Category: Child / Adolescent - Anxiety
Evidence suggests parents can facilitate offspring anxiety in response to bodily arousal via “sick role reinforcement,” a process that may be important during adolescence. Although a sizeable body of work has examined the role of parent behavior in these processes, no study to date has examined child-driven effects on parental sick role reinforcement. Furthermore, little work has examined whether parental factors are related to sick role reinforcement, including anxiety sensitivity (AS). The current study investigated the associations among these variables using a set of vignettes in which parents (n = 225) were asked to imagine their adolescent offspring describing somatic sensations in either an anxious or non-anxious manner. A set of vignettes was developed to examine whether adolescent descriptions of somatic sensations as being either anxiety provoking or non-anxiety provoking affect parents’ propensity to engage in sick-role reinforcement behavior. Two versions of the vignettes were administered in which offspring were depicted as describing physical symptoms following gym class in either an anxiety or non-anxious manner. Both vignettes ended with the adolescent requesting to go home. Two primary hypotheses were tested. First, it was hypothesized that parents would be significantly more likely to reinforce sick role behavior in the context of anxious as compared to non-anxious offspring descriptions of physical sensations. Next, it was hypothesized that there would be a main effect of parental AS-physical concerns (AS-P), such that parents who were elevated in AS-P would reinforce more sick role behaviors than parents who were relatively lower in AS-P. Further, it was anticipated that AS-P would interact with vignette type such that, compared to all other variable combinations, parents who were high in AS-P would reinforce significantly more sick role behavior following the anxious physical vignette.
Mixed linear modeling was utilized to examine primary hypotheses. Results suggested significant effects of both offspring descriptions, parental AS, and an interaction between the two, on parental sick role reinforcement behavior. First, vignette type was significantly related to sick role reinforcement scores, such that the anxious vignette resulted in greater sick role reinforcement scores than the neutral vignette. Second, AS-P was significantly positively related to sick role reinforcement scores. Third, AS-P interacted significantly with vignette type in its relation to sick role reinforcement scores. Two separate multilevel models with anxious and neutral sick role reinforcement scores as the dependent variables, respectively, were utilized to examine these interactions. The models specified were the same as the main model, but excluded main and interaction terms involving vignette type. Results indicated that for the anxious vignette, AS-P was significantly positively related to sick role reinforcement scores b = 1.65, t(328) = 4.103, p b = 0.51, t(328) = 1.53, p = .128. Findings are discussed in terms of how they lay the groundwork for future work targeted at improving our understanding of the unique and interactive roles parents and offspring play in the sick role reinforcement process.