Effects of Maternal Interpretation Biases on Child Anxiety and Related Responses
Phase: NA
Conditions: Anxiety Disorders
Sponsor: University of Houston

Study Title: Effect of Maternal Interpretation Biases on Child Anxiety and 
Related Responses 
NCT02095340 
Document Date: 01/05/2016 

Generated at: 1/5/2016
7:57:27 AM
UNIVERSITY OF HOUSTON
Division of Research
Institutional Review Board Application
 
 
 
 
Institutional Review Board 
Application ID : 
15622-02 - (7499)
Title : 
Effects of Maternal Interpretation Biases on Child Anxiety and 
Related Responses
Approval details for the Application Id: 7499 
 
Decision
Approver Name
Date
Comment
PI 
signature
Approved Viana, Andres Dr.
12/29/2015  
DOR 
signature
Approved Admin, IRB
01/05/2016  

 
 
 
 
Application Data for Application ID: 7499 
Title
Effects of Maternal Interpretation Biases on Child Anxiety and Related Responses
Application 
Type
Revision
Review 
Type
Full
Expedite 
Code
Not Applicable
Exemption 
Code
Not Applicable
Research 
Reason
Other (Explain) :This application pertains to a federally funded project (7R21MH101309-03), which is in the 
process of being transferred from the University of Mississippi Medical Center (my former institution) to the 
University of Houston. However, because the grant is not yet at University of Houston, the "funded research" option 
cannot be selected as there is no Project ID assigned or transmittal in the U of H system. 
Investigator Data for Application ID: 7499 
PI Name
Is 
Pricipal?
Is Co-
Investigator?
Is 
External?
Other Personnel 
Type?
Is 
Student?
Faculty Sponsor 
Name
Viana, Andres Dr.
Yes
 
No
 
No
Not Applicable
Alfano, Candice Dr.
 
Yes
No
 
No
Not Applicable
Manning, Kara Ms.
 
 
No
Other Research 
Personnel
No
Not Applicable
Alphonso, Naomi 
Ms.
 
 
No
Other Research 
Personnel
Yes
Not Applicable
Raines, Elizabeth 
Ms.
 
 
No
Other Research 
Personnel
No
Not Applicable
Revision application data for application Id: 7499 
Question
Answer
1) Revision Description (check all that are 
appropriate)
Revision/Addition to currently approved List of 
Documents :130||134||129||131
2) Risk Involve:(Check One)
This revision does not increase risks to participants enrolled in this study. 
(For students, signature of faculty sponsor is required.)
3) Describe the proposed revision. If applicable, 
include a scientific justification for the revision ( for 
example, changes in the study population).
In order to reduce participant burden, we have decided to replace our 
clinical interview, namely the ADIS-C/P, with a shorter, easier-to-administer 
clinical interview: The MINI International Neuropsychiatric Interview (i.e., 
the MINI). The MINI covers exactly the same number of disorders. The 
only difference between the measures is administration time. Because the 
MINI can be administered in a significantly shorter amount of time, we have 
revised (1) the recruitment script (2) the permission and assent documents, 
and (3) the recruitment script to indicate that session 1 is now expected to 
last approximately 2 hours (vs. approximately 3 hours). This is the only 
change being made to these documents. We expect this change will not only 
reduce participant burden but also facilitate recruitment efforts given the now 
shorter session 1. No other changes are requested. 

 
 
Project Review Summary Data for Application ID: 7499 
Question
Answer
4) State the specific research hypotheses or 
questions to be addressed in this study
The goal of this study is to examine the effects of maternal interpretation 
biases on child interpretation biases and child anxiety symptoms during an 
anxiety-provoking speech task. We are proposing to address these 
objectives using a sample of 130 children with anxiety disorders and their 
clinically anxious mothers. Specific aims are as follows: Specific Aim 1: To 
test the effects of positive interpretation bias training on maternal anxious 
behavior. 1.1: Clinically anxious mothers who are trained to interpret child-
related ambiguous situations in a positive manner will exhibit reduced anxious 
behavior as rated by objective observers relative to clinically anxious mothers 
who do not receive interpretation bias training. Specific Aim 2: To test the 
effects of positive interpretation bias training on children’s and mothers’ 
perceptions of threat to an anxiety-provoking speech task. 2.1: Mothers 
trained to interpret child-related ambiguous situations in a positive manner will 
rate the speech task as less threatening than mothers who do not receive 
interpretation bias training. 2.2: Children of clinically anxious mothers who are 
trained to interpret child-related ambiguous situations in a positive manner will 
rate the speech task as less threatening than children of clinically anxious 
mothers who do not receive interpretation bias training. Specific Aim 3: To 
test the effects of positive interpretation bias training on children’s anxious 
behavior, physiology, and performance during an anxiety-provoking speech 
task. 3.1: Children of clinically anxious mothers who receive positive 
interpretation bias training (vs. those who do not receive such training) will 
exhibit lower anxiety during the speech task, as evidenced by (a) lower 
observer-rated anxious behavior, (b) increased heart rate variability, and (c) 
better observer-rated performance during the speech task. 
5) What is the importance/significance of the 
knowledge that may result?
Findings from this study have the potential to elucidate the specific role of 
maternal information processing factors in the expression of child 
interpretation biases associated with anxiety (McLeod et al., 2007). Thus, 
results may speak to parental cognitive processes implicated in the 
intergenerational transmission of cognitive risk for anxiety from parent to 
child. Finally, establishing that changes in maternal cognitive processes are 
specifically associated with changes in children’s interpretation biases and 
related anxiety responses (across behavioral, emotional and 
psychophysiological domains) during anxiety-provoking situations may inform 
the development of effective prevention strategies (Field et al., 2008)—
touted as essential to address early-developing problems like anxiety 
(Merikangas et al., 2010). Indeed, findings from this study may inform the 
potential use of cognitive bias modification interventions or other brief, 
targeted interventions with parents of children with anxiety disorders (or at 
risk for anxiety disorders).
6) Type of Subject Population (check all that are 
appropriate)
Adults,Children or minors (<18 in Texas and most states)
6.01) Expected maximum number of participants
200 mothers and 200 children.
6.02) Age of proposed subject(s) (check all that 
apply)
Children (3yrs-10yrs),Adolescents (11yrs-14yrs),Adults (18yrs-64yrs)
Male and female children aged 8-12 with a primary diagnosis of anxiety 

6.03) Inclusion Criteria:
based on the composite score from child and parent versions of the Anxiety 
Disorders Interview Schedule-IV: Children and Parent Versions (ADIS-IV: 
C/P; Silverman & Albano, 1996) who reside with their mothers will be 
eligible for this study. Further, given our interest in testing the effect of 
maternal interpretation bias modification on children’s anxiety, inclusion 
criteria will also require mothers to score in the clinical range for anxiety 
symptoms on the Depression, Anxiety, and Stress Scales (Lovibond & 
Lovibond, 1995).
6.04) Exclusion Criteria:
Exclusion criteria for children will include: (1) physical disability impairing 
ability to use a computer; (2) IQ less than 80 (based on a short form of 
Wechsler Intelligence Scale for Children-IV); (3) reading comprehension 
composite less than 75 (based on the Wechsler Individual Assessment Test-
III Reading Comprehension and Fluency subtests); (4) concurrent primary 
diagnosis of any non-anxiety disorder; (5) present use of treatment services 
for anxiety, including behavioral or pharmacological intervention; (6) danger 
to self/others; and (7) and non-English speaking child/parent. Exclusionary 
criteria for mothers will only include: (a) involvement in cognitive behavioral 
therapy (given the focus of CBT on patients’ interpretations) and/or (b) 
changes in pharmacological treatment during the 12 weeks prior to 
enrollment. 
6.05) Justification:
Because the proposed study examines the effect of maternal interpretation 
biases on child interpretation biases and child anxiety symptoms in children 
aged 8-12, such school-aged children will be included in the proposed study. 
This age range was specifically chosen as children age 7 and younger may 
lack critical cognitive skills that are central to the experience of anxiety (e.g., 
mental rehearsal of anticipated negative outcomes and/or consequences; 
Borkovec, 1994). Also, children under the age of 8 may show poor reliability 
on self-report measures. Given that peer influence dramatically increases in 
adolescence (Steinberg, 2005), an upper limit of 12 years was chosen in 
order to minimize the role of peers in child interpretation biases and maximize 
our ability to isolate the effects of parental interpretation biases on outcomes 
of interest. We are also excluding children with IQ scores < 80 and reading 
comprehension composite < 75 given the cognitive and reading demands 
presented by the computerized tasks. Likewise, children with a physical 
disability preventing them from using a computer are excluded. This study 
also focuses on mothers as 69-75% of caregivers are women, and female 
caregivers spend as much as 50% more time providing care to children than 
male caregivers (U.S. Census Bureau, 2012). A second consideration 
involved whether to include mothers receiving treatment for anxiety 
(psychosocial [e.g., CBT] or pharmacological). Due to the emphasis of CBT 
on thoughts (e.g., interpretation biases) and the effects of anxiolytics on 
anxious behavior, we chose to exclude mothers involved in psychosocial 
treatment for anxiety and/or mothers who underwent changes in 
pharmacological treatment during the 12 weeks prior to enrollment. 
6.06) Determination:
Mothers who contact project staff will be provided with information about 
the study and screened for inclusion/exclusion criteria. Mothers who appear 
eligible will be invited for the first session. Upon arrival, consent (and assent) 
will be obtained. Consenting families will undergo an in person 
comprehensive psychosocial assessment including structured clinical 
interviews, child and parent questionnaires, and an abbreviated IQ and 

 
 
reading test.
7) If this study proposes to include children, this 
inclusion must meet one of the following criterion 
for risk/benefits assessment according to the 
federal regulations (45 CFR 46, subpart D). 
Check the appropriate box:
(404) Minimal Risk
8) If the research involves any of the following, 
check all that are appropriate:
Interview,Survey/Questionnaire,Behavioral Observation,Other 
(Explain) :Recording of children’s heart rate.
9) Location(s) of Research Activities:
UH campus :All research activities will take place at the University of 
Houston. There are no other sites associated with this project. 
10) Informed Consent of Subjects: Your study 
protocol must clearly address one of the following 
areas: 
Informed Consent. Signed informed consent is the default. A model consent 
is available on the CPHS website and should be used as a basis for 
developing your informed consent document. If applicable, the proposed 
consent must be included with the application. 
(http://www.research.uh.edu/PCC/CPHS/Informed.html) ATTACH COPY 
OF PROPOSED CONSENT DOCUMENT
Research Protocol Data for Application ID: 7499 
Question
Answer
11) Describe the research study design. (Describe 
the research methods to be employed and the 
variables to be studied. Include a description of the 
data collection techniques and/or the statistical 
methods to be employed.)
The study involves two sessions on separate days. All sessions take place at 
the University of Houston. All parent-child dyads will complete multi-method 
assessments of interpretation biases and anxiety disorder symptoms (and 
other forms of psychopathology). Clinically anxious mothers of children with 
anxiety disorders will be randomly assigned to either a computerized training 
paradigm that teaches them to interpret child-related ambiguous situations in 
a positive manner (n=65; “positive training” condition) or a neutral condition 
that does not train interpretation of such situations in either a positive or 
negative direction (n=65; “neutral” condition). Specifically, in the "positive 
training" condition, a child-related scenario will be presented on the computer 
screen (e.g. meet the teacher day). Two possible interpretations of the event 
are subsequently presented on the screen: a threatening and a non-threatening 
interpretation. Mothers will be asked to choose the most accurate 
interpretation of the event by pressing on the corresponding key on the 
keypad. Mothers will receive positive feedback and a brief explanation when 
they choose the positive interpretation explanation, and negative feedback 
and a brief explanation when they choose the negative interpretation 
explanation. Mothers randomly assigned to the neutral condition will not 
receive any feedback on their answers. Children will subsequently be asked 
to participate in an anxiety-provoking speech task. Prior to this task, they will 
have the opportunity to discuss how they will approach the task with their 
mother, and their mothers' behavior during this interaction will be coded. 
Following the discussion, children and mothers will be asked how threatening 
they perceive the task to be and will complete a second computerized 
assessment of interpretation biases to assess interpretation biases post-
training. Finally, children's anxiety, heart rate, and performance on the task 
will be assessed.
This study involves two sessions on separate days. During the first session, 
mothers and children will complete several paper and pencil questionnaires 
(attached) that ask questions about the child’s thoughts, feelings, and 

12) Describe each task subjects will be asked to 
perform.
behaviors. Mothers will also be interviewed about their child’s mood and 
behavior using the the MINI International Neuropsychiatric Interview. 
Children will also complete a brief assessment of intellectual and reading 
ability using a short form of the WISC-IV (Vocabulary and Block Design) 
and two subtests of the WIAT-III (Reading Comprehension and Oral 
Reading Fluency), respectively. This session is expected to last 
approximately 2 hours. During the second visit (within two weeks of the first 
visit), mothers and children will complete a computer task (described in detail 
in attached document labeled “Measures”) that will ask about relationships 
between words and sentences. Second, mothers will be randomly assigned 
to one of two groups. The first group will complete a computer task that will 
ask about relationships between words and sentences while receiving 
feedback about their responses. The second group will complete a computer 
task that will ask about relationships between words and sentences but will 
not receive feedback about their responses. After completing this task, 
mothers will be asked to complete the first computer task again. Third, 
mothers will be asked to talk with their child about how he/she will give a 
brief speech describing his/her family in front of a recording video camera. 
The child’s heart rate will be monitored during the speech. This involves 
placing one sensor (electrode) on the child’s right-side collarbone, one 
sensor on the child’s left-side collarbone, and one sensor on the left side of 
your child’s rib cage. This second session is expected to last approximately 1 
hour. 
13) Describe how potential subjects will be 
identified and recruited? (Attach a script or outline 
of all information that will be provided to potential 
subjects. Include a copy of all written solicitation, 
recruitment ad, and/or outline for oral 
presentation.)
Recruitment strategies will include the use of a multi-media advertising 
campaign targeting: (1) the Sleep and Anxiety Center of Houston (SACH); 
(2) mental health provider offices within the local community; (3) outpatient 
clinics throughout the Houston, TX metropolitan area; (4) community 
pediatric primary care clinics; (5) public/private schools and summer camps; 
(6) churches, community organizations and centers; (7) local colleges and 
universities; (8) coffee shops, bookstores, and grocery stores; and (9) direct 
outreach at local health fairs. Regarding number (1) above, information about 
the study (i.e., the study's flyer) will be posted on the SACH website, 
including contact information. Study flyers will also be posted in the waiting 
area for SACH and made visible to patients. Patients who ask SACH 
personnel about the study will be told to contact the number listed on the 
study's flyer. We will also do direct mailings of study information to 
households of children enrolled in surrounding school districts. Flyers/ 
advertisements will specifically recruit mothers and children with a range of 
clinical anxiety symptoms by specifying that we are looking for children and 
parents who are stressed, anxious, worried, nervous, or shy. Children who 
meet diagnostic criteria for a psychiatric disorder will be referred for 
appropriate treatment services. 
Recruitment materials will instruct interested individuals to call the laboratory 
for further information about the study. The mothers or female guardians of all 
prospective participants will be screened by phone (according to the 
inclusion and exclusion criteria described above), and informed about the 
basic study procedures. Those whose children appear to meet criteria for the 
study and who express an interest in participating will be invited to schedule a 
visit for the first session. Upon arrival, the nature and purpose of data 
collection will be explained to parents by a member of the research team. 

14) Describe the process for obtaining informed 
consent and/or assent. How will investigators 
ensure that each subjects participation will be 
voluntary (i.e., free of direct or implied coercion)?
During this visit, mothers and children will also be asked to provide written 
informed consent and assent, respectively. In particular, mothers and their 
children will be informed that the purpose of this study is to examine how 
maternal personality characteristics influence children’s behaviors and 
feelings. Mothers and children will be informed that the study will involve 
completing two assessment visits, and that both visits will take place in the 
PI’s laboratory at University of Houston. Children (in the presence of their 
caregiver) and mothers will be informed that they will be asked to complete 
self-report questionnaires and interviews pertaining to the parent and the 
child’s personality, behaviors, mood, and emotions. Mothers and children 
will also be informed that the assessment sessions will additionally involve 
having the mother and child complete computerized assessments of 
interpretation biases (one before the mother completes the interpretation bias 
training program, and one after), and the mother will be informed of her 
participation in the computerized training program. Finally, children will be 
informed that they will be asked to engage in a speech task, during which 
their heart rate will be monitored continuously. The procedures for collecting 
heart rate will be described in detail, including the need to adhere sticky 
sensors on the child’s anterior left and right shoulders, and on the left rib cage 
below the pectoral muscle. Mothers and children will be informed that it is 
quite normal for electrodes to leave a slight ring on the skin for a few hours. 
In addition to being informed about the study procedures, mothers and 
children will be informed of the potential risks of participating, including that 
they may experience boredom, distress, discomfort, anxiety, frustration, or 
fatigue as a result of completing the questionnaires, interviews, computer and 
speech tasks. They will also be informed that they may withdraw their 
consent to participate at any time without negative consequences. Finally, 
participants will be informed verbally and in writing about the steps that will 
be taken to protect their confidentiality, as well as the limits of confidentiality. 
In particular, participants will be informed that any reports of child abuse or 
neglect (as well as abuse of the elderly) will be reported, as will the report of 
active suicidal or homicidal intent. Participants (both children and their 
parents/guardians) will have the opportunity to direct questions to the 
experimenter (as well as Drs. Viana or Alfano) to clarify any information 
provided in the informed consent document. Following the provision of 
written informed assent and consent, the child and her/his parent/guardian will 
be taken to separate rooms to complete their respective assessment 
measures (thereby ensuring the child’s privacy as well as the confidentiality of 
her/his responses). At the end of the study, all participants will be given 
contact information for the laboratory.
15) Briefly describe each measurement instrument 
to be used in this study (e.g., questionnaires, 
surveys, tests, interview questions, observational 
procedures, or other instruments) AND attach to 
the application a copy of each (appropriately 
labeled and collated). If any are omitted, please 
explain.
Please see attached documents, labeled “Description of Child Measures” and 
"Description of Parent Measures," respectively. Additionally, there are two 
additional attachments, labeled "Child Measures" and "Parent Measures" 
which contain the actual child and parent questionnaires, respectively.

16) Describe the setting and mode for 
administering any materials listed in question 15 
(e.g., telephone, one-on-one, group). Include the 
duration, intervals of administration, and amount of 
time required for each survey/procedure. Also 
describe how you plan to maintain privacy and 
confidentiality during the administration.
The data collection site is the PI’s laboratory on the 4th floor of the Health 
and Biomedical Sciences Building (HBSB). This space consists of private 
individual and family assessment rooms, and computer testing rooms. All 
rooms have digital audio and video recording equipment to be used for on-
site supervision as well as diagnostic reliability ratings. Consent as well as 
psychosocial, computerized, and psychophysiological assessments will be 
conducted in this setting. These rooms provide ample space for the research 
and administrative goals of this project.
17) Approximately how much time will be required 
of each subject? Provide both a total time 
commitment as well as a time commitment for each 
visit/session.
The total time commitment for this study is expected to be approximately 3 
hours. Specifically, the first session is expected to last 2 hours and the second 
session is expected to last 1 hour.
18) Will Subjects experience any possible risks 
involved with participation in this project?
 
18.01) Risk of Physical Discomfort or Harm
Yes: :On very rare occasions, participants may experience minor, temporary 
skin irritation at the site of electrode placements.
18.02) Risk of Psychological Harm (including 
stress/discomfort)
Yes: :Risks are minimal and entail possible boredom, fatigue, testing anxiety, 
and possible embarrassment or frustration if they find a task difficult. Parents 
and children will also complete behavioral inventories and interviews about 
the child's behaviors, feelings, and personality traits. Such 
inventories/interviews may include sensitive issues and could result in mild 
discomfort. Any discomfort experienced during assessments is expected to 
dissipate quickly after completion of the study. No other risks are 
anticipated. Mothers and children will be given ample opportunities for 
breaks and experimenters will be trained to be sensitive towards any 
participant who appears to be at all distressed. Assessments would be 
interrupted if a child becomes upset at any time, and the child's parent would 
then be consulted. Prior experience with children suggests that even mild 
upset in the form of task frustration is rare and has always been readily 
resolved by a conference between the child and his/her parent, who is on site 
at all times. Parents or children concerned about reactions to assessment 
procedures will be encouraged to discuss their concerns with research staff. 
Research staff (including the PI and Co-I) will be fully prepared to debrief 
participants at the end of the study and will answer any remaining questions 
regarding assessment procedures. 
18.03) Risk of Legal Actions (such as criminal 
prosecution or civil sanctions)
No:
18.04) Risk of Harm to Social Status (such as loss 
of friendship)
No:
18.05) Risk of Harm to Employment Status
No:
18.06) Other Risks
No:
19) Does the research involve any of these 
possible risks or harms to subjects? Check all that 
apply.
Any probing for personal or sensitive information in surveys or interviews
Interested participants will benefit by discussing with staff the results of the 
diagnostic evaluation, along with treatment recommendations, referral 
information, and book and website recommendations relevant to the child’s 
diagnostic status (at no cost to them). Also, findings from this study may 

 
 
 
 
20) What benefits, if any, can the subject expect 
from their participation?
inform the development of effective prevention strategies (Field et al., 
2008)—touted as essential to address early-developing problems like anxiety 
(Merikangas et al., 2010). Specifically, results may inform the potential use of 
cognitive bias modification interventions or other brief, targeted interventions 
with parents of children with anxiety disorders (or at risk for anxiety 
disorders). Given the mild risks involved, the potential benefits to participants 
are thought to clearly outweigh the risks.
21) What inducements or rewards (e.g., financial 
compensation, extra credit, and other incentives), if 
any, will be offered to potential subjects for their 
participation?
Each mother-child dyad will be given $50 for participating in each session 
($100 total per dyad if they complete both sessions). Payment will be in the 
form of a Target gift card. Children will also choose a small toy after 
completing each assessment session. 
Research Data for Application ID: 7499 
Question
Answer
22) Will you record any direct identifiers, names, 
social security numbers, addresses, telephone 
numbers, patient or student ID numbers, etc.? 
Yes: :The information collected in this study includes: the mother's name, 
address, social security number, phone number, email address, age, gender, 
race or ethnicity, marital status, income, education, and employment status; 
and the child's name, address, gender, and date of birth. We will safeguard 
against breaches of confidentiality by coding participant data by ID number 
rather than by name, and by keeping information linking these ID numbers to 
specific individuals in a locked file cabinet accessible only to project staff. 
Further, individuals will not be identified by name (nor will any identifying 
information be offered) when results from data are disseminated. The 
database will be password protected and only accessible to project staff. 
Prior experience indicates that these procedures are successful in maintaining 
confidentiality.
23) Will you retain a link between study code 
numbers and direct identifiers after the data 
collection is complete?
No:
24) Will anyone outside the research team have 
access to the links or identifiers? 
No:
25) Where, how long, and in what format (such as 
paper, digital or electronic media, video, audio or 
photographic) will data be kept? In addition, 
describe what security provisions will be taken to 
protect these data (password protection, 
encryption, etc.). [Note: University of Houston 
policy on data retention requires that research data 
be maintained for a minimum of 3 years after 
completion of the project. All research data 
collected during this project is subject to the 
University of Houston data retention policy found 
at http://www.research.uh.edu/Home/Division-of-
Research/Research-Services/Research-
Policies/Access-to-and-Retention-of-Research-
Data.aspx ]
Subject confidentiality will be protected to the full extent required by law and 
applicable local, State and Federal regulations and guidelines. All paper- 
format data will be kept in locked files in the locked office (HBSB Room 
475) of the project coordinator and accessible only to study staff, 
governmental agencies (e.g., NIH) and local convening authorities (e.g., UH 
IRB) for the purpose of audit regarding scientific validity and/or aspects 
pertaining to the ethical conduct of human clinical investigation. Electronic 
data will be kept in password- protected files and kept on the University's 
secure servers which meet all applicable federal and state standards for data 
privacy and protection. Upon completion of the study, data encryption 
procedures will be used to safeguard all files. Files will be kept for 7 years 
after study completion.

Analyses 1.1: Related to H1, scores on coding dimensions of maternal anxious behavior will be checked first 
for potential reduction or combination due to low frequency (i.e., not all codable behaviors are actually observed). 
If child sex effects on maternal behaviors are observed, child sex will be included as a covariate. Then, a two-
group (positive training vs. neutral training), one-way MANOVA (5 DVs: manifest anxiety, passivity, promotion of 
avoidance, overprotection, and intrusiveness) will be used to examine the effects of the positive interpretation 
bias training paradigm on maternal anxious behavior during the parent-child discussion. If the MANOVA is 
significant, ANOVAs for each significant dependent variable will be conducted, controlling for Type I error using 
Holm’s (1979) modified Bonferroni correction method (Jaccard & Guilamo-Ramos, 2002).  
Analyses 2.1: Related to H2 and H3, Holm’s (1979) modified Bonferroni-corrected independent-samples t-tests 
will examine mean group differences (positive training vs. neutral training) in child and maternal ratings of 
perceived threat prior to the anxiety-provoking speech task.  
Analyses 3.1: Related to H4.1, coding of child anxious behavior will be first subjected to similar procedures 
described for H1 above. A two-group (positive training vs. neutral training) one-way MANOVA (4 DVs: facial 
expression, body movements, speech quality, and content) will be used to examine the effects of the positive 
interpretation bias training paradigm on child behavior during the parent-child discussion. If the MANOVA is 
significant, the follow-up procedures will be identical to those reported above (see Analyses 1.1.). To address 
H4.2, ANCOVAs (controlling for baseline RSA) will be used to examine between group (positive training vs. 
neutral training) mean differences in children’s RSA. Finally, we will conduct independent-samples t-tests to 
examine mean group differences in overall observer-rated performance during the speech (H4.3).  
Analyses 4.1: Related to H5, a hierarchical linear regression will be conducted using child anxiety during the 
speech task as dependent variable in order to examine child SoP diagnosis as a moderator of associations 
between maternal interpretation biases child anxiety symptoms. Predictor variables will be mean-centered. In 
the first step of the model, any necessary control variables will entered. In the second step, both maternal 
interpretation biases and child SoP diagnosis will enter the model as predictor variables. In the third step, a 
maternal interpretation biases X child SoP interaction term will enter the model as a predictor.