Anxiety
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- Anxiety disorder in childhood Origins of ear
- Health of baby- crying Infant needs to learn how to regulate emotion Facialexpressions High heartrate
- Yonas
- Uses shadow casting Looks like expanding dot B4 9m reflexive blinking 8-9m anticipatory reaction- heart rate increased
- Gibson & Walk
- Depth perception Visual cliff Babies arenÂ’t afraid until can crawl 5ms heart rate slows- attention 9m heart rate acceleration
- strangers
- end 1st year of life wariness to strangers
- Reingold and Eckeman
- Predicatbility Control How mother reacts
- Gunnar
- noisy bear if unpredictable cried if could push button ok
- Ross & Goldman
- Intrusive strangers vs people who wait -better to wait
- Lewis
- Look in mirror Red dot on nose
- Cantor
- One way window- Platform self regulation experiment Ramp
- Fear
- Cognitive appraisal of situation Look to motherÂ’s emotion 2-3yrs kids talk about emotion scared or afraid Fears expand when lang development and imagination And understanding of future Fears change as get older
- Silverman 95
- 273 kids semistructured interview what is it they worry about health school physical harm performance lowest worry appearance
- precurors
- temperament personality
- kegan:
- behavioral inhibiton
- Kochanska
- Diff scared types of things: Inhiibited Average Disinhibited (rel to boulby attachment)
- Calkins
- Longtitudinal High activity and positive mood At four months
- Shidman
- High heartrate as foetus and activity in womb
- Kegan
- Blue eyed narrow faces and diff temp on forehead Individ diffs may b undergenetic control
- Bio environmental development
- Neuroendocrine reponse Pituary adrenal gland 6months- finetuned damping down of cortisol response to stress over time hemispheric specialisation frontal lobe activation for +ive and –ive emotion Neuroendicrine development Reactivity to events decreases= sharp increase in cortosol
- Injections
- Cortosol level measured at 2ms old Decreases by 4 and 6ms Individual difs Cortosol correlated btw 2m and 4m =0 2-6m correl a little 4 sig correl w response at 6m individual diffs level out over development
- Fox and davidson
- electrodes on head +ive emotion = L activation -ive emotion = R frontal activation High levels of cortosol in baby saliva High levels of frontal asymmetry
- Early fearfulness and inhibition
- Kids w parents w panic dis- have probs Kids w fearfulness shy in preschool Early fearfulness in babies: high risk for anxiety dis
- Biederman –
- kids w anxious parents Inhibitied kids high risk for social anxiety 16% less likely to be diagnosed w disruptive behavior dis not inhib- opposite trend
- Biederman
- If risk for panc dis / dep – high risk for SAD Parent may panic therefore fx kid Parental panic disorder associated with panic attack and agoraphobia. Parental psychopathology
- General characteristics
- Oversensitivity Unreaslistic fears Shyness/ intimdated Pervasive inadequacy Sleep disturbances Fear of school Dependency
- Ethnic diffs
- North America African american vs hispanic or european
- Ordinance of national statistics survey
- Only asked mothers May be underestimates in UK 5-15yrs Twice incidence in girls 0-15yrs than 5-10yrs Anxiety disorder –different most common is seperation anxiety
- SLCDS 11 yr olds
- London community sample Child and mother say symptoms Girls greater than boys No sig diffs btw girls and boys
- Diagnostic criteria
- Excessive anxiety after sep from home or primary caregiver Not baby
- Symptoms
- Excessive distress Persistent worry Reluctance to be alone Refusal to go to sleep Nightmares Physical symptoms Worry about loosing or harm
- 199 kids 8-13yrs
- high comorbid diag than kids w GAD/ social phobia and exteranlizing probs
- Kearney
- Longtitudinal study Clinical/ subclinical separation anxiety Assessed at 3& 6 Yrs Clin diff from non clin Diag not stable over time SAD high comorbid diag Parents of SAD high dep and OCD and phobias
- Great smoky mountains study
- Anxious school refusal vs truancy 13 more likely to be depressed SAD 8.7 more likely to have diagnoses of this Truency- odd –2.2 x as likely and cd-7.4 x as likely
- Hay & Pawlby 2003
- Adversities of child Mother been murdered some had but ?is it a sign of empthay look at other info in sample kids high prosocial and internalizing low externalizing- t think of childÂ’s inner world high prosocial kids may be anxious and visa versa
- genetic transmission
- comorbidity 4 emotional problem
- parental depression
- fx attatchment
- Hay 2003
-
SLCDS study
High rate of SAD if parent depressed post natally, even if depression worn off quickly - Angold costello and erkmann 99
- internalizing probs
- Beidel Turner & morris 99
- child meets more than one category for externalizing disorder
- Barrios & O'dell 98
-
Tripartite model
a)overt behavioral response
running away
b)physiological reponse (change heart rate)
c) subjective response - feeling upset - Rabian & silverman 2000
-
Disagreement over categorisation
DSMIV approache
Correlational approach- empiracle - Birth
- 41/2 days old: fearful reaction
- McFarlane 54
-
Longditudinal study
Kids 2-4 yrs
Specific fears 90% time - Laponse & Monk 59
-
43 % of 6-12 yr olds 7 or more fears
Mothers 41% fewer fears than child reports - Gullone 2000
-
longditudinal study
normal fears transitory - Miller, Barrett & Hampe 74
- Less than 5% mothers = kid w extreme fears
- Rutter 70
-
Isle of white study
7/1000 10-11yrs olds - Ollendick 83
- 3-11yrs = 9-13 fears
- Kirkpatricks 84
- 15-17 yrs 2-3 fears
- Rutter 89
- More extreme fears
- Bell-Dolan 90
- anxiety dis btw 10.7 22.6 %
- Gilburg silverman 2000
- maybe only girls admit to fear
- Bauer 76
- Developmental change = change in perception
- Ollier King 89
- Frequency of fears across age declines
- Thurber & Sigman 98
- Homesickness
- Hersov 60
- School refusal
- Kessler 88
-
psychodynamic
child agressive projection
fears will be carried out - Kearney & Silver
- differentiated school refusal vs truancy
- Albano 96
- 12-13% primary diagnoses of separation anxiety disorder
- Last 96
- anxiety often get depressed later
- King 2000
-
School refusal
1-2% in general population
5% clinical population
no sex difs - Last & Strauss 90
- 69% of refusal to do with school refusal
- Bernstein 2001
- Prognosis best for kids under 10 yrs
- Blagg & Yule 94
- Important to get child back to school
- Elliot 99
- Longterm anxiety can escalate
- Dolan 2002
- emotions are complex psychological and physiological states to a greater or lesser degree index the occurances of value
- Morris 98
- Amy= lots of blood activity w fear resp
- Adolphs 99
- Lesion amy = impare cog to fearful faces
- Bentin & Carmel 2002
- Brain circuits relative to fear give off SCR
- Kotsoni 2001
- 9-8m infants attend to fearful eyes
- dehan 2002
- electrical brain impluses for fear found in 6m infants
- Morris & Dolan 2002
-
Amy responds to eye contact - esp eye response
Think butterflies with eyes and peacock feathers! - Morris 2002
- adults find hard to make eyecontact w strangers
- Dawson
- Familiarity inversley proportional to threatening activity in amy when seeing familiar face
- Adolphs
- fear and anger pathways associated
- Mineka & Oluman 2002
-
monkeys need to learn that are afraid of snake before occurs
social learning
? - Cahill 99
-
visual cliff
storage in amy facilitates learning
mother's eyes enought to make circuit - Marks 87
- Social learning
- King Eleonora Ollendick 97
- social learning parents TV,peers
- Moracco & Camilleri 83
- New brain synapses formed for fear
- Muris, Merkelback 2000
-
Chiuldhood fears asociated w subclinical manifestations 49%
23% full criteria for anxiety dis - Muris Merkelbach 2000
-
Parent interviews
Fulfilled criteria - Darwin
- evolution of fear
- Boulby 73
- Theory of attachment
- Cannon 29
- adaptive functions
- Ekman & Fieson 71
- basic emotions invariant
- Field Woodson
- inborn basic emotions
- Kalin 91
- Fear in monkeys determined by neurochemical systems
- Hiatt 79
- not consistent fear facial expressions therefore not innate
- Caldi Tannenbaum, Sharma 98
- fearful responses to stress programmed by maternal care
- Donovan & Spence 2000
- Multiple risk factors
- Kiln 2001
- anxiety dis happen in families
- Lichenstein & Anhos 2000
-
gender diffs influences
Girls treated better - Last 91
-
Interviewed family
kids w anxiety, ADHD none
Parents of kids w anxiety dis were more anxious - Litchenstein & Annas 2000
- Twin studies DZ vs MZ high concordance for anxiety dis
- Eaves 97
-
Virginia twin study
Lower heritability than other disorders - King & Ollendick 97
-
gender factors limited to role
emotional responsivity may be cause
viginia twin study
high anxiety girls vs boys - Lichtenstien and Annas 2000
- environment important
- Kagan 97
- temperamental 51/2 yrs kids are inhibited high fears than uninhibited kids
- Kagain 90
-
inhibited fears - not caused by trauma
uninhibited fears- caused by trauma - Kagan & Biederman 93
- Sig difs btw inhib and non inhib- inhib for criteria for dishabited
- Ollendick & King 91
- Families create environment for kids to be at risk
- Natson & Rayner 20
- Little albert