Environmental Factors Key in Anxiety Disorders

Article excerpt

ST. LOUIS -- Anxiety disorders may be transmitted from one generation to the next by specific family environmental factors such as parental modeling, overcontrolling parental behavior, and family conflict, according to a study presented at the annual conference of the Anxiety Disorders Association of America.

The role of genetics in anxiety is not clear, though it's thought that heredity is a minor player, said Kelly L. Drake, Ph.D., who is among several investigators trying to find answers to this complicated disorder.

A key factor in this parent-to-child psychopathology is anxiety sensitivity (AS), which is based on the belief that internal symptoms of anxiety will have harmful consequences socially, physically, or mentally. "Basically, anxiety sensitivity is the fear of fear," said Dr. Drake in an interview.

Anxious parents may transmit, verbally or nonverbally, misinformation to their children that can put them at risk for becoming hypersensitive to symptoms of anxiety--racing heart, sweaty palms, and feeling faint--and ultimately for developing full-blown anxiety disorders, said Dr. Drake, senior research program coordinator in the department of psychiatry and behavioral sciences at Johns Hopkins University, Baltimore.

Child anxiety disorders occur in about 10% of youth and are associated with significant impairment in functioning, she explained.

"These children often are misdiagnosed and therefore undertreated, and they tend to overutilize medical services," Dr. Drake said.

Known risk factors for childhood anxiety disorders include parent psychopathology; increased rates of anxiety disorders and somatic symptoms in children of anxious or depressed parents; a moderate genetic heritability; and parent anxiety sensitivity, Dr. Drake said.

Potential mediators of childhood anxiety include child anxiety sensitivity, which is predicted by parental anxiety sensitivity; and family environment, including threatening, hostile, or rejecting parenting styles, she said, adding that parents of anxious children often are described as anxious, controlling, overprotective, affectionless, and demanding.

Also, child anxiety is related to family environments with greater conflict, less cohesion, and poor communication.

Dr. Drake set out to test two hypotheses:

* Child anxiety will be influenced by parental AS and anxiety-based psychopathology, depending on the level of the child's AS.

* Child anxiety will be influenced by parental AS and anxiety-based psychopathology, depending on the levels of family expressiveness, conflict, independence, and control.

The study involved a multiethnic community sample of 157 youth-parent dyads. …

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