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Tu EN, Manley H, Saunders KEA, Creswell C. Systematic Review and Meta-Analysis: Risks of Anxiety Disorders in Offspring of Parents With Mood Disorders. J Am Acad Child Adolesc Psychiatry 2024; 63:407-421. [PMID: 37453607 DOI: 10.1016/j.jaac.2023.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 06/05/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To examine the risk of anxiety disorders in offspring of parents with mood disorders. METHOD We conducted a systematic review and meta-analysis. We searched 4 electronic databases (Medline, Embase, PsycINFO, and Web of Science [core collection]) to identify cross-sectional and cohort studies that examined the association between parental mood disorders (including bipolar disorder and unipolar depression) and risk of anxiety disorders in offspring. Pooled risk ratios (RRs) of overall and specific anxiety disorders were synthesized using a random effects model. Subgroup analyses and meta-regression were performed to identify moderation factors. RESULTS A total of 35 studies were included in the final analysis. Our results showed higher risks of all types of anxiety disorders in the offspring of parents with mood disorders (any anxiety disorder, RR = 1.82, 95% CI = 1.47-2.26), except for agoraphobia (RR = 1.08, 95% CI = 0.56-2.08), and with an especially elevated risk of panic disorder (RR = 3.07, 95% CI = 2.19-4.32). Subgroup analysis demonstrated no significant difference between the risks of anxiety disorders across the offspring of parents with bipolar disorder as opposed to unipolar depression. The absence of anxiety disorders in control parents, younger offspring age, and specific parent/offspring sex were associated with higher RRs for some anxiety disorders in offspring of parents with mood disorders. CONCLUSION Our findings suggest a robust relationship between parental mood disorders and offspring anxiety disorders, and highlight the potential value of prevention and early intervention for anxiety disorders in this context. 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 racial and/or ethnic groups in science. 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. STUDY PREREGISTRATION INFORMATION Anxiety Disorders in Offspring of Parents with Mood Disorders: A Systematic Review; https://www.crd.york.ac.uk/prospero/; CRD42021215058.
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Affiliation(s)
- En-Nien Tu
- University of Oxford, United Kingdom; Chang Gung Memorial Hospital, Keelung, Taiwan, and Chang Gung University, Taiwan
| | | | - Kate E A Saunders
- University of Oxford, United Kingdom; Queen's University, Kingston, Canada, and Oxford Health NHS Foundation Trust, Oxford, United Kingdom
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Jiao C, Cui M. Indulgent parenting, self-control, self-efficacy, and adolescents’ fear of missing out. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04450-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
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Vigdal JS, Brønnick KK. A Systematic Review of "Helicopter Parenting" and Its Relationship With Anxiety and Depression. Front Psychol 2022; 13:872981. [PMID: 35693486 PMCID: PMC9176408 DOI: 10.3389/fpsyg.2022.872981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background Emerging evidence suggests that overprotective and controlling parenting, often referred to as "helicopter parenting" may have negative implications on the child's mental health such as anxiety and depression. However, no systematic review on the topic exists. Objective Conducting a systematic review to identify all studies where the relationship between helicopter parenting and symptoms of anxiety and/or depression have been investigated. Method A systematic literature search conducted the 3rd of November 2021 yielded 38 eligible studies. Since helicopter parenting is a fairly new construct, this review considered parental control and overprotective parenting to be dimensions of helicopter parenting and thus, eligible for the study. Study quality was assessed in accordance with Campbells Validity Typology. Results The majority of the studies included in this review found a direct relationship between helicopter parenting and symptoms of anxiety and depression. However, validity problems undermine these findings with regarding to assessing the causal relationship between helicopter parenting and these symptoms. There were no longitudinal studies of sufficient quality to determine if helicopter parenting precedes the outcome of anxiety and depression. Conclusion Even though the majority of the studies included in this systematic review found a relationship between helicopter parenting and anxiety and depression, the evidence for this relationship is insufficient and must be investigated further. Findings suggest that it is important to include both maternal and paternal parenting style in future studies as they could affect the outcome of anxiety and depression differently. Systematic Review Registration PROSPERO 2020 CRD42020167465, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=167465.
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Affiliation(s)
- Julia Schønning Vigdal
- Department of Welfare and Participation, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Kolbjørn Kallesten Brønnick
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- SESAM, Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway
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Knappe S, Martini J, Muris P, Wittchen HU, Beesdo-Baum K. Progression of externalizing disorders into anxiety disorders: Longitudinal transitions in the first three decades of life. J Anxiety Disord 2022; 86:102533. [PMID: 35092927 DOI: 10.1016/j.janxdis.2022.102533] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 12/06/2021] [Accepted: 01/09/2022] [Indexed: 01/23/2023]
Abstract
BACKGROUND There is a notable comorbidity between externalizing disorders and anxiety disorders, which may be explained by the co-occurrence of two prevalent early-onset disorders, by shared vulnerability and risk factors, or as evidence that one disorder group might be causally related to the other. AIM To investigate the longitudinal trajectories of externalizing disorders, their interplay with anxiety disorders, and putative predictors for symptom progression in youth. METHODS 1053 adolescents (14-17 years) from the general population were assessed at baseline and prospectively at 2, 4, and 10-year follow-up using a standardized interview of mental disorders (DIA-X/M-CIDI) to assess "early" (oppositional-defiant disorder, conduct disorder, ADHD) and "late" (antisocial behavior, substance use disorders) externalizing disorders as well as anxiety disorders. Longitudinal associations and predictors for symptom progression were examined using Kaplan-Meier-analyses. RESULTS Lifetime prevalence of early externalizing disorders were 9.1% and 6.4% among those with and without any anxiety disorder. A late externalizing disorder was reported by 50.3% of those with an early externalizing disorder and in 26.6% of those with any anxiety disorder. Both early (HR: 1.5, 95%CI: 1.0-2.3) and late externalizing disorders (HR: 2.1, 95%CI: 1.7-2.6) were associated with incident anxiety disorders. Higher parental rejection, lower volitional inhibition, and higher volitional avoidance predicted incident anxiety disorders among those with early externalizing disorders. DISCUSSION Early externalizing disorders likely follow a homotypic continuity (to late externalizing disorders) and/or a heterotypic continuity to anxiety disorders, and thus appear as a useful target for prevention and early intervention.
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Affiliation(s)
- Susanne Knappe
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 36, 01187 Dresden, Germany; Evangelische Hochschule Dresden (ehs), University of Applied Sciences for Social Work, Education and Nursing, Dürerstr. 25, 01307 Dresden, Germany.
| | - Julia Martini
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 36, 01187 Dresden, Germany; Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Peter Muris
- Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 36, 01187 Dresden, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Nußbaumstr. 7, 80336 Munich, Germany.
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 36, 01187 Dresden, Germany.
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Jones LB, Risley SM, Kiel EJ. Maternal respiratory sinus arrhythmia contextualizes the relation between maternal anxiety and overprotective parenting. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2022; 36:92-101. [PMID: 35084875 PMCID: PMC8795692 DOI: 10.1037/fam0000877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This current study examined maternal characteristics that predict the use of overprotective parenting in mothers of toddlers. Maternal respiratory sinus arrhythmia (RSA) reactivity was tested as a moderator of the relation between maternal anxiety and overprotective parentig. Mothers (n = 151) and their 2-year-old toddlers participated in a laboratory visit and returned for a follow-up visit 1 year later. At child age 2, mothers reported their own anxiety. Mothers' RSA reactivity was measured between a resting baseline and a standardized laboratory task, and overprotective parenting was observed in that task. Toddler fearful temperament (FT) was observed in a separate standardized task as well as reported by mothers. At child age 3, mothers' overprotective parenting behaviors were observed according to the same procedures so change from age 2 could be measured. Results revealed that maternal anxiety and maternal RSA at age 2 interacted to predict relative increases in overprotective parenting behaviors at age 3. At low levels of RSA reactivity, reflecting RSA suppression, maternal anxiety predicted lower levels of overprotective parenting. At high levels of RSA reactivity, reflecting RSA augmentation, maternal anxiety predicted higher levels of overprotective parenting. Our results suggest that RSA suppression may protect mothers with anxiety symptoms from engaging in overprotective parenting, whereas RSA augmentation may put mothers with anxiety symptoms at risk for engaging in overprotective parenting. Findings indicate that the interaction of multiple parental traits should be considered when working with parents and families on parenting behavior. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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CHENG T, CHENG N, WANG M, WANG Z. Toddlers' anxiety predicts their creativity at the age of five: The chain mediation effects of general cognition and mastery motivation. ACTA PSYCHOLOGICA SINICA 2022. [DOI: 10.3724/sp.j.1041.2022.00799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Alam N, Ahmed O, Naher L, Hiramoni FA. The psychometric properties of Social Anxiety Scale for Adolescents (SAS-A) short form-Bangla. Heliyon 2021; 7:e07801. [PMID: 34466696 PMCID: PMC8384893 DOI: 10.1016/j.heliyon.2021.e07801] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/19/2021] [Accepted: 08/12/2021] [Indexed: 11/28/2022] Open
Abstract
There is a lack of available valid assessment tools (published) for assessing social anxiety symptoms among Bangladeshi people. Therefore, this study was aimed to examine the psychometric properties of the Social Anxiety Scale for Adolescents (Short Form) to assess the social anxiety symptoms among Bangladeshi young adults. In this study, the data (N = 683) from the ‘Social Media Addiction among University Students’ project were utilized. Results regarding item-level information using classical test theory and item response theory demonstrated that all items of the scale had a higher discrimination index and acceptable infit and outfit mean squares. The confirmatory factor analysis supported a three-factor structure for the scale and strict invariance between males and females. Scale level results showed that this translated scale had good internal consistency reliabilities, composite reliability, as well as acceptable average variance extracted values, standard error of measurement, and discrimination power. Regarding validity, this scale had moderate to low correlations with loneliness and the big five personality traits. To sum up, the SAS-A-SF Bangla is a psychometrically sound measure that would be helpful for practitioners and researchers to assess the social anxiety symptoms among Bangladesh young adults.
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Affiliation(s)
- Najifa Alam
- Department of Psychology, University of Chittagong, Chattogram, 4331, Bangladesh
| | - Oli Ahmed
- Department of Psychology, University of Chittagong, Chattogram, 4331, Bangladesh
| | - Lutfun Naher
- Department of Psychology, University of Chittagong, Chattogram, 4331, Bangladesh
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Fox JK, Ryan JL, Martin Burch J, Halpern LF. The Role of Parental Overcontrol in the Relationship between Peer Victimization, Social Threat Cognitions, and Social Anxiety in School-Age Children. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09466-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
The purpose of the current article is to explore familial factors that influence the development of social anxiety disorder (SAD) in children and adolescents, including parenting, sibling relationships, and family environment. A multitude of interrelated genetic and familial factors have been found to cause and maintain SAD in children and adolescents. There are many challenges in diagnosing and treating the disorder. Knowledge and awareness of familial factors provide insight on targeted treatments that prevent or ameliorate SAD. [Journal of Psychosocial Nursing and Mental Health Services, 59(7), 23-34.].
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Bark K, Ha JH, Jue J. Examining the Relationships Among Parental Overprotection, Military Life Adjustment, Social Anxiety, and Collective Efficacy. Front Psychol 2021; 12:613543. [PMID: 33643141 PMCID: PMC7904882 DOI: 10.3389/fpsyg.2021.613543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/19/2021] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to verify the relationships among parental overprotection (PO), military life adjustment (MLA), social anxiety, and collective efficacy (CE). There have been studies examining the influence of each of these variables in isolation, but no study has examined these variables simultaneously. Two hundred and thirty-one male conscript soldiers participated in the study. Results indicated that all four variables were correlated with one another. Through hierarchical regression analysis, we determined that social anxiety fully mediated the relationship between PO and MLA. Furthermore, we found that CE moderated the relationship between PO and social anxiety. Finally, we confirmed the moderated mediation effect of CE in our proposed model. We discuss the implications and limitations of this model.
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Affiliation(s)
- Kyounghee Bark
- Learning Science Department of Graduate School, Hanyang University, Seoul, South Korea
| | - Jung Hee Ha
- Graduate School of Counseling Psychology, Hanyang University, Seoul, South Korea
| | - Juliet Jue
- Department of Art Therapy, Hanyang Cyber University, Seoul, South Korea
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Paroxetine-Overview of the Molecular Mechanisms of Action. Int J Mol Sci 2021; 22:ijms22041662. [PMID: 33562229 PMCID: PMC7914979 DOI: 10.3390/ijms22041662] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/31/2021] [Accepted: 02/04/2021] [Indexed: 12/20/2022] Open
Abstract
In the 21st century and especially during a pandemic, the diagnosis and treatment of depression is an essential part of the daily practice of many family doctors. It mainly affects patients in the age category 15–44 years, regardless of gender. Anxiety disorders are often diagnosed in children and adolescents. Social phobias can account for up to 13% of these diagnoses. Social anxiety manifests itself in fear of negative social assessment and humiliation, which disrupts the quality of social functioning. Treatment of the above-mentioned disorders is based on psychotherapy and pharmacotherapy. Serious side effects or mortality from antidepressant drug overdose are currently rare. Recent studies indicate that paroxetine (ATC code: N06AB), belonging to the selective serotonin reuptake inhibitors, has promising therapeutic effects and is used off-label in children and adolescents. The purpose of this review is to describe the interaction of paroxetine with several molecular targets in various points of view including the basic chemical and pharmaceutical properties. The central point of the review is focused on the pharmacodynamic analysis based on the molecular mechanism of binding paroxetine to various therapeutic targets.
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Shahar B. New Developments in Emotion-Focused Therapy for Social Anxiety Disorder. J Clin Med 2020; 9:E2918. [PMID: 32927706 PMCID: PMC7565910 DOI: 10.3390/jcm9092918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/23/2020] [Accepted: 09/07/2020] [Indexed: 11/30/2022] Open
Abstract
Social anxiety disorder (SAD) is a highly complex, chronic, disabling and costly anxiety disorder. Although cognitive-behavioral therapy (CBT) is effective for many patients, many others do not respond to CBT or remain considerably symptomatic at the end of treatment. Pharmacological effects are also modest. More empirically-supported treatment options are needed in order to increase patient access to effective treatment. Emotion-focused therapy (EFT) shows great promise in treating SAD effectively and is particularly suitable for treating SAD because pervasive emotional avoidance, difficulties with emotional differentiation, and high levels of self-criticism, which are central psychopathological processes in SAD, are also primary therapeutic targets in EFT. EFT is based on the assumption that the most efficient way to change a maladaptive emotion is not through reason or skill learning, but through the activation of other, more adaptive emotions. EFT aims to access shame-based emotional memories that underlie SAD, and transform them by exposing them to new adaptive emotional experiences, such as empowering assertive anger, grief, and self-compassion. In this paper, the core features of EFT for SAD are presented, as well as the EFT view of dysfunction in SAD and EFT change processes. Research findings regarding the effectiveness of EFT for SAD are presented together with initial findings regarding mechanisms of change occurring during treatment.
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Affiliation(s)
- Ben Shahar
- The Paul Baerwald School of Social Work and Social Welfare, Hebrew University, Jerusalem 91905, Israel
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Wu Q, Zhang J, Slesnick N. Intergenerational transmission of maternal overprotection and child anxiety in substance-using families. J Anxiety Disord 2020; 73:102236. [PMID: 32447226 PMCID: PMC7318452 DOI: 10.1016/j.janxdis.2020.102236] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 03/14/2020] [Accepted: 05/05/2020] [Indexed: 11/16/2022]
Abstract
The current study investigated an intergenerational transmission model between maternal overprotection and child anxiety across three generations, among a sample of substance-using women and their children. Participants included 183 mother-child pairs. Mothers reported overprotective behaviors of their own mothers, as well as their own anxiety symptoms and substance use at baseline. Mothers reported their adolescents' internalizing behaviors, and adolescents reported their mothers' overprotection, five times over 1.5 years. Growth curve models showed that overprotection among the first generation (G1) mothers was related to anxiety among the second generation (G2) mothers and sequentially the rate of change of overprotection among G2 mothers. Baseline overprotection among G2 mothers was related to baseline internalizing problems among the third generation (G3). More importantly, substance use among G2 mothers moderated the link between the rate of change in overprotection among G2 mothers and the rate of change in internalizing problems among G3 children. Findings uncover the intergenerational transmission model of overprotection-anxiety and shed light upon the complex relations among anxiety, substance use, and parenting in substance-using families.
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Affiliation(s)
- Qiong Wu
- Department of Family and Child Sciences, College of Human Sciences, Florida State University, 322 Sandels Building, 120 Convocation Way, Tallahassee, FL, 32306, United States.
| | - Jing Zhang
- Department of Human Development and Family Studies, School of Lifespan Development and Educational Sciences, Kent State University, 406G White Hall, 150 Terrace Drive, P.O. Box 5190, Kent, OH, 44242, United States
| | - Natasha Slesnick
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Campbell Hall Room 135, 1787 Neil Ave., Columbus, OH, 43210, United States
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Parental Socialization, Social Anxiety, and School Victimization: A Mediation Model. SUSTAINABILITY 2020. [DOI: 10.3390/su12072681] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The aim of this study was to examine the relationship between parenting dimensions (involvement/acceptance vs. strictness/imposition) and school victimization, considering the possible mediating role of social anxiety. The sample comprised 887 adolescents (52.3% girls) aged between 12 and 16 (M = 13.84 and SD = 1.22) enrolled at three compulsory secondary education ("ESO" or "Educación Secundaria Obligatoria" in Spanish) schools located in the provinces of Valencia, Teruel and Seville (Spain). A structural equations model was developed using the Mplus 7.4 program. The results obtained indicate that social anxiety mediates the relationship between parenting dimensions (involvement/acceptance vs. strictness/imposition) and school victimization. Finally, the results and their potential theoretical and practical implications are discussed.
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Trait social anxiety as a conditional adaptation: A developmental and evolutionary framework. DEVELOPMENTAL REVIEW 2020. [DOI: 10.1016/j.dr.2019.100886] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Albers CC, Müller JM, Mehring K, Romer G. Is a mother's recalled parental rearing behavior, her attributions of her child's behavior, and her psychopathology associated with her mother-child relationship quality? Infant Ment Health J 2020; 41:378-392. [PMID: 32057116 DOI: 10.1002/imhj.21850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND The mother-child relationship quality (MCRQ) may represent a transgenerational transmission mechanism of mental health problems. In this context, we examine the mother's recalled parental rearing behavior, actual attributions of her child's behavior, and her current psychopathology. METHOD A clinical sample of mother-child dyads was assessed with the Questionnaire for the Assessment of Recalled Parental Rearing Behavior, the Parent Cognition Scale, and the Symptom Checklist at the Child Psychiatric Family Day Hospital for preschool children in Münster, Germany, at admission. MCRQ was assessed with the Parent-Infant Relationship Global Assessment Scale, a structured interview with the child (Strukturiertes Interview zur Erfassung der Kind-Eltern-Interaktion), and the Multiperspective Parent-Child Relationship Questionnaire. RESULTS Multiple regression analyses showed no direct association between the mother's recalled parental rearing behavior and any measure of the MCRQ. However, maternal dysfunctional attributions about her child's behavior and her actual psychopathology showed the expected negative associations with the multiperspective measures of MCRQ. The relationship quality assessments did not correlate significantly with each other. CONCLUSION The divergent measures of MCRQ, which seem to assess different aspects, are a barrier to investigate the association between the mother's recalled parental rearing behavior and MCRQ. However, low MCRQ is associated with increased maternal psychopathology and maternal dysfunctional attributions on child behavior.
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Affiliation(s)
- Carolin C Albers
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Jörg M Müller
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Kathrin Mehring
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Georg Romer
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
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Gómez-Ortiz O, Romera EM, Jiménez-Castillejo R, Ortega-Ruiz R, García-López LJ. Parenting practices and adolescent social anxiety: A direct or indirect relationship? Int J Clin Health Psychol 2019; 19:124-133. [PMID: 31193117 PMCID: PMC6517642 DOI: 10.1016/j.ijchp.2019.04.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 04/15/2019] [Indexed: 02/07/2023] Open
Abstract
According to existing evidence, parental educational practices and social anxiety are to some degree connected. However, the possibility that this relationship is an indirect one and is mediated by individual factors such as self-esteem or emotional regulation has not yet been explored. The aim of this study was therefore to explore the relationship between maternal and paternal educational practices and social anxiety, and test both the direct and the indirect pathways. METHOD The representative sample consisted of 2,060 Andalusian students (47.7% girls, M age = 14.34) who filled in various self-reports. RESULTS The structural equation models confirmed that a direct relationship, with a low effect size, exists between parental educational practices and social anxiety and that there is also an indirect relationship, mediated by negative self-esteem and emotional suppression (the emotional regulation strategy), which accounted here for 49.1% of the variance in social anxiety. CONCLUSIONS Parental education practices seem to act as a family asset which either promotes or hinders the development of basic attitudes and competencies such as self-esteem or emotional regulation and, by doing this, either encourages or prevents the emergence of problems such as social anxiety.
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Weymouth BB, Fosco GM, Feinberg ME. Nurturant-involved parenting and adolescent substance use: Examining an internalizing pathway through adolescent social anxiety symptoms and substance refusal efficacy. Dev Psychopathol 2019; 31:247-260. [PMID: 29212564 PMCID: PMC5991983 DOI: 10.1017/s0954579417001766] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Research has clearly established the important role of parents in preventing substance use among early adolescents. Much of this work has focused on deviance (e.g., antisocial behavior, delinquency, and oppositional behavior) as a central pathway linking parenting behaviors and early adolescent substance use. This study proposed an alternative pathway; using a four-wave longitudinal design, we examined whether nurturant-involved parenting (Fall sixth grade) was inversely associated with adolescent drunkenness, marijuana use, and cigarette use (eighth grade) through social anxiety symptoms (Spring sixth grade) and subsequent decreases in substance refusal efficacy (seventh grade). Nurturant-involved parenting is characterized by warmth, supportiveness, low hostility, and low rejection. Analyses were conducted with a sample of 687 two-parent families. Results indicated that adolescents who were in families where fathers exhibited lower levels of nurturant-involved parenting experienced subsequent increases in social anxiety symptoms and decreased efficacy to refuse substances, which in turn was related to more frequent drunkenness, cigarette use, and marijuana use. Indirect effects are discussed. Findings were not substantiated for mothers' parenting. Adolescent gender did not moderate associations. The results highlight an additional pathway through which parenting influences youth substance use and links social anxiety symptoms to reduced substance refusal efficacy.
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Thorslund K, Alfredsson E, Axberg U. Universal parental support for parents of adolescents: Who wants municipality-based parental support and in what form? Scand J Psychol 2018; 60:16-25. [PMID: 30412930 DOI: 10.1111/sjop.12498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 09/27/2018] [Indexed: 11/29/2022]
Abstract
Parenting a child through adolescence can be a challenge for many parents; adolescents go through notable developmental, physical, and psychological changes that affect the relationships around them. Most parents find parental support during these years important. These young people's relationships with their parents are important to their mental health, but although parental support is universally available to parents of younger children, it is still scarce for parents of adolescents. The aim of this study was to explore what factors are associated with interest in universal parental support through telephone interviews and questionnaires with 223 parents of 13- to 17-year-olds. Parents' interest in parental support was linked to their own anxious mood, their lower perceived parental capacity, their perception of the child as having psychiatric problems, the parents' perception of their adolescents' openness about things and their perception of the adolescent's overall difficulties in daily life due to psychiatric symptoms. The results show that lighter forms of support such as lectures or seminars were more appealing to parents with higher social status. Offering community-based individual counseling and leader-led parent training groups therefore has the potential to reach parents with difficulties more equally, while offering support only through lectures and seminars could increase the inequality between parents in different social situations.
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Affiliation(s)
- Karin Thorslund
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Elin Alfredsson
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Ulf Axberg
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
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Çetinkaya M, Üneri ÖŞ, Göker Z. Serum oxytocin and vasopressin levels in children with social anxiety disorder and the effects of parent characteristics. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1505280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Miray Çetinkaya
- Department of Child and Adolescant Psychiatry, Dr. Sami Ulus Maternity and Child Health Training Hospital, Ankara, Turkey
| | - Özden Şükran Üneri
- Department of Child and Adolescant Psychiatry, Ankara Child Health and Hematology/Oncology Training and Research Hospital, Ankara, Turkey
| | - Zeynep Göker
- Department of Child and Adolescant Psychiatry, Ankara Child Health and Hematology/Oncology Training and Research Hospital, Ankara, Turkey
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Griffith JM, Silk JS, Oppenheimer CW, Morgan JK, Ladouceur CD, Forbes EE, Dahl RE. Maternal Affective Expression and Adolescents' Subjective Experience of Positive Affect in Natural Settings. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2018; 28:537-550. [PMID: 29057589 PMCID: PMC5913005 DOI: 10.1111/jora.12357] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
This study investigated the association between maternal affective expression during laboratory-based interaction tasks and adolescents' experience of positive affect (PA) in natural settings. Participants were 80 healthy adolescents and their mothers. Durations of maternal positive (PA) and negative affective (NA) expressions were observed during a conflict resolution task and a positive event planning interaction task. Ecological momentary assessment (EMA) procedures were employed to assess adolescents' momentary and peak experience of PA in daily life. Results indicated that maternal NA, but not maternal PA, was related to adolescents' EMA-reported PA. Adolescents whose mothers expressed more NA experienced less PA in daily environments. Results suggest that adolescents' exposure to maternal negative affective behavior is associated with adolescents' subjective daily well-being.
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Telman LGE, van Steensel FJA, Maric M, Bögels SM. What are the odds of anxiety disorders running in families? A family study of anxiety disorders in mothers, fathers, and siblings of children with anxiety disorders. Eur Child Adolesc Psychiatry 2018; 27:615-624. [PMID: 29110074 PMCID: PMC5945734 DOI: 10.1007/s00787-017-1076-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 10/27/2017] [Indexed: 11/05/2022]
Abstract
This family study investigated (1) the prevalence of anxiety disorders (ADs) in parents and siblings of children (n = 144) aged 8-18 years with ADs compared to control children (n = 49), and (2) the specificity of relationships between child-mother, child-father, and child-sibling ADs. Clinical interviews were used to assess current DSM-IV-TR ADs in children and siblings, and lifetime and current ADs in parents. Results showed that children with ADs were two to three times more likely to have at least one parent with current and lifetime ADs than the control children (odds ratio (OR) = 2.04 and 3.14). Children with ADs were more likely to have mothers with current ADs (OR = 2.51), fathers with lifetime ADs (OR = 2.84), but not siblings with ADs (OR = 0.75). Specific relationships between mother-child ADs were found for Social Anxiety Disorder (SAD, OR = 3.69) and Generalized Anxiety Disorder (OR = 3.47). Interestingly, all fathers and siblings with SAD came from families of children with SAD. Fathers of children with SAD were more likely to have lifetime ADs themselves (OR = 2.86). Findings indicate that children with ADs more often have parents with ADs, and specifically SAD is more prevalent in families of children with SAD. Influence of parent's (social) ADs should be considered when treating children with ADs.
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Affiliation(s)
- Liesbeth G. E. Telman
- 0000000084992262grid.7177.6Research Institute of Child Development and Education, University of Amsterdam, Postbus 15780, 1001 NG Amsterdam, The Netherlands
| | - Francisca J. A. van Steensel
- 0000000084992262grid.7177.6Research Institute of Child Development and Education, University of Amsterdam, Postbus 15780, 1001 NG Amsterdam, The Netherlands
| | - Marija Maric
- 0000000084992262grid.7177.6Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Susan M. Bögels
- 0000000084992262grid.7177.6Research Institute of Child Development and Education, University of Amsterdam, Postbus 15780, 1001 NG Amsterdam, The Netherlands ,UvA minds, Academic Outpatient Child and Adolescent Treatment Center, Amsterdam, The Netherlands
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Mak HW, Fosco GM, Feinberg ME. The Role of Family for Youth Friendships: Examining a Social Anxiety Mechanism. J Youth Adolesc 2017; 47:306-320. [PMID: 28866796 DOI: 10.1007/s10964-017-0738-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 08/20/2017] [Indexed: 10/18/2022]
Abstract
The quality of family relationships and youth friendships are intricately linked. Previous studies have examined different mechanisms of family-peer linkage, but few have examined social anxiety. The present study examined whether parental rejection and family climate predicted changes in youth social anxiety, which in turn predicted changes in friendship quality and loneliness. Possible bidirectional associations also were examined. Data for mothers, fathers, and youth (M age at Time 1 = 11.27; 52.3% were female) from 687 two-parent households over three time points are presented. Results from autoregressive, cross-lagged analyses revealed that father rejection (not mother rejection or family climate) at Time 1 (Fall of 6th Grade) predicted increased youth social anxiety at Time 2 (Spring of 7th Grade), which in turn, predicted increased loneliness at Time 3 (Spring of 8th Grade). The indirect effect of father rejection on loneliness was statistically significant. Mother rejection, father rejection, and a poor family climate were associated with decreased friendship quality and increased loneliness over time. Finally, there was some evidence of transactional associations between father rejection and youth social anxiety as well as between social anxiety and loneliness. This study's findings underscore the important role of fathers in youth social anxiety and subsequent social adjustment.
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Affiliation(s)
- Hio Wa Mak
- Human Development and Family Studies, Pennsylvania State University, 119 Health and Human Development Building, University Park, PA, 16802, USA.
| | - Gregory M Fosco
- Human Development and Family Studies, Pennsylvania State University, 226 Health and Human Development Building, University Park, PA, 16802, USA
| | - Mark E Feinberg
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, 314 Biobehavioral Health Building, University Park, PA, 16802, USA
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24
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The Role of Environmental Factors in the Aetiology of Social Anxiety Disorder: A Review of the Theoretical and Empirical Literature. BEHAVIOUR CHANGE 2017. [DOI: 10.1017/bec.2017.7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Social anxiety disorder (SAD) is characterised by a marked and persistent fear of social/performance situations, and a number of key environmental factors have been implicated in the aetiology of the disorder. Hence, the current article reviews theoretical and empirical evidence linking the development of SAD with parenting factors, traumatic life events, and aversive social experiences. Specifically, research suggests that the risk of developing SAD is increased by over-controlling, critical and cold parenting, an insecure attachment style, aversive social/peer experiences, emotional maltreatment, and to a lesser extent other forms of childhood maltreatment and adversity. Moreover, these factors may lead to posttraumatic reactions, distorted negative self-imagery, and internalised shame-based schemas that subsequently maintain SAD symptomatology. However, further research is necessary to clarify the nature, interactions, and relative contributions of these factors. It is likely that SAD develops via a complex interplay of biological and environmental factors, and that multiple aetiological pathways underlie the development of the disorder.
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25
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Nelemans SA, Meeus WHJ, Branje SJT, Van Leeuwen K, Colpin H, Verschueren K, Goossens L. Social Anxiety Scale for Adolescents (SAS-A) Short Form: Longitudinal Measurement Invariance in Two Community Samples of Youth. Assessment 2017; 26:235-248. [PMID: 28052690 DOI: 10.1177/1073191116685808] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In this study, we examined the longitudinal measurement invariance of a 12-item short version of the Social Anxiety Scale for Adolescents (SAS-A) in two 4-year longitudinal community samples ( Nsample 1 = 815, Mage T1 = 13.38 years; Nsample 2 = 551, Mage T1 = 14.82 years). Using confirmatory factor analyses, we found strict longitudinal measurement invariance for the three-factor structure of the SAS-A across adolescence, across samples, and across gender. Some developmental changes in social anxiety were found from early to mid-adolescence, as well as gender differences across adolescence. These findings suggest that the short version of the SAS-A is a developmentally appropriate instrument that can be used effectively to examine adolescent social anxiety development.
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Affiliation(s)
| | - Wim H J Meeus
- 2 Utrecht University, Utrecht, the Netherlands.,3 Tilburg University, Tilburg, the Netherlands
| | | | | | - Hilde Colpin
- 1 KU Leuven-University of Leuven, Leuven, Belgium
| | | | - Luc Goossens
- 1 KU Leuven-University of Leuven, Leuven, Belgium
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26
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Spence SH, Rapee RM. The etiology of social anxiety disorder: An evidence-based model. Behav Res Ther 2016; 86:50-67. [DOI: 10.1016/j.brat.2016.06.007] [Citation(s) in RCA: 137] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 06/07/2016] [Accepted: 06/29/2016] [Indexed: 12/16/2022]
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27
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Norton AR, Abbott MJ. Bridging the Gap between Aetiological and Maintaining Factors in Social Anxiety Disorder: The Impact of Socially Traumatic Experiences on Beliefs, Imagery and Symptomatology. Clin Psychol Psychother 2016; 24:747-765. [DOI: 10.1002/cpp.2044] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 09/01/2016] [Accepted: 09/09/2016] [Indexed: 01/08/2023]
Affiliation(s)
- Alice R. Norton
- Clinical Psychology Unit, School of Psychology; The University of Sydney; Sydney NSW Australia
| | - Maree J. Abbott
- Clinical Psychology Unit, School of Psychology; The University of Sydney; Sydney NSW Australia
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Laurin-Barantke L, Hoyer J, Fehm L, Knappe S. Oral but not written test anxiety is related to social anxiety. World J Psychiatry 2016; 6:351-357. [PMID: 27679775 PMCID: PMC5031936 DOI: 10.5498/wjp.v6.i3.351] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 07/15/2016] [Accepted: 08/01/2016] [Indexed: 02/05/2023] Open
Abstract
AIM To examine the associations of test anxiety (TA) in written vs oral exam situations with social anxiety (SA).
METHODS A convenience sample of 204 students was recruited at the Technische Universität Dresden (TU Dresden, Germany) and contacted via e-mail asking to complete a cross-sectional online survey based on established questionnaires. The study protocol was approved by the ethics committee of the TU Dresden. Full data of n = 96 students were available for dependent t-tests and correlation analyses on the associations of SA and TA respectively with trigger events, cognitions, safety behaviors, physical symptoms and depersonalization. Analyses were run using SPSS.
RESULTS Levels of TA were higher for fear in oral exams than for fear in written exams (M = 48.1, SD = 11.5 vs M = 43.7, SD = 10.1 P < 0.001). Oral TA and SA were positively correlated (Spearman’s r = 0.343, P < 0.001; Pearson’s r = 0.38, P < 0.001) contrasting written TA and SA (Spearman’s r = 0.17, P > 0.05; Pearson’s r = 0.223, P > 0.05). Compared to written TA, trigger events were more often reported for oral TA (18.2% vs 30.3%, P = 0.007); which was also accompanied more often by test-anxious cognitions (7.9% vs 8.5%, P = 0.001), safety behavior (8.9% vs 10.3%, P < 0.001) and physical symptoms (for all, P < 0.001).
CONCLUSION Written, but not oral TA emerged being unrelated to SA and may rather not be considered as a typical facet of SA disorder.
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29
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Otto C, Petermann F, Barkmann C, Schipper M, Kriston L, Hölling H, Ravens-Sieberer U, Klasen F. Risiko- und Schutzfaktoren generalisierter Ängstlichkeit im Kindes- und Jugendalter. KINDHEIT UND ENTWICKLUNG 2016. [DOI: 10.1026/0942-5403/a000185] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Die generalisierte Angststörung bei Kindern und Jugendlichen weist eine Prävalenz von 2 % und ein Erstmanifestationsalter von 8.5 Jahren auf. Anhand der Daten der BELLA-Kohortenstudie wurden Einflüsse ausgewählter Risiko- und Schutzfaktoren auf das Auftreten und die Entwicklung von Symptomen generalisierter Angststörung (generalisierte Ängstlichkeit) untersucht. Mit latenten Wachstumsmodellen und linearen Regressionen wurden die Angaben von n = 1 469 Teilnehmern (11 bis 17 Jahre) zu drei Messzeitpunkten analysiert. Zu Studienbeginn wirkte die elterliche Ängstlichkeit als Risikofaktor und das Selbstwertgefühl der Kinder und Jugendlichen als Schutzfaktor auf die generalisierte Ängstlichkeit. Initiale elterliche Ängstlichkeit wirkte auch nachhaltig auf die Veränderung generalisierter Ängstlichkeit über den Studienverlauf. Weiterhin ging eine Verbesserung des Selbstwertgefühls über den Studienverlauf mit einem Abfall generalisierter Ängstlichkeit einher. Einflüsse der potentiellen Schutzfaktoren elterliche Fürsorge und soziale Unterstützung lagen nicht vor. Obwohl nur geringe Effekte gefunden wurden, ist das Selbstwertgefühl für die klinische Arbeit mit Kindern und Jugendlichen mit generalisierter Angststörung interessant.
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Affiliation(s)
- Christiane Otto
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - Claus Barkmann
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | - Marc Schipper
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - Levente Kriston
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf
| | - Heike Hölling
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin
| | - Ulrike Ravens-Sieberer
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | - Fionna Klasen
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
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30
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Adolescent and Parental Contributions to Parent-Adolescent Hostility Across Early Adolescence. J Youth Adolesc 2015; 45:713-29. [PMID: 26346035 DOI: 10.1007/s10964-015-0348-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 08/31/2015] [Indexed: 10/23/2022]
Abstract
Early adolescence is characterized by increases in parent-adolescent hostility, yet little is known about what predicts these changes. Utilizing a fairly large sample (N = 416, 51 % girls, 91 % European American), this study examined the conjoint and unique influences of adolescent social anxiety symptoms and parental intrusiveness on changes in parent-adolescent hostility across early adolescence. Higher mother and father intrusiveness were associated with increased mother- and father-adolescent hostility. An examination of reciprocal effects revealed that mother- and father-adolescent hostility predicted increased mother and father intrusiveness. Significant associations were not substantiated for adolescent social anxiety symptoms. These findings suggest that intrusive parenting has important implications for subsequent parent-adolescent interactions and that similar patterns may characterize some aspects of mother- and father-adolescent relationships.
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31
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Beesdo-Baum K, Knappe S, Asselmann E, Zimmermann P, Brückl T, Höfler M, Behrendt S, Lieb R, Wittchen HU. The 'Early Developmental Stages of Psychopathology (EDSP) study': a 20-year review of methods and findings. Soc Psychiatry Psychiatr Epidemiol 2015; 50:851-66. [PMID: 25982479 DOI: 10.1007/s00127-015-1062-x] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 04/27/2015] [Indexed: 01/03/2023]
Abstract
PURPOSE The "Early Developmental Stages of Psychopathology (EDSP)" study is a prospective-longitudinal study program in a community sample (Munich, Germany) of adolescents and young adults. The program was launched in 1994 to study the prevalence and incidence of psychopathological syndromes and mental disorders, to describe the natural course and to identify vulnerability and risk factors for onset and progression as well as psychosocial consequences. This paper reviews methods and core outcomes of this study program. METHODS The EDSP is based on an age-stratified random community sample of originally N = 3021 subjects aged 14-24 years at baseline, followed up over 10 years with up to 3 follow-up waves. The program includes a family genetic supplement and nested cohorts with lab assessments including blood samples for genetic analyses. Psychopathology was assessed with the DSM-IV/M-CIDI; embedded dimensional scales and instruments assessed vulnerability and risk factors. RESULTS Beyond the provision of age-specific prevalence and incidence rates for a wide range of mental disorders, analyses of their patterns of onset, course and interrelationships, the program identified common and diagnosis-specific distal and proximal vulnerability and risk factors including critical interactions. CONCLUSIONS The EDSP study advanced our knowledge on the developmental pathways and trajectories, symptom progression and unfolding of disorder comorbidity, highlighting the dynamic nature of many disorders and their determinants. The results have been instrumental for defining more appropriate diagnostic thresholds, led to the derivation of symptom progression models and were helpful to identify promising targets for prevention and intervention.
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Affiliation(s)
- Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany,
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Di Blasi M, Cavani P, Pavia L, Lo Baido R, La Grutta S, Schimmenti A. The relationship between self-Image and social anxiety in adolescence. Child Adolesc Ment Health 2015; 20:74-80. [PMID: 32680392 DOI: 10.1111/camh.12071] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Self-image is the subjective perception about one's own self, body, mental functioning, social attitudes, and adjustment in different aspects of life. Research has linked negative self-image with a number of problem behaviors and psychiatric symptoms in adolescence; however, studies of the relationship between self-image and anxiety disorders are still scarce. METHOD This study involved a community sample of 1305 high-school students (51.4% female) who ranged in age from 14 to 19 years old. They completed self-report measures of self-image and social anxiety disorder (SAD). RESULTS A quarter of the students reported high levels of social anxiety. Statistical analyses showed significant differences between these students and the other students in all the self-image subscales. Several dimensions of impaired self-image (emotional tone, social attitudes, vocational and educational goals, family relationships, external mastery, and psychological health) were associated with high levels of social anxiety, with some gender differences underpinning these relationships. CONCLUSIONS Clinicians treating SAD in youth may wish to consider that a negative self-image may play a critical role in the onset and retention of social anxiety symptoms.
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Affiliation(s)
- Maria Di Blasi
- Department of Psychology, University of Palermo, Palermo, Italy
| | - Paola Cavani
- Department of Psychology, University of Palermo, Palermo, Italy
| | - Laura Pavia
- Department of Psychology, University of Palermo, Palermo, Italy
| | - Rosa Lo Baido
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| | | | - Adriano Schimmenti
- Department of Human and Social Sciences, UKE, Kore University of Enna, Cittadella Universitaria, Enna, 94100, Italy
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Asselmann E, Wittchen HU, Lieb R, Höfler M, Beesdo-Baum K. The role of behavioral inhibition and parenting for an unfavorable emotional trauma response and PTSD. Acta Psychiatr Scand 2015; 131:279-89. [PMID: 25039395 DOI: 10.1111/acps.12316] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The role of behavioral inhibition (BI) and parenting for an unfavorable emotional trauma response (DSM-IV criterion A2) and post-traumatic stress disorder (PTSD) development is unclear. METHOD A community sample of adolescents and young adults (aged 14-24) was followed up over 10 years (N=2378). Traumatic events, criterion A2, and PTSD (according to DSM-IV-TR) were assessed using the M-CIDI. BI and parenting were assessed using the Retrospective Self-Report of Inhibition and the Questionnaire of Recalled Parenting Rearing Behavior. Multiple logistic regressions adjusted for sex, age, and number of traumata were used to examine associations of BI as well as maternal and paternal overprotection, rejection, and reduced emotional warmth with (i) criterion A2 in those with trauma (N=1794) and (ii) subsequent PTSD in those with criterion A2 (N=1160). RESULTS Behavioral inhibition (BI; odds ratio, OR=1.32) and paternal overprotection (OR=1.27) predicted criterion A2 in those with trauma, while only BI (OR=1.53) predicted subsequent PTSD. BI and paternal emotional warmth interacted on subsequent PTSD (OR=1.32), that is, BI only predicted PTSD in those with low paternal emotional warmth. CONCLUSION Our findings suggest that BI and adverse parenting increase the risk of an unfavorable emotional trauma response and subsequent PTSD. Paternal emotional warmth buffers the association between BI and PTSD development.
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Affiliation(s)
- E Asselmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
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Asselmann E, Wittchen HU, Lieb R, Beesdo-Baum K. The role of the mother-child relationship for anxiety disorders and depression: results from a prospective-longitudinal study in adolescents and their mothers. Eur Child Adolesc Psychiatry 2015; 24:451-61. [PMID: 25201054 DOI: 10.1007/s00787-014-0596-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 08/01/2014] [Indexed: 01/04/2023]
Abstract
This study aims to examine whether (a) low child valence (emotional connectedness) within the mother-child relationship increases the risk for offspring depression, (b) low child potency (individual autonomy) increases the risk for offspring anxiety, and (c) maternal psychopathology pronounces these associations. We used data from a prospective-longitudinal study of adolescents (aged 14-17 at baseline) and their mothers (N = 1,015 mother-child dyads). Anxiety disorders and depression were assessed repeatedly over 10 years in adolescents (T0, T1, T2, T3) and their mothers (T1, T3) using the DSM-IV/M-CIDI. Valence and potency were assessed in mothers (T1) with the Subjective Family Image Questionnaire. Odds ratios (OR) from logistic regression were used to estimate associations between low child valence/potency and offspring psychopathology (cumulated lifetime incidences; adjusted for sex and age). In separate models (low valence or low potency as predictor), low child valence predicted offspring depression only (OR = 1.26 per SD), while low child potency predicted offspring anxiety (OR = 1.24) and depression (OR = 1.24). In multiple models (low valence and low potency as predictors), low child valence predicted offspring depression only (OR = 1.19), while low child potency predicted offspring anxiety only (OR = 1.22). Low child potency interacted with maternal anxiety on predicting offspring depression (OR = 1.49), i.e. low child potency predicted offspring depression only in the presence of maternal anxiety (OR = 1.33). These findings suggest that low child valence increases the risk for offspring depression, while low child potency increases the risk for offspring anxiety and depression and interacts with maternal psychopathology on predicting offspring depression.
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Affiliation(s)
- Eva Asselmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany,
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35
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Schimmenti A, Bifulco A. Linking lack of care in childhood to anxiety disorders in emerging adulthood: the role of attachment styles. Child Adolesc Ment Health 2015; 20:41-48. [PMID: 32680332 DOI: 10.1111/camh.12051] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND Emotional neglect can be characterized as cold or critical parenting and denotes a parent intentionally or unintentionally overlooking the signs that a child needs comfort or attention and ignoring its emotional needs. Parental emotional neglect is widely posited as an antecedent of anxiety disorder, with attachment researchers arguing for anxious-ambivalent attachment style as a mediating factor. METHOD Childhood experience of neglect and abuse, including antipathy (cold, critical parenting), attachment styles, and anxiety disorders were assessed in a high-risk sample of 160 adolescents and young adults by means of interview measures. RESULTS Antipathy was associated with 12-month prevalence of anxiety disorders in the sample. Anxious-ambivalent attachment scores statistically mediated the relationship between antipathy and anxiety disorders. CONCLUSIONS Clinicians treating anxiety disorders in youths need to consider that emotional neglect in childhood in the form of antipathy could lead to anxious-ambivalent internal working models operating around fear of rejection and fear of separation.
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Affiliation(s)
- Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE - Kore University of Enna, Cittadella Universitaria, 94100, Italy
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Unternaehrer E, Meyer AH, Burkhardt SCA, Dempster E, Staehli S, Theill N, Lieb R, Meinlschmidt G. Childhood maternal care is associated with DNA methylation of the genes for brain-derived neurotrophic factor (BDNF) and oxytocin receptor (OXTR) in peripheral blood cells in adult men and women. Stress 2015; 18:451-61. [PMID: 26061800 DOI: 10.3109/10253890.2015.1038992] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
In adults, reporting low and high maternal care in childhood, we compared DNA methylation in two stress-associated genes (two target sequences in the oxytocin receptor gene, OXTR; one in the brain-derived neurotrophic factor gene, BDNF) in peripheral whole blood, in a cross-sectional study (University of Basel, Switzerland) during 2007-2008. We recruited 89 participants scoring < 27 (n = 47, 36 women) or > 33 (n = 42, 35 women) on the maternal care subscale of the Parental Bonding Instrument (PBI) at a previous assessment of a larger group (N = 709, range PBI maternal care = 0-36, age range = 19-66 years; median 24 years). 85 participants gave blood for DNA methylation analyses (Sequenom(R) EpiTYPER, San Diego, CA) and cell count (Sysmex PocH-100i™, Kobe, Japan). Mixed model statistical analysis showed greater DNA methylation in the low versus high maternal care group, in the BDNF target sequence [Likelihood-Ratio (1) = 4.47; p = 0.035] and in one OXTR target sequence Likelihood-Ratio (1) = 4.33; p = 0.037], but not the second OXTR target sequence [Likelihood-Ratio (1) < 0.001; p = 0.995). Mediation analyses indicated that differential blood cell count did not explain associations between low maternal care and BDNF (estimate = -0.005, 95% CI = -0.025 to 0.015; p = 0.626) or OXTR DNA methylation (estimate = -0.015, 95% CI = -0.038 to 0.008; p = 0.192). Hence, low maternal care in childhood was associated with greater DNA methylation in an OXTR and a BDNF target sequence in blood cells in adulthood. Although the study has limitations (cross-sectional, a wide age range, only three target sequences in two genes studied, small effects, uncertain relevance of changes in blood cells to gene methylation in brain), the findings may indicate components of the epiphenotype from early life stress.
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Affiliation(s)
- Eva Unternaehrer
- a Department of Psychology, Division of Clinical Psychology and Epidemiology , University of Basel , Basel , Switzerland
- b National Center of Competence in Research (NCCR), Swiss Etiological Study of Adjustment and Mental Health (sesam), University of Basel , Switzerland
- c Douglas Mental Health University Institute, McGill University , Montréal , Canada
| | - Andrea Hans Meyer
- a Department of Psychology, Division of Clinical Psychology and Epidemiology , University of Basel , Basel , Switzerland
| | - Susan C A Burkhardt
- b National Center of Competence in Research (NCCR), Swiss Etiological Study of Adjustment and Mental Health (sesam), University of Basel , Switzerland
- d Department of Research & Development , University of Applied Sciences in Special Needs Education , Zürich , Switzerland
| | - Emma Dempster
- e University of Exeter Medical School, Exeter University , Exeter , UK
| | - Simon Staehli
- a Department of Psychology, Division of Clinical Psychology and Epidemiology , University of Basel , Basel , Switzerland
- f Institute of Psychobiology, University of Trier , Trier , Germany
| | - Nathan Theill
- g Division of Psychiatry Research , University of Zurich , Zurich , Switzerland , and
| | - Roselind Lieb
- a Department of Psychology, Division of Clinical Psychology and Epidemiology , University of Basel , Basel , Switzerland
- b National Center of Competence in Research (NCCR), Swiss Etiological Study of Adjustment and Mental Health (sesam), University of Basel , Switzerland
| | - Gunther Meinlschmidt
- a Department of Psychology, Division of Clinical Psychology and Epidemiology , University of Basel , Basel , Switzerland
- b National Center of Competence in Research (NCCR), Swiss Etiological Study of Adjustment and Mental Health (sesam), University of Basel , Switzerland
- h Faculty of Medicine , Ruhr-University Bochum , Germany
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Can parent training for parents with high levels of expressed emotion have a positive effect on their child's social anxiety improvement? J Anxiety Disord 2014; 28:812-22. [PMID: 25265549 DOI: 10.1016/j.janxdis.2014.09.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 08/24/2014] [Accepted: 09/03/2014] [Indexed: 10/24/2022]
Abstract
The role that parents' involvement may play in improving their child's social anxiety is still under debate. This paper aimed to investigate whether training parents with high expressed emotion (EE) could improve outcomes for adolescent social anxiety intervention. Fifty-two socially anxious adolescents (aged 13-18 years), whose parents exhibited high levels of expressed emotion, were assigned to either (a) a school-based intervention with an added parent training component, or (b) a school-based program focused solely on intervening with the adolescent (no parental involvement). Post-treatment and 12-month follow-up findings showed that school-based intervention with parent training was superior to the adolescent-specific program, yielding significant reductions in diagnosis remission, social and depressive symptomatology, particularly when the EE status of parents changed. Overall, the findings suggest that high-EE parents of children with social anxiety need to be involved in their child's therapy.
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Shahar B, Doron G, Szepsenwol O. Childhood Maltreatment, Shame-Proneness and Self-Criticism in Social Anxiety Disorder: A Sequential Mediational Model. Clin Psychol Psychother 2014; 22:570-9. [PMID: 25196782 DOI: 10.1002/cpp.1918] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 07/24/2014] [Accepted: 08/01/2014] [Indexed: 11/07/2022]
Abstract
UNLABELLED Previous research has shown a robust link between emotional abuse and neglect with social anxiety symptoms. However, the mechanisms through which these links operate are less clear. We hypothesized a model in which early experiences of abuse and neglect create aversive shame states, internalized into a stable shame-based cognitive-affective schema. Self-criticism is conceptualized as a safety strategy designed to conceal flaws and prevent further experiences of shame. However, self-criticism maintains negative self-perceptions and insecurity in social situations. To provide preliminary, cross-sectional support for this model, a nonclinical community sample of 219 adults from Israel (110 females, mean age = 38.7) completed measures of childhood trauma, shame-proneness, self-criticism and social anxiety symptoms. A sequential mediational model showed that emotional abuse, but not emotional neglect, predicted shame-proneness, which in turn predicted self-criticism, which in turn predicted social anxiety symptoms. These results provide initial evidence supporting the role of shame and self-criticism in the development and maintenance of social anxiety disorder. The clinical implications of these findings are discussed. KEY PRACTITIONER MESSAGE Previous research has shown that histories of emotional abuse and emotional neglect predict social anxiety symptoms, but the mechanisms that underlie these associations are not clear. Using psycho-evolutionary and emotion-focused perspectives, the findings of the current study suggest that shame and self-criticism play an important role in social anxiety and may mediate the link between emotional abuse and symptoms. These findings also suggest that therapeutic interventions specifically targeting shame and self-criticism should be incorporated into treatments for social anxiety, especially with socially anxious patients with abuse histories.
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Affiliation(s)
- Ben Shahar
- Interdisciplinary Center, School of Psychology, Herzliya, Israel
| | - Guy Doron
- Interdisciplinary Center, School of Psychology, Herzliya, Israel
| | - Ohad Szepsenwol
- Interdisciplinary Center, School of Psychology, Herzliya, Israel
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Abstract
OBJECTIVE Although poor parental bonding is a known risk factor for suicidality, current literature is inconsistent about the relative role of low parental care and parental overprotection, as well as the combination of the two, termed "affectionless control". This review presents the current state of knowledge of the relationship between suicidality and these two aspects of parental bonding. METHOD The computerized databases Medline, PubMed, PsychINFO, PsychLit, and Google Scholar were searched using combinations of the following keywords: suicidality, suicide, suicide attempt, suicidal behavior, parental bonding, and parental bonding instrument. Using the results, we reviewed the reports on the relationship between suicidality and parental bonding as measured by validated parental bonding instruments. RESULTS Twelve papers were analyzed. All of them used the parental bonding instrument (PBI) and one used both the PBI and the object representation inventory (ORI). Most reports agreed that, in mothers, either lack of maternal care and/or overprotection was associated with an increase in suicidal behavior, while in fathers only low care was consistently associated with suicidality. This lack of constancy with regard to the effect of paternal overprotection appears to be due to cultural differences in fathers' role in child rearing. With these differences acknowledged, affectionless control in both parents emerges as the parenting style most strongly associated with suicidal behavior. Common methodological problems included low numbers of subjects, inconsistent control groups, and the lack of a uniform definition of suicidality. CONCLUSION Despite methodological limitations, current literature consistently indicates that parental affectionless control is associated with suicidal behavior. Recognizing affectionless control as a risk factor for suicide and developing early interventions aimed at modifying affectionless and overprotective parenting style in families with a history of affective disorders may be effective in reducing suicidal risk.
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Shahar B. Emotion-Focused Therapy for the Treatment of Social Anxiety: An Overview of the Model and a Case Description. Clin Psychol Psychother 2013; 21:536-47. [DOI: 10.1002/cpp.1853] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 05/26/2013] [Accepted: 05/29/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Ben Shahar
- School of Psychology; Interdisciplinary Center; Herzliya; Israel
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