Preventing Onset of Anxiety Disorders in Offspring of Anxious Parents: A Randomized Controlled Trial of a Family-Based Intervention

Abstract

Objective The authors examined the efficacy of a family-based intervention to prevent the onset of anxiety disorders in offspring of anxious parents. Method Participants were 136 families with a parent meeting DSM-IV criteria for an anxiety disorder and one child 6–13 years of age without an anxiety disorder. Families were randomly assigned to the family-based intervention (N=70) or to an information-monitoring control condition (N=66). All families were expected to complete assessments, administered by blind interviewers, at baseline, at the end of the intervention (or 8 weeks after randomization) and at 6- and 12-month follow-ups. Onset of any anxiety disorder and anxiety symptom severity (assessed using the Anxiety Disorders Interview Schedule for Children) at 12 months were the primary and secondary outcome measures, respectively. Results The incidence of child anxiety disorders was 31% in the control group and 5% in the intervention group (odds ratio=8.54, 95% CI=2.27, 32.06). At the 1-year follow-up, youths in the control group also had higher anxiety symptoms ratings than those in the intervention group. Effect sizes were medium to large (0.81 at 6 months and 0.57 at 12 months for anxiety symptoms), and the number needed to treat was 3.9 at 12 months. Significant moderators included baseline levels of child anxiety; significant mediators were parental distress and modeling of anxiety. Child maladaptive cognitions and parental anxiety did not mediate outcomes. Conclusions A brief psychosocial prevention program holds promise for reducing the 1-year incidence of anxiety disorders among offspring of anxious parents.

Stressful Life Events and Child Anxiety: Examining Parent and Child Mediators

“…Notwithstanding the effects of life events, children of parents with psychiatric disorders, compared to those without a psychiatric disorder, are at particularly high risk for development of anxiety, [20] and greater risk with greater severity of parental impairment [21]. However, the mechanism of this increased risk and the nature of the pathway towards the child’s development of anxiety appears to be complex, with heritability explaining only a third of the variance in anxiety symptoms [7].…”

Parental Emotion Socialization Strategies and Their Interaction with Child Interpretation Biases Among Children with Anxiety Disorders

“…Emotion socialization parent training programs have demonstrated some effectiveness for improving outcomes among young children and children with externalizing disorders (e.g., Herbert et al 2013). To date, there is limited research examining similar techniques in families with children with anxiety disorders; yet, a recent randomized controlled trial of a brief family intervention addressing both parent and child factors yielded promising outcomes for reducing the 1-year incidence of anxiety disorders (Ginsburg et al 2015). In this context, our findings call for additional efforts to examining the effectiveness of specific parent training techniques that incorporate the construct of emotion socialization to optimize outcomes in children with anxiety disorders.…”

Clinical Factor 2015

“…As Ginsburg et al [13] pointed out, etiological models of anxiety disorders implicate several family-based risk factors. In addition, family aggregation studies indicate that children of anxious parents have an elevated risk of having an anxiety disorder, and specific parenting practices, such as modeling of anxiety and overcontrol/overprotection, contribute to elevated anxiety.…”

“…Family-based therapies have been shown to reduce child anxiety, but anxiety prevention studies have not been very successful and have been done mostly in the school environment. Thus, Ginsburg et al [13] examined the efficacy of family- based intervention to prevent the onset of anxiety disorders in offspring of anxious parents. They enrolled 136 families with a parent meeting DSM-IV criteria of an anxiety disorder and one child 6-13 years old without anxiety disorder.…”