Parenting, Family Functioning and Anxiety-Disordered Children: Comparisons to Controls, Changes After Family Versus Child CBT

Abstract

We examined (1) whether families of clinicreferred anxiety-disordered children are characterized by anxiety-enhancing parenting and family functioning, compared to control families; (2) whether family cognitivebehavioral therapy (FCBT) for anxiety-disordered children decreases anxiety-enhancing parenting and family functioning more so than child-focused cognitive-behavioral therapy (CCBT); (3) whether anxiety-disordered children benefit more from therapy in the long-term when parents display less anxiety enhancing parenting and family functioning. The referred sample consisted of 104 anxietydisordered children (8-18 year-olds) and their families, randomized to FCBT or CCBT. The control sample consisted of 44 families from the general population. At pretreatment (referred and control sample), posttreatment, 3-months and 1-year follow up (referred sample), children's anxiety disorders were assessed by the ADIS-C/P. Child and parents' anxiety symptoms, parenting behaviors (autonomy granting, overprotection, rejection) and family functioning (relational functioning, family control) were assessed with questionnaires. Parent-reported autonomy granting and family relational functioning were lower in the referred versus control families. Child-reported autonomy granting was higher in the referred families. Anxietyenhancing parenting/family functioning decreased after FCBT and CCBT, with no differences between treatments. Good family relational functioning at posttreatment predicted more improvement on anxiety measurements at the long term for adolescents, but not for school-aged children. The generally hold idea that certain parenting styles and family functioning cause child anxiety, and need to be specifically targeted in the treatment of anxious children, is not supported. Good relational functioning within adolescent's families however is associated with better long-term outcome on anxiety, suggesting that families can support the maintenance of treatment gains.

Factors Associated with the Referral of Anxious Children to Mental Health Care: the Influence of Family Functioning, Parenting, Parental Anxiety and Child Impairment

“…It is often hypothesized that parents should be involved in childhood anxiety treatment, although little support was found for this idea (e.g. Jongerden and Bögels, ; In‐Albon and Schneider, ; Reynolds et al , ). In this study it was hypothesized that parents' own heightened anxiety, anxiety‐enhancing parenting and family dysfunction, that may or may not be caused by the child's anxiety problems, would be indicative for referral beside the impairment due to the child's anxiety disorder, but no evidence whatsoever was found for this hypothesis.…”

Group- Versus Parent-Involvement CBT for Childhood Anxiety Disorders: Treatment Specificity and Long-Term Recovery Mediation

“…We found only three youth anxiety efficacy trials that examined whether treatment specificity occurs when parent variables are targeted in PCBT but not ICBT (Jongerden & Bögels, 2015, N = 104; Kendall et al, 2008, N = 161; Silverman et al, 2009, N = 119). Parent variables targeted were parenting skills and parent-child relationships.…”

Empirical Evidence for the Outcomes of Therapeutic Video Games for Adolescents With Anxiety Disorders: Systematic Review

“…The extant evidence suggests that the proportion of adolescents suffering from ADs has increased by up to 70% since the mid-1980s and that nearly 300,000 young people in the United Kingdom have a diagnosable AD [ 5 ]. The onset of AD increases significantly during the adolescent years [ 6 ], in part as a result of conflicts regarding existential identity [ 7 ], educational pressures and high self-expectations [ 8 ], negative peer comparisons or perceived relational victimization [ 9 ], and over-demanding intrusive parenting [ 10 , 11 ]. Experience of AD in early life is associated with negative short- and long-term implications for social, academic, financial, and health performance [ 12 ] and predicts adult anxiety and substance abuse disorders [ 13 ].…”