Anxiety and depressive disorders in offspring at high risk for anxiety: A meta-analysis

Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital/Harvard Medical School, Suite 2000, Cambridge, MA 02138, USA.
Journal of anxiety disorders (Impact Factor: 2.68). 09/2009; 23(8):1158-64. DOI: 10.1016/j.janxdis.2009.07.021
Source: PubMed


This paper presents a meta-analysis of studies examining prevalence of psychopathology among offspring of anxiety-disordered parents, with the purpose of determining overall risk among these offspring for developing anxiety and depressive disorders. Pooled odds ratios for these disorders among high-risk offspring, compared to offspring of psychiatric and non-psychiatric controls, were calculated. Sixteen papers (including three follow-up studies) were identified, encompassing 1892 offspring (ages 4-25 years). Results revealed that: (1) offspring of parents with anxiety disorders have greater risk for anxiety and depressive disorders than offspring of non-psychiatric controls (ORs=3.91 and 2.67, respectively) and greater risk for anxiety disorders than offspring of psychiatric controls (OR=1.84); (2) offspring of anxious parents have significantly greater odds of having each type of anxiety disorder and MDD compared to offspring of non-psychiatric controls (ORs range from 1.96 to 8.69); and (3) offspring of parents with anxiety only, anxiety plus MDD, and MDD only have similar odds of having anxiety and depressive disorders but significantly higher odds than offspring of parents without disorder. Results suggest that parental anxiety disorders confer significant risk for anxiety and depression in offspring. Additional studies are needed to examine whether there are differences among specific parental anxiety disorders.

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    • "Empirical studies differ in regard to the parent's diagnosis, the children's ages, families' socioeconomic backgrounds, research designs, methodologies, and data collection tools. To date, review papers either provide an overview of the wide range of child consequences of a parental disorder, without structuring, ordering, or comparing children's outcomes (Beardslee et al. 2011; Del- Bello and Geller 2001; Leverton 2003; Torry and Billick 2011), or only compare a restricted range of child outcomes among children of parents with one mental disorder (Downey and Coyne 1990; Glasheen et al. 2010; Goodman et al. 2011; Jones and Bentall 2008; Micco et al. 2009). "
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    ABSTRACT: Children of mentally ill parents are at high risk of developing problems themselves. They are often identified and approached as a homogeneous group, despite diversity in parental diagnoses. Some studies demonstrate evidence for transgenerational equifinality (children of parents with various disorders are at risk of similar problems) and multifinality (children are at risk of a broad spectrum of problems). At the same time, other studies indicate transgenerational specificity (child problems are specifically related to the parent's diagnosis) and concordance (children are mainly at risk of the same disorder as their parent). Better insight into the similarities and differences between children of parents with various mental disorders is needed and may inform the development and evaluation of future preventive interventions for children and their families. Accordingly, we systematically compared 76 studies on diagnoses in children of parents with the most prevalent axis I disorders: unipolar depression, bipolar disorder, and anxiety disorders. Methodological characteristics of the studies were compared, and outcomes were analyzed for the presence of transgenerational equifinality, multifinality, specificity, and concordance. Also, the strengths of the relationships between child and parent diagnoses were investigated. This review showed that multifinality and equifinality appear to be more of a characteristic of children of unipolar and bipolar parents than of children of anxious parents, whose risk is mainly restricted to developing anxiety disorders. For all children, risk transmission is assumed to be partly specific since the studies indicate a strong tendency for children to develop the same disorder as their parent.
    Clinical Child and Family Psychology Review 10/2015; DOI:10.1007/s10567-015-0191-9 · 4.75 Impact Factor
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    • "Furthermore, these children are two to seven times more likely to develop an anxiety disorder compared to children of parents without an anxiety disorder [13-17]. Moreover, children of parents with an anxiety disorder, a depression, or both, have significantly higher odds of developing depression or anxiety compared to children of parents without these disorders [16]. The first explanation is that these children experience more stress at home and that their parents have less parenting skills. "
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    ABSTRACT: Depression and anxiety disorders during adolescence can have detrimental consequences. Both disorders are related to negative outcome in various areas during adolescence and are also predictive of depression and anxiety disorders later in life. Especially parental psychopathology and being female are risk factors that increase the probability of developing one of these disorders during adolescence. Research has shown that prevention programs have promising results, especially for adolescents who have these risk factors. Therefore, in this study, we will focus on the effectiveness of a prevention program 'A jump forward' that has been developed for adolescent girls with a familial risk of depression and/or anxiety. We designed a randomized controlled trial to test the effectiveness of an indicated and selective prevention program aimed at depression and anxiety in adolescent girls. Adolescents aged between 11 and 15 years old with depressive and/or anxiety symptoms and with parents who show indicators of parental psychopathology will be randomly assigned to the experimental (N = 80) or control groups (N = 80). Participants in the experimental group will follow a preventive intervention, consisting of six sessions of 90 minutes each. All participants will complete baseline, intervention phase 1 (after session 2), intervention phase 2 (after session 4), post-intervention, 6 month follow-up, and 12 month follow-up assessments. Furthermore, parents will be asked to complete assessments at baseline, post-intervention, and 12-month follow-up. Primary outcome will be depressive symptoms. Secondary outcomes will be anxiety symptoms, suicidal ideation, response style, negative cognitive errors, parental emotional support and parental control, parental psychopathology, parenting stress and adolescents' depression and anxiety symptoms according to the parents. This paper described the study designed to evaluate a program for preventing depression and/or anxiety in high-risk adolescents over a 12-month follow-up period. If the program showed to be effective in reducing symptoms of depression and anxiety and preventing adolescents from developing clinical levels of these disorders, our results would be relevant to practice. Thus, the intervention could be used on a large scale. Moreover, this study aims to contribute to the evidence-based prevention of depression and anxiety of adolescents.Trial registration: Dutch Trial Register NTR3720.
    BMC Psychiatry 11/2013; 13(1):316. DOI:10.1186/1471-244X-13-316 · 2.21 Impact Factor
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    • "Moreover, we failed to measure other potentially important predictors of adolescent SA, including parental psychopathology . A recent meta-analysis suggests much greater risk of anxiety and depressive disorders among offspring of anxious parents (Micco et al. 2009). It may be that anxious parents more often engage in overly controlling behaviors, and thus, maternal over-control may mediate the association between parent and child anxiety. "
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    ABSTRACT: Behavioral inhibition (BI) and maternal over-control are early risk factors for later childhood internalizing problems, particularly social anxiety disorder (SAD). Consistently high BI across childhood appears to confer risk for the onset of SAD by adolescence. However, no prior studies have prospectively examined observed maternal over-control as a risk factor for adolescent social anxiety (SA) among children initially selected for BI. The present prospective longitudinal study examines the direct and indirect relations between these early risk factors and adolescent SA symptoms and SAD, using a multi-method approach. The sample consisted of 176 participants initially recruited as infants and assessed for temperamental reactivity to novel stimuli at age 4 months. BI was measured via observations and parent-report across multiple assessments between the ages of 14 months and 7 years. Maternal over-control was assessed observationally during parent-child interaction tasks at 7 years. Adolescents (ages 14-17 years) and parents provided independent reports of adolescent SA symptoms. Results indicated that higher maternal over-control at 7 years predicted higher SA symptoms and lifetime rates of SAD during adolescence. Additionally, there was a significant interaction between consistently high BI and maternal over-control, such that patterns of consistently high BI predicted higher adolescent SA symptoms in the presence of high maternal over-control. High BI across childhood was not significantly associated with adolescent SA symptoms when children experienced low maternal over-control. These findings have the potential to inform prevention and early intervention programs by indentifying particularly at-risk youth and specific targets of treatment.
    Journal of Abnormal Child Psychology 07/2012; 40(8):1363-73. DOI:10.1007/s10802-012-9663-2 · 3.09 Impact Factor
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