CHILDHOOD ANXIETY: THE CONTRIBUTIONS OF EFFORTFUL CONTROL, INTERPRETATION BIASES, AND EARLY LIFE STRESS

Introduction: Research to date has failed to empirically test the mechanisms through which individual differences in effortful control may be protective against childhood anxiety disorder (CAD) symptoms, as well as whether these protective effects may be conditional on the degree of child exposure to early life stress (ELS; e.g., low socioeconomic status, poverty, social support, traumatic events). To this end, the present investigation examined 1) interpretation biases as an underlying mechanism in the relation between effortful control and CAD symptom severity, and 2) ELS as a moderator of hypothesized direct and indirect effects in a sample of 60 clinically anxious children ages 8-12 years. Method: Sixty clinically anxious children (Mage = 9.87 years, SD = 1.47; 50% female; 44% ethnic/racial minority) and their parent completed a multi-method, multi-informant assessment battery of effortful control, interpretation biases, ELS, and anxiety. Children also participated in a behavioral assessment of effortful control. Results: Multiple mediator models indicated a significant indirect effect of effortful control on self-reported CAD symptom severity through self-reported (but not behaviorally indexed) interpretation biases (Aim 1). Moderated mediation results revealed indirect effects of effortful control on child anxiety via interpretation biases at low and mean (but not high) levels of ELS (Aim 2). Discussion: In the context of low and mean (but not high) levels of ELS, anxious children with higher levels of effortful control were less likely engage in biased interpretations, which may lower their anxiety. Clinically anxious children with higher levels of ELS may require more intensive intervention to address the impact of ELS on their cognitive patterns and anxiety symptoms.