Interpersonal Stress Regulation and the Development of Anxiety Disorders: An Attachment-Based Developmental Framework

ObjectivesIn this workshop, I want to broaden the vision on attachment trauma and highlight the importance to acknowledge EAT as a hidden epidemic.The significance of EAT in the development of anxiety symptoms becomes more and more apparent.MethodsRecognizing the effect, that the quality of the attachment relationship has on the development of a secure attachment bond, is important to understand the factors underlying the development of anxiety symptoms.The availability, responsiveness, mentalizing possibilities… of the parent create a secure base from which the child can explore and develop.The absence of those features in the child–parent relationship, causes traumatic stress in the child and impacts his psychological and neurological well-being.ResultsInsecure attachment influences the neurobiology and results in dissociative processes (hyper- and hypo-aroused) expressed in different types of anxiety disorders.Derived from the neurobiology there is a clear link between anxiety, depression and aggression.The internal working model (IWM), rises from insecure attachment, influences adversely the child's capability to regulate and relate.From an intergenerational point of view, an insecure attachment style of the parent implements the absence of affect en stress regulation capabilities and leave the child with the inability to regulate his anxiety.ConclusionThere is a clear link between EAT and different types of anxiety disorders.Treatment strategies should integrate neurobiological, attachment and trauma insights resulting in body oriented therapy, development of affect – and stress – regulation strategies, restructuring the internal working model, the therapeutic relationship as attachment bond…Disclosure of interestThe author has not supplied his declaration of competing interest.

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Can Cognitive Bias Modification of Interpretations Training Alter Mood States in Children and Adolescents? A Reanalysis of Data From Six Studies

Clinical Psychological Science ◽

10.1177/2167702614549596 ◽

2014 ◽

Vol 3 (1) ◽

pp. 112-125 ◽

Cited By ~ 12

Author(s):

Jennifer Y. F. Lau ◽

Victoria Pile

Keyword(s):

Anxiety Disorders ◽

Cognitive Bias ◽

Mood State ◽

Evidence Base ◽

Cognitive Bias Modification ◽

Childhood And Adolescence ◽

Males And Females ◽

Development Of Anxiety ◽

Bias Modification ◽

And Training

Anxiety disorders are common and impairing in childhood and adolescence. Cognitive bias modification of interpretations (CBM-I) training aims to alter information biases associated with anxiety disorders by training the person to endorse benign, rather than negative, interpretations of ambiguous situations. With an expanding evidence base, CBM-I training in childhood and adolescence may provide a key opportunity to prevent the development of anxiety disorders, particularly by capitalizing on the inherent flexibility of the adolescent brain to make durable changes. This article augments existing data with a reanalysis of a large sample of data ( N = 387). The reanalysis highlights that CBM-I is (a) effective in altering interpretation styles; (b) that changes in mood state, although weak, are evident; and (c) tentatively, that effectiveness may vary across age in males and females. We conclude by offering further suggestions on which factors associated with protocol (e.g., multiple sessions) and training package (e.g., use of imagery) may maximize training effectiveness.

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Etiological Factors in the Development of Anxiety Disorders

Child Anxiety Disorders ◽

10.4324/9780203955321-9 ◽

2007 ◽

pp. 61-82

Keyword(s):

Anxiety Disorders ◽

Etiological Factors ◽

Development Of Anxiety

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Family Factors and the Development of Anxiety Disorders

Psychopathology and the Family ◽

10.1016/b978-008044449-9/50008-3 ◽

2005 ◽

pp. 125-145 ◽

Cited By ~ 15

Author(s):

Natalie S. Gar ◽

Jennifer L. Hudson ◽

Ronald M. Rapee

Keyword(s):

Anxiety Disorders ◽

Family Factors ◽

Development Of Anxiety

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Adolescent anxiety disorders and the developing brain: comparing neuroimaging findings in adolescents and adults

General Psychiatry ◽

10.1136/gpsych-2020-100411 ◽

2021 ◽

Vol 34 (4) ◽

pp. e100411

Author(s):

Shuqi Xie ◽

Xiaochen Zhang ◽

Wenhong Cheng ◽

Zhi Yang

Keyword(s):

Prefrontal Cortex ◽

Anxiety Disorders ◽

Emotional Regulation ◽

Current Knowledge ◽

Peak Period ◽

Adolescent Anxiety ◽

Functional Deficits ◽

Adolescents And Adults ◽

Response Systems ◽

Development Of Anxiety

Adolescence is the peak period for the incidence of anxiety disorders. Recent findings have revealed the immaturity of neural networks underlying emotional regulation in this population. Brain vulnerability to anxiety in adolescence is related to the unsynchronised development of anxiety-relevant brain functional systems. However, our current knowledge on brain deficits in adolescent anxiety is mainly borrowed from studies on adults. Understanding adolescent-specific brain deficits is essential for developing biomarkers and brain-based therapies targeting adolescent anxiety. This article reviews and compares recent neuroimaging literature on anxiety-related brain structural and functional deficits between adolescent and adult populations, and proposes a model highlighting the differences between adolescence and adulthood in anxiety-related brain networks. This model emphasises that in adolescence the emotional control system tends to be hypoactivated, the fear conditioning system is immature, and the reward and stress response systems are hypersensitive. Furthermore, the striatum’s functional links to the amygdala and the prefrontal cortex are strengthened, while the link between the prefrontal cortex and the amygdala is weakened in adolescence. This model helps to explain why adolescents are vulnerable to anxiety disorders and provides insights into potential brain-based approaches to intervene in adolescent anxiety disorders.

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Affective modulation of the startle response among children at high and low risk for anxiety disorders

Psychological Medicine ◽

10.1017/s003329171500063x ◽

2015 ◽

Vol 45 (12) ◽

pp. 2647-2656 ◽

Cited By ~ 10

Author(s):

A. Kujawa ◽

C. R. Glenn ◽

G. Hajcak ◽

D. N. Klein

Keyword(s):

Anxiety Disorders ◽

Startle Response ◽

Depressive Disorders ◽

Parental Psychopathology ◽

Affective Modulation ◽

Early Markers ◽

History Of ◽

Picture Viewing ◽

Underlying Mechanisms ◽

Development Of Anxiety

BackgroundIdentifying early markers of risk for anxiety disorders in children may aid in understanding underlying mechanisms and informing prevention efforts. Affective modulation of the startle response indexes sensitivity to pleasant and unpleasant environmental contexts and has been shown to relate to anxiety, yet the extent to which abnormalities in affect-modulated startle reflect vulnerability for anxiety disorders in children has yet to be examined. The current study assessed the effects of parental psychopathology on affective modulation of startle in offspring.MethodNine-year-old children (n = 144) with no history of anxiety or depressive disorders completed a passive picture viewing task in which eye-blink startle responses were measured during the presentation of pleasant, neutral, and unpleasant images.ResultsMaternal anxiety was associated with distinct patterns of affective modulation of startle in offspring, such that children with maternal histories of anxiety showed potentiation of the startle response while viewing unpleasant images, but not attenuation during pleasant images, whereas children with no maternal history of anxiety exhibited attenuation of the startle response during pleasant images, but did not exhibit unpleasant potentiation – even when controlling for child symptoms of anxiety and depression. No effects of maternal depression or paternal psychopathology were observed.ConclusionsThese findings suggest that both enhanced startle responses in unpleasant conditions and failure to inhibit startle responses in pleasant conditions may reflect early emerging vulnerabilities that contribute to the later development of anxiety disorders.

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Eye blink startle responses in behaviorally inhibited and uninhibited children

International Journal of Behavioral Development ◽

10.1177/0165025406071903 ◽

2006 ◽

Vol 30 (5) ◽

pp. 460-465 ◽

Cited By ~ 5

Author(s):

Anna M.L. van Brakel ◽

Peter Muris ◽

Wendy Derks

Keyword(s):

Longitudinal Study ◽

Anxiety Disorders ◽

Facial Expressions ◽

Behavioral Inhibition ◽

Startle Reflex ◽

Modulation Effect ◽

Eye Blink ◽

Habituation Effect ◽

Development Of Anxiety

The present study examined the startle reflex as a physiological marker of behavioral inhibition. Participants were 7to 12-year-old children who had been previously identified as inhibited or uninhibited as part of an ongoing longitudinal study on the role of behavioral inhibition in the development of anxiety disorders. Analysis of their scores on the Behavioral Inhibition Scale revealed that the children were stable in their behavioral inhibition categorization as compared to the beginning of the longitudinal study. An experiment was carried out to study startle modulation effects in response to novel and familiar pictures of threatening and non-threatening facial expressions in inhibited and uninhibited children. The main results can be summarized as follows. To begin with, no modulation effect was found. That is, children did not show the expected (adult-like) startle facilitation while viewing unpleasant pictures. Second, a habituation effect was found: that is, during the testing phase children responded more intensely to the first block of slides than to the second block of slides (irrespective of slide content). Third, unexpectedly behaviorally inhibited children displayed smaller eye blink magnitudes in response to novel slides than uninhibited children. Fourth and finally, no meaningful differences were found in the patterns of startle responses of both genders.

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Generalization of Conditioned Contextual Anxiety and the Modulatory Effects of Anxiety Sensitivity

Neurotherapeutics ◽

10.1007/s13311-020-00831-8 ◽

2020 ◽

Vol 17 (3) ◽

pp. 1239-1252

Author(s):

Marta Andreatta ◽

Dorothea Neueder ◽

Katharina Herzog ◽

Hannah Genheimer ◽

Miriam A. Schiele ◽

...

Keyword(s):

Virtual Reality ◽

Risk Factor ◽

Anxiety Disorders ◽

Unconditioned Stimulus ◽

Anxiety Sensitivity ◽

Physiological Responses ◽

Context Conditioning ◽

Virtual Office ◽

Generalization Gradients ◽

Development Of Anxiety

Abstract Anxiety patients overgeneralize fear responses, possibly because they cannot distinguish between cues never been associated with a threat (i.e., safe) and threat-associated cues. However, as contexts and not cues are discussed as the relevant triggers for prolonged anxiety responses characterizing many anxiety disorders, we speculated that it is rather overgeneralization of contextual anxiety, which constitutes a risk factor for anxiety disorders. To this end, we investigated generalization of conditioned contextual anxiety and explored modulatory effects of anxiety sensitivity, a risk factor for anxiety disorders. Fifty-five participants underwent context conditioning in a virtual reality paradigm. On Day 1 (acquisition), participants received unpredictable mildly painful electric stimuli (unconditioned stimulus, US) in one virtual office (anxiety context, CTX+), but never in a second office (safety context, CTX−). Successful acquisition of conditioned anxiety was indicated by aversive ratings and defensive physiological responses (i.e., SCR) to CTX+ vs CTX−. On Day 2 (generalization), participants re-visited both the anxiety and the safety contexts plus three generalization contexts (G-CTX), which were gradually dissimilar to CTX+ (from 75 to 25%). Generalization of conditioned anxiety was evident for ratings, but less clear for physiological responses. The observed dissociation between generalization of verbal and physiological responses suggests that these responses depend on two distinct context representations, likely elemental and contextual representations. Importantly, anxiety sensitivity was positively correlated with the generalization of reported contextual anxiety. Thus, this study demonstrates generalization gradients for conditioned contextual anxiety and that anxiety sensitivity facilitates such generalization processes suggesting the importance of generalization of contextual anxiety for the development of anxiety disorders.

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