CACP Collection Revision Flashcards
Kessler et al. (2005)
Conducted diagnostic interviews of community samples across lifetimes and found that anxiety disorders are the most commonly experience MH disorder across the lifespan. Statistics indicate that 28.8% of people experience a level of anxiety that could be considered an anxiety disorder at some point in their lifetime, and that the median age of onset of anxiety was 11yo.
Solmi et al. (2021)
Found that the median age of onset of anxiety disorders was around 17yo, but this varies for specific anxiety disorders. For example, separation anxiety and paranoias typically onset in childhood (median 8yo), while panic disorder and GAD typically onset in adulthood (26yo and 33yo, respectively)
Copeland et al. (2014)
Studied the impacts of having anxiety disorders, by looking at the health, financial and interpersonal outcomes of people with different AD diagnoses at 16yo. When compared to controls with no AD, individuals with any of the included ADs (separation, social, GAD & overanxious) displayed worse outcomes in at least one of the domains, and GAD was associated with poor functioning in all the domains
McCrone et al. (2008)
Focused on the economic impact of child anxiety disorders, by analysing UK costs of MH disorders and projections of these costs for 2026. Anxiety disorders were the most costly of the different MH disorders, due to its high prevalence.
Caspi et al. (1998)
Early onset mental health disorders tend to be especially chronic or relapsing, and are predictive of a range of psychological and social impairments in the long-term
Lawrence et al. (2019)
Conducted a systematic review and meta-analysis and found that offspring of parents with anxiety disorders are more likely to have anxiety and depressive disorders compared to those with parents who don’t have anxiety. However, while there is increased risk, they are still in the minority, as about 2/3 of children of parents with anxiety disorders don’t have an anxiety disorder
Murray et al. (2009)
Proposed a model of different pathways to child anxiety, which can explain why individuals develop anxiety in the absence of parental anxiety disorder, but also why there is increased risk when parents do have an anxiety disorder. The model includes genetic vulnerability, life events, and anxiogenic modelling, all of which are influenced by parental anxiety and in turn influence anxious thinking styles, hyperarousal and avoidance.
McLeod et al. (2007)
Conducted a meta-analysis to explore the extent to which different parent behaviours affect childhood anxiety disorders.
Yap & Jorm (2015)
Conducted a systematic review of the existing data, specifically for pre-adolescents aged 5-11yo, and classified the studies into “sound”, “emerging” , and “equivocal”.
Ginsberg (2009)
Explored the effects of a preventative program that targets parental over-involvement for child and adolescent anxiety. Children and their parents were randomly assigned to an 8-week CBT intervention (Coping & Promoting Strength Program) or a waitlist control. 30% of the waitlist children developed at AD by the 1y followup, while none of those in the treatment group did. There was also a decrease in parent-reported anxiety in the treatment group but not in the waitlist control
Siegenthaler et al. (2012)
Conducted a systematic review and meta-analysis and found that preventative interventions for parents with MH issues might be effective in preventing new mental disorders and internalising symptoms in their children.
Hudson et al. (2009)
Conducted a study to explore causal relationships between parental behaviours and child anxiety, with primary school aged children. They compared mother’s behaviours when helping a child complete a task, when they were doing so with an anxious child and with an un-anxious child. Regardless of whether their own child had anxiety, all mothers were coded as more involved when they interacted with a child with clinical anxiety. However, there was an interaction, as mothers of children with anxiety showed a smaller decrease in involvement behaviours when interacting with non-anxious children compared to anxious children.
Hudson & Rapee (2004)
Suggested that parents of children with anxiety are more likely to become overinvolved in their child’s life to try and reduce their distress, but that this is actually a maladaptive pattern which reinforces a child’s vulnerability to anxiety. They propose that this is because it increases the child’s perception of threat and reduces the amount of control they have, and that they perceive to have, leading to increased avoidance, which perpetuates the anxieties, as they don’t learn that the feared situations are not actually a threat
Rubin et al. (1999)
A child’s initial behaviours affect how parents interact with them. They found that a parent’s perception of how shy their child was at 2yo significantly predicted later maternal overprotection at 4yo
Feinman et al. (1992) – social referencing
9-12mo infants use social referencing, as aware of agency of other individuals and modify their responses based on other people’s emotional response to it
Murray et al. (2005)
Argued social referencing might be especially important in the development of social anxiety. They used a social referencing paradigm to examine the development of socially anxious responses to strangers in a large longitudinal study of community sample of mothers with social phobia and their infants. Infant first watched mother interact with a stranger, and then the stranger interacted with the infant while the mother was also able to interact with the child and demonstrate her own response. At 10mo, mothers with social phobia showed more signs of anxiety in both periods, and showed less encouragement of infant in the 2nd phase. At 14mo, children of anxious mothers were more avoidant of the stranger compared to infants of control mothers
De Rosnay et al. (2006)
Investigated the role of anxiogenic modelling.
Thirlwall & Creswell (2010)
Conducted a study to explore how autonomy granting is causally associated with child anxiety. Parents were trained to either be controlling in a task with the child, or to provide autonomy by just giving open suggestions and not being directive. When children had low level trait anxiety, parental manipulation didn’t affect observed child anxiety during the task. However, when children had high trait anxiety, they were rated as more anxious in controlling conditions compared to autonomy promoting conditions.
Moore et al. (2004)
Found that when a mother and a child are both anxious, more catastrophising comments are made. However, there were no significant differences in autonomy promotion or warmth based on parent and child anxiety status
Creswell et al. (2013)
Measured maternal anxiety behaviours when interacting with a child with an anxiety disorder on a range of difficult tasks. They compared mothers with and without anxiety disorders, and explored the relationship between the child’s level of anxiety and parent behaviours and anxiety. When children are anxious, parent behaviour differed based on the parent’s own anxiety status, with anxious mothers becoming more intrusive and having a less positive relationship compared to non-anxious mothers. The child’s level of anxiety also affected parental anxiety for anxious parents – as the child became more anxious, parents with anxiety disorders also appeared more anxious so then even more likely to model anxiety behaviours to children when the children are anxious
Thirlwall et al. (2013)
Evaluated the efficacy of low-intensity parent-delivered CBT treatments for children with anxiety disorder, comparing full parent-delivered CBT, brief parent-delivered CBT, waitlist control. For the intervention, parents were given a self-help book, and received some therapist support (weekly contact over 8 weeks for full programme, and fortnightly contact over 8 weeks for brief programme).
Platt et al. (2016)
Examined the relationship between stressful life events and anxiety symptoms in children, focusing on the role of parenting stress, parental anxious rearing and dysfunctional parent-child interactions as mediators.
Waite & Creswell (2015)
Compared observed behaviours of parents of children (7-10yo) and adolescents (13-16yo) with and without anxiety disorders, while doing mildly anxiety-provoking tasks.
Ahmadzadeh et al. (2019)
Tested the role of genetic mechanisms in the association between parental and child anxiety, by looking at adoptive families.
Solmi et al. (2022)
Conducted a very large meta-analysis on MH problems in adolescence and found that about 75% of all mental health problems have their onset in adolescence. 1/3 of MH illnesses will have had first onset by age 14, and ½ will have onset by 18yo
Morales-Munoz et al. (2022)
Investigated how the balance of different ADs varies over age, using a community sample. They found a reduction in GAD from 8yo to 10yo and 13yo, and an increase in separation anxiety from 8yo to 10yo.
Waite & Creswell (2014)
Investigated the split of ADs in a clinical sample. They found a significant decrease in separation anxiety from pre-adolescence to adolescence, but an increase in social anxiety. In general, adolescent anxiety was rated worse overall (by the child themselves and by the clinician), and adolescents were more likely to have a comorbid mood disorder, usually uni-polar depression.
Larson & Ham (1993)
Suggestion that environment changes hugely in the shift to adolescents. In a large US sample of young people and their parents, they found that the number of negative and stressful events increases as they grew older (from 10yo to 15yo). A substantial amount of this increase was in peer relationships, some was in school stress, and some in family life. Also found a sex effect, where more negative events were reported among boys.
Copeland et al. (2013)
Followed up with 1400 young people from ages 9 to 16, and found that those who were a victim of bullying were at higher risk of developing ADs and other MH difficulties. When they controlled for family environment and existing ADs in pre-adolescence, this relationship holds, indicating that the association isn’t just because those who are vulnerable are more likely to be bullied.
Waite et al. (2014)
Conducted a meta-analysis on studies investigating the links between parenting behaviours and anxiety, focusing on adolescence. In adolescence, the most well-explored parenting construct is over-involvement. There was some indication of a positive association between more overcontrol in parents and AD in adolescence, though these findings are based on self-report, so there is relatively low confidence in the finding.
Hudson & Rapee (2001)
Cross-sectional study of parenting behaviours and age and anxiety disorders, using children and adolescents with AD and a non-clinical community sample. Mothers of clinical children and adolescents were more involved and intrusive when completing difficult cognitive tasks. When participants were categorised according to age, with a separate category for 12-15yo, there was no significant age by group interaction no significant age by group interaction, just mothers of clinical offspring more controlling than non-clinical
Verhoeven et al. (2012)
Found a significant association between perceptions of father’s over-controlling behaviour and adolescent AD, but not for mothers. Indicates father could be more important in adolescence – maybe father should be involved in treatments?
McClure et al. (2001)
Adolescents’ perceptions of their mother’s psychological control predicted AD, but maternal AD did not predict adolescent perceptions of maternal control
Larson et al. (2002)
Following repeatedly measurements of children’s emotional states, they found that in early adolescence, there is a downward shift in self-reported emotional states which increases over time. Overall, there are more positive than negative emotions, but there is a heightened reactivity to both stressor and positive events compared to during adulthood
Young et al. (2019)
As a child grows into adolescence, there is an ever-increasing demand to manage emotions independently. During childhood, parents often help to regulate emotions by re-appraising and by distracting etc., while during adolescence, they are expected to do this themselves. These emotion regulation abilities are underpinned by EFs, including good WM, ability to update and to inhibit thoughts and more. While these EFs start to mature in early adolescence, it takes time for these to develop throughout the period.
Gardner & Steinberg (2005)
Compared adolescents, young adults, and adults’ risk tasking behaviours in a driving game, by measuring how they respond to an amber light. They manipulated whether the participant believed they were doing the task alone or with a peer of the same age. There was a dissociation between risk-taking behaviour in adolescents specifically – when they were alone, they had similar levels of risk as the adults, but they were significantly riskier when they were with peers of the same aged. Perhaps during adolescence, social exclusion is viewed as a great danger and affects behaviours despite them understanding what is the right thing to do. EFs
James et al. (2013)
Cochrane review including 88 studies. Compared to waitlist, there is moderate quality evidence that CBT leads to greater remission of primary anxiety disorder (and of all ADs) compared to passive control.
Ginsberg et al. (2011) – CAMS trial
Including 500 children and adolescents. There was some indication that CBT outcomes were poorer for those who were older. Age was associated with ADIS and CGI scores, but not on remission. Adolescents were less likely than children to achieve remission, but these age differences weren’t tested by treatment condition – not just measuring CBT
