Changes in maternal expressed emotion toward clinically anxious children following cognitive behavioral therapy

The aim of this study was to determine whether maternal expressed emotion (criticism and emotional overinvolvement) decreased across treatment for childhood anxiety. Mothers of 48 clinically anxious children (aged 6-14 years) were rated on levels of criticism (CRIT) and emotional overinvolvement (EOI), as measured by a Five Minute Speech Sample (FMSS) from mothers, prior to and following cognitive behavioral therapy (CBT) for their children’s anxiety. Results showed a significant decrease in the proportion of mothers who expressed high levels of criticism and emotional overinvolvement from pretreatment to posttreatment. This finding suggests that interventions aimed at reducing symptoms of child anxiety can also result in a decrease of maternal expressed emotion (criticism and emotional overinvolvement).     

Parenting Practices of Anxious and Nonanxious Mothers: A Multi-Method,Multi-Informant Approach

Anxious and nonanxious mothers were compared on theoretically derived parenting and family environment variables (i.e., overcontrol, warmth, criticism, anxious modeling) using multiple informants and methods. Mother-child dyads completed questionnaires about parenting and were observed during an interactional task. Findings reveal that, after controlling for race and child anxiety, maternal anxiety was associated with less warmth and more anxious modeling based on maternal-report. However, maternal anxiety was not related to any parenting domain based on child-report or independent observer (IO) ratings. Findings are discussed in the context of the impact of maternal anxiety on parenting and suggest that child, rather than maternal, anxiety may have a greater influence on maternal behavior.     

Interactions between mothers and children: impacts of maternal and child anxiety

This study, an expansion of an earlier study of parenting behaviors of anxious mothers, examined the relationship of both mother and child anxiety disorders to mother behavior in parent--child interactions. Participants were 68 mother--child dyads with children ranging in age from 7 to 15 years. Mothers and children completed diagnostic evaluations and engaged in conversational tasks; behaviors were rated by coders who were blind to diagnosis. Mothers of anxious children, regardless of their own anxiety, were less warm (p <.05) toward their children. They also granted less autonomy (p <.01). There was an interaction between mother and child anxiety in predicting maternal catastrophizing (p <.01), with anxious mothers and nonanxious mothers of anxious children likely to catastrophize. Theoretical and research implications are discussed.     

Maternal Sensitivity and Anxiety: Impacts on Child Outcome

ABSTRACT

Children of anxious parents have been shown to be at an increased risk of developing an anxiety disorder. Thus, it is critically important to identify factors that increase or decrease that risk. The depression literature has shown that maternal sensitivity decreases negative child outcome associated with maternal depression. The current study was designed to determine whether maternal sensitivity may buffer children of anxious mothers in a similar way. Three hypotheses were tested. First, that anxious mothers would display less sensitivity than nonanxious mothers in interactions with their children; that there would be an interaction between sensitivity and anxiety on child outcome; and that sensitivity would account for variance in child outcome beyond that attributed to anxiety. One hundred and twenty-five mothers (75 anxious) and their children (ages 3–12) completed the study. Mothers were administered the Anxiety Disorders Interview Schedule-IV and Parent, and a subset also completed the Beck Anxiety Inventory. Children completed the Anxiety Disorders Interview Schedule-Child. Dyads also engaged in two interaction tasks (one cognitive, one social) which were coded for maternal sensitivity and three child outcome behaviors. Results showed that anxious mothers displayed less sensitivity in the social task but not in the cognitive task. An interaction between anxiety and sensitivity was found only when predicting child negativity in the social task. Finally, maternal sensitivity was found to account for variance in child outcome beyond that of anxiety. Implications and directions for future research are discussed.     

The impact of maternal control on children’s anxious cognitions, behaviours and affect: An experimental study

Controlling parenting is associated with child anxiety however the direction of effects remains unclear. The present study implemented a Latin-square experimental design to assess the impact of parental control on children’s anxious affect, cognitions and behaviour. A non-clinical sample of 24 mothers of children aged 4-5 years were trained to engage in (a) controlling and (b) autonomy-granting behaviours in interaction with their child during the preparation of a speech. When mothers engaged in controlling parenting behaviours, children made more negative predictions about their performance prior to delivering their speech and reported feeling less happy about the task, and this was moderated by child trait anxiety. In addition, children with higher trait anxiety displayed a significant increase in observed child anxiety in the controlling condition. The pattern of results was maintained when differences in mothers’ levels of negativity and habitual levels of control were accounted for. These findings are consistent with theories that suggest that controlling parenting is a risk factor in the development of childhood anxiety.     

Parent–child interactions and anxiety disorders: an observational study

Past research has indicated a potential link between anxiety and parenting styles that are characterised by control and rejection. However, few studies have utilised observational methods to support these findings. In the current study, mother–child interactions were observed while the child completed two difficult cognitive tasks. The sample consisted of clinically anxious children (n=43), oppositional defiant children (n=20) and non-clinical children (n=32). After adjusting for the age and sex of the child, mothers of anxious children and mothers of oppositional children displayed greater and more intrusive involvement than mothers of non-clinical children. Mothers of anxious children were also more negative during the interactions than mothers of non-clinical children. The differences between anxious and non-clinical interactions were equivalent across three separate age groups. The results support the relationship between an overinvolved parenting style and anxiety but question the specificity of this relationship.     

Parenting Practices of Anxious and Non-Anxious Mothers: A Multi-method Multi-informant Approach

Anxious and non-anxious mothers were compared on theoretically derived parenting and family environment variables (i.e., over-control, warmth, criticism, anxious modeling) using multiple informants and methods. Mother-child dyads completed questionnaires about parenting and were observed during an interactional task. Findings revealed that, after controlling for race and child anxiety, maternal anxiety was associated with less warmth and more anxious modeling based on maternal-report. However, maternal anxiety was not related to any parenting domain based on child-report or independent observer (IO) ratings. Findings are discussed in the context of the impact of maternal anxiety on parenting and suggest that child, rather than maternal, anxiety may have a greater influence on parental behavior.     

Associations among mothers’ representations of their relationship with their toddlers,maternal parenting stress,and toddlers’ internalizing and externalizing behaviors

This study examined the array of associations among the emotional valence and the coherence of mothers’ representations of their relationship with their toddlers, mothers’ reported parenting stress, and toddlers’ internalizing and externalizing behaviors. To evaluate maternal representations, 55 mothers were interviewed using the Five Minute Speech Sample procedure (FMSS; Magaña et al., 1986), which was coded for criticism and positive comments (Magaňa-Amato, 1993), as well as coherence (Sher-Censor & Yates, 2015). Mothers also completed the Parenting Stress Index − Short Form (PSI; Abidin, 1997) to evaluate their parenting stress and the Child Behavior Checklist (CBCL/1.5–5; Achenbach & Rescorla, 2000) to assess their toddlers’ internalizing and externalizing behaviors. Results indicated that parenting stress was associated with maternal criticism and fewer positive comments in the FMSS, but not with the coherence of mothers’ FMSS. Parenting stress, criticism, and lower coherence in the FMSS were associated with maternal reports of externalizing behaviors. Only parenting stress and lower coherence in the FMSS were related to mothers’ reports of internalizing behaviors of the child. Thus, the emotional valence and the coherence of mothers’ representations of their relationship with their child and parenting stress may each constitute a distinct aspect of parenting and contribute to the understanding of individual differences in toddlers’ internalizing and externalizing behaviors. Implications for research and practice with families of toddlers are discussed.     

Fathers’ Challenging Parenting Behavior Prevents Social Anxiety Development in Their 4-Year-Old Children: A Longitudinal Observational Study

Recent models on parenting propose different roles for fathers and mothers in the development of child anxiety. Specifically, it is suggested that fathers’ challenging parenting behavior, in which the child is playfully encouraged to push her limits, buffers against child anxiety. In this longitudinal study, we explored whether the effect of challenging parenting on children’s social anxiety differed between fathers and mothers. Fathers and mothers from 94 families were separately observed with their two children (44 % girls), aged 2 and 4 years at Time 1, in three structured situations involving one puzzle task and two games. Overinvolved and challenging parenting behavior were coded. Child social anxiety was measured by observing the child’s response to a stranger at Time 1, and half a year later at Time 2, and by parental ratings. In line with predictions, father’s challenging parenting behavior predicted less subsequent observed social anxiety of the 4-year-old child. Mothers’ challenging behavior, however, predicted more observed social anxiety of the 4-year-old. Parents’ overinvolvement at Time 1 did not predict change in observed social anxiety of the 4-year-old child. For the 2-year-old child, maternal and paternal parenting behavior did not predict subsequent social anxiety, but early social anxiety marginally did. Parent-rated social anxiety was predicted by previous parental ratings of social anxiety, and not by parenting behavior. Challenging parenting behavior appears to have favorable effects on observed 4-year-old’s social anxiety when displayed by the father. Challenging parenting behavior emerges as an important focus for future research and interventions.     

Perceived Intrafamilial Connectedness and Autonomy in Families With and Without an Anxious Family Member: A Multiple Informant Approach

Perceived intrafamilial “emotional connectedness” and “autonomy” were investigated within families with and without an anxious family member using a multiple informant approach. The sample consisted of 32 mothers with a current anxiety disorder and 56 controls, their partners, and their anxious and nonanxious teenage children. No differences were found with respect to the perceived family relationships of family members with versus without anxious mothers. However, compared with nonanxious adolescents, anxious adolescents perceived less autonomy in relation to both parents. Mothers of anxious adolescents also perceived their children to be less autonomous toward them and their partners, than mothers of nonanxious adolescents. In contrast with “autonomy,” “emotional connectedness” was not reported to be different between families with and without an anxious adolescent. Agreement among family members and the importance of perceived individual autonomy in the development of anxiety are discussed.     

The impact of mothers' trait anxiety on their expectations of approach‐avoidance behaviour in anxious and non‐anxious children

This study investigated estimates of approach and avoidance behaviour in clinically anxious and non‐anxious children, and whether mothers' expectations of their children's avoidance differed as a function of high trait anxiety (HTA) versus low trait anxiety (LTA). Participants were 62 clinically anxious and 60 non‐anxious children aged 7–12 years and their mothers. Estimates of avoidance were obtained using an analogue task in which children and mothers were given threat and pleasant information about two novel animals and were asked to estimate children's avoidance of the threat animal's habitat when the threat animal was present (threat condition) and absent (safe condition) from the habitat and when its presence was uncertain (ambiguous condition). Contrary to expectation, anxious children did not differ from controls in estimates of avoidance in any condition. However, relative to HTA mothers of anxious children and LTA mothers of non‐anxious children, HTA mothers estimated greater approach behaviour by their non‐anxious children in the threat condition. Findings suggest that mothers' expectations of children's approach‐avoidance behaviour is influenced by both maternal and child factors.     

Temperament,Family Environment and Anxiety in Preschool Children

This research examines the relationship between behavioural inhibition (BI), family environment (overinvolved and negative parenting, parental anxiety and parent-child attachment) and anxiety in a sample of 202 preschool children. Participants were aged between 3 years 2 months and 4 years 5 months, 101 were male. A thorough methodology was used that incorporated data from multiple observations of behaviour, diagnostic interviews and questionnaire measures. The results showed that children categorised as behaviourally inhibited were significantly more likely to meet criteria for a range of anxiety diagnoses. Furthermore, a wide range of family environment factors, including maternal anxiety, parenting and attachment were significantly associated with BI, with inhibited children more likely to experience adverse family environment factors. No interactions between temperament and family environment were found for child anxiety. However, a significant relationship between current maternal anxiety and child anxiety was found consistently even after controlling for BI. Additionally, there was some evidence of a relationship between maternal negativity and child anxiety, after controlling for BI. The results may suggest that temperament and family environment operate as additive, rather than interactive risk factors for child anxiety. This is discussed in the context of theoretical models of child anxiety and directions for future research.     

Maternal Control Behavior and Locus of Control: Examining Mechanisms in the Relation Between Maternal Anxiety Disorders and Anxiety Symptomatology in Children

This study tested components of a proposed model of child anxiety and examined the mediational roles of (1) maternal control behavior, (2) maternal external locus of control, and (3) child external locus of control in the association between maternal and child anxiety. Thirty-eight clinically anxious mothers and 37 nonanxious mothers participated along with one of their children aged 6 to 14 (52.0% female; 78.7% Caucasian). Path analysis indicated that the overall model fit the data very well. Analyses also indicated that child external locus of control mediated the associations between (1) maternal and child anxiety and (2) maternal control behavior and child anxiety. Maternal anxiety was not related to maternal control behavior and maternal external locus of control was not associated with child anxiety. Findings are discussed in the context of theoretical models (e.g., Chorpita and Barlow 1998) regarding the transmission of maternal anxiety to their children and the specific roles of maternal behavior and child locus of control.     

Temperament Variation in Sensitivity to Parenting: Predicting Changes in Depression and Anxiety

Temperament was examined as a moderator of maternal parenting behaviors, including warmth, negativity, autonomy granting, and guidance. Observations of parenting and questionnaire measures of temperament and adjustment were obtained from a community sample (N = 214; ages 8–12). Trajectories of depression and anxiety were assessed across 3 years. The pattern of parenting as a predictor of internalizing symptoms depended on temperament. Maternal negativity predicted increases in depression for children low in fear. Effortful control moderated sensitivity to maternal negativity, autonomy granting, and guidance. Children low in effortful control reported more symptoms in the presence of negative or poor-fitting parenting. The results support differential responding, but also suggest that temperament may render children vulnerable for the development of problems regardless of parenting.     

The effect of parental modeling of anxious behaviors and cognitions in school-aged children: An experimental pilot study

The current study tested: (1) the impact of parental modeling of anxious behaviors and cognitions on child anxiety level, anxious cognitions, desired avoidance, and objective performance using an experimental paradigm; and (2) whether the impact of parental modeling of anxious behaviors and cognitions differed by parent gender. Twenty-five parents (a random selection of 12 male and 13 female parents) participated with one of their children (ages 8-12 years; 56.0% male; 76.0% Caucasian). All children experienced two test conditions: an anxious condition in which their parent was trained to act anxiously before a planned spelling test and a non-anxious condition in which their parent was trained to act in a relaxed and confident manner before a planned spelling test. Results showed that, regardless of parent gender, children endorsed higher anxiety levels, anxious cognitions, and desired avoidance of the spelling test in the anxious relative to the non-anxious condition. Parental modeling of anxiety did not affect child spelling performance. Significant interaction effects indicated that fathers had a stronger impact on child anxiety level and cognitions than did mothers. Results highlight the importance of parental modeling and the potential role of both mothers and fathers in prevention and treatment for child anxiety.     

Paternal Child-Rearing Style and Child Social Anxiety: Investigation of Child Perceptions and Actual Father Behavior

This study examined associations among perceived and actual father behavior and child social anxiety. Forty-eight children (22 high socially anxious, 26 low socially anxious) completed self-report measures of social anxiety, general anxiety, and depression. Children also completed a measure of perceived parental style and subsequently collaborated with their fathers on a challenging task (origami). After controlling for general anxiety and depression, fathers of high socially anxious children exhibited more controlling behavior during the origami task; high and low socially anxious children, however, did not differ behaviorally from one another. Perceptions of father child-rearing style did not differ as a function of child social anxiety, nor were significant relations found between perceived parenting and specific father behaviors. Findings underscore the importance of assessing various types of internalizing symptoms (i.e., controlling for shared construct variance), obtaining children's perceptions of parental style in conjunction with conducting behavioral observations, and including fathers in psychopathology research.     

Attachment,Behavioral Inhibition,and Anxiety in Preschool Children

This study examined the association between insecure attachment, behavioral inhibition, and anxiety in an at risk sample of preschool children. The relationship between maternal anxiety and child anxiety was also assessed. Participants were 104 children aged 3–4 years who were assessed for behavioral inhibition and mother–child attachment (using the Strange Situation procedure). DSM-IV criteria were used to assess childhood anxiety disorders. Insecure attachment and behavioral inhibition were both independently associated with child anxiety, even after controlling for the effect of maternal anxiety. Maternal anxiety was also associated with child anxiety. This study identified both constitutional and environmental factors associated with the expression of anxiety in young children. Furthermore, the highest levels of anxiety were shown by children who were behaviorally inhibited and insecurely attached and whose mothers were also anxious.     

Exploring the relationships between maternal and child metacognitions and child anxiety

Research has shown that anxiety may be transmitted through verbal information pathways, for example, when parents share their anxious cognitions with their child. Less is known about the influence of parental metacognitions, that is, beliefs regarding thoughts, on child anxiety. We explored the relations between metacognitions in mothers and their children and anxiety in the children. Our study included 111 non‐clinical children aged 8 to 12 years and their mothers. Children rated their metacognitions, worry and anxiety, and mothers rated their metacognitions. Results indicated agreement between maternal and child metacognitions. Maternal metacognitions were positively associated with children's anxiety symptoms and worry, and this relation was mediated by the children's metacognitions. Our results warrant further examination of the role of parental metacognitions in child anxiety.     

Enduring without avoiding: Pauses and verbal dysfluencies in public speaking fear

Direct measures of overt behavior have been underutilized in speech and other social fear, anxiety, and phobia research. This study demonstrates the usefulness of such variables in the evaluation of public speaking fear. A molecular behavioral assessment methodology was used to examine pauses and verbal dysfluencies of individuals with circumscribed speech fear (n=8) or general social anxiety (n=8), as well as nonanxious control participants (n=16), during an impromptu speech behavior test. Speech fear and generally social anxious individuals paused more often and for a longer duration than the nonanxious group. Results also indicated greater increases in state anxiety during the speech in the circumscribed speech fear sample, relative to the generalized social anxiety and control groups. Taken together with other research, these findings provide evidence that circumscribed speech fear is a meaningful subtype and can be independent of generalized social anxiety. The utility of measuring pausing and verbal dysfluencies in the behavioral assessment of speech fear and other social anxiety and phobia is discussed.     

Vigilance and Avoidance of Threat in the Eye Movements of Children with Separation Anxiety Disorder

The vigilance-avoidance attention pattern is found in anxious adults, who initially gaze more at threatening pictures than nonanxious adults (vigilance), but subsequently gaze less at them than nonanxious adults (avoidance). The present research, using eye tracking methodology, tested whether anxious children show the same pattern. Children with separation anxiety disorder or no mental disorder viewed pairs of pictures, while the direction of their gaze was tracked. Each picture pair showed one picture of a woman separating from a child, the other picture of a woman reuniting with a child. The results supported the vigilance-avoidance model in children. Although the two groups’ gaze direction did not differ during the first second of viewing, anxious children gazed significantly more at separating (threatening) pictures than nonanxious children after a period of 1 s. But after 3 s the pattern reversed: anxious children gazed significantly less at the separating pictures than nonanxious children.