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Assessment of Relevant Parenting Factors in Families of Clinically Anxious Children: The Family Assessment Clinician-Rated Interview (FACI)

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Abstract

Objective Research on child and adolescent anxiety disorders has seen a surge in investigations of parenting factors potentially associated with their etiology. However, many of the well-established parenting measures are limited by over-reliance on self-report or lengthy behavioral observation procedures. Such measures may not assess factors most salient to anxiety etiology, since most family functioning measures were not originally developed for this purpose. The Family Assessment Clinician Interview (FACI) was developed as a clinician-administered interview of parent and family factors associated with child and adolescent anxiety. The present study is the first to investigate the psychometric properties of the FACI. Method Using a clinical sample of 65 children with various anxiety disorders, and their parents, inter-rater reliability, convergent validity and associations with child-reported and clinician-evaluated anxiety severity were examined. Results suggest that the FACI has good to excellent inter-rater reliability with kappas ranging from 0.79 to 1.0 across FACI scales and subscales. Some evidence of convergent validity with relevant portions of the Family Environment Scale was observed, although the latter findings varied by respondent (mother versus father). The Family Warmth/Closeness subscale of the FACI was consistently associated with increased child anxiety symptoms. Contrary to expectations, higher levels of parental expectations were associated with lower levels of child anxiety. Conclusion Results suggest that the FACI is a promising measure of family anxiety constructs that may be useful in both research and clinical settings.

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References

  1. Ginsburg GS, Siqueland L, Masia Warner C, Hedtke KA (2004) Anxiety disorders in children: family matters. Cogn Behav Pract 11:28–43. doi:10.1016/S1077-7229(04)80005-1

    Article  Google Scholar 

  2. Chorpita BF, Barlow DH (1998) The development of anxiety: the role of control in the early environment. Psychol Bull 124:3–21. doi:10.1037/0033-2909.124.1.3

    Article  PubMed  Google Scholar 

  3. Chorpita BF, Brown TA, Barlow DH (1998) Perceived control as a mediator of family environment in etiological models of childhood anxiety. Behav Ther 29:457–476. doi:10.1016/S0005-7894(98)80043-9

    Article  Google Scholar 

  4. Manassis K, Bradley S, Goldberg S, Hood J, Swinson RP (1994) Attachment in mothers with anxiety disorders and their children. J Am Acad Child Adolesc Psychiatry 33:1106–1113

    PubMed  Google Scholar 

  5. Rapee RM (1997) Potential role of childrearing practices in the development of anxiety and depression. Clin Psychol Rev 17:47–67. doi:10.1016/S0272-7358(96)00040-2

    Article  PubMed  Google Scholar 

  6. Rubin KH, Mills RS (1991) Conceptualizing developmental pathways to internalizing disorders in childhood. Can J Behav Sci 23:300–317. doi:10.1037/h0079019

    Article  Google Scholar 

  7. Warren SL, Huston L, Egeland B, Sroufe LA (1997) Child and adolescent anxiety disorders and early attachment. J Am Acad Child Adolesc Psychiatry 36:637–644. doi:10.1097/00004583-199705000-00014

    Article  PubMed  Google Scholar 

  8. Rapee RM (2001) The development of generalized anxiety. In: Vasey MW, Dadds MR (eds) The developmental psychopathology of anxiety. Oxford University Press, New York, pp 481–503

    Google Scholar 

  9. Rapee RM (2002) The development and modification of temperamental risk for anxiety disorders: prevention of a lifetime of anxiety? Biol Psychiatry 52:947–957. doi:10.1016/S0006-3223(02)01572-X

    Article  PubMed  Google Scholar 

  10. Siqueland L, Kendall PC, Steinberg L (1996) Anxiety in children: perceived family environments and observed family interaction. J Clin Child Psychol 25:225–237. doi:10.1207/s15374424jccp2502_12

    Article  Google Scholar 

  11. Hudson JL, Rapee RM (2001) Parent–child interactions and anxiety disorders: an observational study. Behav Res Ther 39:1411–1427. doi:10.1016/S0005-7967(00)00107-8

    Article  PubMed  Google Scholar 

  12. Hudson JL, Rapee RM (2002) Parent–child interactions in clinically anxious children and their siblings. J Clin Child Adolesc Psychol 31:548–555

    PubMed  Google Scholar 

  13. Wood JJ (2006) Parental intrusiveness and children’s separation anxiety in a clinical sample. Child Psychiatry Hum Dev 37:73–87. doi:10.1007/s10578-006-0021-x

    Article  PubMed  Google Scholar 

  14. Barrett PM, Rapee RM, Dadds MM, Ryan SM (1996) Family enhancement of cognitive style in anxious and aggressive children. J Abnorm Child Psychol 24:187–203. doi:10.1007/BF01441484

    Article  PubMed  Google Scholar 

  15. Chorpita BF, Albano AM, Barlow DH (1996) Cognitive processing in children: relation to anxiety and family influences. J Clin Child Psychol 25:170–176. doi:10.1207/s15374424jccp2502_5

    Article  Google Scholar 

  16. Dadds MR, Barrett PM, Rapee RM, Ryan S (1996) Family process and child anxiety and aggression: an observational analysis. J Abnorm Child Psychol 24:715–734. doi:10.1007/BF01664736

    Article  PubMed  Google Scholar 

  17. Cobham VE, Dadds MR, Spence SH (1998) The role of parental anxiety in the treatment of child anxiety: a controlled trial. J Consult Clin Psychol 66:893–905. doi:10.1037/0022-006X.66.6.893

    Article  PubMed  Google Scholar 

  18. Eisen AR, Spasaro SA, Brien LK, Kearney CA, Albano AM (2004) Parental expectancies and child anxiety disorders: psychometric properties of the Parental Expectancies Scale. J Anxiety Disord 18:89–109. doi:10.1016/j.janxdis.2001.10.001

    Article  PubMed  Google Scholar 

  19. Kortlander E, Kendall PC, Panichelli-Mindel SM (1997) Maternal expectations and attributions about coping in anxious children. J Anxiety Disord 11:297–315. doi:10.1016/S0887-6185(97)00012-1

    Article  PubMed  Google Scholar 

  20. Micco JA, Ehrenreich JT (2008) Children’s interpretation and avoidant response biases in response to non-salient and salient situations: relationships with mothers’ threat perception and coping expectations. J Anxiety Disord 22:371–385. doi:10.1016/j.janxdis.2007.03.009

    Article  PubMed  Google Scholar 

  21. Dumas JE, LaFreniere PJ, Serketich WJ (1995) “Balance of power”: a transactional analysis of control in mother–child dyads involving socially competent, aggressive, and anxious children. J Abnorm Psychol 104:104–113. doi:10.1037/0021-843X.104.1.104

    Article  PubMed  Google Scholar 

  22. Hibbs ED, Hamburger SD, Kruesi MJ, Lenane M (1993) Factors affecting expressed emotion in parents of ill and normal children. Am J Orthopsychiatry 63:103–112. doi:10.1037/h0079395

    Article  PubMed  Google Scholar 

  23. Hibbs ED, Hamburger SD, Lenane M, Rapoport JL, Kruesi MJ, Keysor CS et al (1991) Determinants of expressed emotion in families of disturbed and normal children. J Child Psychol Psychiatry 32:757–770. doi:10.1111/j.1469-7610.1991.tb01900.x

    Article  PubMed  Google Scholar 

  24. Lieb R, Wittchen HU, Hofler M, Fuetsch M, Stein MB, Merikangas KR (2000) Parental psychopathology, parenting styles, and the risk of social phobia in offspring: a prospective-longitudinal community study. Arch Gen Psychiatry 57:859–866. doi:10.1001/archpsyc.57.9.859

    Article  PubMed  Google Scholar 

  25. Woodruff-Borden J, Morrow C, Bourland S, Cambron S (2002) The behavior of anxious parents: examining mechanisms of transmission of anxiety from parent to child. J Clin Child Adolesc Psychol 31:364–374

    PubMed  Google Scholar 

  26. McClure EB, Brennan PA, Hammen C, Le Brocque RM (2001) Parental anxiety disorders, child anxiety disorders, and the perceived parent–child relationship in an Australian high-risk sample. J Abnorm Child Psychol 29:1–10. doi:10.1023/A:1005260311313

    Article  PubMed  Google Scholar 

  27. Muris P, Steerneman P, Merckelbach H, Meesters C (1996) The role of parental fearfulness and modeling in children’s fear. Behav Res Ther 34:265–268. doi:10.1016/0005-7967(95)00067-4

    Article  PubMed  Google Scholar 

  28. Kashani JH, Vaidya AF, Soltys SM, Dandoy AC, Katz LM, Reid JC (1990) Correlates of anxiety in psychiatrically hospitalized children and their parents. Am J Psychiatry 147:319–323

    PubMed  Google Scholar 

  29. Manassis K, Hood J (1998) Individual and familial predictors of impairment in childhood anxiety disorders. J Am Acad Child Adolesc Psychiatry 37:428–434. doi:10.1097/00004583-199804000-00021

    Article  PubMed  Google Scholar 

  30. Stark KD, Humphrey LL, Crook K, Lewis K (1990) Perceived family environments of depressed and anxious children: child’s and maternal figure’s perspectives. J Abnorm Child Psychol 18:527–547. doi:10.1007/BF00911106

    Article  PubMed  Google Scholar 

  31. Stark KD, Humphrey LL, Laurent J, Livingston R, Christopher J (1993) Cognitive, behavioral, and family factors in the differentiation of depressive and anxiety disorders during childhood. J Consult Clin Psychol 61:878–886. doi:10.1037/0022-006X.61.5.878

    Article  PubMed  Google Scholar 

  32. McLeod BD, Wood JJ, Weisz JR (2007) Examining the association between parenting and childhood anxiety: a meta-analysis. Clin Psychol Rev 27:155–172. doi:10.1016/j.cpr.2006.09.002

    Article  PubMed  Google Scholar 

  33. Wood JJ, Piacentini JC, Southam-Gerow M, Chu B, Sigman M (2006) Family cognitive behavioral therapy for child anxiety disorders. J Am Acad Child Adolesc Psychiatry 45:314–321. doi:10.1097/01.chi.0000196425.88341.b0

    Article  PubMed  Google Scholar 

  34. Moos RH, Moos BS (1974) Manual for the Family Environment Scale. Consulting Psychologists Press, Palo Alto

    Google Scholar 

  35. Skinner HA, Steinhauer PD, Santa-Barbara J (1983) The Family Assessment Measure. Can J Commun Ment Health 2:91–105

    Google Scholar 

  36. Schaefer ES (1965) Children’s reports of parental behavior: an inventory. Child Dev 36:413–424. doi:10.2307/1126465

    Article  PubMed  Google Scholar 

  37. Calvocoressi L, Mazure CM, Kasl SV, Skolnick J, Fisk D, Vegso SJ et al (1999) Family accommodation of obsessive-compulsive symptoms: instrument development and assessment of family behavior. J Nerv Ment Dis 187:636–642. doi:10.1097/00005053-199910000-00008

    Article  PubMed  Google Scholar 

  38. Masia Warner C, Ehrenreich JT, Klein R, Manuzza S (2003) Family Assessment Clinician-rated Interview. Unpublished measure. NYU Child Study Center, Department of Child and Adolescent Psychiatry, NYU School of Medicine and The Nathan Kline Institute for Psychiatric Research, Orangeburg, New York

  39. Silverman WK, Albano AM (1997) Anxiety Disorders Interview Schedule for DSM-IV, Child and Parent Versions. Psychological Corporation, San Antonio

    Google Scholar 

  40. March JS, Parker JD, Sullivan K, Stallings P, Conners CK (1997) The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity. J Am Acad Child Adolesc Psychiatry 36:554–565

    Article  PubMed  Google Scholar 

  41. Baldwin JS, Dadds MR (2007) Reliability and validity of parent and child versions of the Multidimensional Anxiety Scale for Children in community samples. J Am Acad Child Adolesc Psychiatry 46:252–260. doi:10.1097/01.chi.0000246065.93200.a1

    Article  PubMed  Google Scholar 

  42. Reynolds CR, Richmond BO (1979) Factor structure and construct validity of the ‹What I Think and Feel’: The Revised Children’s Manifest Anxiety Scale. J Pers Assess 43:281–283. doi:10.1207/s15327752jpa4303_9

    Article  PubMed  Google Scholar 

  43. Kovacs M (1981) Rating scales to assess depression in school-aged children. Acta Paedopsychiatr 46:305–315

    PubMed  Google Scholar 

  44. Saylor CF, Finch AJ Jr, Spirito A, Bennett B (1984) The children’s depression inventory: a systematic evaluation of psychometric properties. J Consult Clin Psychol 52:955–967. doi:10.1037/0022-006X.52.6.955

    Article  PubMed  Google Scholar 

  45. Moos RH, Moos BS (1983) Clinical applications of the Family Environment Scale. In: Filsinger E (ed) A Sourcebook of Marriage and Family Assessment. Sage Publications, Beverly Hills, pp 253–273

    Google Scholar 

  46. Moos RH (1990) Conceptual and empirical approaches to developing family-based assessment procedures: resolving the case of the Family Environment Scale. Fam Process 29:199–208. doi:10.1111/j.1545-5300.1990.00199.x

    Article  PubMed  Google Scholar 

  47. Moos RH, Moos BS (1976) A typology of family social environments. Fam Process 15:357–371. doi:10.1111/j.1545-5300.1976.00357.x

    Article  PubMed  Google Scholar 

  48. Messer SC, Beidel DC (1994) Psychosocial correlates of childhood anxiety disorders. J Am Acad Child Adolesc Psychiatry 33:975–983. doi:10.1097/00004583-199409000-00007

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Psychology, University of Miami, P.O. Box 248185, Coral Gables, FL, 33124, USA

    Jill T. Ehrenreich

  2. Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, Boston, MA, USA

    Jamie A. Micco

  3. Seton Hall University, South Orange, NJ, USA

    Paige H. Fisher

  4. Department of Child and Adolescent Psychiatry, NYU Child Study Center, NYU Langone Medical Center, New York, NY, USA

    Carrie Masia Warner

  5. The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA

    Carrie Masia Warner

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  1. Jill T. Ehrenreich
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  2. Jamie A. Micco
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  3. Paige H. Fisher
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  4. Carrie Masia Warner
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Correspondence to Jill T. Ehrenreich.

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Ehrenreich, J.T., Micco, J.A., Fisher, P.H. et al. Assessment of Relevant Parenting Factors in Families of Clinically Anxious Children: The Family Assessment Clinician-Rated Interview (FACI). Child Psychiatry Hum Dev 40, 331–342 (2009). https://doi.org/10.1007/s10578-009-0128-y

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  • DOI: https://doi.org/10.1007/s10578-009-0128-y

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