Childrens Symptoms of Anxiety: Relations with Emotion Modulated Startle

1
Childrens Symptoms of Anxiety Relations with
Emotion Modulated Startle Temperament Kristy
McDonald, Nicole Moreno Kathryn
Lemery-Chalfant, Arizona State University1492 S.
Mill Ave Ste 305 Tempe, AZ 85281nicole.moreno_at_asu
.edu
INTRODUCTION
METHOD
RESULTS
DISCUSSION

•   The Emotion-Modulated Startle Paradigm (EMS) is
  a promising measure of individual differences in
  emotional reactivity. The startle response is a
  defensive reflex and an indirect marker of
  activation of affective brain circuitry, measured
  by the magnitude of the eye blink (Essex et al.,
  2002).
• Research with adults report greater startle eye
  blink magnitudes while viewing negative stimuli
  and smaller startle responses while viewing
  positive stimuli, both compared to neutral images
  (Lang, Davis, Ohman, 2000).
• Exaggerated startle is a part of the diagnostic
  description of Post Traumatic Stress Disorder
  (APA, 1994) and children of anxious parents have
  accentuated startle eye-blink magnitudes
  (Grillion et al., 1997).
• Anxious patients show greater startle responses
  across all emotion-eliciting contexts whereas
  clinically depressed patients show attenuated
  startle responses during positive contexts only
  (Forbes et al., 2005 Kavaini, et al., 2004).
• Criminal psychopaths (low in fearfulness) show
  attenuated startle response to affective pictures
  compared to neutral pictures (Patrick et al.,
  1993 Levenston et al., 2000 Sutton et al.,
  2002).
• Few studies have used the EMS with children, so
  one goal of this project is to attempt to
  replicate the pattern of reduced startle
  responses during positive, enhanced responses
  during negative, compared to neutral contexts.

• We used the emotion-modulated startle paradigm
  and obtained child report of temperament and
  symptoms of anxiety and depression to better
  understand anxiety in children.
• We found a significant difference in startle
  magnitude across the different emotion
  conditions, with startle magnitude greater during
  the positive and negative conditions compared to
  the neutral condition. Our pattern of startle
  response across conditions differed from previous
  research, with startle grater during positive as
  compared to neutral conditions. Our selection of
  positive video-clips may have been more arousing
  than those used in previous research.
• Relations between startle response and symptoms
  of anxiety did not reach statistical
  significance, perhaps because our sample was a
  normative community sample and did not include
  children with high levels of symptoms. In
  addition, comorbidity with externalizing symptoms
  could have confounded the associations.
• Child temperament was significantly correlated
  with symptoms. Children who reported more fear,
  shyness, and sadness also had more symptoms of
  anxiety and depression. Anger and low attentional
  focusing were also correlated with more symptoms.
  This is consistent with previous research in
  which anger was positively correlated with
  internalizing, and attentional focusing was
  negatively related to both internalizing and
  externalizing (Lemery, Essex, Smider, 2002).
• Creating a reliable model of EMS in children
  would provide emotion researchers with a useful,
  non-invasive biological measure to assess
  emotional reactivity relevant to etiology of
  child psychopathology.

• Sample
• 96 children between the ages of 6 7
  participated.
• 26 were non-Caucasian, including Mexican
  American, Native American African American.

• Figure 1 displays childrens startle magnitude
  across positive, neutral, and negative emotion
  eliciting contexts.
• The difference in childrens startle magnitude
  across context was significant, F (2, 182) , p
  008. Startle during the negative and positive
  conditions were significantly larger than startle
  during the neutral condition.
• Correlations between childrens startle responses
  and symptoms of anxiety were not significant.
• Table 1 shows the correlations between
  temperament and symptoms of anxiety and
  depression.
• Activity level, discomfort, falling
  reactivity/soothability, high intensity pleasure,
  inhibitory control, low intensity pleasure, and
  smiling laughter were not significantly related
  to symptoms.

• Emotion-Modulated Startle (EMS)
• 10 age-appropriate video clips (3 positive, 3
  neutral, 4 negative)
• were chosen to elicit emotions in children and
  were presented in a
• quasi-random order. Prior to watching the video
  clips, the child viewed
• a short test clip that contained 3 un-scored
  audio probes for familiarization.
• Embedded in each audio track were 3-4 acoustic
  startle probes (50ms, 95dB, 0ms rise time white
  noise). Acoustic probes at this level elicited
• eye blink responses about 2/3 of the time.  
• Eye blink intensity was rated from videotape on a
  7-point Likert scale ranging from 1 no muscle
  movement to 7 fully closed eye with visible
  muscle scrunching. Blink response was not coded
  if it occurred during a natural blink.
• Berkeley Puppet Interview (Measelle et al., 1998)
  
• The BPI is a semi-structured puppet interview
  designed to elicit young childrens self-reports
  of symptoms of psychopathology.
• The child was asked to identify with one of two
  puppets who provide opposing statements, designed
  to reflect positive and negative ends of the same
  behavior or symptom.
• One puppet says, I worry about doing things
  right. Then the other puppet says, I dont
  worry about doing things right. How about you?
• Children agreed with one of the puppets in their
  own method of communication, either verbally or
  by pointing.
• Responses were coded from videotape on a 7-point
  Likert scale. Coders were trained to
  reliability, defined as kappa greater than .70,
  with approximately 15 of the sample
  double-coded.
• The interview was conducted in after school
  programs.
• Child Behavior Questionnaire (Hwang, 1993)

Fig. 1 Startle Response by Emotional Context
REFERENCES

• Essex, M., Boyce, T., Goldstein, L., Armstrong,
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  Child and Adolescent Psychiatry 41,588-603.
• Forbes, E., Miller, A., Cohn, J., Fox, N.,
  Kovacs, M. (2005) Affect-modulated startle in
  adults with childhood-onset depression relations
  to bipolar course and number of lifetime
  depressive episodes. Psychiatry Research, 134,
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• Grillion C., Dierker L., Merikangas, K. (1997)
  Startle modulation in children at risk for
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• Kaviani, H., Gray, J., Checkley, S., Raven, P.,
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• Lang, P., Davis, M., Ohman, A. (2000) Fear and
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• Lemery, K., Essex, M., Smider, N. (2002)
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• Levenston, G., Patrick, C., Bradley, M., Lang, P.
  (2000) The psychopath as observer emotion and
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• Bradley, M., Lang, P., Patrick, C. (1993)
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Table 1 Correlations Between Temperament
Symptoms

• (1) Emotional context will influence children's
  startle eye-blink startle responses. The
  magnitude of the startle response will be greater
  during negative and less during positive
  emotional contexts compared to neutral contexts.
• (2) Startle magnitude across all contexts will be
  positively correlated with symptoms of anxiety in
  children.
• (3) Childrens fear, shyness, and sadness will be
  positively correlated with symptoms of anxiety
  and depression.

HYPOTHESES
p .05 p .01 (two-tailed)
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