Behavioral Sleep-Related Problems in Clinically Anxious Children: A Parent-Report Diary Study Abstract Anxiety disorders and behavioral sleep-related problems (SRPs) frequently co-occur during childhood. However, few studies have used the recommended method of a sleep-diary. The present study examined parental perceptions of behavioral SRPs in anxious compared to non-anxious children using a sleep-diary. Parents of 22 clinically anxious children and 29 healthy controls (aged 6–13 years) completed a 7-day sleep-diary of their child’s behavioral SRPs. Compared to non-anxious peers, anxious children were rated by parents as more often (a) having a negative mood before bed, (b) delaying bed, (c) requiring parental assistance during the night, especially on weeknights, (d) having difficulty waking on their own the next morning, (e) falling back to sleep after morning waking, and (f) waking in a negative mood. There were no significant group differences in sleep onset latency or sleep duration, and behavioral SRPs of anxious children did not negatively affect their functioning or that of their parents the next day based on parent report. Parents of anxious children are more likely to perceive their children as engaging in behavioral SRPs compared to parents of non-anxious children.

Friendship Quality in Youth With and Without Disruptive Behavior Disorders: The Role of Empathy, Aggression, and Callousness Abstract Youth with disruptive behavior disorders (DBD; Oppositional defiant disorder and/or conduct disorder) are known to show impaired social relationships. Little is known about positive (PFQ) and negative best friendship quality (NFQ) in youth with DBD, and their relations with DBD specific symptoms such as aggression subtypes, empathic abilities, and callous unemotional (CU)-traits. The current study includes N = 115 youth with and N = 146 without DBD (Mage = 13.98, SD = 2.2). A diagnostic interview and self-rating questionnaires assessed ODD/CD diagnosis, friendship quality, aggression, empathy, and CU-traits. When examined on a categorical level, youth with and without DBD did not differ in friendship quality. On a dimensional level across groups, perspective taking was positively associated with PFQ. Proactive aggression was positively associated with NFQ. CU-traits in females were positively, while CU-traits in males were negatively, associated with NFQ. Results highlight that behavioral and cognitive symptoms, rather than clinical categories, are important to consider when discussing friendship qualities.

Separation Anxiety Assessment Scale—Parent Version: Spanish Validation (SAAS-P: Spanish Validation) Abstract The objective of this research is to validate the Spanish adaptation of the Separation Anxiety Assessment Scale—Parent Version (SAAS-P). We conducted two studies with parents of schoolchildren aged 8–11 years: (1) exploratory factor analysis: 910 parents completed the Spanish version of the SAAS-P; (2) confirmatory factor analysis, reliability, and discriminant validity: 4127 parents completed the SAAS-P and 392 children were interviewed using the ADIS-IV. We identified four factors which explained 51.56% of the variance and these were confirmed by factor analysis. The internal consistency (α = 0.84) and the temporal stability (r = .75) of the four key symptom dimensions were good. The sensitivity of the scale was 90%, and its specificity, 82%. The additional subscales correlated closely with the four key symptom dimensions (r > .70), and predicted 81% and 57% of the cases with high symptom levels of separation anxiety. The results support the validity, reliability and clinical utility of the Spanish adaptation of the SAAS-P.

Children’s Emotional Self-Regulation in the Context of Adversity and the Association with Academic Functioning Abstract The aims of this study were to study reciprocal interactions between emotion regulation skills, association of these skills with children’s school functioning and how these underlying skills develop in children in the context of adversity. 48 children (mean age = 5 years 8.2 months) were divided into an adversity risk group and a low-risk group. Emotional regulation was assessed via an emotion identification task, a Stroop task and near-infrared spectroscopy. School functioning was documented using the Social Skills Improvement System with parents and teachers. During the Stroop task, there was a difference in the activation of the right Brodmann area 8 in both groups. During the emotion regulation tasks, BA8L and BA9R showed activation and an association with school functioning. These results contribute to the accuracy of cerebral mapping associated with emotion regulation and support its potential contribution in preventive programs aimed at the functioning of children at risk of school difficulties.

Comorbid Psychopathology and the Clinical Profile of Family Accommodation in Pediatric OCD Abstract Family accommodation (FA) has been linked with myriad negative outcomes in pediatric obsessive–compulsive disorder (OCD), but extant literature has yielded differential relationships between FA and clinical variables of interest. Consequently, this study examined the phenomenology, clinical profile, and effects of comorbid psychopathology on FA to better understand these behaviors. A total of 150 youths and their caregivers completed clinician- and self-reported measures at a baseline visit for a larger randomized controlled trial. Sociodemographic variables were not associated with FA, but specific types of OCD symptom clusters were. Higher OC-symptom severity and functional impairment were associated with increased FA. Comorbid anxiety disorders moderated the relationship between OC-symptom severity and FA, but comorbid attention deficit hyperactivity, oppositional defiant, and mood disorders did not. Internalizing and externalizing problems both mediated the relationship between FA and functional impairment. These findings provide clinical implications for important treatment targets and factors that may impact FA.

Content-Specific Interpretation Bias in Children with Varying Levels of Anxiety: The Role of Gender and Age Abstract The current study examined whether children varying in their levels of social anxiety, separation anxiety and spider fear exhibit a negative interpretation bias specific for their fears. Furthermore, age and gender were assessed as moderators of this relation. Children (N = 603) of the age of 7–12 years were asked to solve ambiguous scenarios reflecting social threat, separation threat or spider threat. Children’s levels of anxiety were assessed with self-report questionnaires. Results indicated that children scoring higher on self-reported social anxiety, separation anxiety or spider fear, displayed a negative interpretation bias for the threat-scenarios pertaining to their specific anxiety or fear, even after controlling for comorbidity with other anxiety subtypes. Contrary to our hypotheses, we did not find moderating effects of age or gender. These results indicate that even in a community sample, content-specificity of negative interpretation biases is present.

Spanish Validation of the Child Anxiety Life Interference Scale (CALIS-C): Psychometric Properties, Factorial Structure and Factorial Invariance Across Gender Abstract The Child Anxiety Life Interference Scale (CALIS-C) is a measure created to specifically identify life interference and impairment related to children’s anxiety disorders in areas of daily functioning. Despite being a widely used scale, a Spanish version of the CALIS-C is not available. The purpose of this study was to adapt and validate the CALIS-C for Spanish-speaking children. We examined the CALIS-C factorial structure, factorial invariance across gender, and psychometric properties in a community sample of 336 (46.7% girls) Spanish-speaking children aged 8–12 years. Confirmatory factor analysis provided support for the original two-factor model. Excellent internal consistency coefficients were found for the total scale (0.88) and the subscales (0.85 and 0.82). 8-week test–retest reliability was moderate (IC = 0.51). Evidence of convergent and divergent validity was found, and factorial invariance across gender was reached. The current study provides initial support for the use of the CALIS-C with Spanish-speaking children by clinicians and researchers.

Examining the Relation Between Adolescent Social Anxiety and Positive Affect Regulation: Self-Report vs. Observation Abstract Social anxiety symptomatology is associated with disruptions in positive affect, though no study has examined deficits in responses to positive affect related to adolescent social anxiety symptoms. The present study tested whether adolescents’ self-reported and observed social anxiety symptoms were uniquely associated with specific responses to positive affect. Moreover, we examined whether adolescent gender moderated these relations. Ninety adolescents (ages 11 to 18, Mage = 14.26, SD = 2.03; girls = 62%; white = 79%) completed self-report measures, participated in a social stressor task, and engaged in two positively-valenced interaction tasks with their female caregivers. Adolescent self-reported social anxiety symptoms were not uniquely associated with responses to positive affect. However, observed social anxiety symptoms were uniquely related to greater self-reported inhibiting positive affect responses and fewer observed positive affect maximizing behaviors. These findings highlight the need to examine self-reported and observed social anxiety symptoms in understanding associated disruptions in positive affect regulation.

An Investigation of the Impact of Childhood Trauma on Quality of Caregiving in High Risk Mothers: Does Maternal Substance Misuse Confer Additional Risk? Abstract The quality of caregiving is often compromised when mothers have co-occurring difficulties such as substance misuse and problems associated with extreme emotional dysregulation. These, in turn, are associated with poor child outcomes. The aim of the current study was twofold. First, to investigate the potential differences in risk factors associated with poor child outcome by comparing three groups: substance misusing mothers (Substance Misusing Mothers; SMM); mothers matched on demographic characteristics (Matched Comparison Mothers; MCM) and mothers recruited from the community (Matched Control Comparison; MCC). Second, to investigate the underlying mechanisms which are associated with poor child outcome by testing a mediated moderation model to ascertain (i) whether environmental risk and borderline psychopathology was a mediator between maternal childhood trauma and quality of caregiving and (ii) maternal substance misuse status moderated outcome. There were no significant differences found between the SMM and MCM groups on the key variables, but significant differences on all variables for both SMM and MCM compared to CCM. The moderated mediation analysis found that while there was significant mediation of environmental risk and borderline pathology between maternal childhood trauma and child outcome, this was not moderated by maternal substance abuse status. The importance of environmental-risk as a mechanism leading to reduced caregiving quality suggest treatment programs need to consider targeting these factors in high risk families.

Do Immediate Gains Predict Long-Term Symptom Change? Findings from a Randomized Trial of a Single-Session Intervention for Youth Anxiety and Depression Abstract Single-session interventions (SSIs) can help reduce youth psychopathology, but SSIs may benefit some youths more than others. Identifying predictors of SSIs’ effectiveness may clarify youths’ likelihoods of benefitting from an SSI alone, versus requiring further treatment. We tested whether pre-to-post-SSI shifts in hypothesized symptom change mechanisms predicted subsequent reductions in youth internalizing symptoms. Data were from a trial evaluating whether an SSI teaching growth mindset (the belief that personality is malleable) reduced youth anxiety and depression. Youths (N = 96, ages 12–15) self-reported growth mindsets, perceived primary control, and perceived secondary control pre- and immediately post-intervention. They self-reported depression and anxiety symptoms at pre-intervention and 3, 6, and 9-month follow-ups. Larger immediate increases in primary control predicted steeper depressive symptoms declines across the follow-up; larger immediate increases in secondary control predicted steeper anxiety symptoms declines. Immediate shifts in proximal intervention “targets” may predict longer-term response to an SSI for youth internalizing distress. Clinical Trials Clinicaltrials.gov registration: NCT03132298.