Parental fear of negative child evaluation in child social anxiety

A Systematic Review and Meta-analysis: Paternal Anxiety and the Emotional and Behavioral Outcomes in Their Offspring

OBJECTIVE

Anxiety disorders are highly prevalent worldwide; however, the literature lacks a meta-analytic quantification of the risk posed by fathers' anxiety for offspring development. This systematic review and meta-analysis aimed to provide a comprehensive estimate of the magnitude of the association between paternal anxiety and emotional and behavioral problems of offspring.

METHOD

In February 2022, Web of Science, Ovid (Embase, MEDLINE, PsycINFO), Trip Database, and ProQuest were searched to identify all quantitative studies that measured anxiety in fathers and emotional and/or behavioral outcomes in offspring. No limits were set for offspring age, publication language, or publication year. Summary estimates were extracted from the primary studies. Meta-analytic random-effects 3-level models were used to calculate correlation coefficients. Quality was assessed using the Newcastle-Ottawa Scale. The study protocol was preregistered with PROSPERO (CRD42022311501) and adhered to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) reporting guidelines.

RESULTS

Of 11,746 records identified, 98 were included in the meta-analysis. Small but significant associations were found between paternal anxiety and offspring emotional and behavioral problems overall (r = 0.16, 95% CI [0.13, 0.19]) and behavioral (r = 0.19, 95% CI [0.13, 0.24]), emotional (r = 0.15, 95% CI [0.12, 0.18]), anxiety (r = 0.13, 95% CI [0.11, 0.16]), and depression (r = 0.13, 95% CI [0.03, 0.23]) problems. Some significant moderators were identified.

CONCLUSION

Paternal mental health is associated with offspring development, and the offspring of fathers with anxiety symptoms or disorders are at increased risk of negative emotional and behavioral outcomes, in line with the principles of multifinality and pleiotropy. The substantial heterogeneity among studies and the overrepresentation of White European American groups in this literature highlight the need for further research.

DIVERSITY & INCLUSION STATEMENT

While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list.

The role of fear of negative evaluation on the effects of self-control on affective states and life satisfaction: a moderated mediation analysis

Previous studies have found a robust positive relationship between trait self-control and life satisfaction mediated by both positive and negative affect, but the simultaneous inclusion of the effect of apprehension of being evaluated by others is less commonly investigated. The present study aimed to examine (1) whether the relationship between self-control and life satisfaction was mediated by positive affect and negative affect in parallel, and (2) whether fear of negative evaluation would moderate the strengths of the mediational pathways. With a sample of two hundred fifty university students in Hong Kong, mediational analysis (ME) revealed that both positive affect and negative affect were the mediators between self-control and life satisfaction. Subsequent moderated mediation analysis (moME) supported the moderating role of fear of negative evaluation on the mediational pathway through positive affect, but not on the pathway through negative affect. In particular, higher scores on fear of negative evaluation would attenuate the strength of association between self-control and positive affect. Therefore, to optimize university students' well-being and mental health functioning, treatment modalities should target both behavioral (i.e., self-control) and socio-emotional (i.e., apprehension of being evaluated critically from others) aspects.

Lifetime psychopathology in the offspring of parents with anxiety disorders: A systematic review

BACKGROUND

The offspring of parents with Anxiety Disorders (AD) are at high risk for different types of psychopathology, including AD. However, little is known about how parental anxiety during pregnancy and/or the postnatal period might result in alterations in behavior or neurodevelopmental changes in offspring. To examine the effect of parental AD on offspring behavior and neurodevelopment, we conducted a systematic review.

METHODS

Following PRISMA guidelines, we searched the Web of Science, PubMed, and PsycINFO databases.

RESULTS

Forty-seven articles met the inclusion criteria for the systematic review. Prenatal maternal anxiety is related to negative temperament, increased attention to fearful vocalizations, decreased alertness, and impaired psychomotor and cognitive development in early and middle childhood. AD during the postnatal period is associated with greater negative temperament, internalizing symptoms, and anxiety symptoms in early childhood, middle childhood, and adolescence.

CONCLUSION

Our review is the first to demonstrate that prenatal and postnatal AD symptoms impact offspring. Future research should explore the mediating and moderating factors leading to the development of psychopathology in the offspring of parents with AD.

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.

Intergenerational Transmission of Social Anxiety in Childhood Through Fear of Negative Child Evaluation and Parenting

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.

Social Anxiety in 15-19 Year Adolescents in Association with Their Subjective Evaluation of Mental and Physical Health

BACKGROUND

Studies show that social anxiety in adolescence have negative impact on quality of life. The study evaluates social anxiety links with mental and physical health factors in adolescents aged 15-19 years.

METHODS

The research was performed in 2018 in secondary schools in Lithuania and included 1722 participants (46.1% males and 53.9% females). The social anxiety was assessed using Social Anxiety and Avoidance Scale for Adolescents. The main results were obtained using univariate and multivariate logistic regression analysis.

RESULTS

Total of 58.5% of adolescents were characterized by high social anxiety and 14.7% by high avoidance. Females more often were characterized by high anxiety compared to males. Multivariate logistic regression revealed that good mental health was a significant protective factor against high SA in adolescents. For females, high anxiety and avoidance were associated with living with both parents, for males, high anxiety was linked with mother's university education. Very common stomach and abdominal pain in females as well as severe and very common stomach or abdominal pain in males, increase the risk of major social anxiety.

CONCLUSIONS

High social anxiety were more prevalent between females than males and was linked with various well-being and health aspects in adolescents.

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.

A Multi-Method, Multi-Informant Test of Maternal Emotion Socialization in Relation to Adolescent Fears of Social Evaluation

Fears of negative and positive social evaluation are considered potential transdiagnostic mechanisms underpinning multiple internalizing disorders and impairments in adolescence. Although emotion socialization processes have been associated with adolescents' internalizing symptoms, the socialization of distinct fears of social evaluation has not been studied. Thus, the goal of the current study was to test whether mother's emotion expression, direct messages, responses to emotions, and parenting behaviors interact with adolescents' gender and temperamental shyness in relation to fears of negative and positive evaluation. A community sample of 107 adolescents ages 11 to 14 (M = 12.39; Girls = 45.8%) and their mothers completed survey measures of emotion socialization, temperament, and fears of social evaluation, in addition to participating in a speech preparation task used to code observed behaviors. For shy adolescents, adolescent-reported maternal cautious messages about social evaluation were associated with greater fears of positive evaluation, while encouraging messages were linked to less fears of positive evaluation. Further, maternal self-reported warmth was associated with fewer fears of negative and positive for shy adolescents, while supportive responses to emotions were linked to higher fears of positive evaluation for boys. Among girls, maternal ratings of encouraging messages were associated with higher fears of social evaluation, while cautious messages were linked to lower fears of negative evaluation. These findings are the first to consider several features of emotion socialization in relation to two distinct valences of adolescents' socio-evaluative fear, and highlight the importance of assessing emotion socialization behaviors via multiple informants and methods.

Family accommodation of anxiety in a community sample of children on the autism spectrum

Anxiety is recognised as one of the most common co-occurring conditions for individuals with a diagnosis on the autism spectrum, with approximately 40 % of children on the spectrum receiving a clinical diagnosis of an anxiety disorder. To date, research has tended to focus upon understanding presentation and evaluating treatment, with little focus on assessing systemic factors, such as the way that family members accommodate the anxiety. This study aimed to investigate the relationship between parent and child anxiety levels and child autism characteristics on the four domains of family accommodation; Participation, Modification, Distress, and Consequence. A community sample (n = 132) of parents of children on the spectrum completed questionnaires on their child's autism characteristics and anxiety symptomatology as well as their own levels of anxiety and family accommodation behaviours. Regression models identified specific aspects of child anxiety as well as parent anxiety as predictive of family accommodation, with the child's difficulties with uncertainty being a consistent predictor of all four domains. Clinical and research implications of this study, including the importance of understanding similarities or differences in the nature and consequence of family accommodation in children on the autism spectrum, are discussed.

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.

Integrating video-feedback and cognitive preparation, social skills training and behavioural activation in a cognitive behavioural therapy in the treatment of childhood anxiety

BACKGROUND

The present study examined the effectiveness of a transdiagnostic prevention programme, Super Skills for Life (SSL), in children with anxiety problems. SSL is based on the principles of cognitive-behaviour therapy (CBT), behavioural activation, social skills training, and uses video-feedback and cognitive preparation as part of the treatment.

METHODS

Participants were 61 primary school children, aged 8-10 years, who were referred by their teachers as having significant anxiety problems. Children were video-recorded during a 2-min speech task in sessions 1 and 8, and during a social interaction task. All the children completed measures of anxiety symptoms, social skills, and self-esteem before and after participating in the 8-week SSL and at the 6-months follow-up assessment.

RESULTS

Anxiety symptoms were significantly reduced at post-test and follow-up assessments. SSL also had a positive effect on hyperactivity, conduct, and peer problems although it took longer for these effects to occur. Behavioural indicators of anxiety during the 2-min speech task decreased, indicating that the independent raters observed behavioural change in the children from pre-treatment to follow-up. Boys had higher overall behavioural anxiety during the 2-min speech task at all three assessment periods, specifically showing higher lip contortions and leg movement than girls.

LIMITATIONS

The present study used an open clinical trial design, had small sample size, and did not use structured diagnostic interview schedules to assess anxiety disorders.

CONCLUSIONS

This study provides preliminary empirical support for the effectiveness of SSL in children with anxiety problems.

Fear of Negative Evaluation as a Mediator of the Relation between Academic Stress, Anxiety and Depression in a Sample of Ghanaian College Students

This study examined the mediator effects of the fear of negative evaluation (FNE) on the relation between academic stress and psychological symptoms in a sample of Ghanaian college students (N = 431). A multi-step structural equation modelling (SEM) procedure was used to test the specified mediator model and several fit indices were calculated to assess how well the model fit the data. In addition, path coefficients were calculated to determine whether mediation had been established. The results indicated that the specified model produced a good fit to the data. Moreover, the findings revealed that FNE partially mediated the relation between academic stress and the psychological symptoms of anxiety and depression. Implications for the study’s findings are discussed and recommendations for future research are presented.

Treatment and outcomes for anxiety disorders among children and adolescents: a review of coping strategies and parental behaviors

This article reviews the current literature on the treatment of anxiety disorders in children and adolescents and describes the factors that are essential to address in treatment. Coping deficits and parental behaviors are highlighted as factors that contribute to anxiety in youth. Interventions for anxious youth are described, with particular emphasis on cognitive-behavioral therapy for anxiety disorders. Finally, a review of the longitudinal course of anxiety and suggestions for future directions in treatment and research are provided.