Anxiety Disorders

Parenting styles of anxious children have been described as overprotecting, ambivalent, rejecting, and hostile (See Ginsburg, Silverman, and Kurtines 1995). Retrospective reports of adults with anxiety disorders show that these adults view their parents as overcontrolling and less affectionate. Studies of families of school-refusing/anxious children indicate that these families score lower on indices of child independence and participation in recreational activities, and higher on indices of hostility/conflict than families of non-school-refusing/anxious children (Kearney and Silverman 1995). These families also have been found to be more overprotective and disturbed in role performance, communication, affective expression, and control relative to families of children with nonanxiety psychiatric disorders (e.g., Bernstein and Garfinkel 1986). In a review of the parenting and child-rearing practices research literature, Ronald Rapee (1997) concluded that rejection and excessive parental control were related to the development and maintenance of anxiety disorders in children. An observational study conducted by Paula Barrett and her colleagues (1996) found that children with anxiety disorders and their parents generated more avoidant solutions in problem-solving situations relative to aggressive and nonclinical controls. These parents also modeled caution, provided information about risks, expressed doubts about child competency, and rewarded avoidant behavior. Moreover, having an anxious family member (e.g., parent) also has been shown to increase risk for distress and dysfunction in family relationships (Bruch and Heimberg 1994). Given the consistency of findings showing the role of the family environment and parenting factors, interventions have been aimed at incorporating these factors in treating children with anxiety disorders.