Parent-child interactions and anxiety disorders: an observational study

Childhood maltreatment, parenting style and anxiety in Chinese youths: A case-control study

BACKGROUND

Although evidence in supporting the associations between childhood maltreatment (CM), parenting style and anxiety in children and adolescents exists, few high-quality analytical epidemiological studies which focusing on clinically diagnosed anxiety disorders (AD) had been published.

OBJECTIVE

The aim of this study was to further corroborate the associations between CM, parenting style, and AD in a large representative sample of Chinese children and adolescents.

PARTICIPANTS AND SETTING

Study subjects were derived from the Mental Health Survey for Children and Adolescents in Yunnan (MHSCAY), a population-based cross-sectional program.

METHODS

Individually matched case-control study design was adopted. Univariate and multivariate conditional binary logistic regression models were used to estimate the associations between CM, parenting style and AD. Dose-response trends were estimated using the Cochran-Armitage Chi-square test. A series of stratified analyses were conducted to explore effect modification on exposure-outcome association by some important features.

RESULTS

Totally we screened out 202 cases and 404 matched controls, with an age mean of 14.43 years. Conditional logistic regression models revealed that EA and a higher level of parental over-protection were significantly associated with increased risk of AD, with adjusted ORs of 3.39 (95 % CI: 2.07-5.56) and 1.93 (95 % CI: 1.28-2.90). Stratified analysis identified noticeable effect modification by sex, age, and whether the only child in the family.

CONCLUSIONS

Major findings of this study suggested that children and adolescents who had experienced EA or raised up by over-protective parents are at increased risk of AD. Targeted intervention measures should be developed and implemented for these high-risk youths.

A family perspective for the mechanism of parent-child conflict on maternal anxiety in Chinese children with autism

BACKGROUND

Mothers of children with autism reported higher levels of anxiety than mothers of typical children. This study revealed the relationship between parent-child conflict, children's problem behavior, parenting stress, and maternal anxiety from the perspective of the relationship within the family.

METHODS

The State-Trait Anxiety Inventory (STAI) and Caregiver Strain Questionnaire (CGSQ) were used to measure maternal anxiety and parenting stress respectively from 102 mothers of children with autism. We also collected information on parent-child relationships and children's problem behaviors by using the Child-Parent Relationship Scale (CPRS) and Conners Parent Symptom Questionnaire (PSQ).

RESULTS

Parent-child conflict positively predicted state and trait anxiety in mothers of children with autism. The severity of children's psychosomatic disorders fully mediated the positive association between parent-child conflict and state-trait anxiety in mothers of children with autism. Parenting stress significantly moderated the impact of parent-child conflict on maternal state anxiety and trait anxiety.

CONCLUSION

In the case of children with autism spectrum disorders, parent-child conflict can directly affect maternal anxiety levels, especially when mothers have low levels of parenting stress. Parent-child conflict can also affect children's problem behaviors and thus indirectly affect maternal anxiety. Therefore, this study is of great significance for the alleviation of anxiety of mothers of autistic children and the family intervention for the early rehabilitation of autistic children.

Parenting and Emotional and Behavioral Difficulties in a General Population Sample of Adolescents: The Mediating Role of Emotional Dysregulation

Research has shown that both parenting and emotional dysregulation are associated with mental health outcomes in youth. This cross-sectional research was developed to replicate these noted findings and explore the mediating role of emotional dysregulation to explain the relationship between parenting and emotional and behavioral difficulties (internalizing and externalizing problems) in adolescents. A total of 104 adolescents (61.5% females; M = 15.62 yrs., SD = 1.38) participated in the study. Participants completed the Parental Bonding Instrument (measuring care, promotion of autonomy, and overprotection) referring to both the mother and father, the Difficulties in Emotion Regulation Scale, and the Youth Self-Report. The results showed that difficulties in emotion regulation fully mediated the relationship between overprotection (in both parents) and low maternal care with internalizing problems, on the one hand, and the relationship between maternal overprotection and low care (in both parents) with externalizing problems, on the other hand. Furthermore, emotional dysregulation partially mediated the effect of paternal care on internalizing problems. These findings help to clarify one of the mechanisms through which parenting can affect mental health in youth. Theoretical and clinical implications are discussed.

The impact of coercive and assertive communication styles on children's perception of chores: an experimental investigation

Introduction

This article presents the findings of an experimental study aimed at investigating the impact of coercive and assertive communication on children's emotional responses and behavioral tendencies within parent-child interactions.

Methods

The study tested four hypotheses related to children's feelings, personalization bias, the need to express their point of view, and the desire to retreat to their room alone. Short audio stimuli recorded by a female assistant, representing a mother addressing her child, were utilized to create five different communication situations. The experimental procedure involved participants listening to the audio stimuli and answering related questions. The study included 123 participants between the ages of 9 and 13, with an equal gender distribution.

Results

The results of One-Way ANOVA tests indicated significant differences among the four types of communication in terms of unpleasant feelings, personalization bias, listening to a personal point of view, and retreating into a personal room. The findings suggest that coercive communication elicited more negative emotional responses and stronger tendencies toward personalization bias, expressing personal opinions, and seeking solitude compared to assertive communication.

Discussion

The implications of these findings highlight the importance of promoting positive and respectful communication strategies in parent-child relationships to foster children's emotional well-being and healthy behavioral development.

Self-perception and perceived parental perception in adolescent girls with anorexia nervosa

Negative self-perception is associated with poor outcomes in adults with anorexia nervosa (AN). Our study aimed to assess the association between the self-perception of female adolescents with AN and how these adolescents perceive the attitudes of their parents toward them on the severity and short-term outcome of their illness. For this purpose, we assessed 30 adolescent girls hospitalized with AN and 30 female controls. Self-perception and perceived parental attitudes were assessed using the Structural Analysis of Social Behavior (SASB), according to which self-perception is formed via close relations with significant others in early life. Patients with AN responded to the SASB and to questionnaires assessing eating disorder (ED) symptomatology and emotional distress at both admission and discharge. Controls were similarly assessed once. We found that patients with AN showed a more negative self-perception than controls. Negative self-perception was associated with negative perceptions of the mothers' attitudes toward the girls. There was no between-group difference in the perceived perception of the fathers' attitude to the girls. Self-perception and perceived parental attitudes were associated with the severity of ED symptoms and emotional distress. Finally, an improvement was found in self-perception and perceived maternal attitudes toward the girl from admission to discharge, alongside a decrease in the severity of ED symptoms and emotional distress. Self-perception at admission was associated with ED pathology and emotional distress at discharge. These findings suggest that self-perception and perceived parental attitudes toward the adolescent with AN may be associated with the severity of the illness and its short-term outcome.

Parent-Child Communication Incongruence in Pediatric Healthcare

Parents play a key role in providing children with health-related information and emotional support. This communication occurs both in their homes and in pediatric healthcare environments, such as hospitals, outpatient clinics, and primary care offices. Often, this occurs within situations entailing heightened stress for both the parent and the child. There is considerable research within the communication literature regarding the nature of both verbal and nonverbal communication, along with the way in which these communication modalities are either similar (i.e., congruent) or dissimilar (i.e., incongruent) to one another. However, less is known about communication congruency/incongruency, specifically in parent-child relationships, or within healthcare environments. In this narrative review, we explore the concept of verbal and nonverbal communication incongruence, specifically within the context of parent-child communication in a pediatric healthcare setting. We present an overview of verbal and nonverbal communication and propose the Communication Incongruence Model to encapsulate how verbal and nonverbal communication streams are used and synthesized by parents and children. We discuss the nature and possible reasons for parental communication incongruence within pediatric settings, along with the consequences of incongruent communication. Finally, we suggest a number of hypotheses derived from the model that can be tested empirically and used to guide future research directions and influence potential clinical applications.

Coding Dyadic Behavior in Caregiver-Child Interaction from a Clinical Psychology Perspective: How Should Multiple Instruments and Outcomes Be Dealt with?

The experiences children have in the interactions with their caregivers influence their developmental outcomes. To target caregiving and optimize intervention effects, the assessment of caregiver-child interactions is highly relevant for families affected by parental mental disorders. Behavioral observation is a widely used method for assessing family dynamics, and the literature offers a wide variety of instruments with which to code such data. However, a structured overview of behavioral observation instruments (BOIs) is lacking, and the multitude of types of dyadic behaviors (DBs) assessed within each BOI are complicating their application. We aim to provide an overview of the BOIs applied to families affected by mental disorders and suggest a DB taxonomy that may be used across BOIs. We first conducted a systemic literature search to identify the most frequently used BOIs and the DBs they capture in clinical psychology. Second, we asked 13 experts to sort DB terms based on perceived conceptual similarity and analyzed these results using multidimensional scaling. We found approximately 450 different terms for DBs, and we argue that DBs can be classified within two overarching dimensions, i.e., in terms of structure and in terms of reaction to a child's signals. These efforts can facilitate the coding and application of BOIs in clinical practice.

Parent Participation in Cognitive Behavioral Therapy for Children and Adolescents: A Scoping Review

This research aims to evaluate the psycho-education and therapy programs prepared for children and adolescents with the Cognitive Behavioral Therapy approach and implemented between 2001-2021 in terms of parental involvement. This research, which was carried out in the descriptive model, is a review study. The articles covered in the research were accessed through Web of Science, ERIC, PubMed, Google Scholar, and ScienceDirect academic databases and were determined to be by the inclusion and exclusion criteria determined by the researchers, 10 of which were quasi-experimental with a control group and 7 in a randomized controlled study design. 17 articles were reviewed. Fifteen of the studies included child and adolescent sessions, while 2 included only children's sessions. According to the findings, it was determined that parent participation was used in all of the studies, the number of therapy sessions was between 8-30, and the session durations varied between 20 minutes and 1.5 hours in total, including the child/adolescent and parents It was stated that children and adolescents included in the treatment experienced various psychological disorders such as anxiety disorder, depression, obsessive-compulsive disorder, anger control disorder, attention deficit, and hyperactivity disorder, and eating disorder. These findings show that Cognitive Behavioral Therapy practices for different psychological disorders for children and adolescents benefit from parental involvement in 82% of the studies. The fact that the types of parental involvement and the presence of parental pathologies are not detailed in the studies constitute the shortcomings of parent involvement studies..

The current state-of-the-art in pharmacotherapy for pediatric generalized anxiety disorder

INTRODUCTION

Anxiety disorders are the most prevalent psychiatric disorders among youth. Among the various anxiety disorders, generalized anxiety disorder is particularly prevalent. Youth with GAD appear at elevated risk of developing other anxiety disorders, mood disorder, and substance use disorders. Functional outcomes of youth with GAD can be improved through early recognition and treatment, thus promoting better longer-term outcomes.

AREAS COVERED

The current article summarizes evidence-based state-of-the-art pharmacotherapy for pediatric GAD based on open-label, randomized, and controlled trials. Two electronic databases (PubMed and Scopus) were systematically searched in April 2022 for relevant publications.

EXPERT OPINION

The literature supports a combination of psychotherapy and pharmacotherapy as being associated with better outcomes when compared to mono-therapies. While longer-term follow-ups are limited, one such study does challenge this notion. Both selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs) have been found across studies to have moderate effect sizes in the treatment of pediatric anxiety disorders. SSRIs continue to be a first-line intervention, whereas SNRIs may be considered a second-line treatment. While more evidence is needed, there are emerging data indicating that SSRIs are associated with a more rapid and greater reduction in anxiety symptoms when compared to SNRIs.

Association between Mothers' Emotional Problems and Autistic Children's Behavioral Problems: The Moderating Effect of Parenting Style

Mothers' emotional problems are associated with autistic children's behavioral problems. We aim to test whether parenting styles moderate associations between mothers' mood symptoms and autistic children's behavioral problems. A sample of 80 mother-autistic child dyads were enrolled at three rehabilitation facilities in Guangzhou, China. The Social Communication Questionnaire (SCQ) and the Strengths and Difficulties Questionnaire (SDQ) were used to collect the autistic symptoms and behavioral problems of the children. Mothers' depression and anxiety symptoms were measured using the Patient Health Questionnaire 9 (PHQ-9) and the General Anxiety Disorder 7-item (GAD-7) scale, respectively, and parenting styles were measured using the Parental Behavior Inventory (PBI). Our results show that mothers' anxiety symptoms were negatively associated with their children's prosocial behavior scores (β = -0.26, p < 0.05) but positively related to their social interaction scores (β = 0.31, p < 0.05). Supportive/engaged parenting styles positively moderated the effects of mothers' anxiety symptoms on their prosocial behavior score (β = 0.23, p = 0.026), whereas hostile/coercive parenting styles had a negative moderation (β = -0.23, p = 0.03). Moreover, hostile/coercive parenting styles positivity moderated the effects of mothers' anxiety symptoms on social interaction problems (β= 0.24, p < 0.05). The findings highlight, where mothers adopted a hostile/coercive parenting style while experiencing high anxiety, their autistic child may have more serious behavioral problems.

Construct Validation for Toddler-Solicited Maternal Comforting Behavior as Relevant to Family Accommodation and Child Anxiety Risk

Reciprocal parent-child interactions are theorized to play a crucial role in child anxiety development and maintenance. The current study tested whether toddler-solicited maternal comforting behavior in low-threat (mildly challenging and novel) situations may be a unique, early indicator of anxiety-relevant interactions. Controlling for other types of maternal comforting behavior, a path model tested solicited comforting behavior in a low-threat context in relation to both family accommodation (FA) and child anxiety symptoms, which may subsequently continue to predict each other over time. Identifying the emergence of this cycle in early childhood could bolster anxiety development theory and preventative interventions. Mother-child dyads (n = 166) of predominantly non-Hispanic/Latinx European American and socioeconomically diverse backgrounds were assessed at child ages 2, 4, and school-age via laboratory observation and maternal report. A longitudinal path model showed that solicited comforting observed in a low-threat situation at age 2 predicted mother-reported FA and child anxiety symptoms at age 4, above and beyond unsolicited comforting behavior and comforting behavior in a high-threat context. Furthermore, FA and child anxiety were bidirectionally related between age 4 and school-age assessments. Results suggest that toddler-solicited comforting in low-threat situations may be a unique indicator of child-directed anxiogenic family processes. The current study also expands the FA literature by providing empirical evidence for a bi-directional relation between anxiety and accommodation in young children.

Perinatal Depression and Anxiety Symptoms, Parental Bonding and Dyadic Sensitivity in Mother-Baby Interactions at Three Months Post-Partum

The quality of the early parent-infant relationship is crucial for the child's optimal development, and parental sensitivity plays a key role in early interactions. The purpose of the study was to evaluate the influence of maternal perinatal depression and anxiety symptoms on dyadic sensitivity at three months post-partum, also considering a large set of maternal and infant variables. At the third trimester of pregnancy (T1) and at three months postpartum (T2), 43 primiparous women filled in a set of questionnaires evaluating symptoms of depression (CES-D) or anxiety (STAI), the woman's parental bonding experiences (PBI), alexithymia (TAS-20), maternal attachment to the baby (PAI, MPAS) and the perceived social support (MSPSS). At T2 mothers also completed a questionnaire on infant temperament and took part in the CARE-Index videotaped procedure. Dyadic sensitivity was predicted by higher maternal trait anxiety scores in pregnancy. In addition, the mother's experience of being cared for by her father in childhood was predictive of her infant's lower compulsivity, while paternal overprotection predicted higher unresponsiveness. The results highlight the influence of perinatal maternal psychological well-being and maternal childhood experiences on the quality of the dyadic relationship. The results may be useful to foster mother-child adjustment during the perinatal period.

Accuracy of paper-and-pencil systematic observation versus computer-aided systems

Computer-aided behavior observation is gradually supplanting paper-and-pencil approaches to behavior observation, but there is a dearth of evidence on the relative accuracy of paper-and-pencil versus computer-aided behavior observation formats in the literature. The current study evaluated the accuracy resulting from paper-and-pencil observation and from two computer-aided behavior observation methods: The Observer XT® desktop software and the Big Eye Observer® smartphone application. Twelve postgraduate students without behavior observation experience underwent a behavior observation training protocol. As part of a multi-element design, participants recorded 60 real clinical sessions randomly assigned to one of the three observation methods. All three methods produced high levels of accuracy (paper-and-pencil, .88 ± .01; The Observer XT, .84 ± .01; Big Eye Observer, .84 ± .01). A mixed linear model analysis indicated that paper-and-pencil observation produced marginally superior accuracy values, whereas the accuracy produced by The Observer XT and Big Eye Observer did not differ. The analysis suggests that accuracy of recording was mediated by the number of recordable events in the observation videos. The implications of these findings for research and practice are discussed.

Internalizing and externalizing correlates of parental overprotection as measured by the EMBU: A systematic review and meta-analysis

Aspects of parenting including overprotection explain individual differences in child adjustment. This review and meta-analysis summarizes studies on parental overprotection and internalizing and externalizing problems. To ensure that findings could be compared as systematically as possible, the focus was on studies that used the overprotection scale of the Egna Minnen Beträffande Uppfostran ("Memories of my Parents' Upbringing") (EMBU) questionnaire, a popular instrument to measure parental overprotection. In total, we extracted 176 effects from 29 studies. A modified version of the Newcastle-Ottawa Scale was used to perform quality assessments for the included studies. Parental overprotection was associated positively with offspring internalizing and externalizing problems, with overall estimates ranging from r = .14 to .18. Moderator analyses suggested that effects of maternal were larger than effects of paternal overprotection. Other factors that moderated the strength of the association between overprotection and maladjustment included whether outcomes were self-reported or parent-reported, the design was cross-sectional or longitudinal, and publication year. Cultural context, age at exposure, and child sex did not explain differences between effect sizes. Most findings were based on cross-sectional studies and therefore do not constitute proof of causal relations. Many studies were of less-than-satisfactory quality regarding representativeness of the sample, descriptions of the data collection, and statistical analyses. There is a clear need for well-powered longitudinal studies to strengthen inferences about associations between parental overprotection and internalizing and externalizing problems.

Adolescent social anxiety undermines adolescent-parent interbrain synchrony during emotional processing: A hyperscanning study

Social anxiety severely impacts adolescents’ social interactions with others; however, the underlying neural mechanism has not been revealed. This study examined how adolescent's social anxiety level influences the interbrain synchrony within adolescent-parent dyads during emotional processing by using electroencephalograph (EEG) hyperscanning. A sample of 25 adolescent-parent dyads completed the picture processing task. Adolescents’ ages ranged from 10 to 14 years old. The results showed that (1) at parietal areas, greater gamma interbrain synchrony was observed in the high social anxiety adolescent-parent dyads (HSAs) than the low social anxiety adolescent-parent dyads (LSAs) in the positive conditions. However, greater gamma interbrain synchrony of the picture processing task was observed in the LSAs than the HSAs in the negative conditions. (2) Compared with the neutral condition, LSAs induced greater interbrain synchronization in the negative condition than in the neutral condition at central and parietal areas. However, HSAs induced greater interbrain synchronization in the positive condition than in the negative condition at parietal areas. (3) HSAs induced greater interbrain synchronization at parietal areas than in the central areas in positive conditions. The results provide neurological evidence that the way parent and adolescent process different emotions in the same emotional episode could be affected by the adolescent's anxiety level.

The Mediating Role of Self-Differentiation and Parental Reflection in the Relationship Between Mother’s Own Childhood Overprotection Experience and Her Parenting Behavior

Objectives: This study aims to determine how mothers’ parenting experiences affect their attitudes toward raising children. Specifically, it examines how the experience of being raised by overprotective parents affects a mother’s parenting behavior and analyzes the structural relationship and impact of self-differentiation and parental reflection variables on the relationship between the two variables.Methods: The study participants were mothers of infants found through children's institutions located in Gwangju and Jeollanam-do. The institutions had been selected randomly and consent was obtained from all participants. A total of 374 questionnaires were analyzed using SPSS 20.0 and SPSS PROCESS macro.Results: First, it was confirmed that self-differentiation completely mediated the relationship between mothers’ childhood overprotection experience and mothers’ negative parenting behavior through self-differentiation. Second, it was confirmed that parental reflection regulates the relationship between mothers’ childhood overprotection experience and self-differentiation. Third, the statistical significance of the controlled mediating effect of parental reflection was confirmed in the path in which the mother's childhood overprotection affected parenting behavior through self-differentiation. This suggests that, even if the mother was overprotected as a child and has a low level of self-differentiation, enhancing parental reflection can reduce negative parenting behaior.Conclusion: This study is meaningful in that it discovered the possibility of modifying the process of negative parenting behavior between generations through the parental reflection function. In addition, the fundamental limitations of the previous parental education were revised and suggestions were made for the development of parental education programs that involve the parental reflection functions.

Intervention Response by Genetic Subtype: PRETEND-Preschool Program for Children with Prader-Willi Syndrome via Remote Parent Training

Prader-Willi Syndrome (PWS) is a rare neurodevelopmental disorder associated with social cognitive challenges, and pretend play has been demonstrated as a tool to achieve developmental goals. Following previous report on feasibility and acceptability of a remote, play-based parent-training program (Zyga, Russ, & Dimitropoulos, 2018), we now report on preliminary efficacy of this program to enhance pretend play skills and social cognitive skills in preschoolers with PWS. Results across two studies demonstrated efficacy when live-coaching play sessions incorporated children into the intervention. Increases in play skills were observed for children with the mUPD subtype of PWS who underwent intervention, compared with children with mUPD who were waitlisted. Children with DEL subtype were less likely to respond to intervention. Implications for results are discussed.

Behavioral Inhibition in the Second Year of Life Is Predicted by Prenatal Maternal Anxiety, Overprotective Parenting and Infant Temperament in Early Infancy

Background

Behavioral inhibition, characterized by shyness, fear and avoidance of novel stimuli, has been linked with internalizing personality traits in childhood, adolescence and early adulthood, and particularly later social anxiety disorder. Little is known about the relevance of potential prenatal precursors and early predictors for the development of inhibited behavior, such as infant vulnerability and family risk factors like parental anxiety and overprotection. Pregnancy-related anxiety has been associated with both infant temperament and maternal overprotective parenting. Thus, the aim of this study was investigating the predictive relevance of prenatal pregnancy-related anxiety for behavioral inhibition in toddlerhood, by considering the mediating role of maternal overprotection and infant distress to novelty.

Materials and Methods

As part of a longitudinal pregnancy cohort, behavioral inhibition at 24 months postpartum was assessed in N = 170 mother-child pairs. Maternal pregnancy-related anxiety was examined in the third trimester of pregnancy, and maternal overprotection and infant distress to novelty at 12 months postpartum.

Results

Mediation analysis with two parallel mediators showed that the significant direct effect of pregnancy-related anxiety on child behavioral inhibition was fully mediated by infant distress to novelty p < 0.001 and maternal overprotection (p < 0.05). The included variables explained 26% of variance in behavioral inhibition. A subsequent explorative mediation analysis with serial mediators further showed a significant positive association between distress to novelty and maternal overprotective parenting (p < 0.05).

Conclusion

Results indicate a predictive relevance of both infant and maternal factors for the development of behavioral inhibition in toddlerhood. Mothers who perceived more pregnancy-related anxiety showed more overprotective parenting and had infants with more distress to novelty. Further, mothers being more overprotective reported their child to be more inhibited in toddlerhood. Our findings also indicate the stability of reported infant distress to novelty as one aspect of later behavioral inhibition. Addressing specific forms of parental anxiety from pregnancy on and in interaction with child-related variables seems to be a promising approach for future studies and clinical interventions.

A Multi-level Longitudinal Model of Risk Factors for Generalized and Separation Anxiety Symptoms in a Community Sample of 6-year-olds

The current longitudinal study examined the relations between variables in four domains-contextual (SES, family conflict, stress), parent (caretaker depression), parenting (support hostility, autonomy granting), and child (negative affect, effortful control, sensory regulation, attachment)-and both the presence of generalized and separation anxiety symptoms at age 6 in a community sample of 796 children and the change in these anxiety symptoms from ages 4 to 6. Anxiety was highly stable over time. Specific results revealed both direct and indirect pathways between age 4 and age 5 variables, and age 6 anxiety. Caretaker depression and the child variables of attachment, effortful control, negative affect, and sensory regulation were directly related to anxiety symptoms at age 6. Contextual variables (SES) at age 4 were indirectly related to age 6 anxiety through parent depression at age 5. Parent depression was indirectly related to age 6 anxiety through age 5 child negative affect. Child negative affect at age 4 was indirectly related to age 6 anxiety through age 5 effortful control and age 4 effortful control was indirectly related to age 6 anxiety through age 5 negative affect. With the exception of attachment, there was a reduction in the impact of other variables when initial levels of anxiety symptoms were included in the model. Implications of results for early intervention and further study are discussed.

Personality disorders, depression and anxiety in mothers of children with ADHD and anxiety disorders in Iran

BACKGROUND/AIM

This study aims to assess and compare personality disorders and psychiatric disorders (depression and anxiety) in mothers of children with ADHD and anxiety disorders aged 2-16 years living in Iran.

MATERIAL AND METHODS

This is a descriptive cross-sectional study. Participants were 168 mothers (100 with children having ADHD and 68 with children having anxiety disorders). The Millon Clinical Multiaxial Inventory-III, the Depression Anxiety Stress Scale (DASS-21) and the Symptom Checklist-90-Revised (SCL-90-R) were used for assessing personality disorders, depression and anxiety in mothers. Collected data were analysed in SPSS software.

RESULTS

Of 168 mothers, only 100 completed the questionnaires completely (68 having children with ADHD and 32 with anxious children). Of 100 mothers, 61 had personality disorders, where 21 had children with anxiety disorders and 40 had children with ADHD. The most common personality disorder was depressive personality disorder (n = 27) followed by compulsive personality disorder (n = 15). No antisocial, borderline and paranoid personality disorders were observed in mothers. Based on DASS-21, 72 mothers had depression, and 84 had anxiety. Based on the SCL-90-R, 86 had depression, and 81 had anxiety. We found no statistically significant difference between the two groups of mothers in terms of personality disorders, depression and anxiety.

CONCLUSION

Prevalence of depression, anxiety and personality disorders in mothers of children with anxiety disorders and ADHD in Iran is high, and there is no difference between them. It is recommended that psychiatric and psychological counseling be provided for these mothers.

Parent-to-Child Anxiety Transmission Through Dyadic Social Dynamics: A Dynamic Developmental Model

The intergenerational transmission of psychopathology is one of the strongest known risk factors for childhood disorder and may be a malleable target for prevention and intervention. Anxious parents have distinct parenting profiles that impact socioemotional development, and these parenting effects may result in broad alterations to the biological and cognitive functioning of their children. Better understanding the functional mechanisms by which parental risk is passed on to children can provide (1) novel markers of risk for socioemotional difficulties, (2) specific targets for intervention, and (3) behavioral and biological indices of treatment response. We propose a developmental model in which dyadic social dynamics serve as a key conduit in parent-to-child transmission of anxiety. Dyadic social dynamics capture the moment-to-moment interactions between parent and child that occur on a daily basis. In shaping the developmental trajectory from familial risk to actual symptoms, dyadic processes act on mechanisms of risk that are evident prior to, and in the absence of, any eventual disorder onset. First, we discuss dyadic synchrony or the moment-to-moment coordination between parent and child within different levels of analysis, including neural, autonomic, behavioral, and emotional processes. Second, we discuss how overt emotion modeling of distress is observed and internalized by children and later reflected in their own behavior. Thus, unlike synchrony, this is a more sequential process that cuts across levels of analysis. We also discuss maladaptive cognitive and affective processing that is often evident with increases in child anxiety symptoms. Finally, we discuss additional moderators (e.g., parent sex, child fearful temperament) that may impact dyadic processes. Our model is proposed as a conceptual framework for testing hypotheses regarding dynamic processes that may ultimately guide novel treatment approaches aimed at intervening on dyadically linked biobehavioral mechanisms before symptom onset.

From mothers to children and back: Bidirectional processes in the cross-generational transmission of anxiety from early childhood to early adolescence

BACKGROUND

Maternal psychopathology and caregiving behavior are linked with child anxiety and these associations may be particularly salient when families face mass trauma together and members influence each other's symptomatology and resilience. Despite the well-known mother-to-child effects, less research addressed the longitudinal bidirectional effects of maternal and child's anxiety symptoms on each other.

METHODS

Mothers and children exposed to chronic war-related trauma from Sderot, Israel, and comparison group were followed at three time-points; Early childhood (T1:N = 232, M_Age  = 2.76 years), late childhood (T3:N = 176, M_Age  = 9.3 years), and early adolescence (T4:N = 110, M_Age  = 11.66 years). At each time-point maternal and child's anxiety symptoms were evaluated via questionnaires and maternal sensitivity was coded from videotaped observations of parent-child interactions. Bidirectional associations were examined using traditional cross-lagged panel model (CLPM) and CLPM with random intercepts (RI-CLPM).

RESULTS

Trauma-exposed mothers and children exhibited more anxiety symptoms and lower maternal sensitivity. Cross-lagged panel models revealed cross-time bidirectional associations between maternal anxiety and child anxiety from early to late childhood. Child anxiety at each time-point predicted maternal anxiety and maternal sensitivity at the next stage; however, maternal sensitivity did not show longitudinal associations with child anxiety, highlighting children's role in shaping caregiving.

CONCLUSIONS

Findings demonstrate bidirectional cross-generational influences of mother and child on each other's anxiety in contexts of trauma and pinpoint early childhood as a sensitive period for such mutual influences. Children's increased anxiety following trauma appears to be further exacerbated via its impact on increasing maternal anxiety and compromising sensitive caregiving, underscoring the potential benefits of parental and mother-child interventions for trauma-exposed populations.

Directional effects of parent and child anxiety 1 year following treatment of child anxiety, and the mediational role of parent psychological control

BACKGROUND

We leveraged a recent efficacy trial to investigate directionality between parent anxiety and child anxiety at posttreatment and 12-month follow-up, and the potential role of parent psychological control as a mediator. We also explored child age and sex as moderators.

METHOD

Two-hundred and fifty-four children were randomized to individual cognitive behavioral therapy (CBT) or to one of two CBT arms with parent involvement. Parent anxiety was not a treatment target in any of the three arms.

RESULTS

Child anxiety at posttreatment was associated with parent anxiety and psychological control at 12-month follow-up, providing evidence of child-to-parent directionality. Parent anxiety at posttreatment was associated indirectly with child anxiety at 12-month follow-up through associations with parent psychological control, providing evidence of parent-to-child directionality. At posttreatment, parent psychological control contemporaneously mediated the relation between parent and child anxiety. Neither child age nor sex moderated any association.

CONCLUSIONS

Findings highlight the directional effects between child anxiety, parent anxiety, and psychological control from posttreatment to 12-month follow-up, even when parent anxiety is not a treatment target. Research and clinical implications are discussed, with an emphasis on enhancing durability following treatment effects.

Overparenting, Parent-Child Conflict and Anxiety among Chinese Adolescents: A Cross-Lagged Panel Study

BACKGROUND

Overparenting is an emerging parenting style in which parents over-protect their children from difficulties and challenges by intruding into their lives and providing extensive assistance to them. Unfortunately, longitudinal studies related to overparenting were severely lacking, particularly on its impacts on early adolescents. Moreover, studies examining the mediational pathways through which overparenting is associated with adolescent anxiety are scant. This study examined the mediating role of parent-child conflict (father-child and mother-child) in the relationship between overparenting (paternal and maternal) and adolescent anxiety over time.

METHOD

Based on a three-wave longitudinal data of 1074 Chinese early adolescents in Hong Kong, the relationships among paternal and maternal overparenting, father- and mother-child conflict, and adolescent anxiety were assessed.

RESULTS

Mother-child conflict mediated the relationship between maternal overparenting and adolescent anxiety over time. Besides, a reverse association of prior adolescent anxiety with subsequent maternal overparenting via mother-child conflict was also identified. In addition, adolescent gender and family intactness did not moderate the relationships among overparenting, parent-child conflict, and adolescent anxiety.

DISCUSSION

This present study identified that the bidirectional relationship between maternal overparenting and adolescent anxiety via mother-child conflict over time, which sheds new light on the study of overparenting on adolescent well-being in the Chinese communities.

Moderators of response to child-based and parent-based child anxiety treatment: a machine learning-based analysis

BACKGROUND

Identifying moderators of response to treatment for childhood anxiety can inform clinical decision-making and improve overall treatment efficacy. We examined moderators of response to child-based cognitive-behavioral therapy (CBT) and parent-based SPACE (Supportive Parenting for Anxious Childhood Emotions) in a recent randomized clinical trial.

METHODS

We applied a machine learning approach to identify moderators of treatment response to CBT versus SPACE, in a clinical trial of 124 children with primary anxiety disorders. We tested the clinical benefit of prescribing treatment based on the identified moderators by comparing outcomes for children randomly assigned to their optimal and nonoptimal treatment conditions. We further applied machine learning to explore relations between moderators and shed light on how they interact to predict outcomes. Potential moderators included demographic, socioemotional, parenting, and biological variables. We examined moderation separately for child-reported, parent-reported, and independent-evaluator-reported outcomes.

RESULTS

Parent-reported outcomes were moderated by parent negativity and child oxytocin levels. Child-reported outcomes were moderated by baseline anxiety, parent negativity, and parent oxytocin levels. Independent-evaluator-reported outcomes were moderated by baseline anxiety. Children assigned to their optimal treatment condition had significantly greater reduction in anxiety symptoms, compared with children assigned to their nonoptimal treatment. Significant interactions emerged between the identified moderators.

CONCLUSIONS

Our findings represent an important step toward optimizing treatment selection and increasing treatment efficacy.

Coparenting Alleviated the Effect of Psychological Distress on Parental Psychological Flexibility

Parenting is full of challenges and responsibilities. It is particularly important for parents to be open to parental difficult experiences and adopt behaviors consistent with self-chosen values, which termed as parental psychological flexibility (PPF). However, few studies have focused on the effect of psychological distress (anxiety and depression) on different components of PPF. This study examined the effect of psychological distress on the three components of PPF (cognitive defusion, committed action, and acceptance) as well as the role of coparenting quality in Chinese parents. A total of 462 parents of children aged 1–18 years completed self-report measures of anxiety, depression, coparenting, and PPF. Our results revealed that higher level of PPF went along with less anxiety and depression, while it was also associated with better coparenting quality. Coparenting partially mediated the effect of anxiety on cognitive defusion and acceptance and fully mediated the effect of depression on cognitive defusion and acceptance. Moderation analyses showed that the link between anxiety and cognitive defusion, as well as the link between anxiety and acceptance were moderated by coparenting. We discussed the implications of coparenting as a protective factor in alleviating the negative effect of psychological distress on PPF.

Childhood Anxiety: Prenatal Maternal Stress and Parenting in the QF2011 Cohort

In this study we examine whether specific 'anxiety-maintaining' parenting behaviors (i.e., overinvolvement and/or negativity) exacerbate the effects of disaster-related prenatal maternal stress (PNMS) on school-age anxiety symptoms. Women (N = 230), pregnant at the time of the 2011 Queensland Floods, reported on their experience of flood-related PNMS (objective hardship, cognitive appraisal, subjective distress). At 4-years, mother-child dyads were coded for maternal overinvolvement and negativity during a challenging task; at 6-years mothers reported on their children's anxiety symptoms and their own mood, N = 83. Results showed no associations between PNMS and 6-year anxiety, nor did parenting moderate these effects. Poorer maternal concurrent mood was associated with greater anxiety symptoms at 6 years (β = 0.52). Findings suggest maternal concurrent mood, but not exposure to disaster-related PNMS nor 'anxiety-maintaining' parenting behaviors at preschool age, is related to school-age anxiety symptoms.

An observational study of emotion regulation in children with Tourette syndrome

BACKGROUND

Explosive outbursts occur in 25%-70% of children with Tourette syndrome (TS) and may cause more distress than the tics themselves. Previous studies have indicated that a comorbid diagnosis of attention-deficit/hyperactivity disorder (ADHD) is associated with emotional dysregulation in TS; however, this relationship has almost exclusively been studied using parent-reported questionnaires.

METHODS

We examined emotion regulation (ER) with an observational measure in 150 medication-naïve children aged 7-12 allocated to four groups: Forty-nine children with TS, 23 children with ADHD, 16 children with TS + ADHD, and 62 typically developing controls. We assessed participants' ER ability, as well as parent-child interactions in the context of a complex puzzle task, and coded the observed behavior with the Tangram Emotion Coding Manual (TEC-M). We examined group differences in ER, as well as associations between ER and severity of symptoms pertaining to TS and ADHD.

RESULTS

Children with TS did not differ from controls in their ER ability. However, children with ADHD and TS + ADHD had more problems with ER than those with TS only and controls. Finally, parents of children with ADHD displayed more tension during the experimental task. ER ability was not associated with tic severity nor premonitory urges; however, better ER ability was associated with less severe symptoms of ADHD.

CONCLUSIONS

This study is the first to evaluate ER with an observational, clinician-rated measure in a controlled social setting in children with TS. Our findings support earlier questionnaire-based studies by showing impaired ER in children with TS + ADHD, but not in children with TS without comorbidity. These findings inform our understanding of the phenomenology of emotional dysregulation in TS and the role of comorbid disorders.

Family Intervention for Child and Adolescent Anxiety: A Meta-analytic Review of Therapy Targets, Techniques, and Outcomes

Parent- and family-level correlates of youth anxiety are well-documented, and they highlight potential targets for family-focused intervention. Although family-based approaches for treating youth anxiety generally are considered efficacious for achieving symptom reduction, they vary in format and approach and it remains unclear whether they offer an advantage over individual child treatment. To better understand the current state of the evidence, we used meta-analytic methods to examine the therapeutic approaches described in existing family interventions for child and adolescent anxiety, whether they mapped to the major mechanisms proposed in the literature, and the timeline along which relevant parent/family variables were measured. We examined how these mechanism-focused family interventions performed in RCTs relative to individual child CBT and whether they shifted symptoms and relevant parenting behaviors. A total of 11 randomized controlled trials (RCTs) compared individual cognitive behavior therapy (CBT) to CBT+ a family component (CBT + FAM) and included a youth anxiety measure at pre- and post-treatment; only half of these (n=6) also included a parent/family functioning measure at both pre- and post-treatment (across both primary and secondary outcome papers). Only a single study included anxiety measures at a mid-treatment time point, and none included parent measures at a mid-treatment time point. Findings are discussed in terms of design considerations and advancing the field of family intervention for youth anxiety.

The developmental cascade of early parenting, emergence of executive functioning, and emotional symptoms across childhood

Many studies focus on proximal associations between parental sensitivity and emotional well-being in early childhood, with less data examining how parenting in infancy predicts children's emotional trajectories across childhood, in particular negative emotional symptoms of anxiety and depression. Thus, this study utilized data from The Family Life Project (N = 1015), a prospective study of child development in rural poverty, and assessed whether sensitive parenting in the first 4 years of life predicted child internalizing emotional symptoms (i.e., anxiety and depression) from kindergarten to fifth grade and whether early child executive functioning mediated this relationship. Path models indicated that observation of sensitive parenting predicted a decrease in teachers' report of child negative emotional symptoms over time and predicted fewer negative emotional symptoms in fifth grade. Moreover, though executive functioning performance did not mediate change in symptoms over time, executive functioning did mediate the relationship between sensitive parenting and fifth-grade symptoms, suggesting that executive functioning is one mechanism by which early sensitive parenting buffers long-term emotional development. Findings highlight the importance of early parenting and executive functioning in development of anxiety and depression symptoms and suggests potential targets for transdiagnostic intervention.

COVID-related fear maintains controlling parenting behaviors during the pandemic

The direct threat posed by the 2019 novel coronavirus (COVID-19), uncertainty surrounding best safety practices, and secondary consequences of the virus have led to widespread stress and declining mental health across communities and individuals. These stresses may impact parenting behaviors, potentially leading to negative consequences for children. Controlling parenting behaviors increase in the face of perceived environmental threat and are associated with adverse mental health outcomes for children; however, determinants of parenting behaviors have not been investigated during the COVID-19 pandemic. The current study prospectively evaluated parenting behaviors during the pandemic (N=87). Results indicated that all negative affect emotions investigated were positively associated with controlling parenting behaviors. However, only COVID-related fear predicted changes in controlling parenting behaviors across timepoints. Specifically, although controlling parenting behaviors decreased in the overall sample from time 1 to time 2, higher COVID-related fear scores at time 1 predicted maintenance of high levels of controlling parenting behaviors at time 2. Additionally, this effect was specific to controlling, as opposed to more adaptive, parenting behaviors. Future studies should investigate the association between parents' COVID-related fear, controlling parenting behaviors, and adverse mental health outcomes for children in the context of the COVID-19 pandemic.

Examining the Relationships Among Parental Overprotection, Military Life Adjustment, Social Anxiety, and Collective Efficacy

The purpose of this study was to verify the relationships among parental overprotection (PO), military life adjustment (MLA), social anxiety, and collective efficacy (CE). There have been studies examining the influence of each of these variables in isolation, but no study has examined these variables simultaneously. Two hundred and thirty-one male conscript soldiers participated in the study. Results indicated that all four variables were correlated with one another. Through hierarchical regression analysis, we determined that social anxiety fully mediated the relationship between PO and MLA. Furthermore, we found that CE moderated the relationship between PO and social anxiety. Finally, we confirmed the moderated mediation effect of CE in our proposed model. We discuss the implications and limitations of this model.

The role of the parent-child relationship in fostering resilience in American Indian/Alaskan Native children

Resilience is a key characteristic to study in families, particularly those who have experienced significant systemic risk factors. While much resilience research focuses on ethnic and cultural minorities, little research focuses specifically on American Indian/Alaskan Native (AI/AN) families. The parent-child relationship has been demonstrated to be a key characteristic in families, and this relationship may also serve as a protective factor for AI/AN families. Positive parent-child relationships are consistently linked to positive child outcomes, and parental psychological symptoms are linked with child psychological symptoms in non-Native families. These associations warrant further examination among AI/AN families. We hypothesized that the parent-child relationship would moderate the link between parent distress (i.e., depressive and anxious symptoms) and child internalizing problems in a sample of 57 AI/AN parents of children 3-5 years of age. As expected, the parent-child relationship moderated the associations between parent anxiety symptoms and child internalizing symptoms, and between parent depressive symptoms and child internalizing symptoms. Furthermore, the strength of the parent-child relationship buffered the effects of parent distress on child internalizing symptoms. Results highlight the potentially protective role of strong parent-child relationships in AI/AN families.

The Role of Parental Beliefs About Anxiety and Attachment on Parental Accommodation of Child Anxiety

This study examined: 1) the relationship between negative parental beliefs about child anxiety (i.e., it is harmful), insecure parental attachment and parental accommodation of child anxiety; 2) whether parental attachment insecurity moderates the effect of negative beliefs about anxiety on parent accommodation; and 3) a path model of parental factors affecting accommodation and child anxiety severity. Participants were 139 parents of children (6-18 years) with a primary anxiety disorder. Parents completed measures of parental accommodation of their child's anxiety, beliefs about child anxiety, and attachment security. Child anxiety diagnosis and severity was determined using semi-structured clinical interviews. Negative beliefs about child anxiety were directly associated with levels of parental accommodation. There was no direct relationship between insecure attachment and accommodation; however anxious attachment moderated the effect of parental beliefs about anxiety on parental accommodation. Among parents with more secure attachment, negative beliefs about anxiety were associated with greater parental accommodation. However, among parents with less secure attachment, accommodation was high regardless of beliefs about anxiety. A path model suggested that negative beliefs about anxiety was related to increased parental accommodation, which in turn was related to increased child anxiety severity. Psychoeducation about the nature of anxiety is likely to be beneficial in helping to reduce accommodation among parents with more secure attachment styles. However, among those with greater anxious attachment, psychoeducation may need to be tailored to focus on corrective information about the impact of treatment processes on the parent-child relationship.

Maternal Depression and Mother-Child Oxytocin Synchrony in Youth with Anxiety Disorders

The neuropeptide oxytocin (OT) plays a central role in the regulation of affiliative bonds and anxiety. However, the degree to which its levels are synchronized between interaction partners has not yet been assessed. Physiological synchrony assessed using other peripheral measures (e.g., heart rate, etc.) has been tied to positive outcomes for the individual and the dyad. The present study examined OT synchrony in the context of child anxiety and maternal depression by examining mother-child dyads. Mothers and their children with anxiety disorders participated in a behavioral interaction task. Changes in OT levels and mother-child OT synchrony before and after the interaction, as well as their moderation by maternal depression, were assessed. Ninety-eight youth with anxiety disorders (ages 10 to 17) and their mothers underwent psychiatric evaluation, and mothers rated their own depressive symptoms and their children's behavior problems. Salivary OT was assayed from mother and child before and after the task. Behavioral coding showed that interactions were characterized by high behavioral synchrony between mothers and their children, and both individuals displayed higher levels of positive vs. negative affect during the interactions. Mothers and their children also showed decreases in OT levels after the interaction. As hypothesized, OT synchrony increased following the task, but only dyads in which mothers showed high levels of depressive symptoms showed this increase. As hypothesized, lower levels of OT-synchrony were associated with higher levels of child internalizing symptoms. The findings suggest that positive interactions may be beneficial for youth with anxiety disorders with mothers with depression.

An Exploratory Study of Autism Traits and Parenting

The study examined the association between autism traits and parenting when raising a typically developing (TD) child, and differences in parenting needs between parents with high and low traits. Fifty-eight parents with a blood relative with Autism (who happened to be an offspring with ASD in all cases) and a TD child completed the Autism Quotient, demographic and psychological information, as well as reporting on Parenting Sense of Competence, the Parent-Child Relationship, and Parenting Needs. Autism traits did not uniquely contribute to parenting self-esteem, but were associated with parenting difficulties for their TD child, and some aspects of this parent-child relationship. Parents with high autism traits reported more parenting difficulties than parents with low traits. The study identified specific aspects of parenting needing support to assist parents with high autism traits prosper in their parenting role.

Early Childhood Predictors of Anxiety in Early Adolescence

This longitudinal study examined a multitude of early childhood predictors of anxiety symptoms and disorders over an 8-year period. The purpose of the study was to identify early life predictors of anxiety across childhood and early adolescence in a sample of at-risk children. The sample included 202 preschool children initially identified as behaviorally inhibited or uninhibited between the ages of 3 years 2 months and 4 years 5 months. Temperament and familial environment variables were assessed using observation and parent report at baseline. Anxiety symptoms and disorders were assessed using questionnaires and diagnostic interviews at baseline (age 4), and at age 6, 9 and 12 years. In line with our hypotheses, the findings showed that preschool children were more likely to experience anxiety symptoms and disorders over time i) when the child was inhibited, ii) when there was a history of maternal anxiety disorders or iii) when mothers displayed high levels of overinvolvement. Further, the study identified a significant interaction effect between temperament and maternal overvinvolvement such that behaviorally inhibited preschoolers had higher anxiety symptoms at age 12, only in the presence of maternal overinvolvement at age 4. The increased risk of anxiety in inhibited children was mitigated when mothers demonstrated low levels of overinvolvement at age 4. This study provides evidence of both additive and interactive effects of temperament and family environment on the development of anxiety and provides important information for the identification of families who will most likely benefit from targeted early intervention.

Prevalence of stress, anxiety and depression due to examination in Bangladeshi youths: A pilot study

An estimated 25% people suffer from mental health disorders worldwide. Almost 7 million suffer from anxiety and depression in Bangladesh. There are several factors that can cause stress among youths, both academic and non-academic, ranging from socioeconomic, environmental, cultural and psychological attributes. However, these are not widely researched in Bangladesh. This study identified the factors that affect the mental health of students due to examinations in Bangladesh, particularly the socio-demographic, lifestyle and psychological factors. An online cross-sectional survey was conducted on May 2020 with a sample size of 210 tertiary level students in Dhaka. A modified DASS-21 was used to measure stress, anxiety and depression scores related to examination. Binary logistic model showed that those who lived with family, spent time with parents, had regular sufficient (self-assessed) sleeps and consumed balanced (self-assessed) diets had significantly lower stress, anxiety, and depression. Balanced lifestyle with greater social bonding might help to better equip youths to reduce stress, anxiety, and depression during examination, which could be an avenue for future intervention studies.

The association between current maternal psychological control, anxiety symptoms, and emotional regulatory processes in emerging adults

BACKGROUND AND OBJECTIVES

High levels of psychological control (PC), the (intentional or unintentional) attempt by parents to control their child's emotional experience, have been associated with increased risk for anxiety in youth. However, little is known regarding the association between PC and anxiety in emerging adulthood, a developmental period marked by various life transitions and high risk for the onset of internalizing symptoms, or about the relation between current parental PC and emotional regulatory processes during this stage. The current study examined whether perceived maternal PC was significantly associated with anxiety symptoms and both objective (psychophysiological; respiratory sinus arrhythmia) and subjective (self-reported) emotion regulatory processes.

METHODS

Participants (N = 125; ages 18 to 25) completed self-reports on their anxiety symptoms, emotion regulation abilities, and perceptions of their mother' behavior, and participated in a laboratory stressor, the Trier-Social Stress Test, while psychophysiological data were acquired.

RESULTS

Emerging adults who reported higher maternal PC also reported higher anxiety symptoms and evidenced greater emotion regulation difficulties on both objective and subjective indices than those who reported lower maternal PC. Moreover, the association between PC and anxiety levels was statistically mediated by self-reported emotion regulation difficulties.

LIMITATIONS

Results of this study should be interpreted in light of its limitations, which include it being cross-sectional in nature with a primarily female sample. Further, perceptions of maternal, but not paternal, parenting were examined.

CONCLUSIONS

Findings might have implications for targeting both psychological control and emotion regulation difficulties in personalized anxiety interventions during this high-risk developmental period.

Impact of Parental Acute Psychological Distress on Young Child Pain-Related Behavior Through Differences in Parenting Behavior During Pediatric Burn Wound Care

Pediatric burn injuries and subsequent wound care can be painful and distressing for children and their parents. This study tested parenting behavior as a mediator for the relationship between parental acute psychological distress and child behavior during burn wound care. Eighty-seven parents of children (1-6-years-old) self-reported accident-related posttraumatic stress symptoms (PTSS), pre-procedural anxiety, general anxiety/depression symptoms, and guilt before the first dressing change. Parent-child behavior was observed during the first dressing change. Mediation analyses identified three indirect effects. Parental PTSS predicted more child distress, mediated through parental distress-promoting behavior. Parental guilt predicted more child distress, mediated through parental distress-promoting behavior. Parental general anxiety/depression symptoms predicted less child coping, mediated through less parental coping-promoting behavior. Parents with accident-related psychological distress have difficulty supporting their child through subsequent medical care. Nature of parental symptomology differentially influenced behavior. Increased acute psychological support for parents may reduce young child procedural pain-related distress.

Parent and child emotion and distress responses associated with parental accommodation of child anxiety symptoms

OBJECTIVE

Parental accommodation contributes to the maintenance of child anxiety and related symptoms. The current study examines the contributions of parent and child factors to parental accommodation in a sample of anxious youth.

METHODS

Sixty-four treatment-seeking youth (6-16 years) and their mothers, as well as a subset of fathers (N = 41) reported on parental accommodation, parental distress and emotion regulation, child psychopathology, child externalizing behaviors, and child intolerance of uncertainty.

RESULTS

Parental accommodation was not related to parental distress or emotion regulation. Parents who viewed their child as being more symptomatic (e.g., anxious, externalizing, and intolerant of uncertainty) were more likely to engage in accommodation. For mothers, child anxiety and externalizing symptoms were notable predictors of accommodation.

CONCLUSIONS

Parent perceptions of child symptomology is an important factor significantly related to accommodation behaviors. This finding can be used to inform programming designed to target parental responses to child anxiety and related disorders.

The Parent-Child Relationship and Posttreatment Child Outcomes Across Two Treatments for Oppositional Defiant Disorder

This study examined the degree to which the parent-child relationship uniquely predicted clinical outcomes in externalizing problems and adaptive skills in children meeting diagnostic criteria for oppositional defiant disorder and whether facets of this relationship moderated the effects of two unique psychosocial treatments. We recruited 134 children and their parents (38.06% female; M age = 9.52 years, range = 7-14; 83.58% White). Families were randomly assigned to 1 of 2 treatments: Parent Management Training (PMT) and Collaborative and Proactive Solutions (CPS). We formed principal components from pretreatment reports and behaviors of the parent-child relationship to predict within- and between-family outcomes in children's externalizing problems and adaptive skills. Four principal components were supported (parental warmth, parental monitoring, family hostility, and family permissiveness). Parental monitoring predicted fewer externalizing problems, whereas family permissiveness predicted more externalizing problems. Parental warmth predicted greatest improvements in children's adaptive skills among families receiving PMT. Family hostility predicted more externalizing problems and poorer adaptive skills for children; however, families receiving CPS were buffered from the negative effect of family hostility on adaptive skills. The parent-child relationship can uniquely inform posttreatment outcomes following treatment for oppositional defiant disorder. Certain treatment approaches may better fit unique relationships that emphasize warmth and/or hostility, allowing clinicians to anticipate and tailor treatments to families.

Associations between family factors, childhood adversity, negative life events and child anxiety disorders: an exploratory study of diagnostic specificity

BACKGROUND

Chronic childhood adversity, negative life events, and anxiogenic parenting behaviours have all been implicated in the development and maintenance of childhood anxiety disorders. However, few studies have addressed whether these factors are associated with particular types of childhood anxiety disorders.

AIMS

The aims of this study were to investigate whether specific associations were obtained between specific types of childhood anxiety disorder - namely, social anxiety disorder (SOC), separation anxiety disorder (SEP) and generalized anxiety disorder (GAD) - and the nature of particular forms of psycho-social risk - namely, chronic childhood adversity, negative life events, and particular forms of parenting behaviours.

METHOD

Two-hundred and ten children (aged 7-12 years) who met diagnostic criteria for SOC, SEP or GAD and their primary caregivers completed questionnaire measures on chronic childhood adversity and negative life events. In addition, dyads participated in two laboratory-based assessments of parent-child interactions.

RESULTS

We found little evidence for disorder specificity for chronic childhood adversity and negative life events, except in the case of separation anxiety disorder. Anxious children with separation anxiety were more likely than children with other forms of anxiety disorders to live with a single parent, experience more frequent parent arguments, and more negative life events. No group differences in observed parenting behaviours were found.

CONCLUSIONS

Childhood SEP may be particularly associated with family challenges which may need specific consideration to optimize prevention and/or treatment. Beyond this, there is limited evidence of specific associations between family and environmental factors and specific types of childhood anxiety disorders.