(PS9-D79) A Test of Proximal Mechanisms Linking Parent and Child GAD Symptoms

Anxiety disorders run in families through genetic and environmental (proximal) mechanisms (Hettema et al., 2001; Noyes et al., 1987). Generalized Anxiety Disorder (GAD) is a debilitating anxiety disorder with a lifetime prevalence of 2-6% (Merikangas et al., 2010). Oftentimes, parental anxiety is addressed in Cognitive Behavioral Therapy for children with GAD because of anxiety’s high transmission rates. In order to maximize treatment effects, we must understand the proximal mechanisms by which parental anxiety leads to children’s GAD. Aktar et al. (2017) theorized specific and non-specific environmental pathways for parent-to-child transmission of GAD. We investigated the applicability of Aktar et al.’s model to an early childhood sample. We tested two general risk factors for anxiety, verbal threat information and excessive reassurance (as indicators of overcontrolling tendencies), and one specific factor of GAD, parental experiential avoidance (PEA), as indirect pathways from parent worry (the hallmark of GAD) to child GAD symptoms. We hypothesized that higher parental worry would predict child GAD symptoms two years later through these proximal mechanisms.

Children and their parents (n = 144) participated in a longitudinal study at child ages 2-years (Time 1), 3-years (Time 2) and 4-years (Time 3). Mothers reported on their trait worry at Time 1 using the Penn State Worry Questionnaire (total score; Meyer et al., 1990). We measured mediators at Times 1 and 2. Verbal threat information and excessive reassurance were scored from laboratory observations of mother-child interactions during strong (remote-controlled spider) and mild (playing with a friendly clown) uncertainty, respectively. Mothers reported on their overprotective parenting (New Friends Vignettes; McShane & Hastings, 2009) and PEA (Parenting Acceptance and Action Questionnaire; Cheron et al., 2009). At Time 3, mothers completed the GAD subscale of the Preschool Anxiety Scale (Spence et al., 2001).

Maternal worry related to Time 1 and Time 2 reassurance (rs=.21, .22), overprotection (rs=.25, .43) and PEA (rs=.49, .43); Time 1 reassurance (r=.36) and Times 1 and 2 PEA (rs=.34, .50) related to Time 3 child GAD symptoms (ps < .05). Verbal threat information related to no variables. We tested two parallel mediation models (Time 1 mediators, Time 2 mediators) with FIML estimation and 10000 bootstrapped samples to test indirect effects. Time 1 reassurance marginally (90% CI [.001, .012]) and Time 2 PEA significantly (95% CI [.114, .348]) acted as indirect effects. Thus, theory and research concerning GAD transmission in early childhood may focus on excessive reassurance and parental experiential avoidance as immediate and prolonged mechanisms, respectively. These findings may also be extended to treatment settings when addressing specific ways parental anxiety may contribute to childhood GAD.