PARENTS’ ANXIETY AND CHILDREN’S OUTCOMES



PARENTS’ ANXIETY AND CHILDREN’S OUTCOMES

INTRO ANXIETY

Social anxiety, generalized anxiety disorder, PTSD

Theoretical models of anxiety disorders have emphasized the influence of parenting on development, maintainence and amelioration of childhood anxiety (Marshall, 2005). Traditional models of childhood anxiety – focus on single main effects and broad parenting dimensions (acceptance vs rejection, autonomy vs control ) -> bipolar dimensions with positive at one and and negative at one end.

Rejection-low levels of warmth, approval, responsiveness (Clark, 2000). –undermines children’s emotion regulation and increases sensitivity to anxiety (Gottman, 1997).

Problem – retrospective reports- adults with mood disorders give biased accounts of parenting that do not reflect their actual childhood experiences (Wood, 2003).

PREVALENCE

Prevalence rates of anxiety in children range from 2.6% - 23.9%. Anxiety can have a detrimental impact on the child especially if it is associated with avoidant behaviours, excessive fears and physiological symptoms. Anxious children are at risk of developing social and academic problems, and comorbid problems in adulthood (depression and substance abuse

phobia – they feel like their fears are real. -substance abuse – self medication. -avoidant behaviour. –socially anxious will avioid parties. -somatic manifestations

Anxiety disorders are one of the most prevalent types of clinical diagnosis in childhood and adolescence. Prevalence rates range from 2 to 17%, with 2.5 to 5% meeting criteria at any given age (Ollendick, 2007) . Average age of onset varies somewhat between studies, but once diagnosed, childhood anxiety has been reported to continue across development.

Research has consistently indicated that anxiety disorders tend to run in families as demonstrated by both “top-down” studies, examining anxiety in children of anxiety-disordered adults, and “bottom-up” studies, examining anxiety in the parents of anxiety-disordered children. Research with both designs has found rates of anxiety disorders in family members above what would be expected when compared to the population at large. For example, up to 60% of anxious parents have been found to have a child with an anxiety disorder (Ginsburg & Schlossberg, 2002

RISK FACTORS (Murray,2009)

Given that relationships are bidirectional in nature (Bell, 1968; Cook & Kenny, 2005), it is difficult to disentangle the effects of the environmental context (e.g., parents, child care providers, peers) from the child’s temperament. Therefore, both temperament and the environment may show transactional effects (Sameroff & Mackenzie, 2003) where they influence one another over time and extend joint effects on psychopathology throughout development.

 Gross and Hen (2004) reviewed empirical evidence which supports the proposition that anxiety in childhood reflects an interaction between genetic vulnerability and early environment, where the development of specific anxieties reflect the nature of the environmental risk (see also Eley & Stevenson, 2000).

1) VULNERABILITY RISK FACTORS

a) GENETICS Children of parents with an anxiety disorder are up to 7 times more likely to show clinical levels of anxiety compared to children of non-anxious parents. Genes account for approximately 30-40% of the variance in anxiety symptoms (Biederman,2006). high role for autism, schizophrenia but lower for anxiety (30-40% - the rest explained by environmentalist factors) . Reviews of twin, sibling, and adoption studies have revealed that a genetic component explains approximately one-third of the etiological variance associated with childhood anxiety disorders, indicating that heritability appears to play a substantial role in the etiology of anxiety disorders (Yang, 2005). That is, children who have a parent with an anxiety disorder are at increased risk for developing an anxiety disorder, but not necessarily the same disorder as the parent. Thus, it may be that environmental variables play an essential role in shaping the particular anxiety disorder developed by the child (Rapee, 2002).

b) BEHAVIOURAL INHIBITION (BI) BI refers to temperamental pattern of responding characterized by fearfulness, reticence or restrain when faced with unfamiliar people or situations. There is a strong association between BI and anxiety disorder in children. !! BUT not all BI children develop anxiety disorders suggesting that other factors are also at play (Fox, 2005). closely related to temperament (not easy temperament – easy to feed, to sooth, to go to bed) but others difficult temp (hard to sooth) or score high on BI (ex: first day of school- will show clingy behaviour). Not all develop anxiety disorder- so other factors need to be identified

(BI, Kagan, 1989) – child temperamental pattern of responding charact by fearfulness, reticence or restraint when faced with unfamiliar people or situations. Strong associations between BI in children and anxiety disorders in parents. And early BI – predict later frank anxiety disorder (Biederman, 2001a).

Functional imaging studies have also found those with BI to display heightened amygdala activation to novel neutral or threatening faces (Schwartz, Wright, Shin, Kagan, & Rauch, 2003; Perez-Edgar et al., 2007). Thus, inhibited behaviors, such as avoidance of novelty/threat, represent overt coping mechanisms by which this amygdala activation and the resulting fear reactivity is decreased. While coping with fear through avoidance does decrease the fearful reaction, it also reinforces the associated physiological responses and behaviors, leading to continued BI and social wariness (Fox, Henderson, & Marshall, 2001). 

c) INTERPRETATION OF AMBIGUITY Anxious children: Give more negative interpretations in ambiguous scenarios , Have lower thresholds for threat perception , Report higher levels of negative emotion. Mothers of clinically anxious children interpreted a higher level of threat when confronted with ambiguous scenarios. There was also a significant association between mother’s and children’s threat interpretations (Cresswell, 2005).significant risk factor for Anxiety. Test- give scenarios that are incomplete and ask them to complete. Anxious children will give negative interpretation and report higher level of negative emotions + lower threshold for threat perception.

Warren, Emde, and Sroufe (2000) used a story stem paradigm to explore children's internal working models associated with story endings (positive, neutral, negative) and investigated links with anxiety. The results showed that negative story endings at five years of age predicted anxiety one year later (when original level of anxiety was entered into the analysis). The authors proposed that the narratives children produced reflect a child's internal representation of familiar situations and that negative expectations indicate a marker for the development of anxiety. The results of this paper are consistent with adult research (e.g., MacLeod et al., 2002) and provide evidence to support the proposition that negative information processing acts as a risk factor for the development of anxiety in childhood.

- information processing biases to threat and childhood anxiety. The origin of these biases in children is, however, unclear. One possible influence highlighted by several developmental models (e.g., Ginsburg and Schlossberg, 2002 and Rapee, 2001) is socialisation through parenting. 

d) ATTENTIONAL BIAS Attentional bias refers to preferential allocation of attention to stimuli depicting fear and threat Paradigms (Emotional stroop, Visual probe) A meta-analysis of 172 studies found support for attentional bias across paradigms and conditions (d=.045) (Roy,2008) paradigms (emotional stroop, visual probe). Cannot pay attention to everything in environment so need to select and attend only some stimuli. Anxious will focus on stimuli that depict fear and threat – ex; phobia of spiders –when entering a room, will look in corners for spiders –search environment and look for evidence of threat.

Pollack and colleagues explored selective attention towards threat in physically abused children compared with children who had no history of abuse (Pollack et al., 2000,Pollack et al., 2001 and Pollack and Tolley, 2003). Pollack and Tolley (2003), for example, used a Posner type task to look at attention to emotionally threatening (angry) faces and non-threatening (happy) faces in a group of physically abused children and a control group aged 8 to 11 years matched for anxiety. In this task a target appears in one of two locations and participants have to make a decision about whether a target was present or absent. Before targets appear a cue identifies the location on the target on a certain amount of trials (valid trials) and on other trials it incorrectly identifies the location of the target (invalid trials). Their results showed decreased reaction times to respond to targets that were cued by angry (versus happy) emotional faces in valid trials in physically abused children. In addition event-related potentials (ERPs) were also taken where these are reduced by rare or target stimuli. The results showed an increase in P3b on invalid angry trials for physically abused children. The authors interpreted this increase to reflect a greater degree of resources in disengaging from threat stimuli and argued that this group of children is hypervigilant for threat. They proposed that if children are raised in a hostile environment it is adaptive for children to detect (and avoid) threat.

. It is plausible that groups of children who experience increased fearfulness and anxiety in their home environment learn to adaptively allocate attention to threat. Consistent with this hypothesis, Rosen and Schulkin (1998) proposed that if individuals are exposed to repeated and ongoing stress, then fear circuits become increasingly easily activated or “hyperexcitable”, where hyperexcitable fear circuits increase an individual's vigilance for threat and danger leading to heightened anxiety.

 Similarly, Pine, Klein et al. (2005) worked with children where one or both parents were diagnosed with Panic Disorder (PD), major depressive disorder (MDD) or no disorder. children in this study whose parents suffered from PD or MDD showed increased levels of anxiety compared with children whose parents had no diagnosis. The focus of interest was in the extent to which children felt increased fear when viewing emotion faces (angry, fearful, happy). The results showed that children of parents with PD (compared with children whose parents had MDD or no diagnosis) reported more fear when viewing emotion faces and took longer to make this decision, where length of time was taken as an indicator of attentional allocation. These studies highlight that exposure to risk or trauma in the form of parental psychopathology is associated with the presence of information processing biases for threat in children and note the importance of measuring parental psychopathology when exploring information processing biases in children. 

Pine, Mogg et al. (2005) and colleagues who explored further the relationship between children who have a history of physical abuse, their level of anxiety and the presence of information processing biases for threat. This study used a dot probe task to explore information processing biases for emotional (happy and angry) faces in children who had experienced physical abuse, where children were additionally diagnosed with PTSD. They found that increased severity of abuse and PTSD were both associated with an avoidance of angry faces.

2) ENVIRONMENTAL RISK FACTORS Negative life events, Information transfer, Modelling, Parenting

 Ginsburg and Schlossberg (2002), for example, discuss “anxiety-enhancing parenting behaviours” (p.144) which include modelling, reinforcement and negative expectations

Craske, 1999) – first, parenting style is hypothesized to provide an environmental context that influences the development of trait anxiety (ex- frequent parental criticism). Then, specific parenting behaviors that promote or reinforce children’s experiences of anxiety contribute to the development of a particular anxiety disorder by centering beliefs about threat upon a specific theme or class of stimuli.

a) NEGATIVE LIFE EVENTS Negative life events are contributing risk factors to the development and maintenance of anxiety in children, There may be bi-directional influences, Anxiety can predict subsequent negative life events (Allen, 2005) . something bad happened and they develop anxiety. –generalizing. What changes – negative schema, changes in physiology (high levels of cortisol-stress hormone), change in HPA axis (like programming to be quite vulnerable), maintainance –negative event as confirmation of fear being necessary.

bidirectional –anxiety may cause a negative event- ex. Socially anxious become socially excluded. Panic attacks. If child anxious- parent will be overly protective and make it worse. Attentional bias- pay attention to negative, will seem more frequent. Like a vicious cycle

b)INFORMATION TRANSFER, Children who received negative information reported greater fear beliefs about a fictitious monster, Information received from an adult had a greater influence (Field, 2001) . when interact with mother, there is transfer of info. Anxious parent will transfer negative info even without verbalizing (ex: facial expression).Monster- mother will display anxiety .children exposed to this- more scared of monster.

Learning accounts of the development of child fears and anxiety have consistently identified parents as playing a particularly important role through instruction and information transfer (Hadwin et al. 2006  Moore et al. (2004), anxious parents were found to make more catastrophizing comments to their children than non-anxious parents. Suveg et al. (2005) found that parents of anxious children were less likely to refer to positive emotions than were parents of non-anxious children. Barrett and colleagues found that, following parent–child discussion, anxious children became more likely to choose avoidant solutions to hypothetical threats (Barrett et al. 1996; Dadds & Barrett, 1996).

 Field and colleagues have carried out several studies highlighting of the role of negative information on children's reporting of fear beliefs and on their fear behaviour. For example, Field et al. (2001) gave children aged 7 to 9 years of age positive or negative information about a toy monster. They found that when negative information was given children's fear beliefs about the monster increased and this effect was greatest when the source of the information was from adults (compared with peers). This result was replicated using pictures of real animals with children aged 6–9 years of age (Field & Lawson, 2003).

Dadds, Barrett, Rapee and Ryan (1996) labelled the influence of family members on children's behavioural responses to social situations as the FEAR (Family Enhancement of Avoidant Responses) effect . mothers were, however, less likely to agree with their anxious child and, consistent with the FEAR effect, were more likely to respond to an avoidant solution.

The interaction between parent and child anxiety and its effect on information processing in anxious children has been replicated in a recent study (Bögels, van Dongen, & Muris, 2003). This study suggested that parental discussion of social scenarios might reflect parental anxiety, where parents model their own interpretation and behaviours to children. Children heard a series of ambiguous stories and were asked to consider what they would think and do if they were in that situation. Parents read the same stories and made similar decisions regarding the thoughts and actions of a hypothetical child. Parents and children then discussed three scenarios. Based on this discussion children decided on their final thoughts and proposed behaviour. child negative interpretations were associated with parents' interpretations and increased maternal anxiety. 

That is, parents may communicate messages to their children regarding safety, wellbeing, and situations that should be avoided due to potential harm. Although the messages are intended to protect the child, the parent may be communicating a level of danger that exceeds the actual threat from these situations

 Communications such as these may influence children’s interpretations and lead to increased fear of those situations. Furthermore, since parents are often the initial, primary, and most influential source of information for their children, anxious parental communication may have a particularly robust impact on how a child interprets various situations and stimuli (e.g., social situations, strange animals, and physical activities).

The monster experiment -> Moreover, in a replication and extension of this paradigm, fear of the animals was found to persist over a 6-month period (Field, Lawson, & Banerjee, 2007). 

parents given that they are often children’s most common source of information (both negative and positive) about the environment.

Remarkably, there is only one known study which specifically explored the influence of parental information transfer on child anxiety. That is, Muris et al.’s (2001) above-described study of non-clinical adolescents also included interview questions about the role of fearful/anxiety information received from parents. Consistent with that found for reinforcement, adolescent report of parental information transfer was not significantly related to their anxiety levels. However, as previously noted, several potential limitations caution interpretation of these findings. 

c) PARENTAL MODELLING OF ANXIETY Parents can model anxious/avoidant behaviour, Display visual signs (shaking, hyperventilation), Express verbally information about their anxiety, Use avoidant coping strategies. Expression of fear or disgust by the mother in the presence of a novel object resulted in greater fearfulness and avoidance of the object in their toddlers . An experiment showed that fathers had a stronger influence on child anxiety and cognitions than did mothers (Bursten, 2010) At which age and developmental level modelling of parental anxious behaviours occur? A response to child’s anxious behaviours.A function of parents who are anxious themselves.A mutual influence between child and parent characteristics (Murray,2009) .

fathers more influence –Mothers more engaged in social play –they are social partners. Fathers different-promote independence and autonomy, will ask lot of direct questions, will request children to solve problems. Mothers show emotions in general so children will think that it needs to be quite a big problem to make the father react. child expects the father to be more brave etc and if father is anxious it probably means more.. which age – important for prevention (start as early as possible if know that they are at risk) and intervention strategies (to help both parents and children)

-clinical accounts of WW2 experiences- display of fear by mothers during air raids determined whether children expressed similar fears (Lewis, 1942). Retrospective studies by adults with a range of phobias document modeling by others as signif influence, particularly for animal phobias, blood phobia, social phobia and panic (Fisak, 2007), De Rosnay (2006) – maternal modeling of anxious vs non-anxious social resp to a stranger determined infants’ subsequent expression of fear to same unfamiliar adults. Longitudinal (Murray, 2008), mothers social phobia cvs non-anxious conversed with stranger. Maternal expressed anxiety at 10 months predicted infant avoidance of stranger at 14 months (Murray, 2008).

Parental overprotection and modeling of fearful behaviors have been proposed to play a central role in the development of anxiety

Empirically, there has also been support for the role of a related style of parent influence sometimes referred to as an “anxious rearing style” (Wood et al. 2003). Anxious rearing typically refers to overt expressions of anxiety of avoidant behavior by parents and is closely related to modeling of anxious behavior. For example, when faced with a stressor in the company of their child, parents may respond with their own avoidant coping style

. This line of research has followed the influential work of Rachman (1977), who hypothesized three main pathways in the acquisition of fears. In addition to classical conditioning, which Rachman considered a direct process of fear acquisition (e.g., a child bit by a dog develops a fear of dogs), he asserted that fears may be learned through two indirect processes (i.e., vicarious learning and transmission of information/verbal instruction). Numerous studies have provided empirical examination of Rachman’s model in relation to the development of fears (cf., King, Gullone, & Ollendick, 1998). Furthermore, more recently researchers have hypothesized that reinforcement of avoidant/anxious behavior may also play a role in the development of anxiety (Rapee, 2002).

Children could also observe their parent(s) using avoidance as a coping strategy when confronted with an anxiety-invoking stimulus. In each of these examples, an observing child could then display avoidant/anxious behaviors by replicating that shown by the parent(s).

Fear acquired through observational learning -> Mineka et al. (1984) examined the interactions between a group of rhesus monkeys who were afraid of snakes and their offspring. The offspring did not exhibit a fear of snakes in the absence of any particular modeling or related learning experiences. However, after observing fearful parental responses to snakes, a majority of the offspring developed an intense and persistent fear of snakes.

Parents who exhibit high levels of avoidance may also have a particularly severe anxiety disorder which, in turn, may be more likely to be inherited. The combination of factors such as these could then be associated with the development, exacerbation, or maintenance of child anxiety symptoms.

Problems with observational research -> anxious mothers may have internalized their distress so that it was not conveyed to observers. For instance, mothers may have evidenced increased awareness of their modeling behaviors in this experimental setting and refrained from displaying overt distress that they would have otherwise expressed

uckley and Woodruff-Borden (2006) conducted an observational study examining the coping behaviors of anxious and non-anxious mothers. Mother–child dyads took part in two mildly stressful parent–child interaction tasks, which included an unsolvable anagram and child preparation for an impromptu speech. In addition to self-report measures, observational ratings of maternal and child coping were examined. Anxious mothers appeared to exhibit fewer adaptive coping strategies (i.e., less able to cope, spent less time modeling positive teaching of the tasks, and expressed more negative emotion) when compared to non-anxious mothers. 

lthough generally not discussed in the field of developmental psychopathology, it is feasible that social referencing is a factor associated with the vicarious learning of fear. Since social referencing takes place in the first 2 years of life, it is possible that modeling of anxiety may begin during this developmental period. This hypothesis was explored by Gerull and Rapee (2002) who examined the impact of maternal modeling on toddlers’ responses to two novel, fear-relevant toys: a spider and a snake. In the presence of the toddlers (aged 15–20 months), mothers responded to the toy either with positive or negative facial expressions. Toddlers who viewed their mother reacting negatively to the toy demonstrated significantly more behavioral avoidance and fear when presented with it. Interestingly, when the toy was presented again after a 10-min delay, toddlers’ fear was found to persist. This finding suggests that toddlers may retain fear-related information obtained from their parents, and that this information may have the potential to be consolidated into long-term memory. It is also noteworthy that girls generally responded with more fear than boys. This result is particularly interesting as it may be related to findings that, later in childhood, anxiety disorder prevalence rates are consistently higher among females (Weiss & Last, 2001).

DOES CHILD’S ANXIETY HAVE AN EFFECT ON PARENTING?

One of the most common environmental factors examined in relation to child temperament and psychopathology is maternal parenting behavior. 

There is a substantial association between child’s anxiety and parent’s control and warmth (the link between warmth and child anxiety is less consistent)

Parental WARMTH- Leads to child’s belief that the environment is hostile and threatening, Sense of low self-worth and competence

Lack of parental warmth has been considered important because it may lead to the child's believing that the environment is fundamentally hostile and threatening, and to a sense of low self-worth and competence (Parker, 1983; Bogels & Tarrier, 2004).

nd maternal acceptance, warmth, sensitivity, and responsiveness are associated with less inhibited, more socially adaptive behavior (Hane, Cheah et al., 2008

Indeed, much of the debate as to where maternal sensitivity ends and maternal intrusiveness begins is due to the different ways sensitive parenting is measured and defined.

Parental CONTROL Increases the child’s perception of threat, Reduces the child’s perceived control over threat. Not provide the child with occasions to explore the environment and to develop new skills to cope with unexpected environmental demands (van der Bruggen, 2008)

There is growing interest in the association between parental control- considered as the pressure parents put on their children to think, feel or behave in desired ways- and child anxiety.(1)- by increasing the child’s perception of threat (Rapee, 2001),(2)-by reducing the child’s perceived control over threat (Chorpita, 1998) ansd (3)- by not providing the child with occasions to explore their environment and to develop new skills to cope with unexpected environm events (Barlow, 2002).

-mothers of anxious children – high levels of aversive control and attempted to elicit compliance with criticism and punishment (Dumas, 95). -parents of anxiety disordered children have been rated as less autonomy granting by observers and children rated their parents as less accepting (Siqueland, 96).

-Chorpita (98) – role of uncontrollability and unpredictability in development of anxiety – parenting –aversive control- foster children’s sense of reduced ability to influence events. -anxious parents have also been found to support their children’s avoidant behaviour (Barrett, 96).

With regard to parental overcontrol, a parent's excessive regulation of the child's activities and routines, and their discouragement of independence, is likely to promote a limited sense of competence and mastery, and may serve to reinforce child avoidance of challenge (Parker, 1983; Chorpita & Barlow, 1998). Three reviews of parenting (Wood et al. 2003; DiBartolo & Helt, 2007; McLeod et al. 2007) conclude that the evidence for parental lack of warmth being associated with child anxiety is inconsistent, whereas that for parental overcontrol is stronger.

 In a recent meta-analysis, van der Bruggen and colleagues (van der Bruggen, Stams, & Bogels, 2008) reported that maternal control was highly associated with children’s anxiety, independent of maternal anxiety. In addition, studies show that harsh discipline and over-intrusive behavior increase the likelihood of adolescent anxiety (Shanahan et al., 2008; van Brakel et al., 2006)

imilarly, by anticipating and protecting the child from potential threat and distress, the parent reduces the child’s opportunities to increase self-confidence and reduce estimates of harm (Rubin, 2009)

Rapee (2001) –also –effect of child anxiety on parental control -> parents exert control in anticipation of their child’s anxiety related distress.

OTHER

argely focused on closely observed parent–child interactions and the assessment of proximal parenting processes, it is important to note that wider parenting practices are also likely to be implicated in the development of child anxiety. Thus, parents' decisions concerning, for example, the use of day-care, and family socialization and recreational activities, all stand to enhance or else limit child exposure to potential challenges beyond the home, and thereby the opportunity to develop coping skills (see reviews by Chorpita & Barlow, 1998; Bogels & Brechman-Toussaint, 2006).

parents from lower SES backgrounds execute more parental control relative to parents from middle or higher SES (Hoff, 2002). –lower- aversive environm influences that may result in unvarying high levels of parental control.

A second learning mechanism that has been described in relation to the etiology of child anxiety is reinforcement of anxious and/or avoidant behaviors. Specifically, it has been hypothesized that parents may support, assist in, or reward children’s anxious/avoidant behaviors (Rapee, 2002). As examples, a parent may: remove a child from an anxiety-inducing situation (e.g., by picking a child up early from school on a test date); support and encourage a child’s avoidance of anxiety-inducing situations (e.g., by allowing a child to stay home from a social event or school); attempt to reduce a child’s distress with special treatment (e.g., by providing attention or rewards); or permit avoidance of responsibilities (e.g., by taking trash outside for a child when there is a feared dog present).

Results indicated that mothers of anxious children tended to exhibit greater levels of anxious parenting (e.g., focusing on negatives/dangers, expression of doubt that the child could succeed) when compared to mothers of non-anxious children

DOES PARENT’S ANXIETY HAVE AN EFFECT ON PARENTING?

Some evidence suggests that anxious parents:Are less engaged and more withdrawn during interactions with their children,Express more criticism, Show less sensitive responsivity and reduced emotional tone,Are less likely to encourage psychological autonomy, Display higher levels of catastrophizing (Nicol-Harper, 2007)

-prevalence of anxiety disorder in offspring as well, which was not merely due to genetic inheritance (Beidel, 97).

-mothers- social phobia- >children- reduced social responsiveness (43)

-fathers- even greater influence- role in socialization of children -PTSD- children developing same disorder after earthquake, maternal PTSD not linked (Ramchadani & Psychogiou, 2009).

contrary to expectation, they monitored their children less (Chilcoat, 1996).

Murray et al., (2007)- -asked mother to encourage infant to interact with stranger. -infants’ irritability (so temperament) but also mother’s encouragement (ex: flat tone of voice, gaze averted etc). Mothers with social phobia did not differ in sensitivity compared to control mothers.During interactions with a stranger, mothers with social phobia were more anxious, less engaged and were less encouraging of the infant’s interaction with the stranger. Infant’s responsiveness in the group of mothers with social phobia was predicted by infant’s irritability and mother’s encouragement to engage with the stranger

de Rosnay et al., (2006)- Infants first observed their mothers interacting with a stranger and then interacted with the stranger themselves, 2 experimental conditions: non-anxious , socially anxious. After a socially anxious mother-stranger interaction, infants were more fearful and avoidant with the stranger

Some longitudinal studies have separately provided support for both directions of influence (Bayer et al. 2006; Rubin et al. 1999). For example, Rubin et al. (1999) showed that toddler shyness predicted parent involvement 2 years later, whereas Bayer et al. (2006) showed that parent overprotection predicted later child internalizing. Only one study has supported both directions of influence within the one data set. Edwards et al. (in press) showed that maternal overprotection predicted child anxiety 12 months later while child anxiety and inhibition predicted later maternal overprotection

Across late childhood and into adolescence children’s differentiation from their family increases and peers begin to exert greater influence (Armsden et al. 1990; Furman and Buhrmester 1992). Consistent with this developmental perspective, Rubin et al. (2009) suggested that the influence of parent overprotection on child anxiousness should reduce beyond middle childhood, after which peer relationships take greater prominence. Similarly, Hudson and Rapee (2004) suggested that the role of parent support of child avoidance in the development of anxiety should decrease with development and that other influences such as peers may take on greater prominence. However, this is not to say that parent influence would become non-existent during the adolescent years and it is likely that parents will continue to influence their child’s anxiety as long as the child stays within the parent’s sphere of control (Rapee and Spence 2004).

DO CHILD’S AND PARENT’S ANXIETY INTERACT IN PREDICTING PARENTING?

Anxious mothers of children high on behavioural inhibition were more critical compared to anxious mothers of children scoring low on behavioural inhibition. Child anxiety, rather than mother’s anxiety or the interaction between the two predicted maternal catastrophising (Moore et al., 2004)

DOES PARENT’S ANXIETY INFLUENCE TREATMENTS FOR ANXIOUS CHILDREN?

Children did less well from treatment where their mothers had a current anxiety disorder. At 3 years follow-up parental anxiety was not a risk factor for children’s treatment outcomes (Creswell, 200*)

- might be anxious of even putting child into treatment in first place

- hard to enforce each other’s behaviours

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GROUP DISCUSSION -How can parent’s anxiety influence the effectiveness of parenting interventions?

-parents of older children (about 6-10 – can understand …etc)

CHILD -CBT – social skills training combined with graded exposure to feared situations, identification and reappraisal of catastrophic cognitions, relaxation etc

PARENT- -CBT, -parent communication training –problem solving, child behaviour management training

FAMILY THERAPY -both child and parent -> teach proper interaction strategies , teach how to enforce each other’s positive behaviour, attachment styles intervention.. -also – non-anxious parent – to learn anxiety triggers.

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