Association Between Family Structure and Anxiety Disorder Among Pre-schoolers: A Cross-Sectional Study in Urban Chongqing, China.

Hongmei Hu,Shanshan Wang,Jiaqiong Zhang,Peiling Chen,Tingting Wu,Xin Zhao

doi:10.3389/fpsyt.2021.626377

Abstract

Objective: This study explores the current situation of anxiety disorder of pre-schoolers and assesses the association between family structure and anxiety disorder (AD) among pre-schoolers in Chongqing, China.Methods: This is a cross-sectional study of 499 main fosterers of children aged 3–6 years who completed the 28-item Chinese version of the Spence Pre-school Anxiety Scale (PAS). Multinomial logistic regression with three models was used to assess the association of the family structure with the different AD.Results: The prevalence of AD was 31.46%, whose score of PAS were more than 48. Among the five different PAS sub-scales, the prevalence of obsessive-compulsive disorder (OCD) was the highest (50.10%), followed by separation anxiety disorder (SAD, 39.28%), fear of physical harm (FPH, 37.68%), generalized anxiety disorder (GAD, 33.47%), and social phobia (SP, 25.85%). Pre-schoolers from inter-generational families were more probably have AD than those from nuclear families (OR = 3.73, p < 0.05). The participants from inter-generational families were more likely to have SAD (OR = 3.39, p < 0.05), FPM (OR = 2.80, p < 0.05), or OCD (OR = 2.40, p < 0.05), in comparison with participants from other family structures.Conclusion: Anxiety disorder among pre-schoolers aged 3–6 in Chongqing is widespread. Pre-schoolers from inter-generational families were more probably have AD, SAD, FPM, and OR and pre-schoolers from stem families may be less likely to have SAD compared with those from nuclear families. Relieving the anxiety of pre-schoolers may be possible with additional interventional efforts in inter-generational families.

Highlights

Psychiatric disorders in pre-school children are becoming a public health problem, their exact scope is not wellunderstood [1, 2]
We found that the number of pre-schoolers who came from nuclear families (44.09%) was larger than that of other family structures
We found that the possibility of anxiety disorders including separation anxiety disorder (SAD), FPM, social phobia (SP), and generalized anxiety disorder (GAD) was not statistically different for pre-schoolers in single-parent families, pre-schoolers in blended families, and children in stem families compared with those from nuclear families

Summary

Introduction

Psychiatric disorders in pre-school children are becoming a public health problem, their exact scope is not wellunderstood [1, 2]. The emotion, cognition level, and physiological state of pre-schoolers are developing and changing. Their anxiety and terror are mainly expressed through behaviors, such as crying, tantrums, disobedience, or withdrawal behavior in response to unpleasant or difficult things, and they may have symptoms such as an accelerated heartbeat, poor sleep quality, or frequent urination [3]. The estimated prevalence of pre-school anxiety disorders by most studies in the range of 10–20% in recent decade [6, 7], even others report prevalence above 20% [8]. In rapidly urbanized areas in China, the prevalence of anxiety disorders in pre-school children is as high as 34.2% [9]. Retrospective studies report the median age of onset for anxiety disorders around 6 years of age [10, 11]

Methods

Results

Discussion

Conclusion