Preventing Onset of Anxiety Disorders in Offspring of Anxious Parents: A Randomized Controlled Trial of a Family-Based Intervention.

OBJECTIVE: The authors examined the efficacy of a family-based intervention to prevent the onset of anxiety disorders in offspring of anxious parents. METHOD: Participants were 136 families with a parent meeting DSM-IV criteria for an anxiety disorder and one child 6-13 years of age without an anxiety disorder. Families were randomly assigned to the family-based intervention (N=70) or to an information-monitoring control condition (N=66). All families were expected to complete assessments, administered by blind interviewers, at baseline, at the end of the intervention (or 8 weeks after randomization) and at 6- and 12-month follow-ups. Onset of any anxiety disorder and anxiety symptom severity (assessed using the Anxiety Disorders Interview Schedule for Children) at 12 months were the primary and secondary outcome measures, respectively. RESULTS: The incidence of child anxiety disorders was 31% in the control group and 5% in the intervention group (odds ratio=8.54, 95% CI=2.27, 32.06). At the 1-year follow-up, youths in the control group also had higher anxiety symptoms ratings than those in the intervention group. Effect sizes were medium to large (0.81 at 6 months and 0.57 at 12 months for anxiety symptoms), and the number needed to treat was 3.9 at 12 months. Significant moderators included baseline levels of child anxiety; significant mediators were parental distress and modeling of anxiety. Child maladaptive cognitions and parental anxiety did not mediate outcomes. CONCLUSIONS: A brief psychosocial prevention program holds promise for reducing the 1-year incidence of anxiety disorders among offspring of anxious parents.

Parent Psychopathology and Children's Psychological Health: Moderation by Sibling Relationship Dimensions.

Offspring of anxious adults are at heightened risk for psychological maladjustment; however factors that protect youth in the context of this risk have been rarely explored. Supported by literature showing the meaningful role of sibling relationships for children's psychological outcomes, this study examined the protective role of the sibling relationship for children in the context of risk for psychological maladjustment due to having a parent with a clinical anxiety disorder. Participants were 81 children ages 7 to 12 years (58% female; 82 % Caucasian), and their parents. Parents met DSM-IV-TR diagnostic criteria for a primary anxiety disorder, and youth did not meet diagnostic criteria for any psychiatric disorder. Parents completed questionnaires on their own psychological distress and use of parenting behaviors, and on their children's psychological adjustment. Children self-reported on the quality of their sibling relationship based on their closest-age sibling. Parenting behaviors were also coded based on a parent-child interaction task. Results of hierarchical regression models demonstrated that sibling relationship quality moderated the relation between parental psychological distress and child adjustment. Post-hoc simple slopes analyses showed that parental distress was significantly positively associated with greater child psychological problems only for children reporting low sibling companionship or high sibling conflict. Aspects of the sibling relationship did not moderate the association between self-rated or observer-rated parenting behaviors and child anxiety symptoms. Findings are consistent with developmental models and empirical literature emphasizing the protective role of sibling relationships for youth's psychological outcomes. Sibling relationships may be a salient target for youth psychological preventive or treatment interventions.

Anxiety-promoting parenting behaviors: a comparison of anxious mothers and fathers.

The majority of research identifying anxiety-promoting parenting behaviors has been conducted with mothers, leaving a gap in current knowledge about the role of fathers' parenting behaviors. In an attempt to fill this gap, this study compared anxiety-promoting parenting behaviors of anxious mothers and fathers. Parents completed self-report measures of parenting behavior and independent coders rated parenting behaviors (i.e., overcontrol, granting of autonomy, warmth, hostility, anxious behavior) of mothers (n = 34) and fathers (n = 21) during a challenging parent-child interaction task (children were ages 6-12). Results indicated that anxious fathers were observed to be more controlling than anxious mothers; while anxious mothers reported using more punishment and reinforcement of children's dependence in anxiety provoking situations compared to fathers. Findings extend our knowledge about anxious fathers, and highlight the need for additional research on the impact of fathers' parenting with respect to the development of child anxiety.