Relations of Anxiety Sensitivity, Control Beliefs, and Maternal Over-Control to Fears in Clinic-Referred Children with Specific Phobia

Parent- and Child-Factors in Specific Phobias: The Interplay of Overprotection and Negative Affectivity

Specific phobias are among the most prevalent anxiety disorders in children and adolescents. Although brief and intensive treatments are evidence-based interventions (Davis III et al. Annual Review of Clinical Psychology, 15, 233-256, 2019), up to one-third of youth do not show significant change in their symptoms following these interventions. Hence, consideration of additional factors influencing treatment response is necessary. Child-factors such as temperament and parent-factors such as parenting behaviors both contribute to the development of specific phobias and their maintenance over time. Specifically, we addressed child temperament (negative affectivity) and parenting behaviors (overprotection) that could uniquely predict clinical outcomes for specific phobias and that might interact to inform goodness-of-fit in the context of these interventions. We also considered whether child- and/or parent-gender shaped the effects of temperament or parenting on clinical outcomes. Participants were 125 treatment-seeking youth (M age = 8.80 years; age range = 6-15 years; 51.5% girls) who met criteria for specific phobia and their mothers and fathers. Mothers' reports of children's negative affectivity uniquely predicted poorer specific phobia symptom severity and global clinical adjustment at post-treatment. Interaction effects were supported between parental overprotection and child negative affectivity for post-treatment fearfulness. The direction of these effects differed between fathers and mothers, suggesting that goodness-of-fit is important to consider, and that parent gender may provide additional nuance to considerations of parent-child fit indices.

Cognitive-Affective Pathways to Child Depressive and Anxious Symptoms: Role of Children's Discipline Attributions

Children's maladaptive cognitive attributions may elicit affective reactions that contribute to depressive and anxious symptoms. This study investigated cognitive-affective pathways in depressive and anxious symptoms in a sample of 110 prepubertal children, evaluating children's specific appraisals of experiences of parental discipline as well as general attributional style, along with their hopelessness, self-esteem, and shame. Pathways toward depressive and anxious symptoms were tested simultaneously to identify potential unique etiological mechanisms. Results suggested that lower self-esteem strongly contributed to depressive and anxious symptoms, whereas shame related to depression only and hopelessness related to depression only marginally. Additionally, general negative attributional style and low sense of control over discipline related to all three affective elements. Lastly, low sense of discipline control directly predicted depressive symptoms, whereas beliefs that discipline was undeserved directly predicted anxious symptoms. Future work should continue to examine the role of children's discipline-specific attributions, which appear important in internalizing symptoms.

The Parent Sensitivity to Child Anxiety Index

Anxiety sensitivity (AS) is the perception that anxiety symptoms and experiences have negative consequences, and has been identified as a risk factor for the development of anxiety disorders. AS has been measured in adults and in children, but to date, the construct of parent's sensitivity to their children's anxiety symptoms has not been identified, measured, or evaluated. The current study presents a novel measure of this construct, the Parent Sensitivity to Child Anxiety Index (PSCAI), and an initial evaluation of its psychometric properties. Factor analysis revealed a three-factor structure consisting of parents' concern for physical symptoms, concern of social evaluation, and fear of anxiety symptoms. The PSCAI demonstrated good internal consistency, and was positively correlated with relevant parental constructs such as parental accommodation, anxiety sensitivity, and trait anxiety. This new measurement system opens new avenues for researching the early development of anxiety disorders and the possibility for novel targeted interventions.

Social anxiety and parental overprotection in young adults with and without intellectual disabilities

OBJECTIVES

Developmental literature highlights peer relationships and parental overprotection as factors implicated in the development of social anxiety. These factors are highly prevalent in the lives of people with intellectual disabilities; however research has not examined whether these factors are associated with social anxiety for this population.

METHODS

Twenty-one individuals without intellectual disabilities and 21 individuals with intellectual disabilities (aged 16-24 years) completed the Social Anxiety Scale for Adolescents with follow-up questions, the Glasgow Anxiety Scale-Intellectual disabilities and the parental overprotection subscale of the Parental Bonding Instrument with follow-up questions.

RESULTS

Aspects of general and social anxiety were significantly greater in the intellectual disabilities group. There were no significant differences in parental overprotection between groups, however, qualitative analyses revealed differences in experiences of social anxiety and parental overprotection.

CONCLUSIONS

Further research into factors associated with social anxiety in people with intellectual disabilities may inform adaptations to therapies and early intervention.

One Session Treatment for Specific Phobias: An Adaptation for Paediatric Blood-Injection-Injury Phobia in Youth

Blood-injection-injury (BII) phobia is a chronic and debilitating disorder, which has largely been neglected in the child literature. The present paper briefly reviews the aetiology of specific phobias with particular attention to BII and provides an integrated developmental model of this disorder in youth. Evidence-based treatments for child-specific phobias are discussed, and the development of a modified one session treatment (OST) approach to enhance treatment outcomes for BII phobia in children and adolescents is described. This approach is illustrated in two children with a primary diagnosis of BII phobia. The cases illustrate the unique challenges associated with treating BII in youth and the need for a modified intervention. Modifications included addressing the role of pain (e.g., psychoeducation, more graduated exposure steps) and disgust (e.g., disgust eliciting exposure tasks) in the expression of the phobia and fainting in the maintenance of this phobia. Moreover, it is recommended that parents be more actively involved throughout treatment (e.g., education session prior to OST, contingency management training, guidance regarding planning exposure tasks following treatment) and for families to participate in a structured e-therapy maintenance programme post-treatment.

Perceived Control, Family Environment, and the Etiology of Child Anxiety-Revisited

In 1998, Chorpita, Brown, and Barlow published a now seminal study in Behavior Therapy examining the development of anxiety in children and adolescents using Barlow's 1988 model of the development of anxiety in adults. Mindful of developmental considerations, parental control and children's perceptions of control were considered key factors in this revised model. Since that study, mixed support has accumulated for the role of control, both parental control and children's perceptions of that control, in the development of childhood anxiety. As a result, the measurement of these constructs has been critically examined and refined in recent years and encouraging findings have been obtained. Unfortunately, however, the Chorpita and colleagues study as well as the studies that have followed have used cross-sectional designs and the directionality of effects has not been clearly established. Longitudinal studies are required. Here, we present a qualitative review of these developments and provide directions for future research.