Exploring affect integration in children with anxiety disorders: A pilot study.

Abstract

Affect integration is considered central to mental health. We define affect integration in terms of the affect consciousness construct as degrees of awareness, tolerance, nonverbal, and conceptual expression of 11 affects (Monsen, Eilertsen, Melgård, & Odegård, 1996). We assessed the construct using a child-adapted version of the semistructured Affect Consciousness Interview and separate scoring scales (Taarvig, Solbakken, Grova, & Monsen, 2015). We administered this interview to 8 children who met the criteria for an anxiety disorder to examine the following questions: (a) Which of a large number of specific affects recur as especially problematic? (b) In what ways do the children cope with the identified affects? To address these questions, we used a qualitative analyses method, based on the affect consciousness model. The anxious children exhibited problems in the way they experienced and coped with a larger number of affects compared with what previous studies on affect integration have reported. Affect couplings were found to be central to the problematic ways in which specific affects were experienced and coped with. Persistent couplings of affects conformed with theoretical perspectives on affect integration and with previous findings obtained in adults with an anxiety disorder, using the same method as applied in this study (Sønderland, 2010). It may be warranted to regard affect experience, particularly coupling of affects, as fundamental to understanding the continuity in anxiety disorders from childhood to adulthood. Our research may contribute to the development of more differentiated treatment models for anxious children.

Differences in affect integration in children with and without internalizing difficulties

“…The results indicate that the ACI provides information that is highly consistent on an overall, dimensional level, with more nuanced information on the level of individual affect. The results were consistent with the hypotheses and corresponds to earlier findings indicating that the Affect Consciousness score and the four dimensions gives the best overall view of affect integration, while a consideration of integration of individual affects can give clinically useful information on an individual level ( 2 , 19 , 25 ).…”

“…Using the affect consciousness interview (ACI) for children, Taarvig et al ( 3 ) found that higher affect integration was linked to better social competency and fewer psychopathology symptoms in 11-year old children with internalizing difficulties. Another study exploring a subset of the same data ( 19 ) found lower integration of particularly fear, shame, guilt, and anger in anxious children.…”

“…Here the child was asked to describe how they express the focal affect in relation to significant others, strangers and when alone, focusing on facial expressions, voice, posture, respiration and similar aspects of nonverbal affective communication. Finally, Conceptual Expressivity refers to how well the child can acknowledge and verbally articulate affect in a clear and nuanced fashion ( 19 , 25 ). Here the interviewer asked the child to share how they would express the affect in words.…”

“…A score of 1 is the lowest attainable score, while 9 is the highest, indicating higher integration. In a small sample of slightly older children with anxiety (mean age 11.5), a score at/below 4 was considered low ( 19 ). A global Affect Consciousness score was calculated as a mean of scores from all nine affects across the four dimensions.…”

“…Anger/Rage differed the most, mirroring earlier results. For instance, Taarvig et al ( 19 ) found difficulties with integration of anger in their sample of anxious children, while Zeman et al ( 16 ) found that lower awareness and greater inhibition of anger predicted more internalizing symptoms. In the affect consciousness model, emotions outside of awareness cannot be efficiently expressed and dealt with in the interpersonal realm, instead lingering unresolved in the body and self ( 4 ).…”