Tal Carthy, Netta Horesh, Alan Apter, Michael D. Edge, James J. Gross

Recent models of anxiety disorders emphasize abnormalities in emotional  reactivity and regulation. However, the empirical basis for this view is  limited, particularly in children and adolescents. The present study examined  whether anxious children suffer both negative emotional hyper-reactivity and  deficits in cognitive emotion regulation. Participants were 49 children aged  10–17 with generalized anxiety disorder, social anxiety, or separation anxiety  disorder as their primary diagnosis, as well as 42 age- and gender-matched  non-anxious controls. After completing a diagnostic interview and self-report  questionnaires, participants were presented with pictures of threatening scenes  with the instructions either to simply view them or to use reappraisal, a  cognitive emotion regulation strategy, to decrease their negative emotional  response. Emotion ratings, content analysis of reappraisal responses, and  reports of everyday use of reappraisal were used to assess negative emotional  reactivity, reappraisal ability, efficacy and frequency. Relative to controls,  children with anxiety disorders (1) experienced greater negative emotional  responses to the images, (2) were less successful at applying reappraisals, but  (3) showed intact ability to reduce their negative emotions following  reappraisal. They also (4) reported less frequent use of reappraisal in everyday  life. Implications for the assessment and treatment of childhood anxiety  disorders are discussed.