Category: Child / Adolescent - Anxiety
Family accommodation (FA), the involvement of caregivers in facilitating avoidance of anxiety-provoking stimuli or alleviating distress caused by anxiety, has recently gained attention as an important process involved in the maintenance of child anxiety symptoms. In a child anxiety treatment context, reducing FA is often necessary to facilitate amelioration of child symptoms. Despite these treatment implications, few studies have examined parent and child factors that may impact the likelihood of FA, beyond maternal and child anxiety symptoms (Jones et al. 2015). Current theories of FA suggest that FA behaviors are driven by parents’ urge to protect youth from distress (Lebowitz et al., 2013). Thus, it is likely that parents’ ability to regulate their own emotion and their perceptions of their child’s ability to understand and tolerate distress will influence their use of FA behaviors (Cheron et al., 2009).
Utilizing data from 134 treatment-seeking youth (ages 4-17) at an anxiety clinic, this study examined the association between maternal FA, maternal and child anxiety, emotion regulation (ER), and distress understanding and tolerance. Study variables were measured using mother reports on the Family Accommodation Scale-Anxiety, Difficulties in Emotion Regulation Scale, Depression Anxiety Stress Scale, Multidimensional Anxiety Scale for Children, Intolerance of Uncertainty Scale for Children, Distress Intolerance Inventory for Youth, and the Emotion Expression Scale for Children.
Hierarchical regression analyses were used to examine whether ER factors predict maternal accommodation behavior, above and beyond anxiety levels. The first regression model included mother variables and showed that maternal difficulties with ER and stress significantly predicted maternal FA above and beyond maternal anxiety symptoms (R2=.13, F(3, 98)=4.65, p=.004). The second regression model included child variables and showed that mothers’ perceptions of child intolerance of uncertainty, distress intolerance, and emotion awareness significantly predicted maternal FA, above and beyond mother reported child anxiety (R2=.48, F(4, 75)=16.99, p < .001).
These findings suggest that both maternal and child ER and related factors contribute to the likelihood of maternal FA, above and beyond mother and child anxiety levels. Although future research will need to elucidate these associations further, these findings have important implications for parental involvement in the treatment of child anxiety. When parents report high levels of accommodation, it may be important to include parental ER skills and instruction in how to concurrently manage child and parent distress resulting from child anxiety.
Erin O'Connor– Graduate Student, Boston University, Brookline, Massachusetts
Lindsay Holly– Postdoctoral Associate, Boston University, Boston, Massachusetts
David Langer– Research Assistant Professor, Boston University, Boston, Massachusetts
Jonathan Comer– Director of the Mental Health Interventions and Technology (MINT) Program; Professor of Psychology and Psychiatry, Florida International University, Florida
Donna Pincus– Associate Professor, Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
Director of the Mental Health Interventions and Technology (MINT) Program; Professor of Psychology and Psychiatry
Florida International University, Florida