The Parent Sensitivity to Child Anxiety Index

Ethical concerns relating to genetic risk scores for suicide

Genome-wide association studies (GWAS) provide valuable information in research contexts regarding genomic changes that contribute to risks for complex psychiatric conditions like major depressive disorder. GWAS results can be used to calculate polygenic risk scores (PRS) for psychiatric conditions, such as bipolar disorder or schizophrenia, as well as for other traits, such as obesity or hypertension. Private companies that provide direct-to-consumer (DTC) genetic testing sometimes report PRS for a variety of traits. Recently, the first well-powered GWAS study for suicide death was published. PRS reports that claim to assess suicide risk are therefore likely to appear soon in the DTC setting. We describe ethical concerns regarding the commercial use of GWAS results related to suicide. We identify several issues that must be addressed before PRS for suicide risk is made available to the public through DTC: (a) the potential for misinterpretation of results, (b) consumers' perceptions about determinism and behavior change, (c) potential contributions to stigma, discrimination, and health disparities; and (d) ethical problems regarding the testing of children and vulnerable adults. Tests for genetic prediction of suicidality may eventually have clinical significance, but until then, the potential for individual and public harm significantly outweighs any potential benefit. Even if genetic prediction of suicidality improves significantly, information about genetic risk scores must be distributed cautiously, with genetic counseling, and with adequate safeguards.

Assessing parental cognitions about child anxiety: Are parents' thoughts about child anxiety associated with child anxiety and anxiety sensitivity?

Anxiety sensitivity (AS) or the fear of anxious symptomatology, has garnered support in both adult and child samples for its predictive validity of anxiety disorders. Recent efforts to identify familial factors that predict anxiety amongst youth have identified a construct similar to AS amongst parents, but instead focused on the child rather than on the self. The overarching goal of the present study was to examine the extent to which two measures of this construct [the Parent Sensitivity to Child Anxiety Index (PSCAI) and the Parental Beliefs about Anxiety Questionnaire (PBA-Q)] correlated with child and parent AS and anxiety and how these measures explained the relationships between parent- and child-reported AS and anxiety. A secondary aim of the present study was to psychometrically compare the PSCAI and the PBA-Q with respect to not only their convergence with parent and child AS and anxiety, but also the extent to which each mediated the parent-child relationships between these variables. The PSCAI and PBA-Q significantly mediated the relationship between parent and child AS, each yielding small significant indirect effects. Support was also observed for a double mediation model in which parental anxiety predicted parental AS, which predicted parental beliefs about and parental sensitivity to child anxiety, which in turn predicted child anxiety. Findings suggest that both parental beliefs about and sensitivity to child anxiety are both correlated with and partially explain the relationship between parent and child AS and anxiety, providing potential points of intervention in treatment and prevention efforts for child anxiety.

Parental Presence Impacts a Neural Correlate of Anxiety (the Late Positive Potential) in 5-7 Year Old Children: Interactions with Parental Sensitivity to Child Anxiety

Anxiety disorders tend to onset early in development and often result in chronic impairment across the lifespan. Thus, there is substantial interest in identifying early neural markers of anxiety and leveraging these markers to better understand processes leading to anxiety. The late positive potential (i.e., LPP) indexes sustained attention to motivationally relevant stimuli; and the LPP to negative images is increased in individuals with anxiety. In the current study, we examined how parental presence impacts the LPP to threatening images in children (52.6% male) between 5 and 7 years-old (N = 78). Moreover, we explored interactions with parental sensitivity to child anxiety symptoms. Results suggest that when children are in the presence of their parent (compared to the presence of an experimenter), they displayed a larger LPP to threatening images. LPP activity was modulated by parental response to their child's anxiety symptoms, such that children with parents who were overly reactive to their children's anxiety symptoms had the greatest LPP response when viewing threatening stimuli in their parent's presence. Additionally, exploratory analyses indicated that children with clinical and subclinical anxiety were characterized by an increased LPP to negative images, but only when the LPP was measured with parents in the room. Findings are novel and extend previous work by suggesting that parents who react strongly when observing their children's anxiety symptoms in turn increase their child's engagement with threatening stimuli, thereby placing them at greater risk for anxiety.