inhibited temperament was also investigated as a moderator. Encouragement to approach novelty displayed the hypothesized curvilinear relation to change in separation anxiety, but not shyness, at extreme levels of inhibited temperament. Toddlers increased in separation anxiety when mothers’ encouragement resided at either extreme end of the continuum, with lower child anxiety occurring when mothers displayed behavior closer to the middle of the continuum. Implications for the study of parenting outcomes for inhibited toddlers are discussed.

Do Maternal Protective Behaviors Alleviate Toddlers’ Fearful Distress?

Parenting behaviors during times when young children may feel vulnerable, such as when encountering novelty, undoubtedly affect how children learn to regulate their reactions to these events. Theory suggests and some research supports the link between protective behavior—behaviors that shield the child from a potential threat—and regulation of emotions. Less is known, however, about the immediate effects of these behaviors on children’s distress. That is, do these protective behaviors alleviate distress in the moment? Presumably, this type of ‘‘successful’’ regulation of distress would be important for the development of successful regulation in other situations. To this end, the current study examined changes in the time course of toddlers’ fearful distress, when protective maternal behaviors were observed during a highly novel, fear-eliciting task. Analyses were conducted for two subgroups of dyads: one group where toddlers’ distress preceded mothers’ protective behavior, and one group where mothers’ protective behavior preceded toddler distress. When toddlers’ distress preceded mothers’ reactions, protective behaviors were found to be associated with less steep decreases in fear for toddlers who had the highest initial distress reactions. Results are discussed in the context of toddlers’ emerging ability to regulate emotions and the adaptive development of these skills.

Early social fear predicts kindergarteners' socially anxious behaviors: Direct associations, moderation by inhibitory control, and differences from nonsocial fear.

Although social and nonsocial fear are discernable as early as preschool, little is known about their distinct associations with developmental outcomes. For example, fear has been identified as a predictor of social anxiety problems, but no work has examined whether social and nonsocial fear make independent contributions to risk. We investigated the extent to which early social and nonsocial fear were associated with socially anxious behaviors during kindergarten. To do this, we identified distinct trajectories of social and nonsocial fear across toddlerhood and preschool. Only social fear was associated with socially anxious behaviors at ages 2 and 5. Because the ability to regulate fear contributes to the degree to which fearful children are at risk for anxiety problems, we also tested whether an early developing aspect of self-regulation modulated associations between early fear and kindergarten socially anxious behaviors. Specifically, we tested whether inhibitory control differentially modulated associations between early levels of social and nonsocial fear and socially anxious behaviors during kindergarten. Associations between trajectories of early social fear and age 5 socially anxious behaviors were moderated by individual differences in inhibitory control. Consistent with previous research showing associations between overcontrol and anxiety symptoms, more negative outcomes were observed when stable, high levels of social fear across childhood were coupled with high levels of inhibitory control. Results suggest that the combination of social fear and overcontrol reflect a profile of early risk for the development of social inhibition and social anxiety problems. (PsycINFO Database Record

The Effect of Trauma Cue Exposure on Cocaine Cravings among Cocaine Dependent Inpatients with and without Posttraumatic Stress Disorder: Exploring the Mediating Role of Negative Affect and Discrete Negative Emotional States

This study examined the effect of personalized trauma cue exposure (relative to neutral cue exposure) on cocaine cravings within a sample of trauma-exposed cocaine dependent patients with and without current PTSD. We also examined the extent to which negative affect (as well as the discrete negative emotional states of anxiety, anger, and shame/guilt) in response to the trauma cue accounted for these cocaine cravings. Sixty cocaine dependent patients in residential substance use treatment (50% with PTSD) were exposed to a personalized trauma and neutral script on separate days. Self-reported cocaine cravings and emotional response prior to and following each script were assessed. PTSD was associated with increased cocaine cravings following a personalized trauma (but not a neutral) script, and, for men specifically, the experience of self-conscious emotions (shame and guilt) to the trauma script mediated the relationship between PTSD and cocaine cravings following trauma script exposure. Treatment implications are discussed.

The effect of toddler emotion regulation on maternal emotion socialization: Moderation by toddler gender.

Although developmental research continues to connect parenting behaviors with child outcomes, it is critical to examine how child behaviors influence parenting behaviors. Given the emotional, cognitive, and social costs of maladaptive parenting, it is vital to understand the factors that influence maternal socialization behaviors. The current study examined childrens observed emotion regulatory behaviors in two contexts (low-threat and high-threat novelty) as one influence. Mother-child dyads (n = 106) with toddlers of 24 months of age participated in novelty episodes from which toddler emotion regulation behaviors (i.e., caregiver-focused, attention, and self-soothing) were coded, and mothers reported their use of emotion socialization strategies when children were 24 and 36 months. We hypothesized that gender-specific predictive relations would occur, particularly from regulatory behaviors in the low-threat contexts. Gender moderated the relation between caregiver-focused emotion regulation in low-threat contexts and nonsupportive emotion socialization. Results from the current study inform the literature on the salience of child-elicited effects on the parent-child relationship. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Emotion Socialization Strategies of Mothers With Borderline Personality Disorder Symptoms: The Role of Maternal Emotion Regulation and Interactions With Infant Temperament.

Although the interpersonal difficulties associated with borderline personality disorder (BPD) are well established, their manifestations within the context of parent-child relationships remain understudied. The current study investigated the relation of maternal BPD symptoms to nonsupportive emotion socialization (i.e., the extent to which mothers punish or minimize their young childrens displays of negative emotions), as well as the mediating role of maternal emotion regulation difficulties in this relation. The authors also investigated the moderating role of maternal BPD symptoms in the relation between infant temperamental anger and fear and punitive/minimizing emotion socialization. Using a sample of 99 mother-infant dyads, the authors found that maternal BPD symptoms were significantly related to punitive/minimizing emotion socialization and that maternal emotion regulation difficulties mediated this relation. Moreover, maternal BPD symptoms strengthened the association between mother-reported infant anger and punitive/minimizing emotion socialization. These results extend the growing literature on the impact of maternal BPD on child development.