Effortful control, interpretation biases, and child anxiety symptom severity in a sample of children with anxiety disorders

Abstract

Introduction: Effortful control-the ability to inhibit impulsive reactions in favor of more adaptive responses-is negatively related to child anxiety severity. One potential explanation is that greater effortful control may "slow down" automatic, threat-laden interpretations, thereby lowering children's anxiety. The present investigation tested this hypothesis by examining associations between effortful control (and its subcomponents) and anxiety symptom severity, mediated by interpretation biases, in a diverse sample of clinically anxious youth.

Method: Participants (N = 105; Mage = 10.09 years, SD = 1.22; 56.7% female; 49% ethnic minority) completed a diagnostic interview; self-report measures of temperament, anxiety, and interpretation biases; a performance-based measure of interpretation biases; and a parent-child interaction task for which an index of behavioral anxiety was computed.

Results: Significant indirect effects were found for effortful control, attentional control, and inhibitory control on child self-reported anxiety severity by way of self-reported (but not behaviorally-indexed) interpretation biases. Models predicting behaviorally-indexed child anxiety severity were not significant.

Discussion: Greater effortful control may result in enhanced attentional capacities that allow children to assess automatic cognitions more objectively, potentially lowering their anxiety. Future work should evaluate whether targeting malleable temperamental constructs, such as effortful control, leads to clinically meaningful reductions in interpretation biases and child anxiety symptoms.

Trial registration: ClinicalTrials.gov NCT02095340.

Keywords: Attentional control; Child anxiety; Cognitive biases; Effortful control; Inhibitory control.

Copyright © 2019 Elsevier Ltd. All rights reserved.

Figures

Figure 1.

Theoretical Model: Child cognitive biases as a potential mediator between effortful control (and its subcomponents) and anxiety symptom severity.

Figure 2.

Child interpretation biases as a mediator between attentional control and self-reported anxiety symptom severity. Note. * p < .001

Figure 3.

Child interpretation biases as a mediator between inhibitory control and self-reported anxiety symptom severity. Note. * p < .001

Figure 4.

Child interpretation biases as a mediator between effortful control and self-reported anxiety symptom severity. Note. * p < .01