title: Phenomenology and clinical correlates of family accommodation in pediatric anxiety disorders.
abstract: Despite evidence documenting high prevalence of family accommodation in pediatric obsessive-compulsive disorder, examination in other pediatric anxiety disorders is limited. Preliminary evidence suggests that family accommodation is common amongst children with anxiety disorders; however, the impact on clinical presentation and functional impairment has not been addressed. This study assessed the nature and clinical correlates of family accommodation in pediatric anxiety, as well as validating a mechanistic model. Participants included 112 anxious youth and their parents who were administered a diagnostic clinical interview and measure of anxiety severity, as well as questionnaires assessing internalizing and externalizing symptoms, family accommodation and functional impairment. Some form of accommodation was present in all families. Family accommodation was associated with increased anxiety severity and externalizing behaviors, having a diagnosis of separation anxiety, and increased functional impairment. Family accommodation partially mediated the relationship between anxiety severity and functional impairment, as well as externalizing behaviors and functional impairment. Family accommodation is common in pediatric anxiety disorders, and is associated with more severe clinical presentations and functional impairment. These findings highlight the importance of parental involvement in treatment and the need to specifically target accommodation practices during interventions to mitigate negative outcomes in anxious youth. Further studies utilizing longitudinal data are needed to validate mechanistic models.
authors.affiliation: Department of Pediatrics, University of South Florida, United States; Department of Health Policy and Management, University of South Florida, United States; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, United States; Department of Psychology, University of South Florida, United States; Rogers Behavioral Health, Tampa Bay, United States; All Children's Hospital, Johns Hopkins Medicine, United States. Electronic address: estorch@health.usf.edu.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Storch
authors.affiliation: School of Social Work, University of South Florida, United States.
authors.forename: Alison
authors.initials: A
authors.lastname: Salloum
authors.affiliation: Department of Pediatrics, University of South Florida, United States.
authors.forename: Carly
authors.initials: C
authors.lastname: Johnco
authors.affiliation: Department of Pediatrics, University of South Florida, United States.
authors.forename: Brittney F
authors.initials: BF
authors.lastname: Dane
authors.affiliation: Department of Psychology, Temple University, United States.
authors.forename: Erika A
authors.initials: EA
authors.lastname: Crawford
authors.affiliation: Department of Pediatrics, University of South Florida, United States.
authors.forename: Morgan A
authors.initials: MA
authors.lastname: King
authors.affiliation: Department of Pediatrics, University of South Florida, United States.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: McBride
authors.affiliation: Department of Pediatrics, University of South Florida, United States; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, United States; Department of Psychology, University of South Florida, United States.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Lewin
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001008:Anxiety Disorders / Q000523:psychology*; D001010:Anxiety, Separation / Q000523:psychology; D002648:Child; D005195:Family Relations / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis; D010290:Parents / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Anxiety disorders; Child; Family; Parents; Risk factors; Treatment