Fearful Temperament, Social Anxiety, And Depressive Symptoms In Clinically Anxious Youth: The Role Of Catastrophizing Cognitions

Introduction: Fearful temperament—a proclivity to remain within reach of caregivers and to exhibit apprehension, heightened physiological reactivity, and/or avoidance in novel situations—is positively associated with youth social anxiety and depressive symptoms. However, there is little understanding of the cognitive mechanisms underlying this association. One potential candidate mechanism is catastrophizing cognitions, defined as the tendency to think that in any given situation the worst possible outcome is very likely to happen. The present investigation tested this hypothesis by examining the effect of fearful temperament on social anxiety and depressive symptoms via catastrophizing cognitions in a sample of clinically anxious youth. Method: A total of 105 children with anxiety disorders (Mage = 10.09 years, SD = 1.22; 56.7% female; 49% ethnic minority) completed a diagnostic interview and self-report measures of temperament, catastrophizing cognitions, and social anxiety and depressive symptoms. Children also completed behaviorally-indexed assessments of catastrophizing cognitions and social anxiety symptoms. Results: Significant indirect effects were found for fearful temperament on child self-reported social anxiety symptoms by way of self-reported (b = 1.96, PM = 0.29, SE = 0.73; 95% CI [0.64, 3.52]) and behaviorally-indexed (b = 0.72, PM = 0.12, SE = 0.50; 95% CI [0.16, 1.96]) catastrophizing cognitions. Significant indirect effects were also found for fearful temperament on child self-reported depressive symptoms by way of self-reported (but not behaviorally-indexed) catastrophizing cognitions (b = 2.82, PM = 0.38, SE = 0.83; 95% CI [1.02, 4.27]). Models predicting behaviorally-indexed child social anxiety severity were not significant. Discussion: Findings suggest that targeting fearful temperament before catastrophizing cognitive responses develop may have clinical utility. Likewise, among youth temperamentally at-risk for emotional disorders, addressing catastrophic cognitions may be warranted to prevent subsequent problems with social anxiety and depression.