The relation between insecure attachment and child anxiety: a meta-analytic review.

Attachment theory suggests that children's attachment insecurity plays a key role in the development of anxiety. In the present study we evaluated the empirical evidence for the link between insecure attachment and anxiety from early childhood to adolescence. A meta-analysis of 46 studies, from 1984 to 2010, including 8,907 children, was conducted. The results show an overall effect size of r = .30, indicating that attachment is moderately related to anxiety. Moderator analyses indicated that ambivalent attachment showed the strongest association with anxiety. Further, the relation was stronger during adolescence, when attachment and anxiety were measured through questionnaires, when the informant was the child, when attachment was measured as internal working model, in cross-sectional studies, and in studies conducted in Europe. No difference was found between studies that measured anxiety as symptoms or as a disorder, and when different kinds of anxiety were considered.

Research review: the relation between child and parent anxiety and parental control: a meta-analytic review.

BACKGROUND: There is growing research interest in the association between parental control and child anxiety. Parental control may enhance child anxiety and parents may exert control in anticipation of their child's anxiety-related distress. Moreover, high levels of anxiety in parents could influence the development of parental control. Whereas past reviews have solely examined the relation between child anxiety and parental control, this meta-analysis focuses on the associations between both child and parent anxiety and parental control. METHODS: The associations of parent anxiety and child anxiety with observed parental control (k = 23 studies, N = 1,305 parent-child dyads) were investigated using a meta-analytic approach. Moreover, factors were identified that may function as moderators of these relations, such as parent and child gender, family socioeconomic status, child age, and design and measurement characteristics. RESULTS: A substantial association between child anxiety and parental control (d = .58) was found. Moderator analyses yielded the strongest effect sizes for studies with an overrepresentation of girls, for school-aged children, for families from higher socioeconomic backgrounds, and for studies using a discussion task to assess parental control. Although a nonsignificant relation was found for the relation between parent anxiety and parental control (d = .08), small but significant effects were found for school-aged children, for studies using a discussion task to assess parental control, and for samples with an overrepresentation of boys. CONCLUSIONS: As the direction of the association between child anxiety and parental control is unknown, future studies should use experimental designs to further explore the causal link between child anxiety and parental control.

Parent-directed cognitive behavioral therapy for young anxious children: a pilot study.

Anxiety in children age 8 years and above has been successfully treated with cognitive behavioral therapy (CBT). However, the efficacy of CBT for anxious children ages 4-7 years has not, to date, been fully investigated. This paper piloted a CBT intervention targeting child anxiety that was delivered exclusively to parents of 26 children with anxiety symptoms ages 4-7 years. The intervention consisted of four 2-hour group sessions of four to six parents (couples). These group sessions were followed by four individual telephone sessions, once per week across a 4-week period. The pre- and postintervention assessment involved measures of multiple constructs of child anxiety (anxiety symptoms, children's fears, behavioral inhibition, and internalizing symptoms) from multiple informants (parents, children, and teachers). Parents also reported parenting strategies they were likely to use to manage their children's anxiety pre- and postintervention. Results indicated a significant decrease in child anxiety and behavioral inhibition as reported by parents and teachers. Furthermore, mothers reported significant increases in their use of positive reinforcement, and modeling and reassurance, and a significant decrease in their use of reinforcement of dependency directly after treatment. Taken together, parent-directed CBT appears to be an effective approach for treating children ages 4-7 years with anxiety symptoms. Limitations of the current research are discussed.