Maternal predictors of anxiety risk in young males with fragile X

Abstract

Children with fragile X syndrome (FXS) demonstrate high rates of anxiety disorders, with 65–83% meeting diagnostic criteria. The severity of anxiety symptoms in FXS has been shown to be partially predicted by elevated negative affect across early childhood (Tonnsen, Malone, et al., 2013). This association suggests that biologically-driven vulnerability emerges early in development, as is reported in non-clinical populations. However, anxiety emergence is likely moderated by multifaceted genetic, biological and environmental risk and protective factors. Mothers with the FMR1 premutation have been shown to exhibit elevated parenting stress and internalizing symptoms, which have each been associated with child behavior problems (Bailey, et al., 2008). Despite these findings, it is unclear whether maternal factors directly relate to anxiety vulnerability in high-risk children with FXS, a question essential to informing targeted, family-sensitive treatment. The present study examines how maternal protective and risk factors relate to child inhibition reflected in (1) child anxiety symptoms, (2) child trajectories of negative affect, and (3) the association between child anxiety and negative affect. Primary predictors include maternal parenting stress, indicators of mental health risk (anxiety and depressive symptoms), and maternal optimism. We also examine genetic correlates in mothers (CGG repeats, activation ratio, mRNA). Our findings suggest that behavioral inhibition in young children with FXS is associated with higher parenting stress and lower optimism, and higher parenting stress is associated with lower maternal X-activation ratio. These findings underscore the need for family-sensitive treatment strategies for anxiety disorders in children with FXS.

Physiological Correlates of Maternal Responsivity in Mothers of Preschoolers With Fragile X Syndrome

“…Our findings, however, were independent of child problem behavior. Consistent with work demonstrating a relationship between parental stress and child outcomes, we recently reported that elevated parenting stress in mothers with the FMR1 premutation was associated with increased anxiety in their young children, which was also associated with the genetic status of the mother (Tonnsen et al, 2014). Additional research is needed to explore the relationship between maternal responsivity and maternal psychopathology, child psychopathology, and genetic status within this population.…”

“…Also, evidence suggests that these effects likely reflect relationships in a subgroup of families and not the entire sample as a whole. Recent evidence supports these hypotheses with elevated behavioral inhibition in young children with FXS (1 to 6 years of age) associated with higher parenting stress that appears rooted in maternal genetic factors with a lower activation ratio associated with elevated parenting stress (Tonnsen, Cornish, Wheeler, & Roberts, 2014). …”

Trajectory and Predictors of Depression and Anxiety Disorders in Mothers With the FMR1 Premutation

“…These data suggest stressors associated with parenting a child with FXS impact both anxiety and MDD with varying time effects. Given the association between maternal stress and well-being to child anxiety in FXS (32), these data underscore importance of attending to psychiatric health in the family of individuals with FMR 1 mutations.…”

Early Language Intervention Using Distance Video-Teleconferencing: A Pilot Study of Young Boys With Fragile X Syndrome and Their Mothers

“…The delivery of a parent-mediated intervention may encourage more positive parent-child interactions and may teach mothers ways to support their children's language development. The indirect effects of interventions that address patterns of parent-child interactions have yet to be examined for children with FXS (Tonnsen, Cornish, Wheeler, & Roberts, 2014).…”