Why children develop anxiety problems: a study of risk factors

Abstract

Anxiety disorders are the most common psychiatric problems faced by children across the world. Without intervention, the lives of anxiety disordered children often unfold with less opportunity and more hardship than their peers. Many will go on to face chronic mental health difficulties in adulthood with worse outcomes in physical health and education. Happily, efforts to detect children at risk of anxiety disorder and intervene during childhood may change this trajectory. Such efforts depend upon a scientific understanding not only of which factors determine risk of anxiety disorders among children, but also how such risk factors may interact. Given the aggregation of anxiety disorders within families and evidence to suggest that intergenerational transmission of anxiety disorders is not genetically mediated, parenting behaviours have become the focus of much research. While parenting behaviours – such as overly controlling parenting and overprotective parenting – have shown modest but robust associations with child anxiety, limited experimental research in this field leaves questions about causality and directionality unanswered. Furthermore, fathers remain completely absent from the available experimental literature on anxiogenic parenting behaviour, and effects have yet to be observed in physiological measures of child anxiety. Previous meta-analyses have synthesised evidence on single risk factors for child anxiety, but have not provided explored whether the presence of more than one risk factor amounts to a greater risk of anxiety disorders in children compared to single factors alone. To expand upon this growing evidence base, the present thesis project will synthesise evidence on combined and individual risk factors for child anxiety and contribute a piece of novel empirical research, both of which emanate from a joint project between two clinical psychology doctoral trainees. In the first chapter, key differences between the joint projects will be delineated and the unique contributions in the present thesis will be justified. In the second, a systematic review and meta-analysis will synthesise evidence from 38 studies on associations between risk factors (parent anxiety disorder, behavioural inhibition and anxiogenic parenting behaviour) and child anxiety, comparing individual risk factor effects with combined risk factor effects. In the third and final chapter, a novel experimental study exploring the causal relationship between the overly controlling parenting behaviour of fathers and anxiety symptoms in their children, including child-reported measures of anxious cognitions and affect along with heartrate variability.

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Identifiers

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

ORCID for Alessio Bellato: orcid.org/0000-0001-5330-6773

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