Factors Predicting Youth Anxiety Severity: Preliminary Support for a Standardized Behavioral Assessment of Parental and Youth Avoidance Behaviors

Abstract

Anxiety severity in youth is associated with a host of negative outcomes including poor response to treatment. Thus, a better understanding of factors that contribute to anxiety severity is needed. Such factors may include parental anxiety as well as anxiety-related approach and avoidance behaviors in both children and parents. In this study, we examined automatic behavioral tendencies as a method of quantifying anxiety-related approach and avoidance behaviors in children and their parents. Clinically anxious youth (N 5 19) with mixed anxiety diagnoses and their parents completed an approach-avoidance task (AAT) comprising different emotional expressions. Our results suggest that in addition to parent report of youth anxiety, both youth and parent automatic avoidance biases predict clinician-rated youth anxiety severity accounting for 62% of the variance in clinician-rated youth anxiety. These results suggest that the AAT may be a useful measure of automatic behavioral tendencies in clinically anxious youth and their parents and that these factors may be relevant to youth anxiety severity.

Intolerance for approach of ambiguity in social anxiety disorder

“…We also removed response latencies deviating more than two SD from the mean response latency for each participant's own overall response latency (Kuckertz et al, 2015). …”

“…These pictures were selected from a well-validated set of emotional facial expressions (Matsumoto & Ekman, 1988) and have been used in previous research examining information-processing biases in SAD (Amir et al, 2009; Schmidt et al, 2009). We selected disgust faces as our non-ambiguous negative facial expression due to previous research utilizing disgust faces in AAT for anxiety disorders (Kuckertz, Carmona, Chang, Piacentini,& Amir, 2015) as well as in other information processing tasks in socially anxious individuals (Amir et al, 2008; Amir et al, 2009; Pishyar, Harris, & Menzies, 2004; Schmidt et al, 2009). The pictures were surrounded by a green or a blue border.…”

Self-report questionnaires, behavioral assessment tasks, and an implicit behavior measure: do they predict social anxiety in everyday life?

“…To investigate prospective predictors of daily social anxiety, experiential avoidance, and the experience of negative social events, we applied a step-wise procedure for each of the three outcome variables using IBM SPSS Statistics 24.0 (IBM, Armonk, NY, USA). This approach has been used in previous studies with large numbers of predictors and relative small sample sizes ( Amir, Taylor & Donohue, 2011 ; Fournier et al, 2009 ; Kuckertz et al, 2015 ). We used this step-wise procedure in order to prevent the rejection of a possible predictor because of the sample size.…”