Child Psychiatry & Human Development

, Volume 49, Issue 3, pp 460–467 | Cite as

Maternal Acceptance Moderates Fear Ratings and Avoidance Behavior in Children

  • Yaara Shimshoni
  • Wendy K. Silverman
  • Simon P. Byrne
  • Eli R. Lebowitz
Original Article

Abstract

Avoidance is a hallmark feature of anxiety disorders, and avoidance-related impairment is often key to meeting diagnostic criteria. In children and adolescents with anxiety disorders, levels of avoidance vary considerably. Using a novel motion-tracking measure of avoidance behavior, we examined whether maternal acceptance, characterized by warm and accepting responses to child feelings and behaviors, moderates the association between fear of spiders and behavioral avoidance of spider stimuli in 103 clinically anxious children. As hypothesized, maternal acceptance significantly moderated children’s avoidance behavior. Child’s fear of spiders was significantly associated with behavioral avoidance when mothers were low in acceptance, as rated by either mothers or children. When mothers were high in acceptance, as rated by either mothers or children, child self-rated fear of spiders was not significantly associated with child avoidance. These are the first results to empirically demonstrate the moderating role of maternal acceptance in anxious children’s avoidance behavior.

Keywords

Maternal acceptance Fear Avoidance Children and adolescents Anxiety disorders 

Notes

Acknowledgements

The authors acknowledge the work of PreviewLabs (previewlabs.com) on software development for YIKES. This research was supported by a NARSAD Young Investigator Grant from the Brain and Behavior Foundation (Grant Number 21470) and by Grants from NIMH (K23MH103555) and NCATS (KL2TR000140).

References

  1. 1.
    Barlow DH (2002) Anxiety and its disorders: the nature and treatment of anxiety and panic, 2nd edn. Guilford Press, New YorkGoogle Scholar
  2. 2.
    American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, ArlingtonCrossRefGoogle Scholar
  3. 3.
    Klein AM, Becker ES, Rinck M (2011) Direct and indirect measures of spider fear predict unique variance in children’s fear-related behaviour. Cogn Emot 25:1205–1213CrossRefPubMedGoogle Scholar
  4. 4.
    Ollendick TH, Lewis KM, Cowart MJ, Davis T 3rd, (2012) Prediction of child performance on a parent-child behavioral approach test with animal phobic children. Behav Modif 36:509–524CrossRefPubMedGoogle Scholar
  5. 5.
    Roelofs K, van Peer J, Berretty E, Jong P, Spinhoven P, Elzinga BM (2009) Hypothalamus-pituitary-adrenal axis hyperresponsiveness is associated with increased social avoidance behavior in social phobia. Biol Psychiatry 65:336–343CrossRefPubMedGoogle Scholar
  6. 6.
    Rapee RM, Murrell E (1988) Predictors of agoraphobic avoidance. J Anxiety Disord 2:203–217CrossRefGoogle Scholar
  7. 7.
    Bögels SM, Brechman-Toussaint ML (2006) Family issues in child anxiety: attachment, family functioning, parental rearing and beliefs. Clin Psychol Rev 26:834–856CrossRefPubMedGoogle Scholar
  8. 8.
    Wood JJ, BD McLeod M, Sigman WC, Hwang, Chu BC (2003) Parenting and childhood anxiety: theory, empirical findings, and future directions. J Child Psychol Psychiatry 44:134–151CrossRefPubMedGoogle Scholar
  9. 9.
    Francis SE, Noel V (2010) Parental contributions to child anxiety sensitivity: a review and recommendations for future directions. Child Psychiatry Hum Dev 41:595–613CrossRefPubMedGoogle Scholar
  10. 10.
    Festa CC, Ginsburg GS (2011) Parental and peer predictors of social anxiety in youth. Child Psychiatry Hum Dev 42:291–306CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Ginsburg GS, Silverman WK, Kurtines WK (1995) Family involvement in treating children with phobic and anxiety disorders—a Look-Ahead. Clin Psychol Rev 15:457–473CrossRefGoogle Scholar
  12. 12.
    McLeod BD, Wood JJ, Weisz JR (2007) Examining the association between parenting and childhood anxiety: a meta-analysis. Clin Psychol Rev 27:155–172CrossRefPubMedGoogle Scholar
  13. 13.
    Maccoby EE (1992) The role of parents in the socialization of children—an historical overview. Dev Psychol 28:1006–1017CrossRefGoogle Scholar
  14. 14.
    Gottman JM, Katz LF, Hooven C (1997) Meta-emotion: how families communicate emotionally. Lawrence Erlbaum Associates Inc, HillsdaleGoogle Scholar
  15. 15.
    Crockenberg SC, Leerkes EM (2006) Infant and maternal behavior moderate reactivity to novelty to predict anxious behavior at 2.5 years. Dev Psychopathol 18:17–34CrossRefPubMedGoogle Scholar
  16. 16.
    Park SY, Belsky J, Putnam S, Crnic K (1997) Infant emotionality, parenting, and 3-year inhibition: exploring stability and lawful discontinuity in a male sample. Dev Psychol 33:218–227CrossRefPubMedGoogle Scholar
  17. 17.
    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 57:859–866CrossRefPubMedGoogle Scholar
  18. 18.
    Siqueland L, Kendall PC, Steinberg L (1996) Anxiety in children: perceived family environments and observed family interaction. J Clin Child Psychol 25:225–237CrossRefGoogle Scholar
  19. 19.
    Hudson JL, Rapee RM (2001) Parent-child interactions and anxiety disorders: an observational study. Behav Res Ther 39:1411–1427CrossRefPubMedGoogle Scholar
  20. 20.
    Miranda MC, Affuso G, Esposito C, Bacchini D (2016) Parental acceptance-rejection and adolescent maladjustment: mothers’ and fathers’ combined roles. J Child Fam Stu 25:1352–1362CrossRefGoogle Scholar
  21. 21.
    Scott WA, Scott R, McCabe M (1991) Family relationships and children’s personality: a cross-cultural, cross-source comparison. Br J Soc Psychol 30:1–20CrossRefGoogle Scholar
  22. 22.
    Kindt M, Brosschot JF, Muris P (1996) Spider phobia questionnaire for children (SPQ-C): a psychometric study and normative data. Behav Res Ther 34:277–282CrossRefPubMedGoogle Scholar
  23. 23.
    Silverman WK, Saavedra LM, Pina AA (2001) Test-retest reliability of anxiety symptoms and diagnoses with the anxiety disorders interview schedule for DSM-IV: child and parent versions. J Am Acad Child Adolesc Psychiatry 40:937–944CrossRefPubMedGoogle Scholar
  24. 24.
    Wood JJ, Piacentini JC, Bergman RL, McCracken J, Barrios V (2002) Concurrent validity of the anxiety disorders section of the anxiety disorders interview schedule for DSM-IV: child and parent versions. J Clin Child Adolesc Psychol 31:335–342CrossRefPubMedGoogle Scholar
  25. 25.
    Silverman WK, Kurtines WM, Ginsburg GS, Weems CF, Rabian B, Serafini LT (1999) Contingency management, self-control, and education support in the treatment of childhood phobic disorders: a randomized clinical trial. J Consult Clin Psychol 67:675–687CrossRefPubMedGoogle Scholar
  26. 26.
    Silverman WK, Kurtines WM, Jaccard J, Pina AA (2009) Directionality of change in youth anxiety treatment involving parents: an initial examination. J Consult Clin Psychol 77:474–485CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Muris PS, van der Heiden, Rassin E (2008) Disgust sensitivity and psychopathological symptoms in non-clinical children. J Behav Ther Exp Psychiatry 39:133–146CrossRefPubMedGoogle Scholar
  28. 28.
    Klein AM, Becker ES, Rinck M (2011) Approach and avoidance tendencies in spider fearful children: the approach-avoidance task. J Child Fam Stud 20:224–231CrossRefPubMedGoogle Scholar
  29. 29.
    Schaefer ES (1965) Children’s reports of parental behavior: an inventory. Child Dev 36:413–424CrossRefPubMedGoogle Scholar
  30. 30.
    Wei C, Kendall PC (2014) Parental involvement: contribution to childhood anxiety and its treatment. Clin Child Fam Psychol Rev 17:319–339CrossRefPubMedGoogle Scholar
  31. 31.
    Kawash GF, Clewes JL (1988) A factor analysis of a short form of the CRPBI: are children’s perceptions of control and discipline multidimensional? J Psychol 122:57–67CrossRefGoogle Scholar
  32. 32.
    Schwarz JC, Barton-Henry ML, Pruzinsky T (1985) Assessing child-rearing behaviors: a comparison of ratings made by mother, father, child, and sibling on the CRPBI. Child Dev 56:462–479CrossRefPubMedGoogle Scholar
  33. 33.
    Margolies PJ, Weintraub S (1977) The revised 56-item CRPBI as a research instrument: reliability and factor structure. J Clin Psychol 33:472–476CrossRefGoogle Scholar
  34. 34.
    Brenning K, Soenens B, Braet C, Bal S (2012) The role of parenting and mother-adolescent attachment in the intergenerational similarity of internalizing symptoms. J Youth Adolesc 41:802–816CrossRefPubMedGoogle Scholar
  35. 35.
    Lebowitz ER, Shic F, Campbell D, MacLeod J, Silverman WK (2015) Avoidance moderates the association between mothers’ and children’s fears: findings from a novel motion-tracking behavioral assessment. Depress Anxiety 32:91–98CrossRefPubMedGoogle Scholar
  36. 36.
    Lebowitz ER, Shic F, Campbell D, Basile K, Silverman WK (2015) Anxiety sensitivity moderates behavioral avoidance in anxious youth. Behav Res Ther 74:11–17CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Lebowitz ER (2017) Mother and child ratings of child anxiety: associations with a measure of behavioral avoidance and the role of family accommodation. Parent Sci Pract 17:124–142CrossRefGoogle Scholar
  38. 38.
    Hayes AF (2013) Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. In: Methodology in the social sciences. The Guilford Press, New YorkGoogle Scholar
  39. 39.
    Silverman WK, Pina AA (2008) Psychosocial treatments for phobic and anxiety disorders in youth. In: Steele RG, Elkin TD, Robertss MCE (eds) Issues in clinical child psychology. Springer Science + Business Media, New York, pp 66–82Google Scholar
  40. 40.
    Compton SN, Peris TS, Almirall D, Birmaher B, Sherrill J, Kendall PC et al (2014) Predictors and moderators of treatment response in childhood anxiety disorders: results from the CAMS trial. J Consult Clin Psychol 82:212–224CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Rapee RM, Schniering CA, Hudson JL (2009) Anxiety disorders during childhood and adolescence: origins and treatment. Annu Rev Clin Psychol 5:311–341CrossRefPubMedGoogle Scholar
  42. 42.
    Walkup JT, Albano AM, Piacentini J, Birmaher B, Compton SN, Sherrill JT et al (2008) Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med 359:2753–2766CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Davey GC (1992) Characteristics of individuals with fear of spiders. Anxiety Research 4:299–314CrossRefGoogle Scholar
  44. 44.
    Lipp OV, Derakshan N (2005) Attentional bias to pictures of fear-relevant animals in a dot probe task. Emotion 5:365–369CrossRefPubMedGoogle Scholar
  45. 45.
    Thorpe SJ, Salkovskis PM (1998) Selective attention to real phobic and safety stimuli. Behav Res Ther 36:471–481CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Yale University Child Study CenterNew HavenUSA

Personalised recommendations