title: Family accommodation in pediatric anxiety disorders.
abstract: BACKGROUND
  Family accommodation has been studied in obsessive compulsive disorder using the Family Accommodation Scale (FAS) and predicts greater symptom severity, more impairment, and poorer treatment outcomes. However, family accommodation has yet to be systematically studied among families of children with other anxiety disorders. We developed the Family Accommodation Scale-Anxiety (FASA) that includes modified questions from the FAS to study accommodation across childhood anxiety disorders. The objectives of this study were to report on the first study of family accommodation across childhood anxiety disorders and to test the utility of the FASA for assessing the phenomenon.
  
  
  METHODS
  Participants were parents (n = 75) of anxious children from two anxiety disorder specialty clinics (n = 50) and a general outpatient clinic (n = 25). Measures included FASA, structured diagnostic interviews, and measures of anxiety and depression.
  
  
  RESULTS
  Accommodation was highly prevalent across all anxiety disorders and particularly associated with separation anxiety. Most parents reported participation in symptoms and modification of family routines as well as distress resulting from accommodation and undesirable consequences of not accommodating. The FASA displayed good internal consistency and convergent and divergent validity. Accommodation correlated significantly with anxious but not depressive symptoms, when controlling for the association between anxiety and depression. Factor analysis of the FASA pointed to a two-factor solution; one relating to modifications, the other to participation in symptoms.
  
  
  CONCLUSIONS
  Accommodation is common across childhood anxiety disorders and associated with severity of anxiety symptoms. The FASA shows promise as a means of assessing family accommodation in childhood anxiety disorders.
authors.affiliation: Yale Child Study Center, New Haven, CT 06520, USA. eli.lebowitz@yale.edu
authors.forename: Eli R
authors.initials: ER
authors.lastname: Lebowitz
authors.forename: Joseph
authors.initials: J
authors.lastname: Woolston
authors.forename: Yair
authors.initials: Y
authors.lastname: Bar-Haim
authors.forename: Lisa
authors.initials: L
authors.lastname: Calvocoressi
authors.forename: Christine
authors.initials: C
authors.lastname: Dauser
authors.forename: Erin
authors.initials: E
authors.lastname: Warnick
authors.forename: Lawrence
authors.initials: L
authors.lastname: Scahill
authors.forename: Adi R
authors.initials: AR
authors.lastname: Chakir
authors.forename: Tomer
authors.initials: T
authors.lastname: Shechner
authors.forename: Holly
authors.initials: H
authors.lastname: Hermes
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Vitulano
authors.forename: Robert A
authors.initials: RA
authors.lastname: King
authors.forename: James F
authors.initials: JF
authors.lastname: Leckman
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001008:Anxiety Disorders / Q000523:psychology*; D001010:Anxiety, Separation / Q000523:psychology; D002648:Child; D005163:Factor Analysis, Statistical; D005190:Family / Q000523:psychology; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D011594:Psychometrics / Q000295:instrumentation; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012919:Social Behavior; D011795:Surveys and Questionnaires