Anger in Anxious Children: Fighting Threat or Reacting to Non-Reward. Possible Implications for Treatment of Comorbid Children

Activity: Talk and presentationAcademic presentationAcademic


Anger in anxious children: fighting threat or reacting to non-reward. Possible implications for treatment of comorbid children. A substantial amount of children with anxiety disorders suffers from comorbid oppositional and anger problems. Children with this comorbid profile profit less from current treatments, present with greater impairment and have an increased risk for future mental health problems. Improving insight in the underlying mechanism of this comorbidity is needed to improve prospects for these children. The temperamental characteristics of punishment sensitivity (PS) and reward sensitivity (RS) in combination with situational characteristics might help in explaining this intriguing profile in children. We propose two sources leading to anger in anxious children, namely through threat and through frustration of non-reward. We hypothesized that punishment sensitivity is especially related to anger out of threat situations, whereas reward sensitivity is especially related to anger out of non-reward situations. Insight in these different pathways to anger in anxious children might help in improving the fit between treatment techniques and the clinical profile of the child, therefore resulting in better outcomes for the child. As a first step we conducted a study in 164 children (age 12-18) examining these two different pathways to anger and the moderating role of punishment and reward sensitivity. Children read through 39 anger evoking scripts and rated the level of anger and anxiety these situations would evoke in them and how they interpreted these situations with regard to threat and non-reward. Furthermore, they filled in questionnaires on punishment and reward sensitivity, anxiety and externalizing symptoms. A hierarchical regression analysis showed that punishment sensitivity predicted the total anger score from the situations, over and above reward sensitivity. Furthermore, the interaction of punishment sensitivity with threat predicted the total anger score from the situations over and above the interaction of reward sensitivity with non-reward, indicating that both pathways help in explain anger in anxious children. Multilevel analyses will be conducted to zoom in on within person differences in evoked emotions in the specific situations and explaining them by situational characteristics and temperament. Results will be presented and possible implications for treatment of comorbid children will be discussed.

Event title9th World Congress of Behavioural and Cognitive Therapies
Event typeConference
LocationBerlin, GermanyShow on map