Promoting the mental health of children with anxious mothers and fathers: examining risk factors and parents’ needs

Abstract

The rising rates of mental ill-health among children and young people represent a pressing global concern and are currently recognised as an international health priority. Investing in prevention has been identified as a key solution to limit these increasing rates and mitigate the associated burden. However, to develop and implement effective prevention strategies, it is crucial to identify the risk factors contributing to youth mental ill-health. Existing literature indicates that parental mental illness is an important, modifiable, risk factor for child mental ill-health. Among all the psychiatric conditions in the general population, anxiety disorders are the most prevalent worldwide, particularly in parents. This thesis, therefore, focuses specifically on the risk posed by parental anxiety to their children and explores strategies to promote the mental health of children with anxious parents.
In Chapter 1, I (i) review the theoretical and empirical evidence related to the importance of parents for child development and the impact of parental mental illness, including anxiety symptoms and disorders, on child mental health outcomes, and (ii) highlight current limitations in the available literature on parental anxiety and child mental health. In the empirical work presented in the following chapters (2-4), I address some of these knowledge gaps. Specifically, in Chapter 2, I focus on our limited understanding of the role played by fathers and present a comprehensive systematic review and meta-analysis showing that paternal anxiety is significantly associated with offspring emotional and behavioural difficulties with small and small-to-medium effect sizes. In Chapter 3, I examine the specific contributions of paternal perinatal anxiety and attempt to disentangle the differential effects of prenatal vs postnatal exposure to paternal anxiety on later child mental health outcomes. In a prospective longitudinal study, using data from a large UK-based birth cohort, I show that paternal perinatal anxiety is a unique risk factor for child mental ill-health, even after accounting for maternal mental health, child temperament and sociodemographic variables, and highlight different patterns of associations at different child ages. In Chapter 4, I address the current lack of understanding of how to support anxious parents in promoting mental health among their children and present a qualitative study that provides insights into what an accessible and acceptable preventive service should entail. Findings from the three empirical chapters are discussed collectively in Chapter 5 and reviewed in the context of the broader literature presented in Chapter 1. In Chapter 5, I also discuss the implications of the findings for research and clinical practice and indicate directions for future research, highlighting the importance of involving both mothers and fathers in the promotion of child mental health.

More information

Identifiers

ORCID for Francesca Zecchinato: orcid.org/0000-0002-4639-8830

ORCID for Pete Lawrence: orcid.org/0000-0001-6181-433X

ORCID for Jana Kreppner: orcid.org/0000-0003-3527-9083

Catalogue record

Export record