Anxiety sensitivity moderates behavioral avoidance in anxious youth

Lebowitz, Eli R.; Shic, Frederick; Campbell, Daniel; Basile, Krista; Silverman, Wendy K.

doi:10.1016/j.brat.2015.08.009

Cited by 31 publications

(13 citation statements)

References 43 publications

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“…Another possible limitation of this study is the exclusive use of spider images to investigate fear and avoidance behavior. We chose to focus on spider stimuli because of the high prevalence of fear of spiders, because spider stimuli have been most widely used to study avoidance, and because avoidance of spider stimuli has been shown to be significantly and strongly associated with global measures of anxiety [35, 36, 43–45]. We are currently conducting research in our lab to examine the role of maternal acceptance using a broader set of stimuli.…”

Section: Discussionmentioning

confidence: 99%

Maternal Acceptance Moderates Fear Ratings and Avoidance Behavior in Children

Shimshoni

Silverman

Byrne

et al. 2017

Child Psychiatry Hum Dev

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Avoidance is a hallmark feature of anxiety disorders, and avoidance-related impairment is often key to meeting diagnostic criteria. In children and adolescents with anxiety disorders, levels of avoidance vary considerably. Using a novel motion-tracking measure of avoidance behavior, we examined whether maternal acceptance, characterized by warm and accepting responses to child feelings and behaviors, moderates the association between fear of spiders and behavioral avoidance of spider stimuli in 103 clinically anxious children. As hypothesized, maternal acceptance significantly moderated children's avoidance behavior. Child's fear of spiders was significantly associated with behavioral avoidance when mothers were low in acceptance, as rated by either mothers or children. When mothers were high in acceptance, as rated by either mothers or children, child self-rated fear of spiders was not significantly associated with child avoidance. These are the first results to empirically demonstrate the moderating role of maternal acceptance in anxious children's avoidance behavior.

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Section: Discussionmentioning

confidence: 99%

Maternal Acceptance Moderates Fear Ratings and Avoidance Behavior in Children

Shimshoni

Silverman

Byrne

et al. 2017

Child Psychiatry Hum Dev

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“…These studies focused on only two kinds of stimuli, spiders and emotional faces. Spiders were selected because fear of spiders has been the focus of other behavioral avoidance studies, is relatively straightforward to trigger, and has established rating-scales for children and adults (Kindt & Brosschot, 1999; Klein, Becker, & Rinck, 2011; Lebowitz, 2017; Lebowitz, Shic, Campbell, Basile, & Silverman, 2015; Lebowitz, Shic, Campbell, MacLeod, et al, 2015; Olatunji, Cisler, Meunier, Connolly, & Lohr, 2007; Renaud, Bouchard, & Proulx, 2002). The emotional faces were selected because they have been used in numerous previous anxiety studies as a more generic anxiety trigger.…”

Section: Discussionmentioning

confidence: 99%

“…The expectancy model developed by Reiss (Reiss, 1991; Reiss & McNally, 1985) suggests that phobic avoidance is motivated in part by harm avoidance and in part by avoidance of internal sensations, a phenomenon termed anxiety sensitivity. Previous research using YIKES found that behavioral avoidance was best explained through the interaction of fear of the stimulus itself and the level of anxiety sensitivity (Lebowitz, Shic, Campbell, Basile, et al, 2015). Additional research is required to further elucidate the relations between behavioral and experiential avoidance and how to best integrate behavioral measures such as YIKES with measures of experiential avoidance.…”

Section: Discussionmentioning

confidence: 99%

Using Motion Tracking to Measure Avoidance in Children and Adults: Psychometric Properties, Associations With Clinical Characteristics, and Treatment-Related Change

Lebowitz¹,

Baudin²

2018

Behavior Therapy

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Avoidance is implicated in many areas of psychopathology, particularly anxiety and its disorders. Accurate, reliable, valid, and objective measurement of avoidance behavior poses methodological challenges. Two key technological advances, increased computing power and the advent of motion-tracking technology, offer novel solutions to these challenges. We describe a series of three studies using a novel motion-tracking system to measure avoidance in children and adults. The first study examined behavioral avoidance of spider stimuli in large samples of children and adults (N=200 each; the adults were the mothers of the children). Behavioral avoidance was associated with self-rated fear of spiders and increased state anxiety from before to after the task. The second study examined avoidance of threat faces in children and adults (N=35 each; the adults were the mothers of the children) and test-retest reliability in the adults. Avoidance of threat faces was associated with broadband anxiety symptom severity. Test-retest correlations in behavioral avoidance measured 6 weeks apart was high and significant. The third study examined behavioral avoidance of spiders in clinically anxious children (N=25) before and after cognitive-behavioral therapy for childhood anxiety disorders. Behavioral avoidance was significantly reduced following cognitive-behavioral therapy and reduction in behavioral avoidance correlated significantly with improvement in child-rated anxiety symptoms. Taken together these studies provide strong support for the promise of motion-tracking technology to enable a new phase of behavioral avoidance research with sensitive, valid, reliable, and cost- and time-effective measurement of behavioral avoidance across the lifespan.

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“…Behavioral avoidance research has been hampered in part by theoretical challenges (LeDoux, Moscarello, Sears, & Campese, 2017) involved in accurately measuring avoidance. Novel approaches to measuring avoidance using sophisticated technological advances hold promise for future research in this direction (Lebowitz, Shic, Campbell, Basile, & Silverman, 2015; Lebowitz, Shic, Campbell, MacLeod, & Silverman, 2015).…”

Section: Negative Valence Systemsmentioning

confidence: 99%

Implications of the Research Domain Criteria project for childhood anxiety and its disorders

Lebowitz

Gee

Pine

et al. 2018

Clinical Psychology Review

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Anxiety disorders are among the most prevalent psychiatric disorders in youth; however, progress in treatment for childhood anxiety has stalled over the past decade. The National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) project represents a shift toward a dimensional and interdisciplinary approach to psychiatric disorders; this shift can reframe developmental psychopathology for childhood anxiety and facilitate novel advances in its classification and treatment. Here we highlight constructs in the Systems for Social Processes and the Negative Valence System domains of RDoC, as they relate to childhood anxiety disorders. Childhood anxiety relates to both RDoC domains. In terms of social processes, through natural reliance on parents to reduce children's fear, attachment represents one particular social process, which plays a central role in anxiety among youth. In terms of negative valence, considerable research links threat conditioning to pediatric anxiety. Finally, fronto-amygdala circuitry relates to all three entities, as it has been shown to underly both attachment processes and threat learning, while it also has been consistently implicated in anxiety disorders across development. Through integrative and translational approaches, RDoC provides unique opportunities and simultaneous challenges for advancing the understanding and treatment of childhood anxiety disorders.

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Anxiety sensitivity moderates behavioral avoidance in anxious youth

Cited by 31 publications

References 43 publications

Maternal Acceptance Moderates Fear Ratings and Avoidance Behavior in Children

Maternal Acceptance Moderates Fear Ratings and Avoidance Behavior in Children

Using Motion Tracking to Measure Avoidance in Children and Adults: Psychometric Properties, Associations With Clinical Characteristics, and Treatment-Related Change

Implications of the Research Domain Criteria project for childhood anxiety and its disorders

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