The effect of parental modeling of anxious behaviors and cognitions in school-aged children: an experimental pilot study

Longitudinal interactions between maternal depression symptoms and familial stressful life events on child anxiety symptoms at 5 years of age

In the current study we identified salient parental factors for child anxiety symptoms by considering the role of stressful life events, maternal anxiety symptoms, maternal depressive symptoms, and maternal neuroticism. Families (N = 399) in an urban area in the United States were participants in a longitudinal study beginning in infancy. Mothers completed measures of stressful life events (Revised Life Events Questionnaire at all visits), maternal anxiety and depressive symptoms (State-Trait Anxiety Inventory and Beck Depression Inventory, respectively, at infancy between 5 and 12 months, at 2 years, and at 3 years), maternal neuroticism (NEO Five-Factor Inventory at infancy), and child anxiety symptoms (Child Behavior Checklist 1.5-5 at 5 years). Linear mixed models (LMMs) were used in analyses. Maternal depressive symptoms from infancy through 3 years were associated with child anxiety symptoms; other main effects modeled (stressful life events, maternal anxiety symptoms, maternal neuroticism) were not associated with child anxiety symptoms. There was a significant interaction effect between stressful life events and maternal depression. Stressful events from infancy through 5 years of age increased risk for child anxiety symptoms at 5 years if the child's mother had a mild mood disturbance or depression, but not for children with non-depressed mothers.

The Role of Parental Verbal Threat Information in Children's Fear Acquisition: A Systematic Review and Meta-analysis

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.

Preschoolers and anxiety: The effect of parental characteristics

PROBLEM

Anxiety is a common phenomenon among children that can lead to adverse developmental outcomes. A challenging parent-child relationship and its characteristics may negatively impact the development of a child's internalizing problems. However, theoretical models on children's anxiety have not fully emphasized the contribution of parenting and environmental factors. Therefore, the aim of this study is to explore the possible correlations between parenting styles and other parental characteristics with children's anxiety.

METHODS

The sample consisted of 443 parents of preschool children who completed the Parenting Styles and Dimension Questionnaire and the Child Behavior Checklist 1.5-5. The univariate analysis included differences between demographic groups, assessed with independent sample t-tests. Associations between demographic evidence and child anxiety were estimated using χ2 tests. Binomial logistic regression analysis assessed the most important parenting characteristics contributing to a child's anxiety.

FINDINGS

A total of 24.6% of the children had borderline or clinical symptoms of anxiety. Parents whose children were anxious were more permissive than parents of nonanxious children (p < 0.001). Mothers were more authoritative compared to fathers. In addition, permissive parenting style increased the probability of a child's anxiety and maternal permissive style emerged as a significant predictor of anxiety in preschoolers (p < 0.003).

CONCLUSIONS

This study revealed that the permissive parenting style is associated with anxiety in preschool children. Furthermore, the maternal permissive style was identified as a predictor of anxiety. Future research may address its causal effect on anxiety and other behavioral problems, focusing on multiple perspective relationships and cultural dimensions.

Perinatal Factors and Emotional, Cognitive, and Behavioral Dysregulation in Childhood and Adolescence

OBJECTIVE

This cohort study assessed perinatal factors known to be related to maternal and neonatal inflammation and hypothesized that several would be associated with emotional, cognitive, and behavioral dysregulation in youth.

METHOD

The Environmental influences on Child Health Outcomes (ECHO) is a research consortium of 69 pediatric longitudinal cohorts. A subset of 18 cohorts that had both Child Behavior Checklist (CBCL) data on children (6-18 years) and information on perinatal exposures including maternal prenatal infections was used. Children were classified as having the CBCL-Dysregulation Profile (CBCL-DP) if the sum of their T scores for 3 CBCL subscales (attention, anxious/depressed, and aggression) was ≥180. Primary exposures were perinatal factors associated with maternal and/or neonatal inflammation, and associations between these and outcome were assessed.

RESULTS

Approximately 13.4% of 4,595 youth met criteria for CBCL-DP. Boys were affected more than girls (15.1% vs 11.5%). More youth with CBCL-DP (35%) were born to mothers with prenatal infections compared with 28% of youth without CBCL-DP. Adjusted odds ratios indicated the following were significantly associated with dysregulation: having a first-degree relative with a psychiatric disorder; being born to a mother with lower educational attainment, who was obese, had any prenatal infection, and/or who smoked tobacco during pregnancy.

CONCLUSION

In this large study, a few modifiable maternal risk factors with established roles in inflammation (maternal lower education, obesity, prenatal infections, and smoking) were strongly associated with CBCL-DP and could be targets for interventions to improve behavioral outcomes of offspring.

DIVERSITY & INCLUSION STATEMENT

We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.

Saudi Arabian Perceptions of Childhood Anxiety, Parental Communication, and Parenting Style

Parenting communication and parenting style, including expressions of fear, worry, and threat, may contribute to children's anxiety and apprehension. This study examined the degree to which perceptions of parental communication (both verbal and nonverbal) and parenting style are linked with childhood anxiety. This is among the first studies to investigate these relationships in a Saudi Arabian context. We employed a sample of 121 Saudi adults who completed questionnaires measuring perceptions of 2 parenting styles (authoritative and authoritarian), parental anxiety, and childhood anxiety. Parental communication elements such as shouting, criticism, facial expression, and body expressions were included among assessments of perceived parental anxiety, authoritative style, and authoritarian style. The results indicated that perceptions of childhood anxiety were positively associated with parental anxiety but not consistently associated with other assessed variables. This research addressed perceptions of parental communication and parenting style in the development of childhood anxiety, extending upon previous research on Western samples to a Middle Eastern sample residing in Saudi Arabia.

Annual Research Review: Developmental pathways linking early behavioral inhibition to later anxiety

Behavioral Inhibition is a temperament identified in the first years of life that enhances the risk for development of anxiety during late childhood and adolescence. Amongst children characterized with this temperament, only around 40 percent go on to develop anxiety disorders, meaning that more than half of these children do not. Over the past 20 years, research has documented within-child and socio-contextual factors that support differing developmental pathways. This review provides a historical perspective on the research documenting the origins of this temperament, its biological correlates, and the factors that enhance or mitigate risk for development of anxiety. We review as well, research findings from two longitudinal cohorts that have identified moderators of behavioral inhibition in understanding pathways to anxiety. Research on these moderators has led us to develop the Detection and Dual Control (DDC) framework to understand differing developmental trajectories among behaviorally inhibited children. In this review, we use this framework to explain why and how specific cognitive and socio-contextual factors influence differential pathways to anxiety versus resilience.

Do parents have exam anxiety, too? The predictive role of irrational beliefs and perfectionism with parental exam anxiety in explaining students’ exam anxiety

Objectives: Exam Anxiety is a condition influenced by both personal and environmental factors as well as cultural, family, and family-related systems. Accordingly, the current study aims at determining the predictive role of parental exam anxiety with irrational beliefs and perfectionism in explaining students’ exam anxiety. Methods: The study included a total of 1006 participants, students (N = 503 (58%) female and (42%) male) and parents (N = 503 (65%) female and (35%) male) of these students. The Test Anxiety Inventory, Exam Anxiety Scale for Parents, The Irrational Beliefs Scale for Adolescence, and Frost Multidimensional Perfectionism Scale were used as data collection instruments for this study. Results: The regression analyses indicated that exam anxiety in students was significantly predicted by the worry sub-dimension of parental exam anxiety, irrational beliefs as well as concern over mistakes, parental criticism, and doubting of actions sub-dimension of perfectionism. Conclusion: The findings are discussed and explained based on the relevant literature.

Displays of negative facial affect during parent-adolescent conflict and the bidirectional transmission of social anxiety

BACKGROUND

Symptoms of social anxiety rise rapidly during adolescence, particularly for girls. Pervasive displays of parental negative affect may increase adolescents' fear of negative evaluation (FNE), thereby increasing risk for social anxiety symptoms. Adolescent displays of negative affect may also exacerbate parents' social anxiety symptoms (via FNE of their child or their parenting skills), yet little research has tested transactional pathways of transmission in families. By early adolescence, rates of parent-child conflict rise, and offspring become increasingly independent in their own displays of negative affect, increasing opportunities for hypothesized transactional pathways between parent-adolescent displays of negative affect and social anxiety symptoms.

METHODS

This study included 129 parents and daughters (11-13; no baseline social anxiety disorder), two-thirds of whom were at high risk for social anxiety due to a shy/fearful temperament. We used actor-partner interdependence models (APIM) to test whether displays of negative facial affect, assessed individually for each parent and daughter during a conflict discussion, would predict their partner's social anxiety symptoms two years later. Automated facial affect coding assessed the frequency of negative affect during the discussion. Clinician ratings of social anxiety symptoms were completed at baseline and two-year follow-up.

RESULTS

Both parents and daughters who displayed more frequent negative facial affect at baseline had partners with higher follow-up social anxiety symptoms, an effect that was maintained after accounting for actors' and partners' baseline symptoms.

CONCLUSIONS

Findings are consistent with intergenerational models positing that parental negative affective behaviors increase risk for adolescent social anxiety symptoms but also suggest that adolescent negative facial affect may exacerbate parental social anxiety symptoms. These bidirectional effects improve understanding of how social anxiety is maintained within a transactional family structure and highlight that displays of negative affect during parent-adolescent interaction may warrant future examination as a potential treatment target for adolescent social anxiety.

Sex-Specific Transmission of Anxiety Disorders From Parents to Offspring

IMPORTANCE

Although anxiety disorders are known to run in families, the relative contribution of genes and environment is unclear. Patterns of sex-specific transmission of anxiety may point to different pathways in how parents pass anxiety disorders down to their children; however, the association of parent and offspring sex with the transmission of anxiety disorders has not been previously studied.

OBJECTIVE

To examine whether the transmission of anxiety from parents to children is sex specific.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional family study recruited participants from the general population (enriched for familial risk of mood disorders) in Nova Scotia, Canada, from February 1, 2013, to January 31, 2020.

EXPOSURES

Anxiety disorder in the same-sex or opposite-sex parent.

MAIN OUTCOMES AND MEASURES

Semistructured interviews were used to establish lifetime diagnoses of anxiety disorder in parents and offspring. The association between anxiety disorder in the same-sex or opposite-sex parent and anxiety disorders in the offspring was tested with logistic regression.

RESULTS

A total of 398 offspring (203 female offspring with a mean [SD] age of 11.1 [3.7] years and 195 male offspring with a mean [SD] age of 10.6 [3.1] years) of 221 mothers and 237 fathers participated in the study. Anxiety disorders in the same-sex parent (odds ratio [OR], 2.85; 95% CI, 1.52-5.34; P = .001) were associated with increased rates of anxiety disorders in the offspring, whereas anxiety disorders in the opposite-sex parent (OR, 1.51; 95% CI, 0.81-2.81; P = .20) were not. Sharing a household with a same-sex parent without anxiety was associated with lower rates of offspring anxiety (OR, 0.38; 95% CI, 0.22-0.67; P = .001), but the presence of an opposite-sex parent without anxiety was not (OR, 0.96; 95% CI, 0.56-1.63; P = .88).

CONCLUSIONS AND RELEVANCE

In this cross-sectional study of families, an association between the same-sex parent's anxiety disorder and anxiety disorders in offspring suggests an environmental mechanism, such as modeling. Future studies should establish whether treating parents' anxiety may protect their children from developing an anxiety disorder.

A Preliminary Examination of the Interaction between Maternal Generalized Anxiety Disorder and Offspring Negative Affect in Relation to Maternal Worry about Offspring and Perceptions of Psychological Control

Both maternal symptoms and adolescent offspring characteristics are associated with maladaptive parenting among families at risk for anxiety. One disorder that may be particularly associated with maladaptive parenting behaviors is generalized anxiety disorder (GAD). Previous work suggests that offspring negative affect (NA) is associated with different levels of maladaptive parenting behaviors among mothers with GAD. No work to date, however, has examined the association between offspring reported NA, maternal GAD, and maternal worry about offspring or maternal perceptions of psychological control (PC) among mothers of adolescents. Sixty-five mothers who were elevated in anxious arousal and their adolescent offspring between the ages of 12 and 16 years old (n = 65, 55% male, M_age = 13.89) reported on parenting (mother report), NA (offspring report), and GAD symptoms (assessed via structured clinical interview), and maternal anxiety sensitivity (AS) symptoms. Study results indicated that maternal GAD status interacted with offspring NA in relation to maternal reported use of PC and worry about offspring. Specifically, offspring NA was positively related to PC for mothers without GAD, but not for mothers with GAD. Further, for mothers with GAD, offspring NA was negatively related to worry about offspring, but this relation did not persist for mothers without GAD. Maternal AS was related to overall higher levels of worry about offspring and PC. Mothers with GAD report using higher levels of maladaptive parenting when offspring report lower levels of NA, and lower levels when offspring report high NA. This pattern was specific to maternal GAD (c.f. anxiety sensitivity).

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.

Intergenerational Transmission of Anxious Information Processing Biases: An Updated Conceptual Model

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.

Development and validation of the Modeling of Parental Anxiety Questionnaire

Parental anxious modeling is assumed to be a risk factor for child anxiety. Until now there has been no self-assessment scale available that measures parental modeling of anxiety in a comprehensive way. Our aim with this study was to bridge this gap by developing the Modeling of Parental Anxiety Questionnaire (MPAQ). To do this, we generated an item pool containing 51 statements covering different aspects of parental modeling of anxious and non-anxious behaviors. A sample of Swedish parents (N = 1092) of children aged 4-12, answered an online survey comprising the generated item pool, the Parental Overprotection Scale (OP) and the PROMIS Anxiety short forms (the adult version and the parent proxy report scale). A factor analysis of the items of parental modeling indicated a structure with four separate factors. These factors formed the final four subscales of MPAQ; (1) being curios and content, (2) being on guard, (3) displaying anxiety and avoidance, and (4) displaying stress. The Cronbach's alpha coefficients of the subscale scores ranged from moderate to good. Linear regression analysis showed that the displaying anxiety and avoidance-subscale had the strongest association with child anxiety symptoms. These findings show that MPAQ demonstrates adequate psychometric properties and has potential for being used in research and clinical settings, for example to identify potential targets for parenting interventions and to measure mediation effects.

Family based treatment of anxiety disorders: A review of the literature (2010-2019)

Anxiety disorders are the most common and impairing mental health problems across the lifespan. Familial factors are strongly implicated in the onset and maintenance of anxiety, but available evidence-based treatments are usually individual-focused. The aim of this review was to evaluate the current evidence base (2010-2019) of family based interventions addressing youth and adult anxiety and highlight findings comparing family based and individual-focused treatments. A systematic literature search was conducted. Articles were considered if they targeted primarily anxiety-related issues and utilized a randomized controlled trial design, resulting in 22 included youth studies. No adult studies met criteria for inclusion. Overall, family based treatments performed better than no-treatment controls and as well as individual-based interventions, with some evidence that family based interventions might outperform individual-based ones in certain populations (i.e., autism). Family based interventions may represent a good alternative for anxiety treatment in youth. Additional research on family based treatment for anxiety is adults is needed.

Overcoming barriers in cognitive-behavioral therapy for youth anxiety and obsessive-compulsive disorder: Addressing parent behaviors

Exposure-based cognitive-behavioral therapy (CBT) is a well-established treatment for anxiety disorders and obsessive-compulsive disorder (OCD) in youth. Although a majority of youth respond to CBT, a substantial portion remain symptomatic and/or experience a return of symptoms after completing a course of treatment. This highlights the need for further improvements to this evidence-based treatment. Given that parent behaviors can negatively influence treatment, addressing parental behaviors in CBT serves as a novel and promising treatment target to improve youth's therapeutic outcomes. The authors review three common parent behaviors that influence anxiety and treatment outcomes: family accommodation, parent anxious behaviors, and management of disruptive behaviors. The authors then discuss each behavior, its effect on anxiety/OCD and treatment, and how to address the behavior within the context of CBT. In doing so, therapeutic learning can be optimized to improve CBT outcomes for youth with anxiety disorders and/or OCD.

The Impact of Treatment Expectations on Exposure Process and Treatment Outcome in Childhood Anxiety Disorders

This study examined the relationship between caregivers' and youths' treatment expectations and characteristics of exposure tasks (quantity, mastery, compliance) in cognitive-behavioral therapy (CBT) for childhood anxiety. Additionally, compliance with exposure tasks was tested as a mediator of the relationship between treatment expectations and symptom improvement. Data were from youth (N = 279; 7-17 years old) enrolled in the Child/Adolescent Anxiety Multimodal Study (CAMS) and randomized to cognitive-behavioral therapy (CBT) or the combination of CBT and sertraline for the treatment of separation anxiety disorder, generalized anxiety disorder, and social phobia. Caregivers and youth independently reported treatment expectations prior to randomization, anxiety was assessed pre- and post-treatment by independent evaluators blind to treatment condition, and exposure characteristics were recorded by the cognitive-behavioral therapists following each session. For both caregivers and youths, more positive expectations that anxiety would improve with treatment were associated with greater compliance with exposure tasks, and compliance mediated the relationship between treatment expectations and change in anxiety symptoms following treatment. Additionally, more positive parent treatment expectations were related to a greater number and percentage of sessions with exposure. More positive youth treatment expectations were associated with greater mastery during sessions focused on exposure. Findings underscore the importance of addressing parents' and youths' treatment expectations at the outset of therapy to facilitate engagement in exposure and maximize therapeutic gains.

Mothers' and children's metacognitions and the development of childhood anxiety: a longitudinal investigation of transmission

Theory and preliminary evidence suggests that parental beliefs and cognitions may be transmitted to their offspring. Transmission of maladaptive cognitions may play a role in the development of anxiety disorders in childhood. However, few studies have investigated such transmission using longitudinal designs. The objective of this study was to investigate the interaction between maternal and child metacognitions and their role in the development of childhood anxiety. We used a longitudinal design with self-report measures of maternal and child anxiety symptoms and metacognitions. Participants were 107 mothers and their children who were assessed when the children were between 7 and 12 years old and again 3 years later. Child metacognitions at baseline did not predict later child anxiety symptoms. Baseline maternal metacognitions approached significance in predicting anxiety symptoms in children at the follow-up, when controlling for known risk factors, including female gender and higher levels of anxiety in mother and child at baseline. Mediation analyses revealed that child metacognitions at baseline, as well as at follow-up fully mediated the relationship between maternal baseline metacognitions and child anxiety 3 years later. Examinations of how child and maternal metacognitions affect child anxiety levels after three years revealed that current levels of child metacognitions play a greater role in predicting child anxiety than child and maternal metacognitions at baseline.

Effects of tryptophan depletion on anxiety, a systematic review

Vulnerability markers for onset of anxiety disorders are scarce. In depression, patients at risk tend to respond with a negative mood to 'acute tryptophan depletion' (ATD), while healthy volunteers and current patients do not. The serotonergic system thus provides indications for vulnerability for depression. It is unknown whether ATD reveals vulnerability in anxiety too. This study systematically reviews the effects of ATD on anxiety and assesses whether challenging anxiety modifies the response. PubMed, Embase and PsychInfo were systematically searched up to April 2019 for studies in which (1) healthy volunteers or patients with a (remitted) anxiety disorder underwent ATD and (2) levels of anxiety were reported. In total, 21 studies were included. Studies conducted in healthy volunteers (n = 13), and patients with a remitted (n = 6) or current (panic, social or generalised) anxiety disorder (n = 4). Studies were mostly of poor quality and heterogeneous regarding population, challenge test used and outcome measures. ATD did not consistently affect anxiety in any of the groups. Moreover, a challenge test after ATD (n = 17 studies) did not consistently provoke anxiety in healthy volunteers or remitted patients. A 35% CO₂ challenge did consistently increase anxiety in patients with a current panic disorder (PD). To conclude, this systematic review found no clear indications that ATD provokes anxiety in those at risk for anxiety disorders. Hence, unlike in depression, ATD does not indicate vulnerability to develop an anxiety disorder. Because included studies were heterogeneous and mostly of poor quality, there is an urgent need for high quality research in homogeneous samples.

Maternal influences on binge eating behaviors in children

Binge eating in childhood has been linked to adverse future health outcomes. Parental factors, such as parents' emotion regulation and executive functioning, are likely to influence children's self-regulatory behaviors, including eating. Executive functioning describes a range of higher-order cognitive functions such as planning, abstraction, inhibitory control and working memory, which involves the ability to learn, update and manipulate new information while managing distractions. No studies have examined associations between maternal emotion regulation and executive functioning and the child's maladaptive eating patterns, which was the goal of the present study. Forty-eight mother and child pairs completed self-report clinical measures of emotion dysregulation and attentional control, and mothers completed a brief neuropsychological battery, which included executive functioning measures. Child's disordered eating was measured with the Child Binge Eating Disorder Scale. Linear regression results indicated that mother's performance on a working memory task and child's emotion dysregulation was significantly associated with child's binge eating symptoms (R ² = 0.34). These data, which reveal that maternal executive functioning is associated with self-regulatory behaviors in children, indicate a possible mechanism through which maladaptive eating behaviors may emerge early in development. This relationship merits further exploration in larger-scale prospective intergenerational studies.

Effects of psychosocial and socio-environmental factors on anxiety disorder among adolescents in Bangladesh

BACKGROUND

Anxiety is a common psychiatric disorder among adolescents in developing countries. This study aimed to examine the risk factors of anxiety disorder and the adverse consequences of anxiety disorder among adolescents in Bangladesh.

METHODS

A total of 2,989 adolescent data of the 2014 Global School-based Student Health Survey (GSHS), Bangladesh, was analyzed WHO. The prevalence of anxiety disorder across psychosocial and socio-environmental factors was calculated as descriptive statistics, whereas their effects on occurring anxiety disorder were determined using the unadjusted and adjusted multivariable binary logistic regression model. The consequences of anxiety disorder were also determined using the multivariable binary logistic regression model.

RESULTS

The prevalence of anxiety disorder was 4.7%, which was found higher among female than their male counterparts. The psychosocial factors were found associated with the anxiety disorder are loneliness (AOR: 2.26, 95% CI: 1.08-4.72), being bullied (AOR: 6.00, 95% CI: 3.14-11.47), and physical abuse (AOR: 2.12, 95% CI: 1.07-4.21). Moreover, poor understandings with parents (AOR: 1.75, 95% CI: 1.02-3.01) and lack of peer support (AOR: 2.23, 95% CI: 1.18-4.23) were the socio-environmental factors that found associated with the anxiety disorder. Subgroup analysis across gender found these associations were consistent for adolescent male and female. Moreover, the likelihood increased with the increasing number of the adverse psychosocial, or socio-environmental factors.

CONCLUSIONS

Around 5% of school-going adolescents in Bangladesh reported anxiety associated with the exposure of single or multiple adverse psychosocial and socio-environmental factors including bullying and physical abuse. Early screening and interventions are essential, targeted to adolescent at risk, which could reduce the rate of anxiety disorder among adolescent in Bangladesh.

Exploring the stress sensitization theory with temperamentally inhibited children: a population-based study

BACKGROUND

This study explored whether temperamentally inhibited children who experience early trauma are vulnerable to developing internalizing problems in the face of later life-stressors.

METHODS

A validated screen for temperamental inhibition was distributed to parents of young children attending preschools in six government regions of Melbourne, Australia. Screening identified 11% of children as inhibited (703 of 6347 screened) and eligible for a prevention study. Participants were 545 parents of inhibited preschoolers (78% uptake), of whom 84% were followed into mid childhood (age 7-10 years: wave 1, n = 446; wave 2, n = 427; wave 3, n = 426). Parents and children then completed questionnaires for child internalizing (anxious and depressive) symptoms, and parents received a diagnostic interview for child anxiety disorder. In mid-childhood parents also completed questionnaires annually to describe recent life-stressors experienced by their child, and any potentially traumatic events in the first four years of life.

RESULTS

Only one in 14 temperamentally inhibited children had experienced a potentially traumatic event in early childhood. In mid childhood 56% experienced recent life-stressors. Inhibited children who had early life trauma experienced slightly more anxiety disorder and symptoms in mid childhood. Those children with more recent life-stressors in mid childhood also had slightly more symptoms of anxiety and depression. In contrast to stress sensitization, inhibited children with early trauma plus recent stressors did not show especially high mid-childhood internalizing difficulties.

CONCLUSIONS

Early life trauma and recent life-stressors each convey a small risk for children with an inhibited temperament to develop internalizing problems. Nevertheless, early life stress may not always result in negative sensitization for children in the general population.

A systematic review of the role of parents in the development of anxious cognitions in children

Anxious cognitions and parental behavior are important in the development of child anxiety. The current review aims to appraise the literature on the relationship between parental factors and chid anxious cognitions. Online database searches of PsycInfo, Scopus, ProQuest Dissertations and Web of Science were systematically searched using key terms related to 'parent', 'child', 'anxiety' and 'cognitions'. Included studies (N = 13) were quality assessed and study findings were appraised in line with cognitive behavioral frameworks of the parental pathways to the development of anxious cognitions in children. Reviewed studies confirmed that parental factors have a role in the development of their children's anxious cognitions by modelling fearful responses, reducing their child's autonomy, and indirectly via their own expectations about their child. Limitations of the literature are considered, including issues of measurement. Future research should consider multi-modal assessment of parental factors and examine parental behavior and child anxious cognitions in the context of real-life threatening events.

The Role of Experiential Avoidance and Parental Control in the Association Between Parent and Child Anxiety

Parenting behavior and practices contribute to the intergenerational relationship between parent and child anxiety, with parental control being a consistent predictor of child anxiety. Parental experiential avoidance refers to how a parent copes with their internal world in the context of parenting. Little is known about how this relatively new parenting concept relates to child anxiety. The current study tested the indirect effect of parent anxiety on child anxiety through parental control and parental experiential avoidance; the indirect effect of parent anxiety on parental control through parental experiential avoidance; and the moderating effect of parental experiential avoidance on the relationship between parental control and child anxiety. Using a cross-sectional design, parents (N = 85) from a community sample of 8–12-year-old children self-reported on a survey measuring parent anxiety, child anxiety, parental control, and parental experiential avoidance. A hierarchical regression indicated that parental experiential avoidance significantly predicted child anxiety and accounted for further variance in child anxiety, over, and above parental control. There was an indirect effect of parent anxiety on child anxiety through parental control and parental experiential avoidance. Parental experiential avoidance moderated the relationship between parental control and child anxiety, such that the relationship was only significant at high levels of parental experiential avoidance. The current study provides support for the role of parental experiential avoidance in an intergenerational understanding of anxiety. Future research should replicate the study with a clinical sample. Theoretical and practice implications are considered.

Preventative Intervention for Social, Emotional and Behavioural Difficulties in Toddlers and Their Families: A Pilot Study

Preventative intervention early in life is key to interrupting trajectories toward subsequent emotional and behavioural problems later in life. This study examined the effectiveness of the Holding Hands program, an innovative program of preventative intervention aimed at improving the behavioural and emotional functioning of 12 to 48-month-old toddlers, and the wellbeing of their parents. This program seeks to synthesise the existing evidence in four ways; it incorporates both traditional Parent Management Training and Direct Coaching methods. It is intensive, significantly reducing session numbers and it explicitly addresses parental emotion regulation. The program also utilises operant learning principals in an effort to contingently reinforce behaviour that parents want to see more of, without employing exclusionary strategies in response to behavior that parents want to see less of. Thirty-one families, with a toddler who met clinical or sub-clinical cut-offs for externalising or internalising problems, were self- or externally-referred to the six- to eight-week program. Results indicated statistically significant improvement in toddler emotional and behavioural functioning, and parent well-being on a range of psychometric measures from pre- to post-treatment. Treatment gains were maintained for parents and children at follow-up. Implications of these findings for clinical practice and suggestions for future research are discussed.

The impact of bowel and bladder problems on children's quality of life and their parents: A scoping review

BACKGROUND

Functional bladder and bowel problems are common in children and have a serious psychological as well as physical impact. The objective of this scoping review was to synthesise evidence on the impact of such conditions both on children's quality of life (QOL) and their parents.

METHODS

The scoping review followed Arksey and O'Malley's framework. Relevant studies were identified by a comprehensive search of scientific databases. Inclusion criteria focused on children with bladder and bowel dysfunction, their QOL, and impact on parents. Studies were analysed for aims, study populations, measures, and results.

RESULTS

A total of 783 records were retrieved with 30 meeting the criteria. Most studies found that QOL was reduced in children with nocturnal enuresis, day bladder dysfunction, bowel dysfunction, and combined bladder and bowel dysfunction. Parents' QOL and social-emotional functioning were also negatively affected.

CONCLUSIONS

Functional bladder and bowel problems should be identified and treated as early as possible to minimise negative impacts on QOL of children and their carers. Future research should focus on how to best provide early and effective intervention in the most accessible manner.

An experimental test of the impact of adolescent anxiety on parental sick role reinforcement behavior

A large body of work links parental sick role reinforcement behavior to adolescent panic vulnerability. To date, however, little work has examined the role of the adolescent in this process. The current study addressed this gap in the literature, using a novel method to experimentally test the impact of adolescent anxiety during a straw-breathing task on parental propensity to engage in sick role reinforcement behavior. An unselected sample of 51 early adolescents (26 female, 10-14 years) and their parents participated in the study. Adolescents were trained to mimic a straw-breathing task, and adolescent reactions to the task were scripted. Parents were randomly assigned to watch their adolescent react either a) anxiously or b) non-anxiously to the straw-breathing task. Parents who viewed their adolescent react anxiously ended the task earlier, reported that they would reinforce more sick role behavior, and reported more negatively valenced reactions during the task than parents who viewed their adolescent react non-anxiously to the task. No group differences emerged in terms of parental self-reported or physiological arousal during the task. Results suggest that adolescent anxiety increases parental sick role reinforcement behavior. Findings are discussed in terms of future directions for reducing parenting behaviors thought to increase vulnerability for panic among adolescents.

A qualitative examination and theoretical model of anxiety in adults with epilepsy

OBJECTIVE

There is an elevated prevalence of anxiety disorders among people with epilepsy, and the comorbidity of anxiety in epilepsy is associated with adverse medical and psychosocial outcomes. Despite its importance, little is known about what psychosocial or epilepsy factors may be associated with the development of anxiety. The aim of this qualitative study was to determine what factors may explain why some people with epilepsy develop anxiety disorders and others do not.

METHODS

Adults with epilepsy were recruited from an outpatient epilepsy service. Semistructured interviews were conducted with 26 participants, 15 of whom reported clinically significant levels of anxiety. Grounded theory analysis was used to develop a theoretical model of anxiety development in the context of epilepsy.

RESULTS

Qualitative analyses revealed a number of processes that appeared to account for the development of anxiety in the context of epilepsy. These included inflated estimates regarding epilepsy-specific risks and excessive attempts to avoid these risks. Such excessive avoidance often resulted in greater interference with participants' role functioning, thus risking ongoing quality of life. A number of premorbid and contextual factors also appear to be implicated in the development of anxiety.

CONCLUSION

This investigation provides a comprehensive account for the development of anxiety in epilepsy, which is consistent with existing theories of anxiety development and maintenance. Importantly, this model provides a foundation for future research and appropriate treatment strategies to address anxiety in people with epilepsy.

Family and Parent Predictors of Anxiety Disorder Onset in Offspring of Anxious Parents

BACKGROUND

Offspring of anxious parents are at increased risk for developing anxiety disorders. There is a need to identify which youth are at greatest risk for disorder onset in this population.

OBJECTIVE

This study prospectively examined several theory-based family and parent characteristics (e. g., family conflict, parental over-control, parental psychopathology) as predictors of anxiety disorder onset in children whose parents were clinically anxious.

METHODS

Families were enrolled in a randomized controlled trial evaluating a familybased preventative intervention, relative to an information monitoring control condition, for offspring of anxious parents (N= 136; child mean age 8.69 years; 55% female; 85% Caucasian). Family and parent measures were collected using multiple informants and an observational task at baseline, post-intervention, and at a six and 12 month followup. Child anxiety disorder diagnosis was determined by independent evaluators using the Anxiety Disorders Interview Schedule for Children.

RESULTS

Results indicated that none of the baseline family or parent variables examined predicted the onset of an anxiety disorder in children over the one year follow-up period.

CONCLUSIONS

Findings raise questions about the short-term risk associated with family and parent factors in anxiety disorder development in this high risk population.

The Parenting Anxious Kids Ratings Scale-Parent Report (PAKRS-PR): Initial Scale Development and Psychometric Properties

Developmental models of pediatric anxiety posit multiple, maladaptive parenting behaviors as potential risk factors. Despite this, a standardized means of assessing multiple of these practices (i.e., anxiogenic parenting) in a comprehensive and efficient manner are lacking. In Study 1531 parents of children 7-17 years old completed an online survey via Amazon Mechanical Turk. In Study 2, a separate community sample (N = 109; 9-17 years old) was recruited and completed a comprehensive assessment battery as part of a larger study. All parents (Study 1 and 2 samples) completed the Parenting Anxious Kids Ratings Scale-Parent Report (PAKRS-PR), a measurement tool designed to assess anxiogenic parenting. Factor analysis conducted as part of Study 1 revealed a 32-item scale consisting of five factors: conflict, overinvolvement, accommodation/beliefs, modeling, and emotional warmth/support. Four of these factors were significantly correlated with parent-report of anxiety severity. Within Study 2, the parents of children diagnosed with an anxiety or related disorder reported significantly higher levels of anxiogenic parenting practices as compared to the parents of healthy controls. The PAKRS-PR and respective subscales demonstrated acceptable reliability and validity in both the internet (Study 1) and community (Study 2) samples. The PAKRS-PR may be a beneficial multidimensional parenting scale for use among anxious youths.

Mütterliches Expressed Emotion und elterliche Angst vor negativer Bewertung bei Kindern mit sozialer Angststörung

Zusammenfassung. Theoretischer Hintergrund: Ziel dieser Studie ist die Untersuchung von Expressed Emotion (EE) als Faktor des familiären Klimas sowie elterlicher Angst vor negativer Bewertung des Kindes als potentieller Mediator für den Zusammenhang von sozialer Angst der Eltern und Kinder. Methode: Kinder mit Sozialer Angststörung (SAS; n = 64) und ohne SAS (healthy control, HC, n = 52) sowie deren Eltern (Mütter und Väter) berichteten über eigene soziale Ängste und ihre Angst vor negativer Bewertung des Kindes. Mütter nahmen zudem am Five Minute Speech Sample (FMSS) zur Erhebung von EE teil. Ergebnisse: Berichte von Müttern von Kindern mit einer SAS wurden häufiger als High Expressed Emotion (HEE) eingestuft als Berichte von Müttern von HC Kindern. Es zeigte sich ein Zusammenhang von EE und sozialer Angst der Mutter wie auch mütterlicher Angst vor negativer Bewertung des Kindes. Zudem wurde der Zusammenhang zwischen kindlicher und mütterlicher sozialer Angst partiell durch die Angst vor negativer Bewertung des Kindes mediiert. Schlussfolgerungen: Es konnte ein Zusammenhang von kindlicher SAS und gleichzeitig erhöhtem EE der Mütter gezeigt werden. Erhöhte Angst vor negativer Bewertung des Kindes stellt einen potenziellen Mechanismus dar, wie mütterliche, nicht aber väterliche, soziale Angst an das Kind vermittelt werden kann.

Emotion Socialization in Anxious Youth: Parenting Buffers Emotional Reactivity to Peer Negative Events

Anxious youth exhibit heightened emotional reactivity, particularly to social-evaluative threat, such as peer evaluation and feedback, compared to non-anxious youth. Moreover, normative developmental changes during the transition into adolescence may exacerbate emotional reactivity to peer negative events, particularly for anxious youth. Therefore, it is important to investigate factors that may buffer emotional reactivity within peer contexts among anxious youth. The current study examined the role of parenting behaviors in child emotional reactivity to peer and non-peer negative events among 86 anxious youth in middle childhood to adolescence (Mean age = 11.29, 54 % girls). Parenting behavior and affect was observed during a social-evaluative laboratory speech task for youth, and ecological momentary assessment (EMA) methods were used to examine youth emotional reactivity to typical daily negative events within peer and non-peer contexts. Results showed that parent positive behaviors, and low levels of parent anxious affect, during the stressful laboratory task for youth buffered youth negative emotional reactivity to real-world negative peer events, but not non-peer events. Findings inform our understanding of parenting influences on anxious youth's emotional reactivity to developmentally salient negative events during the transition into adolescence.

Cross-generational influences on childhood anxiety disorders: pathways and mechanisms

Anxiety disorders are common across the lifespan, cause severe distress and impairment, and usually have their onset in childhood. Substantial clinical and epidemiological research has demonstrated the existence of links between anxiety and its disorders in children and parents. Research on the pathways and mechanisms underlying these links has pointed to both behavioral and biological systems. This review synthesizes and summarizes several major aspects of this research. Behavioral systems include vicarious learning, social referencing, and modeling of parental anxiety; overly protective or critical parenting styles; and aspects of parental responses to child anxiety including family accommodation of the child's symptoms. Biological systems include aspects of the prenatal environment affected by maternal anxiety, development and functioning of the oxytocinergic system, and genetic and epigenetic transmission. Implications for the prevention and treatment of child anxiety disorders are discussed, including the potential to enhance child anxiety treatment outcomes through biologically informed parent-based interventions.

Family process and youth internalizing problems: A triadic model of etiology and intervention

Despite major advances in the development of interventions for youth anxiety and depression, approximately 30% of youths with anxiety do not respond to cognitive behavioral treatment, and youth depression treatments yield modest symptom decreases overall. Identifying networks of modifiable risk and maintenance factors that contribute to both youth anxiety and depression (i.e., internalizing problems) may enhance and broaden treatment benefits by informing the development of mechanism-targeted interventions. A particularly powerful network is the rich array of family processes linked to internalizing problems (e.g., parenting styles, parental mental health problems, and sibling relationships). Here, we propose a new theoretical model, the triadic modelof family process, to organize theory and evidence around modifiable, transdiagnostic family factors that may contribute to youth internalizing problems. We describe the model's implications for intervention, and we propose strategies for testing the model in future research. The model provides a framework for studying associations among family processes, their relation to youth internalizing problems, and family-based strategies for strengthening prevention and treatment.

Stressful Life Events and Child Anxiety: Examining Parent and Child Mediators

While a number of factors have been linked with excessive anxiety (e.g., parenting, child temperament), the impact of stressful life events remains under-studied. Moreover, much of this literature has examined bivariate associations rather than testing more complex theoretical models. The current study extends the literature on life events and child anxiety by testing a theory-driven meditational model. Specifically, one child factor (child cognitions/locus of control), two parent factors (parent psychopathology and parenting stress), and two parent-child relationship factors (parent-child dysfunctional interaction and parenting style) were examined as mediators in the relationship between stressful life events and severity of child anxiety. One hundred and thirty anxious parents and their nonanxious, high-risk children (ages ranged from 7 to 13 years) participated in this study. Results indicated that levels of parenting stress, parental anxious rearing, and dysfunctional parent-child interaction mediated the association between stressful life events and severity of anxiety symptoms. Child cognition and parent psychopathology factors failed to emerge as mediators. Findings provide support for more complex theoretical models linking life events and child anxiety and suggest potential targets of intervention.

Parental involvement: contribution to childhood anxiety and its treatment

Anxiety disorders are prevalent in youth. Despite demonstrated efficacy of cognitive behavioral therapy (CBT), approximately 40% of anxiety-disordered youth remain unresponsive to treatment. Because developmental and etiological models suggest that parental factors are relevant to the onset and maintenance of childhood anxiety, researchers have proposed and investigated family-based interventions with increased parent work in treatment, aiming to improve the efficacy of treatment for childhood anxiety. However, contrary to what theoretical models suggest, data to date did not indicate additive benefit of family-based CBT in comparison with child-centered modality. Is parent/family involvement unnecessary when treating childhood anxiety disorders? Or could there be the need for specificity (tailored family-based treatment) that is guided by a revised conceptualization that improves the implementation of a family-based intervention? The current review examines (1) relevant parental factors that have been found to be associated with the development and maintenance of childhood anxiety and (2) interventions that incorporate parental involvement. Relevant findings are integrated to formulate a "targeted" treatment approach for parental involvement in CBT for youth anxiety. Specifically, there is potential in the assessment of parent/family factors prior to treatment (for appropriateness) followed by a target-oriented implementation of parent training.

Variations in the influence of parental socialization of anxiety among clinic referred children

This study examined the relations between parental socialization of child anxious behaviors (i.e., reinforcement, punishment, modeling, transmission of information) and child anxiety and related problems at varying child sensitivity levels. Data corresponding to 70 clinic-referred children (M age = 9.86 years; 50% girls; 49% Hispanic/Latino, 51% Caucasian) showed that for children with low (but not high) anxiety sensitivity, anxiety-related parental socialization behaviors were associated with more child anxiety and depression symptoms. Findings also indicated that parental socialization of anxious behaviors and anxiety sensitivity functioned similarly in the prediction of anxiety and depression across Caucasian and Hispanic/Latino children. There were no significant mean level variations across child sociodemographic characteristics in general, but anxiety-promoting parenting behaviors were twice as high in Hispanic/Latino compared to Caucasian families.

Avoidance moderates the association between mothers' and children's fears: findings from a novel motion-tracking behavioral assessment

BACKGROUND

Fear and anxiety in children are associated with similar symptoms in parents. Parental modeling of fearful or avoidant behavior is believed to contribute to this association. We employed a novel motion-tracking experimentation platform to test the hypothesis that mothers' behavioral avoidance of spiders moderates the association between fear of spiders in mothers and children.

METHOD

Participants were 86 children (aged 7-17) presenting with an anxiety disorder, and their mothers. Children and mothers completed the Spider Phobia Questionnaire. Mothers completed a motion-tracking assessment of behavioral avoidance of spiders.

RESULTS

Fear of spiders in mothers was associated with fear of spiders in children (r85  = 0.48, 95%CI 0.30 - 0.63, P < 0.001). Two metrics of behavioral avoidance in mothers were associated with mothers' self-reported fear of spiders (r = -0.49, 95% CI 0.31-0.64, P < 0.001; and r = 0.42, 95%CI 0.23 - 0.58 P < 0.001). Mothers' behavioral avoidance moderated the association between fear of spiders in mothers and in children. When mothers' avoidance was intermediate or high the association was significant, and as mothers' behavioral avoidance increased the strength of the association increased. Fear of spiders in mothers with low behavioral avoidance was not associated with fear of spiders in their children.

CONCLUSIONS

The study demonstrates that behavioral avoidance can be measured using the motion-tracking platform and can be useful in understanding the links between symptoms of anxiety in mothers and children. Reducing parents' overt expressions of avoidance may lower the risk of fears being transmitted to children.

Impaired Facial Affect Perception in Unaffected Children at Familial Risk for Panic Disorder

Recent studies suggest that impaired processing of facial affect has a familial component and may reflect a marker of liability to psychopathology. This study investigated whether facial affect processing is impaired in offspring with parental panic disorder (PD). Psychiatrically healthy children with parental PD (n = 51) and age and sex matched control children with no parental psychopathology (n = 51) completed a standard facial recognition task. High-risk children made more errors recognizing fearful faces than controls and misattributed fear and angry facial affect as surprised. High-risk females also made more errors recognizing sad faces compared to low risk females and misattributed sadness as fear. No difference emerged for self-rated anxiety while viewing facial expressions. However, self-rated anxiety correlated moderately with misrecognition of fearful facial affect in high-risk children. Overall, our data suggest that the ability to correctly recognize negative facial emotions is impaired in children with parental PD. Further research is needed to confirm if these deficits represent a trait marker of liability for PD and elucidate the contribution of genetic and family environmental influences.

Factors Predicting Youth Anxiety Severity: Preliminary Support for a Standardized Behavioral Assessment of Parental and Youth Avoidance Behaviors

Anxiety severity in youth is associated with a host of negative outcomes including poor response to treatment. Thus, a better understanding of factors that contribute to anxiety severity is needed. Such factors may include parental anxiety as well as anxiety-related approach and avoidance behaviors in both children and parents. In this study, we examined automatic behavioral tendencies as a method of quantifying anxiety-related approach and avoidance behaviors in children and their parents. Clinically anxious youth (N = 19) with mixed anxiety diagnoses and their parents completed an approach-avoidance task (AAT) comprising different emotional expressions. Our results suggest that in addition to parent report of youth anxiety, both youth and parent automatic avoidance biases predict clinician-rated youth anxiety severity accounting for 62% of the variance in clinician-rated youth anxiety. These results suggest that the AAT may be a useful measure of automatic behavioral tendencies in clinically anxious youth and their parents and that these factors may be relevant to youth anxiety severity.

An experimental test of the effects of parental modeling on panic-relevant escape and avoidance among early adolescents

Escape and avoidance behaviors play a prominent role in the maintenance and possibly development of panic disorder, yet the literature regarding the etiology of these emotion-regulation strategies is relatively underdeveloped. The current study experimentally tests hypotheses that parental modeling of escape during a well-established panic-relevant biological challenge increases panic-relevant escape and avoidance among offspring. Fifty physically and psychologically healthy early adolescents (28 females; Mage=11.58; 86% Caucasian), stratified by gender, were randomly assigned to observe one of their parents (39 females; Mage=40.04): either (a) model completing a 3-min voluntary hyperventilation exercise (no escape modeling group) or (b) model premature termination of a similar procedure (escape modeling group). Offspring in the escape modeling group demonstrated a stronger escape response by discontinuing their own challenge sooner than those in the no-escape modeling group (r=.70). No group differences emerged in terms of avoidance responding, as indexed by nearly identical responding in terms of delay time before initiating the challenge, respiration rate, and self-reported willingness to engage in a second proposed challenge. Results suggest that parental behaviors may play an important role in the development of some forms of panic-relevant responding. These preliminary findings may have important implications for future prevention programs targeting parents and at-risk youth.

Maternal intrusiveness, family financial means, and anxiety across childhood in a large multiphase sample of community youth

Intrusive parenting has been positively associated with child anxiety, although examinations of this relationship to date have been largely confined to middle to upper middle class families and have rarely used longitudinal designs. With several leading interventions for child anxiety emphasizing the reduction of parental intrusiveness, it is critical to determine whether the links between parental intrusiveness and child anxiety broadly apply to families of all financial means, and whether parental intrusiveness prospectively predicts the development of child anxiety. This study employed latent growth curve analysis to evaluate the interactive effects of maternal intrusiveness and financial means on the developmental trajectory of child anxiety from 1st grade to age 15 in 1,121 children (50.7 % male) and their parents from the NICHD SECCYD. The overall model was found to provide good fit, revealing that early maternal intrusiveness and financial means did not impact individual trajectories of change in child anxiety, which were stable from 1st to 5th grade, and then decrease from 5th grade to age 15. Cross-sectional analyses also examined whether family financial means moderated contemporaneous relationships between maternal intrusiveness and child anxiety in 3rd and 5th grades. The relationship between maternal intrusiveness and child anxiety was moderated by family financial means for 1st graders, with stronger links found among children of lower family financial means, but not for 3rd and 5th graders. Neither maternal intrusiveness nor financial means in 1st grade predicted subsequent changes in anxiety across childhood. Findings help elucidate for whom and when maternal intrusiveness has the greatest link with child anxiety and can inform targeted treatment efforts.