Development Of Anxiety In Children Research Articles

Saudi Arabian Perceptions of Childhood Anxiety, Parental Communication, and Parenting Style.

Parenting communication and parenting style, including expressions of fear, worry, and threat, may contribute to children's anxiety and apprehension. This study examined the degree to which perceptions of parental communication (both verbal and nonverbal) and parenting style are linked with childhood anxiety. This is among the first studies to investigate these relationships in a Saudi Arabian context. We employed a sample of 121 Saudi adults who completed questionnaires measuring perceptions of 2 parenting styles (authoritative and authoritarian), parental anxiety, and childhood anxiety. Parental communication elements such as shouting, criticism, facial expression, and body expressions were included among assessments of perceived parental anxiety, authoritative style, and authoritarian style. The results indicated that perceptions of childhood anxiety were positively associated with parental anxiety but not consistently associated with other assessed variables. This research addressed perceptions of parental communication and parenting style in the development of childhood anxiety, extending upon previous research on Western samples to a Middle Eastern sample residing in Saudi Arabia.

Social skills and symptoms of anxiety disorders from preschool to adolescence: a prospective cohort study.

Prior research, mostly cross-sectional or prospective studies with short follow-up periods, has indicated that childhood anxiety is associated with difficulties with social interaction. However, the etiological role of social skills in the development of anxiety in childhood remains unknown. Moreover, it is not known whether childhood anxiety impedes the development of age-appropriate social skills. The relation between anxiety and social skills was, therefore, examined in two birth cohorts of children who were assessed biennially from the ages of 4 to 14 years (n= 1,043). Semistructured psychiatric diagnostic interviews of children (from age 8) and parents were used to measure symptoms of separation, generalized, and social anxiety disorders as well as specific phobias. Social skills were measured through the parent-reported Social Skills Rating System. A random intercept cross-lagged panel model was used to analyze the data, adjusting for observed time-variant covariates (emotion regulation, secure attachment, bullying victimization, and global self-esteem) and all unobserved time-invariant confounding effects. Reduced social skills predicted increased symptoms of anxiety at ages 8, 10, and 12 (β= -.26, β= -.17, and β= -.15, respectively), whereas an increased number of anxiety symptoms did not forecast changes in social skills. The findings suggest that reduced social skills may be involved in the development of anxiety symptoms in middle childhood and should, therefore, be considered in efforts to prevent and treat childhood anxiety.

Threat-biased attention in childhood anxiety: A cognitive-affective developmental model

• Threat-biased attention is inconsistent in clinical and developmental literatures. • Threat-biased attention in childhood anxiety is a matter of relative magnitude. • Executive function and emotion regulation may relate to persistent threat biases. • Unique risk profiles are proposed for the development of anxiety in children. Threat-biased attention presents a paradox among clinical and developmental literatures: while biased attention toward threat has been implicated in childhood anxiety vulnerability, a parallel developmental literature highlights the early emergence of this bias as a normative pattern of attention associated with positive socioemotional outcomes. To bridge between these two literatures, evidence is reviewed across diverse domains (threat-biased attention, temperamental vulnerability, executive function, emotion regulation). An integrative developmental framework is proposed to elucidate how threat-biased attention may progress from a normative response to a more robust and persistent attentional bias associated with childhood anxiety. Deficits in developing executive function (inhibition and attentional control) and emotion regulation are proposed as reciprocal pathways to the perpetuation of this bias and the development of anxiety. Temperamental vulnerability is also considered as a risk factor. This model is most relevant for vigilant models of threat bias and may not account for threat-biases with diverse presentations (e.g., attention bias away from threat). Further, the current model is derived from studies highly reliant on behavioural reaction time and would benefit from validation across more diverse methods and paradigms for studying attentional bias. This model may help identify unique risk profiles for anxiety in children (e.g., deficits in either domain of executive function or emotion regulation with the other domain relatively intact). With further validation, these profiles may have clinical utility in informing the development of treatments that are tailored to address specific affected pathways – allowing for greater specificity in intervention selection.

Cognitive Prerequisites in Development of Childhood Anxiety: An Integrative Literature Review and Thematic Analysis.

It has been suggested that cognitive development affects the emotional experience of children, including anxiety. However, an evidence review is needed to extract cognitive prerequisites that contribute to the development of anxiety in children. The purpose of the study is to explore evidence on cognitive prerequisites involved in experiencing anxiety in children. Four electronic databases of Scopus, OVID-PsycINFO, PubMed, and ScienceDirect were comprehensively searched for 1900 to 2018, yielding 4,618 articles. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and inclusion and exclusion criteria, 25 articles were found as eligible. The analysis of literature identified 3 themes, including threat perception, future thinking, and generalization. It is suggested that these cognitive abilities may underlie anxiety. These results have important implications for better understanding the effect of cognitive prerequisites in anxiety phenomena and also could shed light on the explanation of anxiety in some disorders characterized by deficits in cognitive development.

Elucidating the Roles of Maternal Overcontrol and Warmth in the Development of Childhood Anxiety and Depression: A Moderated Mediation Framework.

Studies have linked childhood anxiety and depression with parenting characterized by high control and low warmth. However, few studies have examined how control and warmth may work together to influence internalizing symptoms in children. Therefore, the goal of this study was to examine the moderating effect of warmth on the relationship between overcontrol and anxiety and depressive symptoms, as well as whether negative thoughts serve as a mediator of these pathways. A total of 182 fourth and fifth grade children completed measures of maternal parenting behavior, negative thoughts, and anxiety and depressive symptoms. Results showed an interaction between overcontrol and warmth for depressive but not anxiety symptoms. Furthermore, low warmth increased the strength of the mediating relationship between overcontrol and depression via thoughts of personal failure. Findings may signal a need for early interventions to address parenting behaviors, such as controlling behaviors, in parents of children at risk for internalizing difficulties.

Effectiveness of Origami on Hospitalized Anxiety among Children Admitted in Paediatric Units of a Selected Tertiary Care Hospital Ludhiana, Punjab

Hospital can be a difficult place for young children and their families. In hospitals, children may find strange faces, different routines, strange equipment’s and limited family contact leads to development of anxiety in children. Anxiety can hamper there early recovery and leads to psychological effect on the child. Play provisions like origami can help children to overcome the anxiety and work as outlets for hostilities. The present study was conducted with an objective to assess the effectiveness of origami on hospitalized anxiety among children admitted in paediatric units. A pre-experimental design was preferred to assess the effectiveness of origami on hospitalized anxiety among 40 children of age group 4–10 years selected by convenience sampling in paediatric units of DMC and Hospital, Ludhiana. The intervention was given to children for minimum 15–20 minutes for three consecutive days. Structured likert scale to assess anxiety and bio-physiological measures was used to collect the data using observation technique and self-report method. The mean anxiety score before intervention was higher (33.10±10.61, 37.61%) than after intervention (28.85±9.37, 32.78%). The difference of mean pre-test and post-test hospitalized anxiety was found to be statistically significant (p<0.05). The study findings revealed that origami was effective in reducing the level of hospitalized anxiety among children.

Parenting Characteristics among Adults With Social Anxiety and their Influence on Social Anxiety Development in Children: A Brief Integrative Review.

The purposes of this brief integrative review are to identify and critically evaluate recent work in the area of parenting processes that are disproportionately observed among parents with social anxiety disorder (SAD) that may ultimately increase risk among offspring, and to further link these processes to specific targets for intervention. Accordingly, we first evaluate the relevance of specific parenting styles as they pertain to increased risk of developing SAD among offspring. Second, we link these parenting processes to observations of certain unfavorable consequences among socially anxious youth, such as low perceived autonomy and poorer social skills. Finally, in light of these consequences we extend our conclusions into potentially modifiable targets among parents with SAD, focusing on the enhancement of autonomy and facilitating offspring's normative period of transition into independence during adolescence. Overall, we conclude that parenting behaviors commonly observed among adults with SAD, such as overcontrol and low parental warmth, likely have a direct impact on the development of social anxiety symptoms among their children. However, these parenting behaviors are plausibly modifiable and therefore repurposing existing interventions for use among parents with SAD in conjunction with interventions with their offspring is likely to provide direct clinical benefit.

Anxiety-Related Attention Bias in Four- to Eight-Year-Olds: An Eye-Tracking Study.

(1) Background: There is evidence of an attention bias–anxiety relationship in children, but lack of appropriate methods has limited the number of studies with children younger than eight years old. This study used eye tracking as a measure of overt attention in young children. The aim of this study was to assess anxiety-related attention bias in children aged four to eight years. Age was considered a moderator, and the influence of effortful control was investigated. (2) Method: A community sample of 104 children was shown pairs of happy–neutral and angry–neutral faces. Growth curve analyses were used to examine patterns of gaze over time. (3) Results: Analyses revealed moderation by age and anxiety, with distinct patterns of anxiety-related biases seen in different age groups in the angry–neutral face trials. Effortful control did not account for age-related effects. (4) Conclusions: The results support a moderation model of the development of anxiety in children.

How important are parents in the development of child anxiety and depression? A genomic analysis of parent-offspring trios in the Norwegian Mother Father and Child Cohort Study (MoBa)

BackgroundMany studies detect associations between parent behaviour and child symptoms of anxiety and depression. Despite knowledge that anxiety and depression are influenced by a complex interplay of genetic and environmental risk factors, most studies do not account for shared familial genetic risk. Quantitative genetic designs provide a means of controlling for shared genetics, but rely on observed putative exposure variables, and require data from highly specific family structures.MethodsThe intergenerational genomic method, Relatedness Disequilibrium Regression (RDR), indexes environmental effects of parents on child traits using measured genotypes. RDR estimates how much the parent genome influences the child indirectly via the environment, over and above effects of genetic factors acting directly in the child. This ‘genetic nurture’ effect is agnostic to parent phenotype and captures unmeasured heritable parent behaviours. We applied RDR in a sample of 11,598 parent-offspring trios from the Norwegian Mother, Father and Child Cohort Study (MoBa) to estimate parental genetic nurture separately from direct child genetic effects on anxiety and depression symptoms at age 8. We tested for mediation of genetic nurture via maternal anxiety and depression symptoms. Results were compared to a complementary non-genomic pedigree model.ResultsParental genetic nurture explained 14% of the variance in depression symptoms at age 8. Subsequent analyses suggested that maternal anxiety and depression partially mediated this effect. The genetic nurture effect was mirrored by the finding of family environmental influence in our pedigree model. In contrast, variance in anxiety symptoms was not significantly influenced by common genetic variation in children or parents, despite a moderate pedigree heritability.ConclusionsGenomic methods like RDR represent new opportunities for genetically sensitive family research on complex human traits, which until now has been largely confined to adoption, twin and other pedigree designs. Our results are relevant to debates about the role of parents in the development of anxiety and depression in children, and possibly where to intervene to reduce problems.

Mothers' and children's metacognitions and the development of childhood anxiety: a longitudinal investigation of transmission.

Theory and preliminary evidence suggests that parental beliefs and cognitions may be transmitted to their offspring. Transmission of maladaptive cognitions may play a role in the development of anxiety disorders in childhood. However, few studies have investigated such transmission using longitudinal designs. The objective of this study was to investigate the interaction between maternal and child metacognitions and their role in the development of childhood anxiety. We used a longitudinal design with self-report measures of maternal and child anxiety symptoms and metacognitions. Participants were 107 mothers and their children who were assessed when the children were between 7 and 12years old and again 3years later. Child metacognitions at baseline did not predict later child anxiety symptoms. Baseline maternal metacognitions approached significance in predicting anxiety symptoms in children at the follow-up, when controlling for known risk factors, including female gender and higher levels of anxiety in mother and child at baseline. Mediation analyses revealed that child metacognitions at baseline, as well as at follow-up fully mediated the relationship between maternal baseline metacognitions and child anxiety 3years later. Examinations of how child and maternal metacognitions affect child anxiety levels after three years revealed that current levels of child metacognitions play a greater role in predicting child anxiety than child and maternal metacognitions at baseline.

Child–Mother Reappraisal and Child’s Anxiety Among Anxious and Non-Clinical Groups

Reappraisal is a major target of cognitive therapy for anxiety disorders because the absence or a low level of reappraisal ability has been identified among highly anxious adults and children. Not enough is known, however, about the development of this ability, although family processes have been implicated. The current study investigated reappraisal ability of anxious children and their mothers by (1) comparing clinical and non-clinical populations, (2) analyzing reappraisal correlations and contribution to child anxiety level, and (3) comparing pre-and post-cognitive behavioral therapy. Participants were 49 children with a primary diagnosis of anxiety disorder and 42 children from a non-clinical population and their mothers. The children completed self-report measures of anxiety. Reappraisal ability was measured using a real-time computer test where children and mothers were asked to react to the content of negative valence pictures. The anxiety disorder group was reassessed again following CBT. The clinical and non-clinical groups differed significantly on measures of reappraisal. Furthermore, mothers’ and children’s reappraisals were significantly correlated, and both predicted the child’s anxiety level. Following treatment, the mothers, but not the children, showed significant improvement in reappraisal. The current study highlights the need to target parent reappraisal as an important factor in the development of child anxiety and reappraisal ability.

Parental overcontrol x OPRM1 genotype interaction predicts school-aged children’s sympathetic nervous system activation in response to performance challenge

Parental overcontrol (OC), the excessive regulation of a child’s behavior, cognition, and emotion, is associated with the development of child anxiety. While studies have shown that genetic factors may increase sensitivity to stress, genetic vulnerability to parental OC has not been examined in anxiety etiology. A functional polymorphism in the mu opioid receptor OPRM1 (A118G, rs1799971) has been shown to impact stress reactivity. Using a community sample of children (N = 85, 9–12 years old), we examined the main and interactive effects of maternal OC and child OPRM1 genotype in predicting children’s sympathetic nervous system reactivity during a performance stressor. Neither OC nor genotype predicted children’s electrodermal activity (EDA); however, the interaction between OC and child genotype significantly predicted stress reactivity, as indexed by EDA, during the challenging task. Among children with the minor G-allele, higher maternal OC was associated with higher reactivity. In A homozygotes, maternal OC was not associated with EDA, suggesting a diathesis-stress pattern of gene x environment interaction. We discuss implications for anxiety etiology and intervention.

Anxiety Levels in Children with Autism Spectrum Disorder: A Meta-Analysis

The aim of the current study was to meta-analytically examine whether anxiety levels in children with autism spectrum disorders (ASD) are elevated. A total of 83 articles were selected from a systematic literature search and were included in the meta-analyses. Results demonstrated that children with ASD had higher anxiety levels compared to typically developing children, and this difference increased with IQ. Youth with ASD also tended to have higher anxiety levels compared to clinically referred children, and this difference increased with age. Children with ASD had higher anxiety levels compared to youth with externalizing or developmental problems, but not when compared to youth with internalizing problems. The study findings highlight the importance of more research in order to fully understand the nature and development of anxiety in children with ASD. More specifically, the results suggest that especially high-functioning adolescents with ASD may be at risk for developing anxiety disorders. Therefore, it seems important to carefully follow and monitor children with ASD transcending to adolescence.

Parenting and Anxiety: Bi-directional Relations in Young Children.

Developmental psychopathologists have long posited a reciprocal relation between parenting behaviors and the development of child anxiety symptoms. Yet, little empirical research has utilized a longitudinal design that would allow exploration of this bi-directional influence. The present study examined the reciprocal relations between parental respect for autonomy, parental hostility, and parental support, and the development of childhood anxiety during a critical developmental period-the transition from preschool to kindergarten and then first grade. Study participants included a community sample of 391 male and 405 female socioeconomically, racially and ethnically diverse 4 to 6-7year olds. 54% of the sample was White, non-Hispanic, 16.8% was African American, 20.4% was Hispanic, 2.4% were Asian and 4.4% self-identified as Other or mixed race. Parent report and observational methodology were used. Parenting and anxiety were found to interact reciprocally over time. Higher levels of age 4 anxiety led to reduced respect for child autonomy at age 5. At age 4 higher levels of parental hostility led to small increases in age 5 anxiety, and increased age 5 anxiety led to increased levels of age 6 parent hostility. Parental support at age 5 resulted in decreased anxiety symptoms at age 6-7 while higher age 5 anxiety levels were associated with reductions in age 6-7 parental support. No relations were found between these variables at the younger ages. Although the magnitude of these findings was small, they suggest that early treatment for childhood anxiety should include both parent intervention and direct treatment of the child's anxiety symptoms.

Introduction to the Special Issue: Understanding the Role of Attentional Control in the Development of Anxiety in Childhood, Adolescence and across the Lifespan

Introduction to the Special Issue: Understanding the Role of Attentional Control in the Development of Anxiety in Childhood, Adolescence and across the Lifespan

Causal Factors of Anxiety Symptoms in Children

Aim: The present work aimed to investigate the impact of the child’s cognitions associated with ambiguous stimuli that refer to anxiety, both parents’ fears and anxiety, and parents’ attributions to the child’s interpretations of ambiguous stimuli on child anxiety. The influence of parental modelling on child’s cognitions was also analyzed. Method: The final sample was composed of 111 children (62 boys; 49 girls) with ages between 10 and 11 years (M = 10.6, SD = 0.5) from a community population, and both their parents. The variables identified as most significant were included in a predictive model of anxiety. Results: Results revealed the children’s thoughts (positive and negative) related to ambiguous stimuli that describe anxiety situations. Parents’ fears and mothers’ anxiety significantly predict children’s anxiety. Those variables explain 29% of the variance in children general anxiety. No evidence was found for a direct parental modeling of child cognitions. Conclusion: Children’s positive thoughts seem to be cognitive aspects that buffer against anxiety. Negative thoughts are vulnerability factors for the development of child anxiety. Parents’ fears and anxiety should be analyzed in separate as they have distinct influences over children’s anxiety. Mothers’ fears contribute to children’s anxiety by reducing it, revealing a possible protective effect. It is suggested that the contribution of both parents’ fears to children’s anxiety may be interpreted acknowledging the existence of “psychological and/or behavioral filters”. Mothers’ filters seem to be well developed while fathers’ filters seem to be compromised. The contribution of mothers’ anxiety (but not fathers’ anxiety) to children’s anxiety is also understood in light of the possible existence of a “proximity space” between the child and parents, which is wider with mothers than with fathers.

Challenging Parenting Behavior from Infancy to Toddlerhood: Etiology, Measurement, and Differences between Fathers and Mothers

Based on evidence that fathers show more challenging and physical play than mothers, it has been theorized that fathers have a different parenting role, more focused at stimulating exploration and taking chances. Challenging parenting behavior (CPB) may foster confidence and buffer against anxiety development in children. In this study, CPB was assessed in fathers and mothers at child ages of 4 months, 1 year, and 2.5 years, using newly developed questionnaires and observational tasks. Reliability of the questionnaire and observational measures was good, and fathers' and mothers' self‐rated CPB showed a similar factor structure. Modest and significant convergence between questionnaires and observations provided support for validity of CPB, whereas negative correlations with overprotection supported divergent validity. CPB correlated positively with warmth. We further found moderate to high stability of CPB from early infancy to toddlerhood, and interparental correspondence in CPB. Fathers and mothers did not differ in observed CPB, but fathers rated themselves higher than mothers in toddlerhood. It is concluded that the development of the instruments to assess CPB was successful. Overall, the results reveal similarities rather than differences between fathers' and mothers' CPB in early childhood. The potential relevance of CPB in child development and psychopathology is discussed.

Early Forms of Controlling Parenting and the Development of Childhood Anxiety

We examined the distinct effects of early types of externally and internally controlling parenting (coercion and overprotection) on the development of childhood anxiety, while controlling for other important risk factors. Developmental trajectories of child anxiety were modeled from a Quebec representative sample (N = 2,120 children; 2.5- to 8-years of age). The relative impact of a host of putative child, mother, and family risk factors measured in early childhood was assessed using multinomial regressions. In addition to child shyness, maternal depression and family dysfunction, both coercive and overprotective parenting increase the risk for higher child anxiety. An interaction between maternal depression and overprotection was found, indicating that overprotection only increases child anxiety when maternal depression is high. Finally, maternal overprotection was also found to predict second grade teacher reports of children’s anxiety.

Parental perfectionism and overcontrol: examining mechanisms in the development of child anxiety.

It has been theorized that perfectionistic parents will engage in behaviors characterized by overcontrol, which then increase child anxiety. Previous research has yet to test this theory within a single study. The current study investigated the proposed theory in a single model, examining the mediational roles of parent perfectionism and overcontrol in the association between parent and child anxiety. Participants were 77 parent-child dyads, with 46 parents and 40 children diagnosed with an anxiety disorder. Children were between 3 and 12 years old (57.1% female, 76.6% Caucasian, 22.1% African American). Path analysis indicated that the overall model fit the data well. Analyses showed that parental overcontrol mediated the relation between parental perfectionism and child anxiety and parental perfectionism mediated the relation between parental anxiety and parental overcontrol. Further, parental perfectionism and overcontrol sequentially mediated the parent to child anxiety relation. However, when parental perfectionism was accounted for in the model, parental overcontrol did not mediate the relation between parent and child anxiety. The findings suggest that parent perfectionism and overcontrol, together, may represent a specific pathway of risk for the development of anxiety disorders in children. The implications of these findings are reviewed in the context of previous theory on parental perfectionism, overcontrol, and the development of child anxiety. The clinical importance of the findings and future directions are also discussed.

Symptoms and Development of Anxiety in Children With or Without Intellectual Disability

The purpose of this study was to examine group differences in presentation and trajectory of anxiety symptoms and disorders in children with moderate to borderline intellectual disability (ID) and children with typical cognitive development (TD). Examined anxiety disorders and symptoms in children with ID (n=74) or TD (n=116) annually from ages 5 through 9 using a parent structured interview and questionnaire. Logistic regression was used to examine odds of meeting anxiety criteria and hierarchical linear modeling was used to examine anxiety trajectory. Children with ID had significantly higher rates of clinical levels of anxiety on the Child Behavior Checklist at ages 8 and 9 and higher rates of separation anxiety disorder at age 5 compared to those with TD. Children with ID were also more likely to have externalizing problems co-occurring with anxiety. The rate of increase of anxiety symptoms over time was positive and similar in the two groups, and neither group showed sex differences in anxiety rates. Results suggest that children with ID have both higher rates of anxiety across time and are delayed in showing typical decreases in separation anxiety in early childhood. Implications for intervention are discussed in terms of the importance of screening for and treating anxiety in children with ID.