An investigation of parent-child interactions in anxious adolescents and a pilot evaluation of a novel family treatment
Lead Research Organisation:
University of Reading
Department Name: Sch of Psychology and Clinical Lang Sci
Abstract
One in twenty British adolescents has an anxiety disorder. These disorders are more common and severe than in younger children. There is a psychological treatment, cognitive-behaviour therapy, which is effective in treating anxiety disorders in young people generally. However, treatments do not adequately address the specific needs of adolescents. There is evidence that parents of anxious children are less likely to let their children do things for themselves, and also respond in fearful ways to challenging situations, compared to parents of non-anxious children. Early reports suggest similar patterns may occur within families of anxious adolescence. This research has the following aims: first, to understand the family processes experienced by anxious adolescents; second, to conduct experiments to establish whether parents‘ behaviours lead to adolescent anxiety; and finally, to develop and test a new psychological treatment through a small clinical trial with anxious adolescents and their parents to target the key parental behaviours that contribute to adolescent anxiety. This research has the potential to have a significant impact on clinical practice by providing greater understanding of adolescent anxiety and improving therapeutic techniques to more effectively treat anxiety in adolescence.
Technical Summary
Aims
Anxiety disorders in adolescents are common and disabling; indeed they are known to be more common, severe and co-morbid than in younger children. However, although cognitive-behaviour therapy (CBT) has been demonstrated to be effective in treating anxiety disorders in young people, treatments have been developed principally for children and the specific needs of adolescents have not been adequately addressed. There is evidence that parents of anxious children are more controlling and model more avoidant behaviour than parents of non-anxious children. Family factors appear also to be a significant factor in relation to adolescent anxiety, however studies are limited in the extent to which causal associations can be concluded. The aims of the proposed research are to (i) clarify the family processes experienced by anxious adolescents, in comparison to anxious children and non-anxious adolescents; (ii) establish experimentally whether family processes have a causal influence on adolescent anxiety; (iii) develop and pilot a novel cognitive-behavioural treatment that targets the key parental processes which maintain adolescent anxiety.
Objectives
1. To conduct a systematic cross-sectional observational study to enhance understanding of the family processes associated with adolescent anxiety.
2. To conduct experimental studies to test the causal link between parenting behaviours identified in the observational study and anxiety in adolescents.
3. To conduct a pilot study of a parental-behaviour focused adjunct to standard CBT for adolescent anxiety.
Design
1. Three groups will be recruited (i) anxious adolescents, (ii) non-anxious adolescents, and (iii) anxious children. Assessments will be made of anxiety symptoms and diagnoses, common co-morbid disorders and parent-offspring interactions. Observational assessments of interactions between participants and their primary caregiver will be made and rated.
2. Experimental studies will be carried out with non-anxious adolescents and their primary caregiver. This will involve manipulating caregiver behaviour via training and then asking them to support their adolescent perform a challenging task. Adolescent response to the task will be assessed.
3. Clinically anxious adolescents will be randomised to receive either CBT + control family intervention or CBT + parent-focused intervention that targets behaviours identified in the observational and experimental studies.
Scientific and medical opportunities
The proposed research is of both scientific and clinical importance as it will (i) contribute to a greater understanding of the role of family factors in adolescent anxiety, and (ii) improve clinical interventions for anxious adolescents.
Anxiety disorders in adolescents are common and disabling; indeed they are known to be more common, severe and co-morbid than in younger children. However, although cognitive-behaviour therapy (CBT) has been demonstrated to be effective in treating anxiety disorders in young people, treatments have been developed principally for children and the specific needs of adolescents have not been adequately addressed. There is evidence that parents of anxious children are more controlling and model more avoidant behaviour than parents of non-anxious children. Family factors appear also to be a significant factor in relation to adolescent anxiety, however studies are limited in the extent to which causal associations can be concluded. The aims of the proposed research are to (i) clarify the family processes experienced by anxious adolescents, in comparison to anxious children and non-anxious adolescents; (ii) establish experimentally whether family processes have a causal influence on adolescent anxiety; (iii) develop and pilot a novel cognitive-behavioural treatment that targets the key parental processes which maintain adolescent anxiety.
Objectives
1. To conduct a systematic cross-sectional observational study to enhance understanding of the family processes associated with adolescent anxiety.
2. To conduct experimental studies to test the causal link between parenting behaviours identified in the observational study and anxiety in adolescents.
3. To conduct a pilot study of a parental-behaviour focused adjunct to standard CBT for adolescent anxiety.
Design
1. Three groups will be recruited (i) anxious adolescents, (ii) non-anxious adolescents, and (iii) anxious children. Assessments will be made of anxiety symptoms and diagnoses, common co-morbid disorders and parent-offspring interactions. Observational assessments of interactions between participants and their primary caregiver will be made and rated.
2. Experimental studies will be carried out with non-anxious adolescents and their primary caregiver. This will involve manipulating caregiver behaviour via training and then asking them to support their adolescent perform a challenging task. Adolescent response to the task will be assessed.
3. Clinically anxious adolescents will be randomised to receive either CBT + control family intervention or CBT + parent-focused intervention that targets behaviours identified in the observational and experimental studies.
Scientific and medical opportunities
The proposed research is of both scientific and clinical importance as it will (i) contribute to a greater understanding of the role of family factors in adolescent anxiety, and (ii) improve clinical interventions for anxious adolescents.
