Children’s and parent’s psychological profiles in selective mutism and generalized anxiety disorder: a clinical study

Abstract

Selective mutism (SM) is classified in DSM-5 as an anxiety disorder. The aim of the study was to investigate the psychological features of children with SM and their parental psychological profiles, compared to generalized anxiety disorder (GAD) children and their parents. The parents of 26 preschool children with SM and 32 with children with GAD filled out the child behavior check list for 1½-5 years (CBCL1½-5) and the symptom checklist-90-revised (SCL-90-R). Information about the children and their parents' histories was collected through clinical interviews. Children with SM scored higher than children with GAD on the CBCL1½-5 withdrawn scale and lower on the attention problems, aggressive behavior, and externalizing problems scales. Mothers of children with SM scored higher on the SCL-90-R obsessive-compulsive subscale and Global Severity Index than mothers of children with GAD, while fathers of children with SM scored higher on the SCL-90-R Phobic Anxiety subscale and on the Global Severity Index than fathers of children with GAD. Parents of children with SM displayed a greater presence of stressful life events than parents of children with GAD. Data appeared to confirm that SM and GAD share a common anxious core, though some differences in the children's psychological profiles and the parents' history and personality emerged. Future research should focus on the role of external factors, such as parent-child relationship, in the development of SM.

The impact of parental psychopathology and sociodemographic factors in selective mutism - a nationwide population-based study

“…Two studies found associations between paternal psychopathology and SM, but not maternal psychopathology [7,8]. A recent study found that the mothers of children with SM displayed more obsessive-compulsive features and fathers exhibited more phobic anxiety symptoms than the parents of children with generalized anxiety disorder [9]. There have been findings of higher rates of maternal schizoid and schizotypal features [10], increased levels of parental anxiety [8,10] and social anxiety among the parents of children with SM [11].…”

“…To address the role of comorbidity, we also report comorbid diagnoses for the SM cases in the study sample. Based on previous findings showing higher rates of parental psychopathology in several different diagnostic categories [9][10][11]21], the study hypothesis was that there would be higher rates of psychiatric morbidity among the parents of children with SM compared to the controls. In addition, we hypothesized that both advanced and young parental age would be associated with SM, as seen with behavioural and emotional disorders of childhood [14].…”

Variations in Parent and Teacher Ratings of Internalizing, Externalizing, Adaptive Skills, and Behavioral Symptoms in Children with Selective Mutism

“…In a study by Capozzi, Manti, Dio Trani, Romani, Vigliante, and Sotos [7], 58 preschool children with SM or generalized anxiety disorder (GAD) and their parents were evaluated at a pediatric clinic over a period of five years. Child and family variables did not discriminate children in the SM and GAD groups.…”

Case Report: Evaluation strategies and cognitive intervention: the case of a monovular twin child affected by selective mutism

“…It is characterized by the child’s significant inability to speak in specific social situations (for instance at school) or in non-familiar circumstances. The clinical and research data confirm that SM is a complex etiological multifactorial disorder whose maintenance is connected with the interaction of biological (familiarity with shyness, preterm birth) ( Capobianco & Cerniglia, 2017) and environmental early factors (anxiety and overprotectiveness of the mother) ( Capobianco et al , 2010; Capobianco et al , 2017; Capozzi et al ., 2017; Pizzuto & Capobianco, 2008) Analysis of the underlying thoughts and emotions in mutacic behavior reveals fear of judgment, fear of failure and being mocked, shame, depression, feelings of worthlessness or inadequacy , catastrophizing, and confirms the comorbidity between selective mutism and internalizing symptoms. The typical age of onset for selective mutism is between 3–6 years, even though the disorder gets usually diagnosed belatedly during the school age (around 7–8 years).…”