Abstract
Anxiety disorders are one of the most prevalent psychiatric disorders among adolescents and can be associated with long-term adverse outcomes if untreated. Our study examined the association between family functioning and symptoms of five anxiety disorders and the potential moderating role of trait mindfulness among adolescent boys and girls. The sample included 1333 adolescents ages 11–15 (Mage = 12.24; SD = 0.69; 51% girls; 52% non-Hispanic White) from the Northeast United States who completed a survey in the fall of 2016 and again in the spring of 2017. Multi-group path analyses were conducted to examine the association separately by gender. For boys, high mindfulness buffered the effect of low family support and high family conflict on the panic disorder (PD), generalized anxiety disorder (GAD), separation anxiety (SEP), and severe school avoidance (SSA). For girls, a cumulative effect of high mindfulness and high family support reduced symptoms for PD and SSA, whereas high mindfulness buffered the effect of low family cohesion on GAD and social anxiety disorder (SAD). Our findings highlight the importance of family functioning on anxiety disorders in adolescents and suggest trait mindfulness may serve as a potential buffer for anxiety in adolescent boys. Implications for these gender differences, potential benefits of socio-emotional learning instruction for adolescents, and future directions are explored.
Highlights
-
Our study examines symptoms of five distinct anxiety disorders in adolescents.
-
Family functioning during early adolescence is associated with anxiety symptoms in boys and girls.
-
Mindfulness moderates the association between family functioning and anxiety symptoms differently for boys and girls.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ackard, D. M., Neumark-Sztainer, D., Story, M., & Perry, C. (2006). Parent–child connectedness and behavioral and emotional health among adolescents. American Journal of Preventive Medicine, 30(1), 59–66. https://doi.org/10.1016/j.amepre.2005.09.013.
Beesdo-Baum, K., & Knappe, S. (2012). Developmental epidemiology of anxiety disorders. Child and Adolescent Psychiatric Clinics of North America, 21(3), 457–478. https://doi.org/10.1016/j.chc.2012.05.001.
Bergin, A. J., & Pakenham, K. I. (2016). The stress-buffering role of mindfulness in the relationship between perceived stress and psychological adjustment. Mindfulness, 7(4), 928–939. https://doi.org/10.1007/s12671-016-0532-x.
Birmaher, B., Brent, D. A., Chiappetta, L., Bridge, J., Monga, S., & Baugher, M. (1999). Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A replication study. Journal of the American Academy of Child and Adolescent Psychiatry, 38(10), 1230–1236. https://doi.org/10.1097/00004583-199910000-00011.
Birmes, P., Raynaud, J. P., Daubisse, L., Brunet, A., Arbus, C., Klein, R., Cailhol, L., Allenou, C., Hazane, F., Grandjean, H., & Schmitt, L. (2009). Children’s enduring PTSD symptoms are related to their family’s adaptability and cohesion. Community Mental Health Journal, 45(4), 290–299. https://doi.org/10.1007/s10597-008-9166-3.
Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., & Devins, G. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11(3), 230–241. https://doi.org/10.1093/clipsy/bph077.
Bollen, K. A. (1989). A new incremental fit index for general structural equation models. Sociological Methods & Research, 17(3), 303–316. https://doi.org/10.1177/0049124189017003004.
Borquist-Conlon, D. S., Maynard, B. R., Brendel, K. E., & Farina, A. S. J. (2019). Mindfulness-based interventions for youth with anxiety: A systematic review and meta-analysis. Research on Social Work Practice, 29(2), 195–205. https://doi.org/10.1177/1049731516684961.
Bronfenbrenner, U., & Morris, P. A. (2006). The bioecological model of human development. In W. Damon & R. M. Lerner (Eds.), Handbook of child psychology: Theoretical models of human development (pp. 793–828). New York, NY: Wiley.
Browne, M. W., & Cudeck, R. (1992). Alternative ways of assessing model fit. Sociological Methods & Research, 21(2), 230–258. https://doi.org/10.1177/0049124192021002005.
Burstein, M., Georgiades, K., Lamers, F., Swanson, S. A., Cui, L., He, J. P., & Merikangas, K. R. (2012). Empirically derived subtypes of lifetime anxiety disorders: Developmental and clinical correlates in U.S. adolescents. Journal of Consulting and Clinical Psychology, 80(1), 102–115. https://doi.org/10.1037/a0026069.
Canty-Mitchell, J., & Zimet, G. D. (2000). Psychometric properties of the multidimensional scale of perceived social support in urban adolescents. American Journal of Community Psychology, 28(3), 391–400.
Cavanaugh, A. M., & Buehler, C. (2016). Adolescent loneliness and social anxiety: The role of multiple sources of support. Journal of Social and Personal Relationships, 33(2), 149–170. https://doi.org/10.1177/0265407514567837.
Chen, P., & Harris, K. M. (2019). Association of positive family relationships with mental health trajectories from adolescence to midlife. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2019.3336.
Cheung, G. W., & Rensvold, R. B. (2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling, 9(2), 233–255. https://doi.org/10.1207/S15328007SEM0902_5.
Chung, G. H., Flook, L., & Fuligni, A. J. (2009). Daily family conflict and emotional distress among adolescents from Latin American, Asian, and European backgrounds. Developmental Psychology, 45(5), 1406–1415. https://doi.org/10.1037/a0014163.
Ciesla, J. A., Reilly, L. C., Dickson, K. S., Emanuel, A. S., & Updegraff, J. A. (2012). Dispositional mindfulness moderates the effects of stress among adolescents: Rumination as a mediator. Journal of Clinical Child and Adolescent Psychology, 41(6), 760–770. https://doi.org/10.1080/15374416.2012.698724.
Copeland, W. E., Angold, A., Shanahan, L., & Costello, E. J. (2014). Longitudinal patterns of anxiety from childhood to adulthood: The great smoky mountains study. Journal of the American Academy of Child and Adolescent Psychiatry. https://doi.org/10.1016/j.jaac.2013.09.017.
Cortazar, N., & Calvete, E. (2019). Dispositional mindfulness and its moderating role in the predictive association between stressors and psychological symptoms in adolescents. Mindfulness, 10(10), 2046–2059. https://doi.org/10.1007/s12671-019-01175-x.
Cox, S. J., Mezulis, A. H., & Hyde, J. S. (2010). The influence of child gender role and maternal feedback to child stress on the emergence of the gender difference in depressive rumination in adolescence. Developmental Psychology, 46(4), 842–852. https://doi.org/10.1037/a0019813.
Crawford, T. N., Cohen, P., Midlarsky, E., & Brook, J. S. (2001). Internalizing symptoms in adolescents: Gender differences in vulnerability to parental distress and discord. Journal of Research on Adolescence, 11(1), 95–118. https://doi.org/10.1111/1532-7795.00005.
Creswell, J. D., & Lindsay, E. K. (2014). How does mindfulness training affect health? A mindfulness stress buffering account. Current Directions in Psychological Science, 23(6), 401–407. https://doi.org/10.1177/0963721414547415.
de Lijster, J. M., Dieleman, G. C., Utens, E. M. W. J., Dierckx, B., Wierenga, M., Verhulst, F. C., & Legerstee, J. S. (2018). Social and academic functioning in adolescents with anxiety disorders: A systematic review. Journal of Affective Disorders, 230, 108–117. https://doi.org/10.1016/j.jad.2018.01.008.
Demaray, M. K., Malecki, C. K., Davidson, L. M., Hodgson, K. K., & Rebus, P. J. (2005). The relationship between social support and student adjustment: A longitudinal analysis. Psychology in the Schools, 42(7), 691–706. https://doi.org/10.1002/pits.20120.
DeWit, D. J., Chandler-Coutts, M., Offord, D. R., King, G., McDougall, J., Specht, J., & Stewart, S. (2005). Gender differences in the effects of family adversity on the risk of onset of DSM-III-R social phobia. Journal of Anxiety Disorders, 19(5), 479–502. https://doi.org/10.1016/j.janxdis.2004.04.010.
Doty, H. D., & Glick, W. H. (1998). Common method bias: Does common methods variance really bias results? Organizational Research Methods, 1(4), 374–406. https://doi.org/10.1177/109442819814002.
Durlak, J. A., Weissberg, R. P., Dymnicki, A. B., Taylor, R. D., & Schellinger, K. B. (2011). The impact of enhancing students’ social and emotional learning: A meta-analysis of school-based universal interventions. Child Development, 82(1), 405–432. https://doi.org/10.1111/j.1467-8624.2010.01564.x.
Enders, C. K., & Bandalos, D. L. (2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling, 8(3), 430–457. https://doi.org/10.1207/S15328007SEM0803_5.
Essau, C. A., Lewinsohn, P. M., Olaya, B., & Seeley, J. R. (2014). Anxiety disorders in adolescents and psychosocial outcomes at age 30. Journal of Affective Disorders, 163, 125–132. https://doi.org/10.1016/j.jad.2013.12.033.
Felver, J. C., Celis-de Hoyos, C. E., Tezanos, K., & Singh, N. N. (2016). A systematic review of mindfulness-based interventions for youth in school settings. Mindfulness, 7(1), 34–45. https://doi.org/10.1007/s12671-015-0389-4.
Fendrich, M., Warner, V., & Weissman, M. M. (1990). Family risk factors, parental depression, and psychopathology in offspring. Developmental Psychology, 26(1), 40–50. https://doi.org/10.1037/0012-1649.26.1.40.
Galla, B. M., Tsukayama, E., Park, D., Yu, A., & Duckworth, A. L. (2020). The mindful adolescent: Developmental changes in nonreactivity to inner experiences and its association with emotional well-being. Developmental Psychology, 56(2), 350–363. https://doi.org/10.1037/dev0000877.
Goodman, E., Adler, N. E., Kawachi, I., Frazier, A. L., Huang, B., & Colditz, G. A. (2001). Adolescents’ perceptions of social status: development and evaluation of a new indicator. Pediatrics, 108. https://doi.org/10.1542/peds.108.2.e31
Greco, L. A., Baer, R. A., & Smith, G. T. (2011). Assessing mindfulness in children and adolescents: Development and validation of the child and adolescent mindfulness measure (CAMM). Psychological Assessment, 23(3), 606–614. https://doi.org/10.1037/a0022819.
Hale, W. W., Raaijmakers, Q., Muris, P., Van Hoof, A., & Meeus, W. (2008). Developmental trajectories of adolescent anxiety disorder symptoms: A 5-year prospective community study. Journal of the American Academy of Child and Adolescent Psychiatry, 47(5), 556–564. https://doi.org/10.1097/CHI.0b013e3181676583.
Harold, G. T., Osborne, L. N., & Conger, R. D. (1997). Mom and dad are at it again: Adolescent perceptions of marital conflict and adolescent psychological distress. Developmental Psychology, 33(2), 333–350. https://doi.org/10.1037/0012-1649.33.2.333.
Herrenkohl, T. I., Kosterman, R., Hawkins, J. D., & Mason, W. A. (2009). Effects of growth in family conflict in adolescence on adult depressive symptoms: Mediating and moderating effects of stress and school bonding. Journal of Adolescent Health, 44(2), 146–152. https://doi.org/10.1016/j.jadohealth.2008.07.005.
Hyde, J. S., Mezulis, A. H., & Abramson, L. Y. (2008). The ABCs of depression: Integrating affective, biological, and cognitive models to explain the emergence of the gender difference in depression. Psychological Review, 115(2), 291–313. https://doi.org/10.1037/0033-295X.115.2.291.
Johnson, H. D., LaVoie, J. C., & Mahoney, M. (2001). Interparental conflict and family cohesion: Predictors of loneliness, social anxiety, and social avoidance in late adolescence. Journal of Adolescent Research, 16(3), 304–318. https://doi.org/10.1177/0743558401163004.
Johnson, D. P., & Whisman, M. A. (2013). Gender differences in rumination: A meta-analysis. Personality and Individual Differences, 55(4), 367–374. https://doi.org/10.1016/j.paid.2013.03.019.
Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H. U. (2012). Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International Journal of Methods in Psychiatric Research, 21(3), 169–184. https://doi.org/10.1002/mpr.1359.
Khoury, B., Sharma, M., Rush, S. E., & Fournier, C. (2015). Mindfulness-based stress reduction for healthy individuals: A meta-analysis. Journal of Psychosomatic Research, 78(6), 519–528. https://doi.org/10.1016/j.jpsychores.2015.03.009.
Kiken, L. G., Garland, E. L., Bluth, K., Palsson, O. S., & Gaylord, S. A. (2015). From a state to a trait: Trajectories of state mindfulness in meditation during intervention predict changes in trait mindfulness. Personality and Individual Differences, 81, 41–46. https://doi.org/10.1016/j.paid.2014.12.044.
LaBelle, B. (2019). Positive outcomes of a social-emotional learning program to promote student resiliency and address mental health. Contemporary School Psychology, 1–7. https://doi.org/10.1007/s40688-019-00263-y.
Laursen, B., & Collins, W. A. (2009). Parent-child relationships during adolescence. In Handbook of Adolescent Psychology. https://doi.org/10.1002/9780470479193.adlpsy002002.
Lewinsohn, P. M., Lewinsohn, M., Gotlib, I. H., Seeley, J. R., & Allen, N. B. (1998). Gender differences in anxiety disorders and anxiety symptoms in adolescents. Journal of Abnormal Psychology, 107(1), 109–117. https://doi.org/10.1037/0021-843X.107.1.109.
Little, T. D. (2013). Longitudinal Structural Equation Modeling. The Guilford Press.
Little, T. D., Cunningham, W. A., Shahar, G., & Widaman, K. F. (2002). To parcel or not to parcel: Exploring the question, weighing the merits. Structural Equation Modeling: A Multidisciplinary Journal, 9(2), 151–173. https://doi.org/10.1207/s15328007sem0902_1.
Lucas‐Thompson, R. G., Seiter, N. S., Miller, R. L., & Crain, T. L. (2020). Does dispositional mindfulness buffer the links of stressful life experiences with adolescent adjustment and sleep? Stress and Health, 37, 140–150. https://doi.org/10.1002/smi.2980.
Maldonado, L., Huang, Y., Chen, R., Kasen, S., Cohen, P., & Chen, H. (2013). Impact of early adolescent anxiety disorders on self-esteem development from adolescence to young adulthood. Journal of Adolescent Health, 53(2), 287–292. https://doi.org/10.1016/j.jadohealth.2013.02.025.
Marks, A. D. G., Sobanski, D. J., & Hine, D. W. (2010). Do dispositional rumination and/or mindfulness moderate the relationship between life hassles and psychological dysfunction in adolescents? Australian and New Zealand Journal of Psychiatry, 44(9), 831–838. https://doi.org/10.3109/00048674.2010.487478.
McLeod, B. D., Wood, J. J., & Weisz, J. R. (2007). Examining the association between parenting and childhood anxiety: A meta-analysis. Clinical Psychology Review, 27(2), 155–172. https://doi.org/10.1016/j.cpr.2006.09.002.
Medvedev, O. N., Norden, P. A., Krägeloh, C. U., & Siegert, R. J. (2018). Investigating unique contributions of dispositional mindfulness facets to depression, anxiety, and stress in general and student populations. Mindfulness, 9(6), 1757–1767. https://doi.org/10.1007/s12671-018-0917-0.
Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., Benjet, C., Georgiades, K., & Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the national comorbidity survey replication-adolescent supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980–989. https://doi.org/10.1016/j.jaac.2010.05.017.
Mestre, J. M., Turanzas, J., García-Gómez, M., Guerra, J., Cordon, J. R., De La Torre, G. G., & Lopez-Ramos, V. M. (2019). Do trait emotional intelligence and dispositional mindfulness have a complementary effect on the children’s and adolescents’ emotional states? Frontiers in Psychology, 10, 2817 https://doi.org/10.3389/fpsyg.2019.02817.
Muris, P., Merckelbach, H., Ollendick, T., King, N., & Bogie, N. (2002). Three traditional and three new childhood anxiety questionnaires: Their reliability and validity in a normal adolescent sample. Behaviour Research and Therapy, 40(7), 753–772. https://doi.org/10.1016/S0005-7967(01)00056-0.
Muthén, L. K., & Muthén, B. O. (2017). Mplus user’s guide: Statistical analysis with latent variables (8th ed.) Los Angeles, CA: Muthén & Muthén.
Nelemans, S. A., Hale, W. W., Branje, S. J. T., Raaijmakers, Q. A. W., Frijns, T., Van Lier, P. A. C., & Meeus, W. H. J. (2014). Heterogeneity in development of adolescent anxiety disorder symptoms in an 8-year longitudinal community study. Development and Psychopathology, 26(1), 181–202. https://doi.org/10.1017/S0954579413000503.
Ohannessian, C. M. (2014). Anxiety and substance use during adolescence. Substance Abuse, 35(4), 418–425. https://doi.org/10.1080/08897077.2014.953663.
Ohannessian, C. M., Lerner, R. M., Lerner, J. V., & Von Eye, A. (1999). Does self-competence predict gender differences in adolescent depression and anxiety? Journal of Adolescence, 22(3), 397–411. https://doi.org/10.1006/jado.1999.0231.
Ohannessian, C. M., Cavanaugh, A., & Cheeseman, K. (2017a). Gender and Racial/Ethnic Differences in Anxiety Disorders During Adolescence. Adolescent Psychiatry, 7(1), 1–12. https://doi.org/10.2174/2210676607666170908160057.
Ohannessian, C. M., Milan, S., & Vannucci, A. (2017b). Gender Differences in Anxiety Trajectories from Middle to Late Adolescence. Journal of Youth and Adolescence, 46(4), 826–839. https://doi.org/10.1007/s10964-016-0619-7.
Olson, D., & Wilson, R. (1982). Family satisfaction scale. In D. H. Olson, H. I. McCubbin, H. Barnes, A. Larsen, M. Muxen, & M. Wilson (Eds.), Family Inventories (pp. 89–103). Minnesota, MN: University of Minnesota Press
Olson, D. H. (1992). Family inventories: Inventories used in a national survey of families across the family life cycle: Family Social Science, University of Minnesota
Paclikova, K., Veselska, Z. D., Bobakova, D. F., Palfiova, M., & Geckova, A. M. (2019). What role do family composition and functioning play in emotional and behavioural problems among adolescent boys and girls? International Journal of Public Health, 64(2), 209–217. https://doi.org/10.1007/s00038-018-1171-x.
Pinquart, M. (2017). Associations of parenting dimensions and styles with internalizing symptoms in children and adolescents: A meta-analysis. Marriage and Family Review, 53(7), 613–640. https://doi.org/10.1080/01494929.2016.1247761.
Priest, J. B., & Denton, W. (2012). Anxiety disorders and Latinos: The role of family cohesion and family discord. Hispanic Journal of Behavioral Sciences, 34(4), 557–575. https://doi.org/10.1177/0739986312459258.
Queen, A. H., Stewart, L. M., Ehrenreich-May, J., & Pincus, D. B. (2013). Mothers’ and fathers’ ratings of family relationship quality: Associations with preadolescent and adolescent anxiety and depressive symptoms in a clinical sample. Child Psychiatry and Human Development, 44(3), 351–360. https://doi.org/10.1007/s10578-012-0329-7.
Rabinowitz, J. A., Osigwe, I., Drabick, D. A. G., & Reynolds, M. D. (2016). Negative emotional reactivity moderates the relations between family cohesion and internalizing and externalizing symptoms in adolescence. Journal of Adolescence, 53, 116–126. https://doi.org/10.1016/j.adolescence.2016.09.007.
Rapee, R. M., Schniering, C. A., & Hudson, J. L. (2009). Anxiety disorders during childhood and adolescence: Origins and treatment. Annual Review of Clinical Psychology, 5(1), 311–341. https://doi.org/10.1146/annurev.clinpsy.032408.153628.
Rubin, K. H., Bukowski, W. M., & Parker, J. G. (2006). Peer interactions, relationships, and groups. In N. Eisenberg (Ed.), Handbook of Child Psychology, Vol. 3, Social, emotional, and personality development (pp. 571–645). John Wiley & Sons.
Rueger, S. Y., Malecki, C. K., & Demaray, M. K. (2010). Relationship between multiple sources of perceived social support and psychological and academic adjustment in early adolescence: Comparisons across gender. Journal of Youth and Adolescence, 39(1), 47–61. https://doi.org/10.1007/s10964-008-9368-6.
Simonson, J., Mezulis, A., & Davis, K. (2011). Socialized to ruminate? Gender role mediates the sex difference in rumination for interpersonal events. Journal of Social and Clinical Psychology, 30(9), 937–959. https://doi.org/10.1521/jscp.2011.30.9.937.
Simpson, E. G., Vannucci, A., & Ohannessian, C. M. (2018). Family functioning and adolescent internalizing symptoms: A latent profile analysis. Journal of Adolescence, 64, 136–145. https://doi.org/10.1016/j.adolescence.2018.02.004.
Simpson, E. G., Vannucci, A., Lincoln, C. R., & Ohannessian, C. M. C. (2019). Perceived stress moderates the impact of internalizing symptoms on family functioning in early adolescence. Journal of Early Adolescence. https://doi.org/10.1177/0272431619837378
Smetana, J. G., & Rote, W. M. (2019). Adolescent-parent relationships: Progress, processes, and prospects. Annual Review of Developmental Psychology, 1, 41–68. https://doi.org/10.1146/annurev-devpsych-121318-084903.
Streiner, D. L. (2005). Finding our way: an introduction to path analysis. The Canadian Journal of Psychiatry, 50(2), 115–122. https://doi.org/10.1177/070674370505000207.
Tomlinson, E. R., Yousaf, O., Vittersø, A. D., & Jones, L. (2018). Dispositional mindfulness and psychological health: A systematic review. Mindfulness, 9(1), 23–43. https://doi.org/10.1007/s12671-017-0762-6.
Vandenberg, R. J., & Lance, C. E. (2000). A review and synthesis of the measurement invariance literature: suggestions, practices, and recommendations for organizational research. Organizational Research Methods, 3(1), 4–69. https://doi.org/10.1177/109442810031002.
Vøllestad, J., Nielsen, M. B., & Nielsen, G. H. (2012). Mindfulness- and acceptance-based interventions for anxiety disorders: A systematic review and meta-analysis. British Journal of Clinical Psychology, 51(3), 239–260. https://doi.org/10.1111/j.2044-8260.2011.02024.x.
White, J., Shelton, K. H., & Elgar, F. J. (2014). Prospective associations between the family environment, family cohesion, and psychiatric symptoms among adolescent girls. Child Psychiatry and Human Development, 45(5), 544–554. https://doi.org/10.1007/s10578-013-0423-5.
Williams, J. M. G., & Kabat-Zinn, J. (2011). Mindfulness: Diverse perspectives on its meaning, origins, and multiple applications at the intersection of science and dharma. Contemporary Buddhism, 12(1), 1–18. https://doi.org/10.1080/14639947.2011.564811.
Yap, M. B. H., Pilkington, P. D., Ryan, S. M., & Jorm, A. F. (2014). Parental factors associated with depression and anxiety in young people: A systematic review and meta-analysis. Journal of Affective Disorders, 156, 8–23. https://doi.org/10.1016/j.jad.2013.11.007.
Zhou, X., Guo, J., Lu, G., Chen, C., Xie, Z., Liu, J., & Zhang, C. (2020). Effects of mindfulness-based stress reduction on anxiety symptoms in young people: A systematic review and meta-analysis. Psychiatry Research, article 113002. https://doi.org/10.1016/j.psychres.2020.113002
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52(1), 30–41.
Acknowledgements
The authors would like to thank the adolescents who have participated in this study. They would also like to acknowledge the project staff for their dedication to the implementation of this study. Thank you to the Alvord Foundation for their support.
Author Contributions
Dr. Ohannessian is the PI on the project, and was involved in sample attainment, survey development, and implementation. All authors contributed in the design of the study. Watkins conducted the statistical analyses, and wrote the complete first draft. All authors contributed to and have approved the final manuscript.
Funding
Funding provided by the Alvord Foundation.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare no competing interest.
Consent to Participate
Parental assent and written informed consent was obtained from all individual participants included in the study.
Ethical Approval
IRB approval received by Connecticut Children’s Medical Center.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Rights and permissions
About this article
Cite this article
Watkins, N.K., Salafia, C. & Ohannessian, C.M. Family Functioning and Anxiety Symptoms in Adolescents: The Moderating Role of Mindfulness. J Child Fam Stud 31, 1474–1488 (2022). https://doi.org/10.1007/s10826-021-02219-4
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10826-021-02219-4