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Nimphy CA, Mitrou V, Elzinga BM, Van der Does W, Aktar E. The Role of Parental Verbal Threat Information in Children's Fear Acquisition: A Systematic Review and Meta-analysis. Clin Child Fam Psychol Rev 2024:10.1007/s10567-024-00485-4. [PMID: 38789695 DOI: 10.1007/s10567-024-00485-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2024] [Indexed: 05/26/2024]
Abstract
Children can acquire fears of novel stimuli as a result of listening to parental verbal threat information about these stimuli (i.e., instructional learning). While empirical studies have shown that learning via parental information occurs, the effect size of parental verbal threat information on child fear of a novel stimulus has not yet been measured in a meta-analysis. We conducted a systematic review and meta analysis to assess the effect of parents' verbal statements on their children's fear acquisition. Additionally, we explored potential moderators of this effect, namely, parent and child anxiety levels, as well as child age. WebOfScience, Pubmed, Medline, and PsycINFO were used to identify eligible studies that assessed children's (30 months to 18 years old) fear of novel stimuli after being exposed to parental verbal threat information. We selected 17 studies for the meta-analysis and 18 for the systematic review. The meta-analysis revealed a significant causal effect of parental verbal threat information on children's fear reaction towards novel stimuli [g = 1.26]. No evidence was found for a moderation of verbal learning effects, neither by child or parent anxiety levels nor by child age. The effect of parents' verbal threat information on children's fear of novel stimuli is large and not dependent on anxiety levels or child age.
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Affiliation(s)
- Cosima Anna Nimphy
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands.
| | - Vasiliki Mitrou
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Bernet M Elzinga
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden, The Netherlands
| | - Willem Van der Does
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden University Treatment Center (LUBEC), Leiden, The Netherlands
| | - Evin Aktar
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden, The Netherlands
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Nimphy CA, Venetikidi M, Elzinga B, van der Does W, Aktar E. Parent to Offspring Fear Transmission via Modeling in Early Life: A Systematic Review and Meta-Analysis. Clin Child Fam Psychol Rev 2023; 26:751-772. [PMID: 37500947 PMCID: PMC10465674 DOI: 10.1007/s10567-023-00448-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 07/29/2023]
Abstract
Infants can acquire fears vicariously by observing parents' fearful reactions to novel stimuli in everyday situations (i.e., modeling). To date, no systematic or meta-analytic review examined the role of modeling in parent-child transmission of fear and avoidance in early life. In our systematic review and meta-analysis, we aimed to investigate the effect of modeling parents' fearful reactions on infants' acquisition of fear and avoidance of novel stimuli and explore the moderation of this effect by child behavioral inhibition (BI) and parent trait anxiety. The search conducted in Web Of Science, Pubmed, Embase, and PsycINFO revealed 23 eligible studies for the systematic review and 19 for the meta-analysis. Eligible studies included published studies that measured infant fear and avoidance (infants aged up to 30 months) of novel stimuli following exposure to parental fearful expressions. Meta-analysis findings revealed a significant causal effect of modeling of parental fear on infants' fear [g = .44] and avoidance of novel stimuli [g = .44]. The findings support moderation by child BI on infant avoidance (not fear) acquisition, with the effects being larger for infants with higher BI. However, this moderation was only found, when including both experimental and correlational studies (p > .05), but not when exclusively including experimental studies (p = .17). This meta-analysis provides support for early parent-to-offspring fear transmission: a causal small to medium effect of parents' fearful reactions was shown on infants' fear and avoidance of novel stimuli. Elucidating parent-to-offspring anxiety transmission pathways can inform us about potential fear reduction and prevention strategies.
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Affiliation(s)
- Cosima Anna Nimphy
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands.
| | - Marianna Venetikidi
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Bernet Elzinga
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
| | - Willem van der Does
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden University Treatment Center (LUBEC), Leiden University, Leiden, The Netherlands
| | - Evin Aktar
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
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Parental anxiety and offspring development: A systematic review. J Affect Disord 2023; 327:64-78. [PMID: 36740142 DOI: 10.1016/j.jad.2023.01.128] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Parental anxiety has been associated with increased risk of emotional and behavioural problems for offspring, yet the differing impact of each parent is unclear. As emotional disorders continue to present a significant challenge to the health system and with the role of mothers and fathers changing over the past two decades, we sought to systematically review the available literature for an association between parental anxiety and offspring suboptimal outcomes. METHODS A systematic review was conducted using the following databases: Ovid MEDLINE, Embase; PsycINFO and Google Scholar. Reference lists of the included papers were also searched. Data was analysed and grouped based on offspring age. RESULTS Eighteen studies were included in this review. Results suggest that both parents' mental health can impact negatively on the functioning of offspring, during infancy, childhood, and adolescence. This association is weak in infancy, with equivocal results, however the association in childhood appears robust for both mothers and fathers. In adolescence, the findings suggest that maternal anxiety may be more influential than paternal anxiety. LIMITATIONS As the methodology of the included studies was heterogenous, and the timing of assessment varied across the papers, drawing concrete conclusions from the existing research is somewhat impaired. CONCLUSIONS Both mothers' and fathers' anxiety have the propensity to negatively impact on their child's development. Implementing preventative interventions, which include both parents, as well as systemic interventions, which include the whole family, are essential in stemming the intergenerational transmission of mental health problems within families.
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Fernandes CC, Martins AT, Santa-Rita A, Faísca L. The influence of parental variables and child behavioral inhibition on social anxiety in preschool children: The moderator effects of gender. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03247-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Aktar E, Nimphy CA, van Bockstaele B, Pérez‐Edgar K. The social learning of threat and safety in the family: Parent-to-child transmission of social fears via verbal information. Dev Psychobiol 2022; 64:e22257. [PMID: 35312048 PMCID: PMC8944018 DOI: 10.1002/dev.22257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/22/2021] [Accepted: 01/21/2022] [Indexed: 11/18/2022]
Abstract
Parental verbal threat (vs. safety) information regarding the social world may impact a child's fear responses, evident in subjective, behavioral, cognitive, and physiological indices of fear. In this study, primary caregivers provided standardized verbal threat or safety information to their child (N = 68, M = 5.27 years; 34 girls) regarding two strangers in the lab. Following this manipulation, children reported fear beliefs for each stranger. Physiological and behavioral reactions were recorded as children engaged with the two strangers (who were blind to their characterization) in a social interaction task. Child attention to the strangers was measured in a visual search task. Parents also reported their own, and their child's, social anxiety symptoms. Children reported more fear for the stranger paired with threat information, but no significant differences were found in observed child fear, attention, or heart rate. Higher social anxiety symptoms on the side of the parents and the children exacerbated the effect of parental verbal threat on observed fear. Our findings reveal a causal influence of parental verbal threat information only for child-reported fear and highlight the need to further refine the conditions under which acquired fear beliefs persist and generalize to behavior/physiology or get overruled by nonaversive real-life encounters.
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Affiliation(s)
- Evin Aktar
- Department of Clinical PsychologyLeiden UniversityLeidenThe Netherlands
- Leiden Institute for Brain and Cognition (LIBC)Leiden UniversityLeidenThe Netherlands
| | - Cosima A. Nimphy
- Department of Clinical PsychologyLeiden UniversityLeidenThe Netherlands
| | - Bram van Bockstaele
- Department of Child Development and EducationUniversity of AmsterdamAmsterdamThe Netherlands
| | - Koraly Pérez‐Edgar
- Department of PsychologyChild Study CenterThe Pennsylvania State UniversityState CollegePennsylvaniaUSA
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All that meets the eye: The contribution of reward processing and pupil mimicry on pupillary reactions to facial trustworthiness. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02486-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Van Bockstaele B, Aktar E, Majdandžić M, Pérez-Edgar K, Bögels SM. The relation between early behavioural inhibition and later social anxiety, independent of attentional biases to threat. Cogn Emot 2021; 35:1431-1439. [PMID: 34382502 DOI: 10.1080/02699931.2021.1963682] [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: 10/20/2022]
Abstract
Early behavioural inhibition, a temperamental characteristic defined by fearful, overly-sensitive, avoidant, or withdrawn reactions to the unknown, is a predictor of later social anxiety. However, not all behaviourally inhibited children develop anxiety problems, and attentional bias to threat has been proposed to moderate the relation between behavioural inhibition and anxiety. The current study aimed to further specify the relation between early behavioural inhibition and later social anxiety by testing this potentially moderating role of childhood attentional bias to threat. Behavioural inhibition was assessed during toddlerhood (age 2.5 years) using laboratory observations of children's behaviours in response to unknown objects and situations. When children were 7.5 years old, attentional bias was measured in 86 children (46 girls) using both a visual probe task and a visual search task with angry and happy faces. Child social anxiety was measured using questionnaires completed by the child and both parents, and clinical interviews conducted with both parents. Our results showed that while early behavioural inhibition was related to later social anxiety, there was no evidence for a moderation of this relation by attentional bias, suggesting that the relation between early fearful temperament and later social anxiety holds across children, independent of their attentional biases.
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Affiliation(s)
- Bram Van Bockstaele
- School of Psychological Science, University of Western Australia, Crawley, Australia.,Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Evin Aktar
- Clinical Psychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Mirjana Majdandžić
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Koraly Pérez-Edgar
- Department of Psychology, Child Study Center, The Pennsylvania State University, State College, USA
| | - Susan M Bögels
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands.,Psychology Research Institute, University of Amsterdam, Amsterdam, The Netherlands
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Garcia KM, Carlton CN, Richey JA. Parenting Characteristics among Adults With Social Anxiety and their Influence on Social Anxiety Development in Children: A Brief Integrative Review. Front Psychiatry 2021; 12:614318. [PMID: 33995142 PMCID: PMC8113611 DOI: 10.3389/fpsyt.2021.614318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 03/30/2021] [Indexed: 11/13/2022] Open
Abstract
The purposes of this brief integrative review are to identify and critically evaluate recent work in the area of parenting processes that are disproportionately observed among parents with social anxiety disorder (SAD) that may ultimately increase risk among offspring, and to further link these processes to specific targets for intervention. Accordingly, we first evaluate the relevance of specific parenting styles as they pertain to increased risk of developing SAD among offspring. Second, we link these parenting processes to observations of certain unfavorable consequences among socially anxious youth, such as low perceived autonomy and poorer social skills. Finally, in light of these consequences we extend our conclusions into potentially modifiable targets among parents with SAD, focusing on the enhancement of autonomy and facilitating offspring's normative period of transition into independence during adolescence. Overall, we conclude that parenting behaviors commonly observed among adults with SAD, such as overcontrol and low parental warmth, likely have a direct impact on the development of social anxiety symptoms among their children. However, these parenting behaviors are plausibly modifiable and therefore repurposing existing interventions for use among parents with SAD in conjunction with interventions with their offspring is likely to provide direct clinical benefit.
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Affiliation(s)
- Katelyn M Garcia
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - Corinne N Carlton
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - John A Richey
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
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Aktar E, Van Bockstaele B, Pérez‐Edgar K, Wiers RW, Bögels SM. Intergenerational transmission of attentional bias and anxiety. Dev Sci 2019; 22:e12772. [PMID: 30428152 PMCID: PMC6590262 DOI: 10.1111/desc.12772] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 09/29/2018] [Accepted: 11/02/2018] [Indexed: 12/02/2022]
Abstract
Earlier evidence has revealed a bi-directional causal relationship between anxiety and attention biases in adults and children. This study investigated the prospective and concurrent relations between anxiety and attentional bias in a sample of 89 families (mothers, fathers, and first-born children). Parents' and children's attentional bias was measured when children were 7.5 years old, using both a visual probe task and visual search task with angry versus happy facial expressions. Generalized and social anxiety symptoms in parents and children were measured when children were 4.5 and 7.5 years old. Anxiety in parents and children was prospectively (but not concurrently) related to their respective attentional biases to threat: All participants showed a larger attentional bias to threat in the visual search (but not in the visual probe) task if they were more anxious at the 4.5 (but not at the 7.5) year measurement. Moreover, parents' anxiety levels were prospectively predictive of the visual search attentional bias of their children after controlling for child anxiety. More anxiety in mothers at 4.5 years was related to a faster detection of angry among happy faces, while more anxiety in fathers predicted a faster detection of happy among angry faces in children at 7.5 years. We found no direct association between parental and child attentional biases. Our study contributes to the recently emerging literature on attentional biases as a potential mechanism in the intergenerational transmission of anxiety by showing that parents' anxiety rather than parents' attentional bias contributes to the intergenerational transmission of risk for child anxiety.
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Affiliation(s)
- Evin Aktar
- Institute of Psychology, Clinical Psychology UnitLeiden UniversityLeidenthe Netherlands
- Department of Child Development and EducationUniversity of AmsterdamAmsterdamthe Netherlands
| | - Bram Van Bockstaele
- Department of Child Development and EducationUniversity of AmsterdamAmsterdamthe Netherlands
- Department of PsychologyUniversity of AmsterdamAmsterdamthe Netherlands
| | - Koraly Pérez‐Edgar
- Department of PsychologyChild Study CenterThe Pennsylvania State UniversityPennsylvania
| | - Reinout W. Wiers
- Department of PsychologyUniversity of AmsterdamAmsterdamthe Netherlands
| | - Susan M. Bögels
- Department of Child Development and EducationUniversity of AmsterdamAmsterdamthe Netherlands
- Department of PsychologyUniversity of AmsterdamAmsterdamthe Netherlands
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