Janet Woodruff-Borden

Prevalence of psychiatric disorders in 4 to 16‐year‐olds with Williams syndrome

The prevalence of a range of DSM‐IV psychiatric disorders in a sample of 119 4–16‐year‐old children with Williams syndrome (WS) was assessed using a structured diagnostic interview with their parents. Most children (80.7%) met criteria for at least one DSM‐IV diagnosis. The most prevalent diagnoses were Attention Deficit/Hyperactivity Disorder (ADHD; 64.7%) and Specific Phobia (53.8%). There was a significant shift in Predominant Type of ADHD as a function of CA, from Combined for the youngest group (ages 4–6 years) to Inattentive for the oldest group (ages 11–16 years). The prevalence of Generalized Anxiety Disorder (GAD) increased significantly with age. These findings are another step toward defining the behavioral phenotype of WS.

The Behavior of Anxious Parents: Examining Mechanisms of Transmission of Anxiety From Parent to Child

Examined the behavior of anxious parents in interactions with their children (ages 6 to 12 years) to test hypotheses about possible psychosocial mechanisms of transmission of anxiety from parent to child. Fifty-one parent-child dyads completed the study. Parents and children were assessed with structured interviews and participated in 2 tasks that were videotaped and coded. Twenty-five dyads had an anxious parent. Primary diagnoses of the anxious group were mostly panic disorder (PD), with or without agoraphobia (AG), social phobia (SP), and generalized anxiety disorder. Anxious participants were excluded if they presented a secondary diagnosis other than another anxiety disorder. Control parents had no present or past diagnosis. Observational data revealed that anxious parents were significantly less productively engaged and more withdrawn and disengaged during the interactions but did not differ from nonanxious parents in terms of overall levels of control. Sequential analyses indicated that there was a trend for both parent group and child sex to effect efforts to control the interaction in response to child expression of negative affect. Implications of these results for a mediational role of parental behavior in the development and maintenance of child anxiety are discussed.

Anxiety disorders in children with williams syndrome, their mothers, and their siblings: implications for the etiology of anxiety disorders.

This study examines the prevalence of anxiety disorders in children with Williams syndrome (WS), their sibling closest in age, and their mothers as well as the predictors of anxiety in these groups. The prevalence of anxiety disorders was assessed and compared to that in the general population. Children with WS had a significantly higher prevalence of specific phobia, generalized anxiety disorder (GAD), and separation anxiety in comparison to children in the general population. While mothers had a higher prevalence of GAD than population controls, the excess was accounted for by mothers who had onset after the birth of their WS child. The siblings had rates similar to the general population. This pattern of findings suggests the presence of a gene in the WS region whose deletion predisposes to anxiety disorders. It is also worthwhile to investigate relations between genes deleted in WS and genes previously implicated in anxiety disorders.

Longitudinal Course of Anxiety in Children and Adolescents With Williams Syndrome

The longitudinal course of anxiety disorders in 45 children and adolescents with Williams syndrome (WS) was examined. Children were ages 4–13 years at the initial assessment. To assess their childs DSM‐IV diagnoses, parents completed a structured diagnostic interview 3–9 times at intervals of at least 1 year. At the first assessment, 60% of the sample presented with at least one anxiety diagnosis; 82.2% received an anxiety diagnosis at some time during the study. Chronic, persistent anxiety within the period 5 years after their initial diagnosis was shown by 62.2% of those with an anxiety diagnosis (51.1% of the entire sample). The most common diagnoses were specific phobias and generalized anxiety disorder. Multilevel logistic regression models were estimated for the presence of any anxiety disorder, specific phobia, and specific phobia of loud noises. Developmental trajectories, expressed as the probability of a positive diagnosis, suggested that the odds of a positive diagnosis did not change with age. IQ was not significantly related to the presence of an anxiety disorder. However, there was a significant relation between executive functioning and anxiety such that the presence of an anxiety diagnosis was associated with increased scores on behavioral regulation, indicative of increased difficulty with inhibitory control of affect and behavior. These findings are discussed in terms of persistence of anxiety over time and the need to develop and test interventions to address the high levels of anxiety experienced by children and adolescents with WS.

A confirmatory factor analysis of the Beck Anxiety Inventory in African American and European American young adults

The anxiety literature is particularly sparse as it relates to African Americans, and there are few studies to date that have examined the factor structure of anxiety assessment tools within this population. The current study investigated the original two-factor structure of the Beck Anxiety Inventory (BAI) in addition to two extant factor structures of the BAI in a non-clinical sample of African American and European American young adults. One hundred twenty one European American and 100 African American young adults completed the BAI. Results of a confirmatory factor analysis indicated that the previous factor structures of the Beck Anxiety Inventory do not provide the best fit for either the African American or the European American sample. An exploratory factor analysis revealed that an alternative, two-factor model provided the best fit for the sample, particularly for the African American sample. Implications and suggestions for future research are discussed.

Duplication of GTF2I Results in Separation Anxiety in Mice and Humans

Duplication (dup7q11.23) and deletion (Williams syndrome) of chromosomal region 7q11.23 cause neurodevelopmental disorders with contrasting anxiety phenotypes. We found that 30% of 4- to 12-year-olds with dup7q11.23 but fewer than 5% of children with WS or in the general population met diagnostic criteria for a separation-anxiety disorder. To address the role of one commonly duplicated or deleted gene in separation anxiety, we compared mice that had varying numbers of Gtf2i copies. Relative to mouse pups with one or two Gtf2i copies, pups with additional Gtf2i copies showed significantly increased maternal separation-induced anxiety as measured by ultrasonic vocalizations. This study links the copy number of a single gene from 7q11.23 to separation anxiety in both mice and humans, highlighting the utility of mouse models in dissecting specific gene functions for genomic disorders that span many genes. This study also offers insight into molecular separation-anxiety pathways that might enable the development of targeted therapeutics.

A structural equation model analysis of perceived control and psychological distress on worry among African American and European American young adults

Perceived control has been identified as an important factor in the development and maintenance of mood disorders, and worry has been shown to have a unique relationship with psychological distress associated with mood disorders. The relationships between these variables have received little attention in the literature, and even less in terms of the role racial status may serve. The current study investigated the structural relationship between psychological distress and perceived control in predicting self-reported worry as well as potential differences in paths to worry in African American and European American young adults using a structural equation model. One hundred twenty-one European American and 100 African American undergraduate students completed the Beck Depression Inventory (BDI), the State Trait Anxiety Inventory (STAI), the Anxiety Control Questionnaire (ACQ), and the Penn State Worry Questionnaire (PSWQ). Results suggest that psychological distress and perceived control predict worry in both the African American and European American samples, however there were significant differences in terms of which construct contributed most. For African Americans, psychological distress contributed significantly more to worry than perceived control, whereas low perceived control contributed more to worry for European Americans. Implications and suggestions for future research are discussed.

SELF-FOCUSED ATTENTION: COMMONALITIES ACROSS PSYCHOPATHOLOGIES AND PREDICTORS

Self-focused attention, also thought of a self-absorption, has been linked to a variety of affective states and clinical syndromes, including depression, panic disorder, social anxiety, schizophrenia, and alcoholism. Ingram (1990b) has suggested that self-focus may be a “nonspecific process” that is common across psychopathologies. Studies with nonclinical samples have supported this contention, and the current study assessed whether self-focus was common across various clinically diagnosed groups. A second issue, given this commonality, was to examine the factors across diagnostic conditions to which self-focus was related. One hundred and thirty-eight outpatients were included, and were divided into three groups based on primary diagnosis: “depression”, “panic”, and “other anxiety”. They were assessed with the ADIS-R/IV and completed measures assessing self-focus, affective states, global psychopathology, and problem-solving. Self-focus was common across groups, with minor valence variations. Severity of primary diagnosis predicted total self-focus, with level of depression and trait anxiety predicting negative self-focus. Correlational analyses suggested that self-focused attention is related to general measures of psychopathology and severity, and negatively related to problem-solving. The pattern with negative self-focus was even more pronounced, with significant relationships to all measures of psychopathology, clinician-rated severity, and a negative relationship with problem-solving. Results are discussed in terms of differences between “normal” and problematic self-focus, the causal direction in the relationship between self-focus and negative affect, and the link between self-focus and problem-solving.

Social anxiety in older adults: phenomenology, prevalence, and measurement.

Although phobias represent the most common anxiety disorders among the elderly, little is known about their social nature. The present study provides information about the prevalence, measurement, and phenomenology of social anxiety in older adults (n = 283) and compares results to those of younger adults (n = 318). Analyses revealed that social anxiety is less prevalent in old age than it is within younger cohorts and is associated with different symptomatology. The psychopathological profile of those who reach clinical levels of social anxiety is however similar, irrespective of age. Results regarding the psychometric properties of the SPAI when used for the elderly were promising, but the questionnaire appears to be difficult for some older adults to complete. Results are discussed in terms of explanations for age differences in social anxiety, initial psychometrics of the SPAI in an older adult sample, and suggestions for future research.

The Developmental Psychopathology of Worry

Although childhood generalized anxiety disorder is generally understudied, worry, the cardinal feature of GAD, appears to be relatively common in youth. Despite its prevalence, there are few conceptual models of the development of clinical worry in children. The current review provides a framework for integrating the developmental psychopathology perspective, models of worry in adults, and data available on worry in children. General risk factors for the development of worry are considered, as well as potential pathways including genetics, temperament, cognitive, emotional and parenting influences, as well as the influence of cognitive development. Based on this review, it appears unlikely that main effects models will be able to explain the development of GAD or clinical worry in children and that a broad, complex model incorporating a number of factors and their interactions will best describe etiological and maintaining factors. With this perspective in mind, a number of suggestions for future work are offered.