Worry In Children Research Articles

Collaborative intervention in early childhood: consulting with parents and teachers of 3- to 7-year-olds

PART I. FOUNDATIONS FOR UNDERSTANDING 1. When Young Children Need Help: What Do We See? What Do We Think? What Do We Do? 2. Seven Building Blocks of Development: Understanding Core Emotional, Behavioral, and Social Competencies 3. The Contribution of Constitution: Understanding a Child's Temperament and Neurodevelopmental Profile 4. The Contribution of Family Life: Understanding a Family's History and Patterns of Interaction PART II. FOUNDATIONS FOR INTERVENTION 5. Setting the Stage for Mastery: Developing a Working Hypothesis, Goals for Growth, and a Plan of Action 6. Home-Based Strategies: Helping Parents Set Effective Behavioral Expectations 7. Classroom-Based Strategies: Mentoring Teachers in the Skills of Developmental Scaffolding PART III. SPECIFIC APPROACHES FOR SPECIFIC DIFFICULTIES 8. Helping the Shy, Cautious, or Withdrawn Child: Getting to Work When a Youngster Holds Back from Connections, Play, and Conversation 9. Helping the Child with Language and Information Processing Issues: Getting to Work When a Youngster Struggles to Understand and Be Understood 10. Helping the High-Energy and/or Inattentive Child: Getting to Work When a Child Has Trouble Slowing Down or Tuning In 11. Helping the Easily Frustrated, Impulsive Child: Getting to Work When a Child Doesn't Calm Down and Think Before Acting 12. Helping the Anxious Child: Getting to Work When a Child's Worries, Fears, or Sensory Sensitivities Take Over Daily Life 13. Helping the Disengaged, Offbeat, or Gifted but Rigid Child: Getting to Work When a Child Has Trouble Relating with Interest and Flexibility PART IV. QUESTIONS AND CONCLUSIONS 14. Additional Issues: Addressing Trauma and Loss, Monitoring Media Choices, Providing Guidance During Crises and More 15. Elementary School and Beyond: Perspectives for the Long Haul

Fathers as informants of children’s fears and worries

The recognition of excessive fears and worries in children is important for early intervention. Despite current knowledge about the important contribution fathers make to their children's emotional, social and cognitive development, more emphasis is often given to the views of mothers in both research and practice. This paper reports on a community study of 220 families. Fathers, mothers and children reported on children's fears and worries using three different methods. While father and mother ratings were moderately correlated on two of the measures, there was relatively poor parent-child agreement. Implications for the role of fathers in the assessment of childhood fears and worries are discussed.

Narrative Practice at a Walk-In Therapy Clinic: Developing Children's Worry Wisdom

This article provides a practice-focused look at narrative therapy in a relatively unexplored context—therapy at a walk-in clinic. The author provides readers with a clear and detailed examination of both narrative practice in brief work at a walk-in clinic, and of narrative practices with one of the most common presenting struggles in children's mental health settings—children experiencing anxiety. The article demonstrates the usefulness and “fit” of narrative practice in extremely brief contexts, therefore introducing “brief narrative,” with a clear guideline for narrative questions being outlined and illustrated by actual transcripts from sessions at the walk-in clinic with a child who presented with serious struggles with anxiety. Children's “worry wisdom” is developed in conversations at the walk-in clinic therefore increasing their understanding, knowledge, abilities, and skills.

Worry in Adults and Children: Developmental Differences in the Importance of Probability and Cost Judgments

This study investigated developmental differences in the relationship of probability and cost estimates to worrying. Adults, younger children (M age = 8.67 years) and older children (M age = 11.06 years) rated the extent to which they worry about a list of negative social and physical outcomes and provided subjective probability and cost estimates for the same outcomes. Adults reported worrying more about social outcomes and rated them as less ‘bad’ (or costly) but more likely to occur than physical outcomes. Unlike adults, children in both age groups reported worrying more about physical outcomes. However, similar to adults, they also rated social outcomes as less ‘bad’ but more likely to occur than physical outcomes. Regression analyses showed that probability ratings were the best predictors of worry in adults, both probability and cost ratings equally predicted worry in older children, but only cost ratings predicted worry in younger children.

Threat is a Multidimensional Construct: Exploring the Role of Children’s Threat Appraisals in the Relationship Between Interparental Conflict and Child Adjustment

Past research has emphasised the importance of children's appraisals of the threat posed by parent conflict for understanding links between interparental conflict and child outcomes. However, little is known about what it is that children actually find threatening about parent conflict. Children (n = 236) aged 10-16 years were recruited to examine the relative contribution of four specific threat subtypes--fear of parent conflict escalating, fear of being drawn into parent conflict, fear of parent conflict resulting in family breakdown, and fear of parent conflict disrupting parent/child attachment relationships--in explaining links between interparental conflict and child internalising adjustment. Results showed that children's worries about being drawn into parent conflict mediated the relationship between interparental conflict and child internalising adjustment. Fear of interparental conflict disrupting parent/child attachment bonds mediated the relationship between interparental conflict and child internalising problems for girls, but not boys. Results are discussed in terms of the importance of considering multiple dimensions of threat for advancing understanding of the processes underlying the interparental conflict/child adjustment relationship.

Self-Efficacy, Personal Worries, and School Achievement of Primary School Students in Hong Kong

This article reports data from 154 primary-school children attending a government school in Hong Kong. Focus group discussions and a questionnaire were used to gain information on children's worries within the school context and in their lives outside school. Data were also collected on children's perceived self-efficacy across academic and non-academic domains. The study explored the nature of children's personal worries and the relationships existing among variables comprising degree of worry, self-efficacy, and academic achievement.

Psychometric Properties of the Penn State Worry Questionnaire for Children in a Large Clinical Sample

The Penn State Worry Questionnaire for Children (PSWQ–C; Chorpita, Tracey, Brown, Collica, & Barlow, 1997) is a 14-item self-report measure of worry in children and adolescents. Although the PSWQ–C has demonstrated favorable psychometric properties in small clinical and large community samples, this study represents the first psychometric evaluation of the PSWQ–C in a large clinical sample (N = 491). Factor analysis indicated a two-factor structure, in contrast to all previously published findings on the measure. The PSWQ–C demonstrated favorable psychometric properties in this sample, including high internal consistency, high convergent validity with related constructs, and acceptable discriminative validity between diagnostic categories. The performance of the 3 reverse-scored items was closely examined, and results indicated retaining all 14 items.

Relations among perceived parental rearing behaviors, attachment style, and worry in anxious children

The present study extended the findings of Muris et al. [Muris, P., Meesters, C., Merckelbach, H., & Hulsenbeck, P. (2000). Worry in children is related to perceived parental rearing and attachment. Behavior Research and Therapy, 38, 487–497] regarding the relations between perceived parental rearing behaviors, self-reported attachment style, and worry in a community sample to a clinical sample of anxious children. Sixty-four children and adolescents, aged 7–18 years, with a primary anxiety disorder completed (a) the EMBU-C, a questionnaire measuring perceptions of parental rearing behaviors, (b) a single-item measure of attachment style, and (c) an index of worry severity. Findings revealed that child rated parental rearing behaviors, particularly parental rejection, were positively related to child worry. Self-reported attachment style was also related to worry, such that children who classified themselves as ambivalently attached reported higher levels of worry than did children who classified themselves as securely attached. Parenting style and attachment were found to make independent contributions to worry. The results are compared to those from Muris et al.'s community study, and implications for future research are discussed.

HEALTH-RELATED QUALITY OF LIFE (HRQOL) AFTER PEDIATRIC LIVER TRANSPLANTATION

Background: Long-term survival after liver transplantation (LT) is now the rule rather than the exception. Better understanding of the broader determinants of health after pediatric LT will support the eventual transition of adolescents to adult programs. We examined health concerns of adolescent survivors of pediatric LT. Methods: Data were gathered via semi-structured 1:1 interviews with 14 (50% male) adolescent patients and 15 parents (87% mothers) at ambulatory LT follow-up at two Canadian pediatric tertiary care institutions. All interviews were audio taped, transcribed verbatim, subjected to content analysis utilizing QSR NVivo 2.0 software for qualitative research and subsequent identification of HRQOL related themes. Results: Mean recipient age at LT was 6.5 (range, 0.5 to 12 years). Mean patient age at time of interview was 15.5 (range, 14 to 18) years, all >1 year post LT. Identified HRQOL themes included impact of a permanent scar, medications, interpersonal functioning, school, physical activities,and coping with life after LT. Adolescents and parents concurred on issues regarding i) compliance with immune suppression medications; ii) school attendance and functioning; iii) parent worries exceeding recipient worries; and iv) impact of living with a surgical scar. Adolescent patients were discordant with their parents in self-reporting i) no memory of health before LT; ii) no worries about future health; and iii) normal peer relationships. In contrast, parents of adolescent LT survivors focused on i) severity of illness at time of LT; ii) child worries about need for re-LT; and iii) difficulties in peer and family relationships. Conclusions: Perceived HRQOL and well-being by adolescent survivors of LT appear excellent and more positive than their care-providing parent. These issues underscore the importance and need for further study and development of measures to assess HRQOL after pediatric LT.

Youth With Epilepsy: Developmentof a Model of Children's Attitudes Toward Their Condition

A model of children's attitudes toward their epilepsy was tested in 173 children (9-14 years) with epilepsy and their parents. Predictor variables tested were child characteristics, family mastery, child worry, child self-efficacy for seizure management, child psychosocial care needs, and seizure variables. Data were analyzed using structural equation modeling, leading to a revised model in which less child worry, greater family mastery, and greater child seizure self-efficacy were directly related to more child positive attitudes. Discussion focuses on potential targets for psychosocial interventions aimed at improving attitudes toward epilepsy.

Differences in parenting needs of fathers of children with chronic conditions related to family income

Children with chronic conditions now survive longer than has been true historically, creating a need to promote optimal growth and development for themselves, their family members and the family as a whole. This article reporting a midwestern United States study compares the concerns and coping strategies of fathers of chronically-ill children with household annual incomes less than $50,000 with fathers of chronically-ill children with household incomes of $50,000 or more. The sample of 48 fathers completed the Hymovich Family Perception Inventory anonymously. The results revealed differences in the parenting concerns of fathers related to family income. The low-income fathers expressed a desire for more knowledge about the children's condition and worries about family finances. Professional anticipatory guidance and dissemination of information holds promise for providing the support needed by fathers of children with chronic conditions, particularly those with lower household incomes.

What is Worse? A Hierarchy of Family-Related Risk Factors Predicting Alcohol Use in Adolescence

The aim of the present study was to determine if family structure, perception of excessive drinking in the family, and family bonding hold a graduated importance in predicting adolescent alcohol use and their association with peers who drink excessively. Three nested linear structural models were calculated separately for frequent and excessive drinking, based on a sample of 3,127 eighth and ninth graders in Switzerland (mean age 15.3, SD 0.8) surveyed in spring 2002 in the context of the “Health Behavior in School-Aged Children (HBSC)” study. The results confirm that the perception of excessive drinking in the family is more closely related to both frequent and excessive drinking than family structure, and family bonding is more closely related than drinking perception. Adjusting for both socio-demographic variables and the association with peers who drink excessively only slightly changed the results. To predict an association with the latter, family structure was more important than the perception of drinking, but family bonding remained the predominant predictor. The results stress the graduated importance of family-related risk factors: by listening to their children's worries, by spending their free time with them, and by providing help when needed, parents might have the possibility to actively minimize the risk of frequent and excessive drinking regardless of whether they are frequent excessive drinkers or live without a partner.

What do Tanzanian children worry about?

This paper explores the worries of children in a sample of 8- to 15-year-old children, drawn from three primary schools on the outskirts of Moshi, Tanzania. Data about children's worries were collected by two methods. First, lists of worries were generated by 270 children who gave a total of 3 409 statements. The worries they expressed were categorised and condensed into 55 questions on a questionnaire designed to measure the frequency of the most common worries. In part two, 978 children participated by filling in this questionnaire. The majority of the children's worries fell into four categories: education, health, care/abuse and safety issues. The children elaborated on worries within each of these groups, whether or not they themselves were affected by HIV/AIDS through orphan-hood. However, their statements demonstrate their serious concern with the epidemic in the community and society. Concern for others above self is mirrored in the children's worries, reflecting the collective orientation of the local culture. Finally, ways that this knowledge may be utilised to strengthen children's coping strategies are discussed.

Anxiety and Social Worries in Children with Asperger Syndrome

The current study examined anxiety and social worries in a group of children with Asperger syndrome (AS). Sixty-five children with AS were compared with a clinically anxious sample and a normative sample using parent and child reports. Comparisons between clinically anxious children and children with AS showed similar scores on overall anxiety and on six anxiety subscales using child reports. Parent reports revealed higher ratings of overall anxiety and described children with AS experiencing more obsessive-compulsive symptoms and physical injury fears than clinically anxious children. Children with AS without a diagnosis of anxiety, present with more anxiety symptoms than a normal population and with a different profile than a clinically anxious population. Study limitations are identified and considerations for future research presented.

Anxiety and social worries in children with Asperger syndrome

Objective: The current study examined anxiety and social worries in a group of children with Asperger syndrome (AS). Method: Sixty-five children with AS were compared with a clinically anxious sample and a normative sample using parent and child reports. Results: Comparisons between clinically anxious children and children with AS showed similar scores on overall anxiety and on six anxiety subscales using child reports. Parent reports revealed higher ratings of overall anxiety and described children with AS experiencing more obsessive–compulsive symptoms and physical injury fears than clinically anxious children. Conclusions: Children with AS without a diagnosis of anxiety, present with more anxiety symptoms than a normal population and with a different profile than a clinically anxious population. Study limitations are identified and considerations for future research presented.

The Cognitive Content of Thought-Listed Worry Episodes in Clinic-Referred Anxious and Nonreferred Children

We investigated the cognitive content of worry in 8- to 13-year-old clinic-referred anxious (n = 38) and nonreferred (n = 51) children. The children were interviewed individually. They thought-listed their latest worry episodes, rated the uncontrollability of the episodes, and reported on the strategies they used to terminate worry. Content analyses showed that children's worry episodes contained predominantly thoughts reflecting negative outcome anticipation, but other types of thought content also were present. These included problem-solving, ruminating, and self-blaming thoughts. Compared to clinic-referred children, nonreferred children reported more problem solving and less ruminating. In the nonreferred group, increasing age was associated with more problem solving and less ruminating. No such age-related associations were found in the clinic-referred group. The 2 groups did not differ in the types of worry-termination strategies they reported, but clinic-referred children were more likely to keep worrying until the perceived threat was removed. The results suggest that the problem-solving function of worry is still emerging during late childhood and that developmental delays in problem solving may be associated with excessive and uncontrollable worrying.

Mothers of Survivors of Childhood Cancer

Numerous studies have examined the psychosocial effects of childhood cancer on teenage and young adult survivors. Yet, there is relatively little research on the consequences of survivorship for the parents of these people. This study explored the realities of life for mothers of survivors of childhood cancer. Data from self-report questionnaires with 167 mothers of survivors and follow-up intensive interviews with 29 of them were analyzed. Findings indicated that mothers' worries were not so much a function of “objective” physical consequences of their child's illness. Instead, their worries were significantly related primarily to their own perceptions of their child's worries and the meanings they attached to their own and their child's cancer experience. The implications of the results for intervention with survivors of childhood cancer and their families include hospital-organized information and education programs; supportive counseling; meetings with other parents; and, for parents whose children have actual limitations, supportive rehabilitation services.

The connection between cognitive development and specific fears and worries in normal children and children with below-average intellectual abilities: a preliminary study

The present study explored the relationship between cognitive development and anxiety phenomena in 4–12-year-old children. Fears and worries of normal children ( n=176) were compared to those of children with below-average intellectual abilities (children with BAIA; n=105). We evaluated to what extent level of cognitive development as indexed by a Piagetian conservation task was associated with the presence of fears and worries. While normal children and children with BAIA did not differ with regard to the content of their fears and worries, normal children more frequently reported such anxiety phenomena during the semi-structured Anxiety Interview than did children with BAIA. Furthermore, in normal children, evidence was found to suggest that level of cognitive development contributes to the experience of fears and worries. That is, anxiety phenomena were more prevalent among those children who passed a Piagetian conservation task. However, when anxiety phenomena were assessed by means of the Koala Fear Questionnaire (KFQ), a different picture emerged. KFQ data suggested that fears were less frequent in normal children and those children with BAIA who had a higher level of cognitive functioning. Apparently, the Anxiety Interview and the KFQ tap quite different aspects of anxiety. The KFQ seems to measure primitive fears that are likely to be prevalent among children with limited cognitive capacity, whereas the Anxiety Interview assesses more sophisticated anxiety phenomena that probably depend on high levels of cognitive functioning.

Psychological issues among children of hereditary breast cancer gene (BRCA1/2) testing participants.

Children growing up in hereditary breast cancer families may experience diminished psychological well-being. In addition to coping with having a cancer-affected parent or close relatives, these children may focus on their own health risks in light of shared genetic information. While knowledge of a parent's BRCA1/2 negative status may allay a subset of children's worries and fears about cancer, others could experience distressing thought patterns over positive test results. The purpose of this preliminary study is to explore conceptions of health, cancer risk, and psychological adjustment among children in families suggestive of carrying BRCA1/2 susceptibility genes. As part of a longitudinal investigation of the outcomes of BRCA1/2 testing in adults, 20 children of a highly select group of 15 mothers (80% previously affected by breast/ovarian cancer) completed a self-report survey of their beliefs and opinions regarding cancer and genetic testing, stress and worry about cancer, and anxiety, depression, and behavior problems. All information was completed at baseline, prior to the mother's receipt of her genetic test result. The data did not suggest unusually elevated cancer worries or psychological adjustment problems in these children at this point in the parental genetic testing process. However, children with more psychological distress symptoms did experience more frequent thoughts of becoming sick and greater cancer worries. To the extent that learning about a parent's positive test result could exacerbate these tendencies, recommendations to promote child psychological and family communications research that monitor such responses are offered.

The relationship of child worry to cognitive biases: Threat interpretation and likelihood of event occurrence

Worry, the cognitive component of anxiety, has been related to cognitive processing biases in adults. However, the relationship of child worry to cognitive biases has been largely unexplored. The present study examined this relationship. Worry in a community sample of 277 5th- and 6th-grade children was assessed with the Penn-State Worry Questionnaire for Children (Chorpita, Tracey, Brown, Collica, & Barlow, 1997). The Children's Opinions of Everyday Life Events (COELE) was designed to measure children's threat interpretation biases. Children's responses to worry-relevant vignettes were used to assess interpretation of ambiguous and threatening situations, degree of perceived threat, degree of situation-specific worry, and perceived likelihood of future occurrence. Results suggested strong relationships between child worry and threat interpretation biases. Compared to nonworriers, worriers interpreted both ambiguous and threatening situations as more threatening, expressed more worry in response to the events, and judged the events to have a higher probability of happening to them in the future. Temporal stability was only moderate, perhaps reflecting worry and cognitive biases as more variable phenomena in a community sample. Theoretical, clinical, and research implications of the findings are discussed.