Category: Child / Adolescent - Anxiety
Parental accommodation, in the context of child anxiety, refers to parental participation in child symptoms or parental modification of routines or the environment with the intention of reducing or preventing their children from experiencing anxiety related distress (Flessner et al., 2011; Lebowitz et al., 2013; Thompson-Hollands et al., 2014). Studies suggest that parental accommodation serves to maintain child anxiety in the long term through negative reinforcement, despite short-term reductions in child symptoms. Much of the early literature on parental accommodation investigated accommodation of obsessive-compulsive disorder (OCD; Caporino et al., 2012; Garcia et al., 2010; Storch et al., 2007). More recent research, though, has examined the impact of parental accommodation on other childhood anxiety disorders, with 88-97% of parents of clinic-referred youth reporting at least some level of accommodation (Lebowitz et al., 2013; Thompson-Hollands, 2014). To date, most of research on the impact of parenting on child anxiety has been conducted with mothers (e.g., McLeod et al., 2007). Studies just evaluating mothers fail to capture important patterns of paternal behaviors on child anxiety symptoms, and, importantly, interactions between maternal and paternal parenting dynamics on child anxiety. The present study examined maternal and paternal accommodation of child anxiety symptoms, and how mother-father concordance and discordance differentially associate with child anxiety severity, type, and comorbidity. The present sample included children age 7-17 (N = 162) and their parents presenting for treatment for child anxiety concerns. The Family Accommodation Checklist and Interference Scale (FACLIS; Thomason-Hollands et al., 2014) was used to measure parental accommodation in mothers and in fathers. The FACLIS yields three scores, a total accommodation score, a total interference score, and an average interference score. Child anxiety severity and diagnosis was measured using the Anxiety Disorders Interview Schedule (ADIS-IV-C/P; Silverman & Albano, 1997). Preliminary analyses revealed a significant difference between the total parental accommodation engaged in by fathers (M = 2.78, SD = 2.44) versus mothers (M = 3.28, SD = 2.69; t(161) = 2.57, p = 0.01), as well as in total interference of accommodation rated by fathers (M = 9.31, SD = 9.29) versus mothers (M = 13.65, SD = 13.71; t(124) = 3.81, p < 0.001). Additionally, greater discordance in interference from accommodation across mothers and fathers predicted higher child comorbidity, F(1,116) = 3.95, B = 0.13 p < 0.05. Further exploratory analyses will examine factors that predict greater discordance across mothers and fathers in the provision of parental accommodation. These analyses highlight very high rates of accommodation across mothers and fathers of anxious youth, with mothers reporting higher levels of accommodation than fathers, and mothers reporting greater interference associated with their accommodation versus that associated with paternal accommodation. Moreover, discordance in the extent and interference of parental anxiety across mothers versus fathers predicts less favorable clinical presentations in children.
Bridget Poznanski– Doctoral Student, Florida International University, Miami, Florida
Jonathan Comer– Professor, Florida International University
Leah Feinberg– Doctoral Student, Florida International University
Donna Pincus– Associate Professor, Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts