Family Factors in the Development, Treatment, and Prevention of Childhood Anxiety Disorders

It is now widely accepted that anxiety disorders run in families, and current etiological models have proposed both genetic and environmental pathways to anxiety development. In this paper, the familial role in the development, treatment, and prevention of anxiety disorders in children is reviewed. We focus on three anxiety disorders in youth, namely, generalized, separation, and social anxiety as they often co-occur both at the symptom and disorder level and respond to similar treatments. We begin by presenting an overview of a broad range of family factors associated with anxiety disorders. Findings from these studies have informed intervention and prevention strategies that are discussed next. Throughout the paper we shed light on the challenges that plague this research and look toward the future by proposing directions for much needed study and discussing factors that may improve clinical practice and outcomes for affected youth and their families.     

Young Freud's linkage with Persia

Abstract

Sigmund Freud's hands helped to mutilate a volume containing a series of “colored plates” like the one replicated in Figure 1 in the text. As a young adult, his personal library included a fairytale whose German text was entitled Die Träumleiter: Ein Marchen. No one has yet been able to authenticate the author's identity beyond the following imprint: “S. Andreas (1832).” The poetic play centers upon a celestial meeting featuring Shakespeare, Goethe, and Dschami. It has been translated into English (The dream ladder: A fairy tale), but still awaits a psychoanalytically informed exegesis.     

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.     

Transporting CBT for Childhood Anxiety Disorders into Inner-City School-Based Mental Health Clinics

The systematic expansion of evidence-based cognitive behavioral (CBT) protocols into the schools provides an opportunity for training front-line service providers in the early identification of anxious children and in the delivery of evidence-based treatments to children who might otherwise go without such treatment [Weist, M. D., & Evans, S. W. (2005). Expanded school mental health: Challenges and opportunities in an emerging field. Journal of Youth and Adolescence, 3, 3­6]. In this article, we discuss the progress of our ongoing study aimed at transporting manualized CBT for anxious youth into inner-city school-based clinics. In this context, we outline the rationale for the study and specific adaptations and obstacles encountered to date.     

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.     

To coerce and be coerced

Coercion is a way of forcibly influencing others. While one's core conflicts may contribute to an experience of being coerced in any interaction, specific situations or circumstances commonly encountered in clinical practice set the stage for analyst or patient to feel forced or manipulated. The interaction that develops in these instances is conceptualized as a coercive enactment. Conditions that increase the susceptibility to coercing and being coerced may develop at any stage in the psychoanalytic process. Supervision and conversion from psychotherapy to psychoanalysis are examined as situations that predispose to coercion. Silences and other difficulties in maintaining the analytic frame, as well as crises in the life of the analyst, may also lead to coercive enactments. Pertinent literature is reviewed and illustrative clinical cases are presented.     

Kept Under the Hood: Neglect of the Clitoris in Common Vernacular

Even though the “clitoris” is the organ homologous to the “penis,” this term may not be commonly used as the female counterpart to the penis. We conducted three studies to examine the usage of terminology for female sexual anatomy. In the first study 57 books in a university computer database for “sex instruction” were examined for the inclusion of terms such as penis, clitoris, vagina, vulva, and uterus. Penis was mentioned more often than either the clitoris or vulva in these books. In the second and third studies we investigated the terminology used by college students as well as their sexual attitudes and knowledge. Participants in the studies were Euro-American (76%/76%, Study 2/Study 3 respectively), Hispanic (18%/14%), and African American (4%/7%); students reported that they were overwhelmingly taught vagina as the female counterpart to the penis. Believing that the inner portion of the vagina is the most sexually sensitive part of the female body correlated with negative attitudes toward masturbation (Study 2) and agreement with sex myths (Studies 2 and 3).     

Dreaming of freud: Ferenczi,freud, and an analysis without end

The beginning of this paper documents Sigmund Freud's pre-psychoanalytic experience as a ‘first hand’ observer of childhood behavior both professionally and as the patriarch of a large extended family in Vienna. During 1898, Freud was in the midst of an intensive correspondence with Wilhelm Fliess – his most trusted confidant, mentor and colleague – when he wrote, in part, about his sister Marie whose family was relocating in Berlin. She was apparently about to consult Fliess as her prospective physician. During the process, Freud voiced psychological assessments not only about his sister; but, also about her husband and their three daughters. The youngest among them was a 5-year old whom he characterized as “a rather gifted child, severely [hysterical]” (bracketed word in quotation juxtaposed for clarity).

Eleven years later, Freud wrote a case study about a 5-year old boy whose pseudonym, for publication purposes, was Little Hans. The life of Little Hans (as well as the lives of his parents) has been thoroughly examined and we now know something about how he matured as an adult. In a contrasting context, less is known about the ‘psychological trajectory’ of Freud's 5-year old niece who also distinguished herself in certain respects as she matured during her abbreviated later life. She remained the subject of documentable correspondence mailed to him by his youngest daughter Anna as well as foreboding prospects articulated in a letter he subsequently wrote to an English nephew.