Exploring the Contribution of Parental Perceptions to Childhood Anxiety

Parental rearing practices such as over-involvement are associated with childhood anxiety; however, little is known about the contribution of parental perceptions to child anxiety. This study explores the relationship between maternal and paternal perceptions of parenting and childhood anxiety. The perceived rearing behaviors and parental sense of competence (i.e., satisfaction and efficacy) of the parents of anxious children (n = 59) were compared with those of a non-clinical control sample (n = 44). In line with the findings from the literature that addresses externalizing disorders, parental sense of competence was significantly associated with childhood outcomes. Logistical regression suggested that paternal efficacy beliefs, acceptance, and maternal satisfaction were associated with an absence of clinical anxiety and lower levels of anxiety symptoms in children. Parental perceptions may thus provide an important area for understanding childhood anxiety

Parental responsibility beliefs: associations with parental anxiety and behaviours in the context of childhood anxiety disorders

Background: High levels of parental anxiety are associated with poor treatment outcomes for children with anxiety disorders. Associated parental cognitions and behaviours have been implicated as impediments to successful treatment. We examined the association between parental responsibility beliefs, maternal anxiety and parenting behaviours in the context of childhood anxiety disorders. Methods: Anxious and non-anxious mothers of 7-12 year old children with a current anxiety disorder reported their parental responsibility beliefs using a questionnaire measure. Parental behaviours towards their child during a stressor task were measured. Results: Parents with a current anxiety disorder reported a greater sense of responsibility for their child’s actions and wellbeing than parents who scored within the normal range for anxiety. Furthermore, higher parental responsibility was associated with more intrusive and less warm behaviours in parent-child interactions and there was an indirect effect between maternal anxiety and maternal intrusive behaviours via parental responsibility beliefs. Limitations: The sample was limited to a treatment-seeking, relatively high socio-economic population and only mothers were included so replication with more diverse groups is needed. The use of a range of stressor tasks may have allowed for a more comprehensive assessment of parental behaviours. Conclusions: The findings suggest that parental anxiety disorder is associated with an elevated sense of parental responsibility and may promote parental behaviours likely to inhibit optimum child treatment outcomes. Parental responsibility beliefs may therefore be important to target in child anxiety treatments in the context of parental anxiety disorders

The effect of targeting tolerance of children's negative emotions among anxious parents of children with anxiety disorders: a pilot randomised controlled trial

Following cognitive behavioural therapy for child anxiety a significant minority of children fail to lose their diagnosis status. One potential barrier is high parental anxiety. We designed a pilot RCT to test claims that parental intolerance of the child’s negative emotions may impact treatment outcomes. Parents of 60 children with an anxiety disorder, who were themselves highly anxious, received either brief parent-delivered treatment for child anxiety or the same treatment with strategies specifically targeting parental tolerance of their child’s negative emotions. Consistent with predictions, parental tolerance of the child’s negative emotions significantly improved from pre- to post-treatment. However, there was no evidence to inform the direction of this association as improvements were substantial in both groups. Moreover, while there were significant improvements in child anxiety in both conditions, there was little evidence that this was associated with the improvement in parental tolerance. Nevertheless, findings provide important clinical insight, including that parent-led treatments are appropriate even when the parent is highly anxious and that it may not be necessary to adjust interventions for many families

Navigating the development and dissemination of internet cognitive behavioral therapy (iCBT) for anxiety disorders in children and young people: a consensus statement with recommendations from the #iCBTLorentz workshop group

Initial internet-based cognitive behavioral therapy (iCBT) programs for anxiety disorders in children and young people (CYP) have been developed and evaluated, however these have not yet been widely adopted in routine practice. The lack of guidance and formalized approaches to the development and dissemination of iCBT has arguably contributed to the difficulty in developing iCBT that is scalable and sustainable beyond academic evaluation and that can ultimately be adopted by healthcare providers. This paper presents a consensus statement and recommendations from a workshop of international experts in CYP anxiety and iCBT (#iCBTLorentz Workshop Group) on the development, evaluation, engagement and dissemination of iCBT for anxiety in CYP

The role of experiential avoidance and parental control in the association between parent and child anxiety

Parenting behavior and practices contribute to the intergenerational relationship between parent and child anxiety, with parental control being a consistent predictor of child anxiety. Parental experiential avoidance refers to how a parent copes with their internal world in the context of parenting. Little is known about how this relatively new parenting concept relates to child anxiety. The current study tested the indirect effect of parent anxiety on child anxiety through parental control and parental experiential avoidance; the indirect effect of parent anxiety on parental control through parental experiential avoidance; and the moderating effect of parental experiential avoidance on the relationship between parental control and child anxiety. Using a cross-sectional design, parents (N = 85) from a community sample of 8–12-year-old children self-reported on a survey measuring parent anxiety, child anxiety, parental control, and parental experiential avoidance. A hierarchical regression indicated that parental experiential avoidance significantly predicted child anxiety and accounted for further variance in child anxiety, over, and above parental control. There was an indirect effect of parent anxiety on child anxiety through parental control and parental experiential avoidance. Parental experiential avoidance moderated the relationship between parental control and child anxiety, such that the relationship was only significant at high levels of parental experiential avoidance. The current study provides support for the role of parental experiential avoidance in an intergenerational understanding of anxiety. Future research should replicate the study with a clinical sample. Theoretical and practice implications are considered

Cognitive Behavior Therapy and Metacognitive Therapy: Moderators of Treatment Outcomes for Children with Generalized Anxiety Disorder.

Although cognitive behavioral therapy (CBT) is effective for childhood anxiety disorders, approximately 40% of youth remain anxious after treatment. Metacognitive therapy (MCT-c) for children with generalized anxiety disorder (GAD) has shown promising effects. The present study aimed to examine if CBT and MCT-c show differential effects in children with primary GAD based on baseline characteristics, in a quasi-experimental design. To investigate which treatment is most beneficial for whom, three potential moderators: age, symptom severity, and comorbid social anxiety were examined. Sixty-three children aged 7-14 completed CBT or MCT-c. Participants were assessed before and after treatment. Both CBT and MCT-c were highly effective in treatment of childhood GAD. None of the selected variables significantly moderated treatment outcomes. Subgroups of children with high symptom severity and social anxiety comorbidity showed trends of responding better to CBT. Methodologically stronger studies are needed to facilitate a better adaptation of treatment for children with GAD