Effortful Control, Interpretation Biases, and Child Anxiety Symptom Severity in a Sample of Children with Anxiety Disorders

Introduction: The present investigation examined associations between effortful control (and its subcomponents: attention control and inhibitory control) and anxiety symptom severity, by way of interpretation biases, in a diverse sample of clinically anxious youth. It was hypothesized that effortful control would be inversely related to interpretation biases and child anxiety symptoms. It was also hypothesized that interpretation biases would significantly mediate the association between effortful control and child anxiety symptom severity. Each subcomponent of effortful control (i.e., attention control and inhibitory control), as well as the total construct, was examined in tests of mediation. 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 assessment of interpretation biases; and a parent-child interaction task. Results: Multiple mediator models indicated a significant indirect effect of effortful control (completely standardized point estimate = -.24, SE = .06, BC 95% CI [-.36, -.14]), attentional control (completely standardized point estimate = -.22, SE = .06, BC 95% CI [-.34, -.12]), and inhibitory control (completely standardized point estimate = -.19, SE = .05, BC 95% CI [-.31, -.09]) on self-reported anxiety symptom severity through self-reported, but not behaviorally-indexed, interpretation biases. Multiple mediator models predicting behaviorally-indexed child anxiety severity were not significant. Discussion: Clinically anxious children with higher levels of effortful control (and its subcomponents) are less likely engage in biased interpretations, which may lower their anxiety. Future work should evaluate whether targeting these malleable temperamental constructs leads to clinically meaningful reductions in interpretation biases and child anxiety symptoms.