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Nimphy CA, Mitrou V, Elzinga BM, Van der Does W, Aktar E. The Role of Parental Verbal Threat Information in Children's Fear Acquisition: A Systematic Review and Meta-analysis. Clin Child Fam Psychol Rev 2024:10.1007/s10567-024-00485-4. [PMID: 38789695 DOI: 10.1007/s10567-024-00485-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2024] [Indexed: 05/26/2024]
Abstract
Children can acquire fears of novel stimuli as a result of listening to parental verbal threat information about these stimuli (i.e., instructional learning). While empirical studies have shown that learning via parental information occurs, the effect size of parental verbal threat information on child fear of a novel stimulus has not yet been measured in a meta-analysis. We conducted a systematic review and meta analysis to assess the effect of parents' verbal statements on their children's fear acquisition. Additionally, we explored potential moderators of this effect, namely, parent and child anxiety levels, as well as child age. WebOfScience, Pubmed, Medline, and PsycINFO were used to identify eligible studies that assessed children's (30 months to 18 years old) fear of novel stimuli after being exposed to parental verbal threat information. We selected 17 studies for the meta-analysis and 18 for the systematic review. The meta-analysis revealed a significant causal effect of parental verbal threat information on children's fear reaction towards novel stimuli [g = 1.26]. No evidence was found for a moderation of verbal learning effects, neither by child or parent anxiety levels nor by child age. The effect of parents' verbal threat information on children's fear of novel stimuli is large and not dependent on anxiety levels or child age.
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Affiliation(s)
- Cosima Anna Nimphy
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands.
| | - Vasiliki Mitrou
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Bernet M Elzinga
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden, The Netherlands
| | - Willem Van der Does
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden University Treatment Center (LUBEC), Leiden, The Netherlands
| | - Evin Aktar
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden, The Netherlands
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2
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Raymond C, Cernik R, Beaudin M, Arcand M, Pichette F, Marin MF. Maternal attachment security modulates the relationship between vulnerability to anxiety and attentional bias to threat in healthy children. Sci Rep 2024; 14:6025. [PMID: 38472274 DOI: 10.1038/s41598-024-55542-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 02/24/2024] [Indexed: 03/14/2024] Open
Abstract
This study aimed to investigate whether attentional bias to threat, commonly observed in clinically anxious children, also manifests in healthy children, potentially aiding the early detection of at-risk individuals. Additionally, it sought to explore the moderating role of parent-child attachment security on the association between vulnerability factors (anxiety sensitivity, intolerance of uncertainty, perseverative cognitions) as indicators of vulnerability to anxiety, and attentional bias towards threat in healthy children. A total of 95 children aged 8 to 12 years completed the Visual Search Task to assess attentional bias. Vulnerability to anxiety was measured using a composite score derived from the Childhood Anxiety Sensitivity Index, Intolerance of Uncertainty Scale for Children, and Perseverative Thinking Questionnaire. Parent-child attachment security was assessed using the Security Scale-Child Self-Report. Analyses revealed that higher vulnerability to anxiety was associated with faster detection of anger-related stimuli compared to neutral ones, and this association was further influenced by high maternal security. These findings in healthy children suggest an interaction between specific factors related to anxiety vulnerability and the security of the mother-child relationship, leading to cognitive patterns resembling those seen in clinically anxious individuals. These results hold promise for early identification of children at risk of developing anxiety disorders.
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Affiliation(s)
- Catherine Raymond
- Department of Psychology, Université du Québec À Montréal, Montreal, Canada.
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada.
| | - Rebecca Cernik
- Department of Psychology, Université du Québec À Montréal, Montreal, Canada
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada
| | - Myriam Beaudin
- Department of Psychology, Université du Québec À Montréal, Montreal, Canada
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada
| | - Maryse Arcand
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Florence Pichette
- Department of Psychology, Université du Québec À Montréal, Montreal, Canada
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada
| | - Marie-France Marin
- Department of Psychology, Université du Québec À Montréal, Montreal, Canada
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada
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3
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Han X, Shen Q, Hou C, Yang H, Chen W, Zeng Y, Qu Y, Suo C, Ye W, Fang F, Valdimarsdóttir UA, Song H. Disease clusters subsequent to anxiety and stress-related disorders and their genetic determinants. Nat Commun 2024; 15:1209. [PMID: 38332132 PMCID: PMC10853285 DOI: 10.1038/s41467-024-45445-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 01/23/2024] [Indexed: 02/10/2024] Open
Abstract
Anxiety/stress-related disorders have been associated with multiple diseases, whereas a comprehensive assessment of the structure and interplay of subsequent associated diseases and their genetic underpinnings is lacking. Here, we first identify 136, out of 454 tested, medical conditions associated with incident anxiety/stress-related disorders attended in specialized care using a population-based cohort from the nationwide Swedish Patient Register, comprising 70,026 patients with anxiety/stress-related disorders and 1:10 birth year- and sex-matched unaffected individuals. By combining findings from the comorbidity network and disease trajectory analyses, we identify five robust disease clusters to be associated with a prior diagnosis of anxiety/stress-related disorders, featured by predominance of psychiatric disorders, eye diseases, ear diseases, cardiovascular diseases, and skin and genitourinary diseases. These five clusters and their featured diseases are largely validated in the UK Biobank. GWAS analyses based on the UK Biobank identify 3, 33, 40, 4, and 16 significantly independent single nucleotide polymorphisms for the link to the five disease clusters, respectively, which are mapped to several distinct risk genes and biological pathways. These findings motivate further mechanistic explorations and aid early risk assessment for cluster-based disease prevention among patients with newly diagnosed anxiety/stress-related disorders in specialized care.
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Affiliation(s)
- Xin Han
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Qing Shen
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
- Institute for Advanced Study, Tongji University, Shanghai, China
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Can Hou
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Huazhen Yang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Wenwen Chen
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yu Zeng
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yuanyuan Qu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Chen Suo
- Department of Epidemiology & Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
- Taizhou Institute of Health Sciences, Fudan University, Taizhou, China
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Unnur A Valdimarsdóttir
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Huan Song
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.
- Med-X Center for Informatics, Sichuan University, Chengdu, China.
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
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4
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Grzadzinski R, Jatkar A, Donovan K, Truong K, Holbrook A, Lord C, Kim SH. Examining Treatment Outcomes Across Contexts: How Do Child Baseline Characteristics Impact Measurement of Treatment Response? J Autism Dev Disord 2023; 53:4121-4131. [PMID: 35969334 PMCID: PMC9969996 DOI: 10.1007/s10803-022-05655-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2022] [Indexed: 10/15/2022]
Abstract
The evaluation of the overlap between the ADOS BOSCC and Standard BOSCC as well as the exploration of child characteristics that may predict change are important steps in consolidating data-driven definitions of "improvement". Participants were seen between 2 and 5 times with Standard BOSCC and ADOS BOSCC observations over the course of early intervention trials (Grzadzinski et al. in J Autism Dev Disord 46:2464, 2016; Kim et al. in Autism 23:5, 2019). Results showed consistency between the Standard BOSCC and ADOS BOSCC, highlighting the utility of both as metrics of change and treatment outcome across contexts. Baseline characteristics may play a role in the tailoring of early intervention to maximize treatment outcome and may offer guidance when determining which outcome measures to use.
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Affiliation(s)
- Rebecca Grzadzinski
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC, USA
- Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina, Chapel Hill, NC, USA
| | - Alapika Jatkar
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC, USA
| | - Kevin Donovan
- Penn Statistics in Imaging and Visualization Endeavor (PennSIVE), Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Kinh Truong
- Gillings School of Global Public Health, Department of Biostatistics, Chapel Hill, USA
| | | | - Catherine Lord
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, USA
| | - So Hyun Kim
- School of Psychology, Korea University, Seoul, South Korea.
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5
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Nimphy CA, Venetikidi M, Elzinga B, van der Does W, Aktar E. Parent to Offspring Fear Transmission via Modeling in Early Life: A Systematic Review and Meta-Analysis. Clin Child Fam Psychol Rev 2023; 26:751-772. [PMID: 37500947 PMCID: PMC10465674 DOI: 10.1007/s10567-023-00448-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 07/29/2023]
Abstract
Infants can acquire fears vicariously by observing parents' fearful reactions to novel stimuli in everyday situations (i.e., modeling). To date, no systematic or meta-analytic review examined the role of modeling in parent-child transmission of fear and avoidance in early life. In our systematic review and meta-analysis, we aimed to investigate the effect of modeling parents' fearful reactions on infants' acquisition of fear and avoidance of novel stimuli and explore the moderation of this effect by child behavioral inhibition (BI) and parent trait anxiety. The search conducted in Web Of Science, Pubmed, Embase, and PsycINFO revealed 23 eligible studies for the systematic review and 19 for the meta-analysis. Eligible studies included published studies that measured infant fear and avoidance (infants aged up to 30 months) of novel stimuli following exposure to parental fearful expressions. Meta-analysis findings revealed a significant causal effect of modeling of parental fear on infants' fear [g = .44] and avoidance of novel stimuli [g = .44]. The findings support moderation by child BI on infant avoidance (not fear) acquisition, with the effects being larger for infants with higher BI. However, this moderation was only found, when including both experimental and correlational studies (p > .05), but not when exclusively including experimental studies (p = .17). This meta-analysis provides support for early parent-to-offspring fear transmission: a causal small to medium effect of parents' fearful reactions was shown on infants' fear and avoidance of novel stimuli. Elucidating parent-to-offspring anxiety transmission pathways can inform us about potential fear reduction and prevention strategies.
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Affiliation(s)
- Cosima Anna Nimphy
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands.
| | - Marianna Venetikidi
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Bernet Elzinga
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
| | - Willem van der Does
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden University Treatment Center (LUBEC), Leiden University, Leiden, The Netherlands
| | - Evin Aktar
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
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6
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Somers JA, Chu K, Schwartz C, Towner E, Callaghan B. Sometimes "we" can help: parents' pronoun use buffers fear and anxiety transmission. ANXIETY, STRESS, AND COPING 2023; 36:488-501. [PMID: 36153744 PMCID: PMC10038937 DOI: 10.1080/10615806.2022.2127694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Parents' natural language when describing health-related threats reflects parents' cognitions that may shape their transmission of anxiety and fear. Parents' greater communal focus (i.e., higher we-talk) and less self-focus (i.e., lower I-talk) may buffer against intergenerational fear/anxiety transmission. The current study investigated whether the relation between parents' and children's anxiety and pandemic-related fear differed by parent we- and I-talk. DESIGN AND METHODS Parents of 114 children (2-19 years; M = 9.75, SD = 3.73) completed online measures assessing children's and parents' anxiety and COVID-19-related fears, and engaged in a written reflection on their early pandemic experiences. The proportion of parents' we-talk and I-talk during the reflection was obtained using Linguistic Inquiry Word Count software. RESULTS Results of multilevel structural equation models were partially consistent with expectations: The protective effect of we-talk was only observed for parents with lower fear/anxiety. For parents with higher fear/anxiety, higher I-talk was associated with lower child fear/anxiety. At higher levels of parent we-talk and at lower levels of I-talk, there was an unexpectedly positive association between parents' and children's fear/anxiety. CONCLUSIONS The concordance between parents' and their children's fear/anxiety differs depending on parents' natural language when reflecting on the pandemic.
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Affiliation(s)
- Jennifer A. Somers
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Kristen Chu
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Chloe Schwartz
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Emily Towner
- Department of Psychology, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Bridget Callaghan
- Department of Psychology, University of California, Los Angeles, CA, USA
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7
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Costa VPP, Goettems ML, Quevedo L, Armfield J, Pinheiro RT, Demarco FF. Relation between anxiety disorders in adolescent mothers and dental fear in children. Int J Paediatr Dent 2023; 33:124-131. [PMID: 35962616 DOI: 10.1111/ipd.13027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/31/2022] [Accepted: 06/23/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Maternal anxiety disorders can cause adverse consequences in child's health, cognitive development, and behavior. AIM To investigate the association of maternal anxiety disorders with the occurrence of dental fear in children aged 24-36 months. DESIGN This cross-sectional study is part of a cohort of adolescent mothers and their children (n = 527) in the city of Pelotas, RS, Brazil. Anxiety disorders in mothers were assessed using Mini International Neuropsychiatric Interview (DSM-IV), whereas the Dental Anxiety Question was used to assess children's dental fear. Clinical oral examinations were performed on the cohort. Poisson regression analysis was used to determine the association of maternal anxiety disorders with maternal perception of dental fear in children (p < .05). RESULTS The prevalence of dental fear in children was 21.7% (n = 114), and maternal age, agoraphobia, social phobia, and maternal caries experience (p < .05) were associated with the presence of dental fear. After adjusted analysis, children of mothers presenting with agoraphobia (Prevalence ratios [PR] = 1.52; 95% confidence interval [CI] = 1.00-2.32) and social phobia (PR = 1.69; 95% CI = 1.06-2.71) had higher prevalence of dental fear than children whose mothers did not have any of these conditions. CONCLUSIONS In this population of young mothers, agoraphobia and social phobia were associated with children's dental fear. Detection of and treatment for maternal mental disorders may aid in the prevention of dental fear and its oral health-related consequences.
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Affiliation(s)
- Vanessa Polina Pereira Costa
- Department of Social and Preventive Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Marília Leão Goettems
- Department of Social and Preventive Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Luciana Quevedo
- Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Jason Armfield
- University of Adelaide's Australian Research Centre for Population Oral Health (ARCPOH), Adelaide, South Australia, Australia
| | | | - Flávio Fernando Demarco
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
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8
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The Development and Validation of a Subscale for the School-Age Child Behavior CheckList to Screen for Autism Spectrum Disorder. J Autism Dev Disord 2023; 53:1034-1052. [PMID: 35165798 PMCID: PMC9986212 DOI: 10.1007/s10803-022-05465-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 10/19/2022]
Abstract
The first aim of this study was to construct/validate a subscale-with cut-offs considering gender/age differences-for the school-age Child Behavior CheckList (CBCL) to screen for Autism Spectrum Disorder (ASD) applying both data-driven (N = 1666) and clinician-expert (N = 15) approaches. Further, we compared these to previously established CBCL ASD profiles/subscales and DSM-oriented subscales. The second aim was to cross-validate results in two truly independent samples (N = 2445 and 886). Despite relatively low discriminative power of all subscales in the cross-validation samples, results indicated that the data-driven subscale had the best potential to screen for ASD and a similar screening potential as the DSM-oriented subscales. Given beneficial implications for pediatric/clinical practice, we encourage colleagues to continue the validation of this CBCL ASD subscale.
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Intergenerational Transmission of Social Anxiety in Childhood Through Fear of Negative Child Evaluation and Parenting. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10320-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Abstract
Background
Parents’ fear of negative evaluation (FNE) has been proposed to play a role in the intergenerational transmission of social anxiety. We investigated whether (1) parents’ own FNE, a core belief of social anxiety, extends to their child’s environment resulting in fear of negative child evaluation (FNCE); and (2) parents’ FNCE mediates the association between parents’ social anxiety, parenting behavior and children’s social anxiety.
Methods
In this cross-sectional study, fathers (n = 84) and mothers (n = 92) from 99 Caucasian families completed questionnaires on social anxiety, FNE, FNCE, and parenting (intrusiveness, negative parenting and encouragement of social daring) when their child was 7.5 years old. Child social anxiety was measured by questionnaires (child and parent report).
Results
For both parents, FNE mediated the association between their social anxiety and FNCE. Furthermore, FNCE mediated the relation between both parents’ social anxiety and intrusiveness and the relation between mothers’ social anxiety and negative parenting. In addition, FNCE mediated the relation between fathers’ social anxiety and children’s social anxiety (parents’ report only) directly and through intrusive parenting.
Conclusions
Our study suggests that parents’ FNE extends to their children’s environment and provides support for the role of FNCE in various pathways of intergenerational transmission of social anxiety during middle childhood.
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10
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Baartmans JMD, van Steensel FJA, Klein AM, Wiers RWHJ, Bögels SM. The role of parental anxiety symptoms in the treatment of childhood social anxiety disorder. Behav Res Ther 2022; 156:104157. [PMID: 35863242 DOI: 10.1016/j.brat.2022.104157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 06/17/2022] [Accepted: 06/29/2022] [Indexed: 11/28/2022]
Abstract
The study investigated the role of parental anxiety symptoms in treatment outcomes for children with a primary social anxiety disorder compared to children with other primary anxiety disorders. Participants were 152 children between 7 and 18 years and their parents (146 mothers, 123 fathers). Anxiety was assessed pretreatment, posttreatment, and at three months and one year follow ups. There were no baseline differences in parental anxiety symptoms between the two groups. In both groups parental anxiety symptoms decreased from pretreatment to posttreatment, and only mothers' anxiety symptoms decreased further from posttreatment to the one year follow up. Parental anxiety symptoms before the treatment were not related to the being free of all anxiety diagnoses in the children at posttreatment. However, some indications were found for greater improvements during treatment when parents had higher anxiety symptoms before treatment. Changes in parental anxiety symptoms were found to be related to changes in child anxiety symptoms. This was not found for the total clinical severity of all inclusion anxiety disorders. This relation was visible independently in fathers or mothers, or in groups of children with a primary social anxiety disorder or with another primary anxiety disorder. In conclusion, we did not find clear indications that parental anxiety symptoms explain the differences in treatment outcomes for children with a primary social anxiety disorder compared to children with other primary anxiety disorders. More research with larger samples is needed to draw stronger conclusions.
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Affiliation(s)
- J M D Baartmans
- UvA Minds, Academic Treatment Centre, the Netherlands; Developmental Psychology, University of Amsterdam, the Netherlands.
| | - F J A van Steensel
- Child Development and Education, University of Amsterdam, the Netherlands
| | - A M Klein
- UvA Minds, Academic Treatment Centre, the Netherlands
| | - R W H J Wiers
- Developmental Psychology, University of Amsterdam, the Netherlands
| | - S M Bögels
- Child Development and Education, University of Amsterdam, the Netherlands
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11
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Konstantellou A, Sternheim L, Hale L, Simic M, Eisler I. The experience of intolerance of uncertainty for parents of young people with a restrictive eating disorder. Eat Weight Disord 2022; 27:1339-1348. [PMID: 34292530 PMCID: PMC9079010 DOI: 10.1007/s40519-021-01256-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/18/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study aimed to explore how parents of young people with a restrictive eating disorder (ED) experience and manage uncertainty. METHODS Seventeen parents of young people with a restrictive ED were recruited from multi-family therapy groups run within a specialised ED clinic. Five focus groups were conducted asking parents about their experience of uncertainty both prior and after the onset of their child's illness. RESULTS Data were analysed using interpretative phenomenological analysis which yielded seven superordinate themes. (1) Anorexia nervosa and uncertainty, (2) Positive and negative experiences of uncertainty (3), Helpful and unhelpful ways of coping with uncertainty, (4) Parent's self-efficacy and uncertainty (5), Needs of parents, (6) Parents' perceptions of intolerance of uncertainty in their children and (7) Impact of uncertainty on family life. CONCLUSION Parents caring for young people with a restrictive ED exhibit a strong intolerance of uncertainty, particularly in relation to their child's illness. This 'negative uncertainty' was thought to reduce their confidence as parents in how they managed their child's ED. Targeting high levels of intolerance of uncertainty in parents caring for young people with an ED could be beneficial for supporting parents when faced with their child's illness, increasing parental self-efficacy, decreasing accommodating behaviours and ultimately contributing to improved treatment outcomes. LEVEL OF EVIDENCE Level V: Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
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Affiliation(s)
- Anna Konstantellou
- Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK
| | - Lot Sternheim
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Lucy Hale
- Department of Psychology, University of Surrey, Guildford, UK
| | - Mima Simic
- Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK
| | - Ivan Eisler
- Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK.
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12
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Aktar E. Intergenerational Transmission of Anxious Information Processing Biases: An Updated Conceptual Model. Clin Child Fam Psychol Rev 2022; 25:182-203. [PMID: 35218453 PMCID: PMC8948131 DOI: 10.1007/s10567-022-00390-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 11/28/2022]
Abstract
Anxiety disorders are globally one of the most prevalent and disabling forms of psychopathology in adults and children. Having a parent with an anxiety disorder multiplies the risk of anxiety disorders in the offspring, although the specific mechanisms and processes that play a role in this intergenerational transmission remain largely unknown. According to information processing theories, threat-related biases in cognitive processing are a causal mechanism in the development and maintenance of anxiety. These theories propose that individuals with anxiety are more likely to cognitively process novel stimuli in their environment as threatening. Creswell and colleagues proposed a theoretical model that highlighted the role of these cognitive biases as a mechanism in the intergenerational transmission of anxiety (Creswell et al., in Hadwin, Field (eds) Information processing biases and anxiety: a developmental perspective, Wiley, pp 279–295, 2010). This model postulated significant associations between (1) parents’ and children’s threat-related cognitive biases (2) parents’ threat-related cognitive biases in their own and their child’s environment, (3) parents’ threat-related cognitive biases and parenting behaviors that convey anxiety risk to the offspring (e.g., modeling of fear, and verbal threat information transmission), and (4) parenting behaviors and child threat-related biases. This theoretical review collated the recent empirical work testing these four core hypotheses of the model. Building on the reviewed empirical work, an updated conceptual model focusing on threat-related attention and interpretation is proposed. This updated model incorporates the links between cognition and anxiety in parents and children and addresses the potential bidirectional nature of parent–child influences.
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Affiliation(s)
- Evin Aktar
- Department of Psychology, Clinical Psychology Unit, Leiden, The Netherlands. .,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.
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Kennedy E, Niedzwiedz CL. The association of anxiety and stress-related disorders with C-reactive protein (CRP) within UK Biobank. Brain Behav Immun Health 2022; 19:100410. [PMID: 35028602 PMCID: PMC8741412 DOI: 10.1016/j.bbih.2021.100410] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/18/2021] [Indexed: 11/29/2022] Open
Abstract
Anxiety and stress-related disorders are both common and disabling psychiatric conditions. There are a number of hypotheses suggesting the underlying pathophysiology of these disorders, however, the exact mechanism is unknown. Inflammation has previously been linked with depression and has more recently been suggested as a possible link to anxiety aetiology. The objectives of this study are to assess the relationship between different anxiety/stress-related disorders and inflammation (measured by C-reactive protein) using the UK Biobank, and also determine whether any relationship between anxiety/stress disorders and inflammation is explained by depressive symptoms and other social and health-related factors. We utilised the UK Biobank for the sample of this study. Our sample included 353,136 participants of which 12,759 (3.61%) had a history of an anxiety (phobic, obsessive-compulsive, or other anxiety disorder including generalised anxiety and panic disorders) or stress-related disorder (including acute stress reaction, post-traumatic stress disorder and adjustment disorders). Four logistic regression models were calculated in which we tested the association between anxiety/stress disorders and C-reactive protein (CRP) >3 mg/L, adjusting for covariates (including age, sex, ethnicity, education level, socioeconomic deprivation, depressive symptoms, body mass index (BMI) and multimorbidity). An association was observed between other anxiety disorders (including panic and generalised anxiety disorders) and CRP (OR: 1.164 [95% CI: 1.096–1.236]). This was attenuated in models after the addition of BMI, multimorbidity and depressive symptoms. Stress/adjustment disorders followed a similar pattern of results (OR: 1.107 [95% CI: 1.040, 1.178]), with the association attenuated with the addition of BMI and multimorbidity). Phobic anxiety disorders (OR: 1.059 [95% CI: 0.896, 1.251]) and obsessive-compulsive disorders (OR: 1.299 [95% CI: 0.973, 1.733]) both showed no statistically significant results in any of the models. Our results support the hypothesis that some anxiety and stress-related disorders may be associated with high levels of inflammatory markers, as measured by CRP. Further studies are required to untangle the potential causal relationships involved. We explored the association of anxiety and stress-related disorders with C-reactive protein (CRP) using UK Biobank. Several disorders (e.g. generalised anxiety, panic and stress/adjustment) were associated with higher levels of CRP. Associations were attenuated with adjustment for health-related factors, such as multimorbidity and depressive symptoms.
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Abstract
The purpose of the current article is to explore familial factors that influence the development of social anxiety disorder (SAD) in children and adolescents, including parenting, sibling relationships, and family environment. A multitude of interrelated genetic and familial factors have been found to cause and maintain SAD in children and adolescents. There are many challenges in diagnosing and treating the disorder. Knowledge and awareness of familial factors provide insight on targeted treatments that prevent or ameliorate SAD. [Journal of Psychosocial Nursing and Mental Health Services, 59(7), 23-34.].
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Naimi E, Babuei A, Moslemirad M, Rezaei K, Eilami O. The Effect of Spirituality Intervention on the Anxiety Parents of Hospitalized Newborns in a Neonatal Department. JOURNAL OF RELIGION AND HEALTH 2021; 60:354-361. [PMID: 30715661 DOI: 10.1007/s10943-018-00753-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Admission leads to many problems in the family, one of the most important of which is Stress parents. Therefore, specify The Effect of Religious Intervention on the Anxiety parents of hospitalized newborns in a neonatal department. The study was a semi-experimental study with experimental and control groups and before and after the intervention, Anxiety and care pressure questionnaires were given to parents. The religion intervention in the 8 Session parents of hospitalized newborns in a neonatal. Data were analyzed by SPSS16 and descriptive and analytical tests. The study indicated that religion has an effective role in enhancing and bettering stress of parents. Thus, it is suggested that a cleric be present in the section for religious intervention. Moreover, it is suggested that religious interventions should be done by nurses as a group of people with a close relationship with the patients and their parents.
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Affiliation(s)
- Ebrahim Naimi
- Department of Public Health, Faulty of Health, Yasuj University of Medical Science, Yasuj, Iran
| | - Amin Babuei
- Deputy of Development of Managment, Yasuj University of Medical Science, Yasuj, Iran
| | | | - Karim Rezaei
- Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Owrang Eilami
- School of Medicine Social, Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
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16
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de Kluiver H, Milaneschi Y, Jansen R, van Sprang ED, Giltay EJ, Hartman CA, Penninx BWJH. Associations between depressive symptom profiles and immunometabolic characteristics in individuals with depression and their siblings. World J Biol Psychiatry 2021; 22:128-138. [PMID: 32425087 DOI: 10.1080/15622975.2020.1761562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The present study examined associations between immunometabolic characteristics (IMCs) and depressive symptom profiles (DSPs) in probands with lifetime diagnoses of depression and/or anxiety disorders and their siblings. METHODS Data were from the Netherlands Study of Depression and Anxiety, comprising 256 probands with lifetime diagnoses of depression and/or anxiety and their 380 siblings. Measured IMCs included blood pressure, waist circumference, and levels of glucose, triglycerides, HDL cholesterol, CRP, TNF-α and IL-6. DSPs included mood, cognitive, somatic and atypical-like profiles. We cross-sectionally examined whether DSPs were associated with IMCs within probands and within siblings, and whether DSPs were associated with IMCs between probands and siblings. RESULTS Within probands and within siblings, higher BMI and waist circumference were associated with higher somatic and atypical-like profiles. Other IMCs (IL-6, glucose and HDL cholesterol) were significantly related to DSPs either within probands or within siblings. DSPs and IMCs were not associated between probands and siblings. CONCLUSIONS The results suggest that there is a familial component for each trait, but no common familial factors for the association between DSPs and IMCs. Alternative mechanisms, such as direct causal effects or non-shared environmental risk factors, may better fit these results.
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Affiliation(s)
- Hilde de Kluiver
- Department of Psychiatry, Amsterdam UMC, Department of Amsterdam Public Health research institute and Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam UMC, Department of Amsterdam Public Health research institute and Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Rick Jansen
- Department of Psychiatry, Amsterdam UMC, Department of Amsterdam Public Health research institute and Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eleonore D van Sprang
- Department of Psychiatry, Amsterdam UMC, Department of Amsterdam Public Health research institute and Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Catharina A Hartman
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Department of Amsterdam Public Health research institute and Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Psychosocial and biological risk factors of anxiety disorders in adolescents: a TRAILS report. Eur Child Adolesc Psychiatry 2021; 30:1969-1982. [PMID: 33113027 PMCID: PMC8563629 DOI: 10.1007/s00787-020-01669-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 10/19/2020] [Indexed: 01/04/2023]
Abstract
Anxiety disorders are a common problem in adolescent mental health. Previous studies have investigated only a limited number of risk factors for the development of anxiety disorders concurrently. By investigating multiple factors simultaneously, a more complete understanding of the etiology of anxiety disorders can be reached. Therefore, we assessed preadolescent socio-demographic, familial, psychosocial, and biological factors and their association with the onset of anxiety disorders in adolescence. This study was conducted among 1584 Dutch participants of the TRacking Adolescents' Individual Lives Survey (TRAILS). Potential risk factors were assessed at baseline (age 10-12), and included socio-demographic (sex, socioeconomic status), familial (parental anxiety and depression), psychosocial (childhood adversity, temperament), and biological (body mass index, heart rate, blood pressure, cortisol) variables. Anxiety disorders were assessed at about age 19 years through the Composite International Diagnostic Interview (CIDI). Univariate and multivariate logistic regression analyses were performed with onset of anxiety disorder as a dependent variable and the above-mentioned putative risk factors as predictors. Of the total sample, 25.7% had a lifetime diagnosis of anxiety disorder at age 19 years. Anxiety disorders were twice as prevalent in girls as in boys. Multivariate logistic regression analysis showed that being female (OR = 2.38, p < .01), parental depression and anxiety (OR = 1.34, p = .04), temperamental frustration (OR = 1.31, p = .02) and low effortful control (OR = 0.76, p = .01) independently predicted anxiety disorders. We found no associations between biological factors and anxiety disorder. After exclusion of adolescents with an onset of anxiety disorder before age 12 years, being female was the only significant predictor of anxiety disorder. Being female was the strongest predictor for the onset of anxiety disorder. Psychological and parental psychopathology factors increased the risk of diagnosis of anxiety, but to a lesser extent. Biological factors (heart rate, blood pressure, cortisol, and BMI), at least as measured in the present study, are unlikely to be useful tools for anxiety prevention and intervention strategies.
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Adolph D, Margraf J, Schneider S. Your Fear is My Fear: The Relationship Between Parental and Offspring Anxieties. Child Psychiatry Hum Dev 2021; 52:772-781. [PMID: 32948972 PMCID: PMC8405516 DOI: 10.1007/s10578-020-01060-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/12/2020] [Indexed: 11/26/2022]
Abstract
Contrary to the well-documented link between parental and offspring clinical anxiety, little is known about the relationship between parental everyday-life anxieties (e.g., concerning family, finances, health) and offspring anxieties. To close this gap, we assessed the frequency of parental symptoms of DSM-IV anxiety disorders and everyday-life anxieties, as well as the frequency of offspring anxiety symptoms in a representative sample by self-report. Parents reported that 48.4% of the children were free of specific symptoms of DSM-IV anxiety disorders within the last 12 months, 39.2% showed low symptom load (1-3 symptoms) and 12.4% were moderately or severely strained (4-10 symptoms). Replicating previous studies, parental DSM-IV symptoms increased offspring risk for the same symptoms. In addition, parental everyday-life anxieties showed a positive relationship with offspring symptom severity. Demographic variables (female sex, low socioeconomic status and younger age) and parental anxiety markers explained 18% of variance in offspring symptom severity. The data are discussed in light of current models of familial transmission.
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Affiliation(s)
- Dirk Adolph
- Mental Health Research and Treatment Center, Ruhr-University Bochum, Massenbergstrasse 9-13, 44847, Bochum, Germany.
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Ruhr-University Bochum, Massenbergstrasse 9-13, 44847, Bochum, Germany
| | - Silvia Schneider
- Mental Health Research and Treatment Center, Ruhr-University Bochum, Massenbergstrasse 9-13, 44847, Bochum, Germany
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The association between prenatal maternal anxiety disorders and postpartum perceived and observed mother-infant relationship quality. J Anxiety Disord 2019; 68:102148. [PMID: 31604204 DOI: 10.1016/j.janxdis.2019.102148] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 07/29/2019] [Accepted: 09/18/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Prenatal maternal anxiety disorders have been associated with adverse outcomes in offspring including emotional, behavioral and cognitive problems. There is limited understanding of the mechanisms underpinning these associations, although one possible candidate is an impaired mother-infant relationship. The authors investigated whether prenatal anxiety disorders were associated with poorer postpartum mother-infant relationship quality, measured by maternal self-reported bonding and observed mother-infant interactions. METHODS A cohort of 454 pregnant women recruited from an inner-city maternity service in London (UK) were assessed for mental disorders using the Structured Clinical Interview for DSM-IV and followed up at mid-pregnancy and 3-months postpartum. Depressive symptoms were assessed at baseline and mid-pregnancy (using the Edinburgh Postnatal Depression Scale). At three months postpartum, women were assessed for self-reported bonding difficulties (using the Postpartum Bonding Questionnaire) and a subsample (n = 204) participated in video-recorded mother-infant interaction, coded using the Child-Adult Relationship Experimental Index by an independent rater. RESULTS Prenatal anxiety disorders were associated with higher perceived bonding impairment, but not associated with observed poor mother-infant interaction quality. Higher levels of depressive symptoms were associated with lower maternal sensitivity. CONCLUSIONS Interventions for anxiety disorders in the perinatal period could be tailored to address anxieties about mother-infant relationship and co-morbid depressive symptoms.
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