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Assessment of Parental Experiential Avoidance in a Clinical Sample of Children with Anxiety Disorders

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Abstract

This investigation seeks to establish the psychometric properties of an adapted measure of experiential avoidance (EA) in the parenting context by assessing its relation to other parenting constructs and psychosocial correlates of child anxiety in a clinical sample. Participants were 154 children (90 female, 64 male) diagnosed with anxiety disorders and their parents (148 mothers, 119 fathers). The newly developed Parental Acceptance and Action Questionnaire (PAAQ) was administered to parents along with self-report measures of adult experiential avoidance, parental psychopathology, affective expression, and parental control behaviors. A subsample of participants, n = 35, were re-administered the PAAQ to assess temporal stability. Factor analysis of the PAAQ yielded a two-factor solution with factors labeled Inaction and Unwillingness. Temporal stability of the PAAQ was found to be moderate, r = .68–.74. Internal consistency was fair across subscales of the PAAQ, α = .64–.65. Correlational analysis of the PAAQ and parent-report measures support the criterion validity of the PAAQ, suggesting that the PAAQ correlates with parent-report measures of parental locus of control, affective expression, and controlling parental behaviors as well as child psychopathology symptoms. Finally, the clinical applicability of the PAAQ is indicated by the PAAQ’s ability to predict a significant amount of variance in parent- and clinician-rated levels of child anxiety and related psychopathology.

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References

  1. Vasey MW, Dadds MR (2001) The developmental psychopathology of anxiety. Oxford University Press, New York

    Google Scholar 

  2. Hettema JM, Neale MC, Kendler KS (2001) A review and meta-analysis of the genetic epidemiology of anxiety disorders. Am J Psychiatry 158:1568–1578. doi:10.1176/appi.ajp.158.10.1568

    Article  PubMed  Google Scholar 

  3. Last CG, Hersen M, Kazdin A, Orvaschel H (1991) Anxiety disorders in children and their families. Arch Gen Psychiatry 48:928–934

    PubMed  Google Scholar 

  4. Turner SM, Beidel DC, Costello A (1987) Psychopathology in the offspring of anxiety disorders patients. J Consult Clin Psychol 55:229–235. doi:10.1037/0022-006X.55.2.229

    Article  PubMed  Google Scholar 

  5. Biederman J, Rosenbaum JF, Bolduc EA, Faraone SV (1991) A high risk study of young children of parents with panic disorder and agoraphobia with and without comorbid major depression. Psychiatry Res 37:333–348. doi:10.1016/0165-1781(91)90068-Z

    Article  PubMed  Google Scholar 

  6. Beidel DC, Turner SM (1997) At risk for anxiety: I. Psychopathology in the offspring of anxious parents. J Am Acad Child Adolesc Psychiatry 36:918–924. doi:10.1097/00004583-199707000-00013

    Article  PubMed  Google Scholar 

  7. Turner SM, Beidel DC, Wolff PL, Spaulding S (1996) Clinical features affecting treatment outcome in social phobia. Behav Res Ther 34:795–804. doi:10.1016/0005-7967(96)00028-9

    Article  PubMed  Google Scholar 

  8. Wood JJ, McLeod BD, Sigman M, Hwang W-C, Chu BC (2003) Parenting and childhood anxiety: theory, empirical findings, and future directions. J Child Psychol Psychiatry 44:134–151. doi:10.1111/1469-7610.00106

    Article  PubMed  Google Scholar 

  9. Eley TC, Liang H, Plomin R, Sham P, Sterne A, Williamson R (2004) Parental familial vulnerability, family environment, and their interactions as predictors of depressive symptoms in adolescents. J Am Acad Child Adolesc Psychiatry 43:298–306. doi:10.1097/00004583-200403000-00011

    Article  PubMed  Google Scholar 

  10. 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 

  11. Krohne HW, Hock M (1991) Relationships between restrictive mother–child interactions and anxiety of the child. Anxiety Res 4:109–124

    Google Scholar 

  12. 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 

  13. Kohlmann C-W, Schumacher A, Streit R (1988) Trait anxiety and parental child-rearing behavior: support as a moderator variable? Anxiety Res 1:53–64

    Google Scholar 

  14. Craske MG (1999) Anxiety disorders: psychological approaches to theory and treatment. Westview, Boulder, CO

    Google Scholar 

  15. 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 

  16. 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 

  17. 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 

  18. Fox NA, Henderson HA, Marshall PJ, Nichols KE, Ghera MM (2005) Behavioral inhibition: linking biology and behavior within a developmental framework. Annu Rev Psychol 56:235–262. doi:10.1146/annurev.psych.55.090902.141532

    Article  PubMed  Google Scholar 

  19. Hudson JL, Rapee RM (1998) Parenting of anxious children and their siblings. Poster session presented at the World Congress of Behavior and Cognitive Therapies, Acapulco

    Google Scholar 

  20. Park S-Y, 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 33:218–227. doi:10.1037/0012-1649.33.2.218

    Article  PubMed  Google Scholar 

  21. 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 

  22. Rubin KH, Burgess KB, Hastings PD (2002) Stability and social-behavioral consequences of toddlers’ inhibited temperament and parenting behaviors. Child Dev 73:483. doi:10.1111/1467-8624.00419

    Article  PubMed  Google Scholar 

  23. Silverman WK, Cerny JA, Nelles WB (1988) The familial influence in anxiety disorders: studies on the offspring of patients with anxiety disorders. Adv Clin Child Psychol 11:223–248

    Google Scholar 

  24. 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 

  25. León CA, León A (1990) Panic disorder and parental bonding. Psychiatr Ann 20:503–508

    Google Scholar 

  26. 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 

  27. Whaley SE, Pinto A, Sigman M (1999) Characterizing interactions between anxious mothers and their children. J Consult Clin Psychol 67:826–836. doi:10.1037/0022-006X.67.6.826

    Article  PubMed  Google Scholar 

  28. Hayes SC, Wilson KG, Gifford EV, Follette VM, Strosahl K (1996) Experiential avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. J Consult Clin Psychol 64:1152–1168. doi:10.1037/0022-006X.64.6.1152

    Article  PubMed  Google Scholar 

  29. Hayes SC, Strosahl K, Wilson KG, Bissett RT, Pistorello J, Toarmino D, Polusny MA, Dykstra TA, Batten SV, Bergan J, Stewart SH, Zvolensky MJ, Eifert GH, Bond FW, Forsyth JP, Karekla M, McCurry SM (2004) Measuring experiential avoidance: a preliminary test of a working model. Psychol Rec 54:553–578

    Google Scholar 

  30. Coyne LW, Cheron DM, Ehrenreich JT (2008) Assessment of acceptance and mindfulness concepts in youth. In: Greco LA, Hayes SC (eds) Acceptance and mindfulness interventions for children adolescents and families. New Harbinger, Oakland

    Google Scholar 

  31. Ehrenreich JT, Micco JA, Fisher PA, Masia-Warner C (2009) Assessment of relevant parenting factors in families of clinically anxious children: the family assessment clinician-rated interview (FACI). Child Psychiatry Hum Dev [Epub ahead of print]

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

    Article  Google Scholar 

  33. Silverman WK, Albano AM (1996) The anxiety disorders interview schedule for DSM-IV: child and parent versions. Oxford University Press, New York

    Google Scholar 

  34. Silverman WK, Saavendra 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 40:937–944. doi:10.1097/00004583-200108000-00016

    Article  PubMed  Google Scholar 

  35. 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 31:335–342

    PubMed  Google Scholar 

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

    Google Scholar 

  37. Skinner HA, Steinhauer PD, Santa-Barbara J (1995) The family assessment measure-III manual. Multi-Health Systems, Toronto, Canada

    Google Scholar 

  38. Achenbach TM (1991) Manual for the child behavior checklist/4–18 and 1991 profile. Department of Psychiatry, University of Vermont, Burlington

    Google Scholar 

  39. Achenbach TM (1991) Integrative guide for the 1991 CBCL/4–18, YSR and TRF profiles. Department of Psychiatry, University of Vermont, Burlington

    Google Scholar 

  40. Lovibond PF, Lovibond SH (1993) Manual for the depression anxiety stress scale (DASS): available from the psychology foundation. University of New South Wales, Australia

    Google Scholar 

  41. Brown TA, Chorpita BF, Korotitsch W, Barlow DH (1997) Psychometric properties of the depression anxiety stress scales (DASS) in clinical samples. Behav Res Ther 35:79–89. doi:10.1016/S0005-7967(96)00068-X

    Article  PubMed  Google Scholar 

  42. Antony MM, Orsillo SM, Roemer L (2001) Practitioner’s guide to empirically based measures of anxiety. Plenum, New York

    Google Scholar 

  43. Bond FW, Bunce D (2003) The role of acceptance and job control in mental health, job satisfaction, and work performance. J Appl Psychol 88:1057–1067. doi:10.1037/0021-9010.88.6.1057

    Article  PubMed  Google Scholar 

  44. Cattell RB (1966) The scree test for the number of factors. Multivariate Behav Res 1:245–276. doi:10.1207/s15327906mbr0102_10

    Article  Google Scholar 

  45. Achenbach TM, McConaughy SH, Howell CT (1987) Child/adolescent behavioral and emotional problems: implications of cross-informant correlations for situational specificity. Psychol Bull 101:213–232. doi:10.1037/0033-2909.101.2.213

    Article  PubMed  Google Scholar 

  46. Duhig AM, Renk K, Epstein MK, Phares V (2000) Interparental agreement on internalizing, externalizing, and total behavior problems: a meta-analysis. Clin Psychol Sci Pract 7:435–453. doi:10.1093/clipsy/7.4.435

    Article  Google Scholar 

  47. Ritzler B, Gryll S, Kiecolt-Glaser J, Jones F, Singer M (1981) Predicting offspring vulnerability to psychopathology from parents’ test data. J Pers Assess 45:600–607. doi:10.1207/s15327752jpa4506_6

    Article  PubMed  Google Scholar 

  48. Merikangas KR, Avenevoli S, Dierker L, Grillon C (1999) Vulnerability factors among children at risk for anxiety disorders. Biol Psychiatry 46:1523–1535. doi:10.1016/S0006-3223(99)00172-9

    Article  PubMed  Google Scholar 

  49. Dadds MR, Roth JH (2001) Family processes in the development of anxiety problems. In: Vasey MW, Dadds MR (eds) The developmental psychopathology of anxiety. Oxford University Press, New York, pp 278–303

    Google Scholar 

  50. Ginsburg GS, Silverman WK, Kurtines WK (1995) Family involvement in treating children with phobic and anxiety disorders: a look ahead. Clin Psychol Rev 15:457–473. doi:10.1016/0272-7358(95)00026-L

    Article  Google Scholar 

  51. Krain AL, Kendall PC (2000) The role of parental emotional distress in parent report of child anxiety. J Clin Child Psychol 29:328–335. doi:10.1207/S15374424JCCP2903_4

    Article  PubMed  Google Scholar 

  52. Ginsburg GS, Grover RL, Cord JJ, Ialongo N (2006) Observational measures of parenting in anxious and nonanxious mothers: does type of task matter? J Clin Child Adolesc Psychol 35:323–328. doi:10.1207/s15374424jccp3502_16

    Article  PubMed  Google Scholar 

  53. Khorakiwala D, Hayes SC, Wilson K (1991) A behavior analytic approach to change processes in verbal therapies: An example from acceptance and commitment therapy. Paper presented at the meeting of the association for behavior analysis, Atlanta, GA

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Correspondence to Daniel M. Cheron.

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See Tables 1, 2, 3, 4, 5, 6.

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Cheron, D.M., Ehrenreich, J.T. & Pincus, D.B. Assessment of Parental Experiential Avoidance in a Clinical Sample of Children with Anxiety Disorders. Child Psychiatry Hum Dev 40, 383–403 (2009). https://doi.org/10.1007/s10578-009-0135-z

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