Examining risk factors for anxiety disorders in children

Abstract

Childhood anxiety disorders (ADs) are among the most common mental health conditions worldwide. Often chronic and persisting into adulthood, childhood ADs can significantly impact individuals, families, and society. Parental anxiety, anxiogenic parenting behaviours, and behavioural inhibition (BI) are three robust risk factors in the development of childhood ADs. Evidence suggests a complex interplay between these factors, with increasing focus on their interactive and cumulative effects. Identifying children exposed to multiple risk factors may enable the development of more targeted preventive programmes. Therefore, this thesis focuses on expanding our understanding of the key risk factors that contribute to childhood anxiety. Chapter 1 presents a systematic review and meta-analysis examining whether the prevalence of childhood AD is higher in children exposed to multiple risk factors (parental anxiety, parenting behaviours and BI) compared to those exposed to a single risk factor. Due to limitations in data reporting, direct comparisons between these groups were not possible. However, small to moderate associations were found between childhood ADs and the combined effects of the risk factors with large effects for BI and parenting behaviours than for parental anxiety. Chapter 2 uses an experimental design to investigate the effects of paternal controlling vs autonomy-granting behaviours on child anxiety (observed and self-reported), performance prediction and evaluation. When fathers were more controlling compared to autonomy-granting, children showed more observed anxious behaviours during a speech task, reported feeling more scared and rated their performance more negatively after the speech. Chapter 3 discusses the differential impact of maternal and paternal parenting behaviours, highlighting the limited research on father’s role in childhood anxiety development and explores the scarcity of cross-cultural research on intergenerational transmission of anxiety. It also provides a rationale for the moderators included in the systematic review and meta-analysis.

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Identifiers

ORCID for Kashmala Sher: orcid.org/0009-0004-9105-0202

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

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

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