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The development of anxiety disorders in childhood: an integrative review

  • L. Murray (a1), C. Creswell (a1) and P. J. Cooper (a1)
Abstract

We present an integrative review of the development of child anxiety, drawing on a number of strands of research. Family aggregation and genetic studies indicate raised vulnerability to anxiety in offspring of adults with the disorder (e.g. the temperamental style of behavioural inhibition, or information processing biases). Environmental factors are also important; these include adverse life events and exposure to negative information or modelling. Parents are likely to be key, although not unique, sources of such influences, particularly if they are anxious themselves. Some parenting behaviours associated with child anxiety, such as overprotection, may be elicited by child characteristics, especially in the context of parental anxiety, and these may serve to maintain child disorder. Emerging evidence emphasizes the importance of taking the nature of child and parental anxiety into account, of constructing assessments and interventions that are both disorder specific, and of considering bidirectional influences.

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Corresponding author
*Address for correspondence: Professor L. Murray, Winnicott Research Unit, School of Psychology, University of Reading, Reading RG6 6AL, UK. (Email: lynne.murray@reading.ac.uk)
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S Arbelle , J Benjamin , J Golin , I Kremer , RH Belmaker , RP Ebstein (2003). Relation of shyness in grade school children to the genotype for the long form of the serotonin transporter promoter region polymorphisms. American Journal of Psychiatry 160, 671676.

PM Barrett , RM Rapee , MR Dadds (1996). Family treatment of childhood anxiety: a controlled trial. Journal of Consulting and Clinical Psychology 64, 333342.

M Battaglia , A Ogliari , A Zanoni , A Citterio , U Pozzoli , R Giorda , C Maffei , C Marino (2005). Influence of the serotonin supporter gene and shyness on cerebral responses to facial expressions. Archives of General Psychiatry 62, 8594.

AT Beck (1986). Cognitive approaches to anxiety disorders. In Anxiety Disorders: Psychological and Biological Perspectives (ed. B. F. Shaw , Z. V. Segal , T. M. Vallis and F. E. Cashman ), pp. 115136. Plenum Press: New York.

J Biederman , S Faraone , DR Hirshfeld-Becker , D Friedman , JA Robin , JF Rosenbaum (2001 a). Patterns of psychopathology and dysfunction in high-risk children of parents with panic disorder and major depression. American Journal of Psychiatry 158, 4957.

J Biederman , DR Hirshfeld-Becker , JF Rosenbaum , C Hérot , D Friedman , N Snidman , J Kagan , SV Faraone (2001 b). Further evidence of an association between behavioral inhibition and social anxiety in children. American Journal of Psychiatry 158, 16731679.

J Biederman , JF Rosenbaum , EA Bolduc , SV Faraone , DR Hirshfeld (1991). A high risk study of young children of parents with panic disorder and agoraphobia with and without comorbid major depression. Psychiatry Research 37, 333348.

A Bittner , HL Egger , A Erklanli , J Costello , DL Foley , A Angold (2007). What do childhood anxiety disorders predict? Journal of Child Psychology and Psychiatry 48, 11741183.

SM Bogels , ML Brechman-Toussaint (2006). Family issues in child anxiety: attachment, family functioning, parental rearing and beliefs. Clinical Psychology Review 26, 834856.

SM Bogels , N Tarrier (2004). Unexplored issues and future directions in social phobia research. Clinical Psychology Review 24, 731736.

A Caspi , K Snudgen , TE Moffitt , A Taylor , IW Craig , H Harrington , J McLay , J Mill , J Martin , A Braithewaite , R Poulton (2003). Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science 301, 386389.

BF Chorpita , DH Barlow (1998). The development of anxiety: the role of control in the early environment. Psychological Bulletin 124, 321.

VE Cobham , SH Spence , MR Dadds (1998). The role of parental anxiety in the treatment of childhood anxiety. Journal of Consulting and Clinical Psychology 66, 893905.

M Cook , S Mineka (1987). Second-order conditioning and overshadowing in the observational conditioning of fear in monkeys. Behavior Research and Therapy 25, 349364.

PJ Cooper , V Fearn , L Willetts , H Seabrook , M Parkinson (2006). Affective disorder in the parents of a clinic sample of children with anxiety disorders. Journal of Affective Disorders 93, 205212.

J Costello , HL Egger , A Angold (2004). Developmental epidemiology of anxiety disorders. In Phobic and Anxiety Disorders in Children and Adolescents (ed. T. H. Ollendick and J. S. March ), pp. 6191. Oxford University Press: New York.

C Creswell , L Willetts , L Murray , M Singhal , P Cooper (2008 b). Treatment of child anxiety: an exploratory study of the role of maternal anxiety and behaviours in treatment outcome. Clinical Psychology and Psychotherapy 15, 3844.

C Creswell , M Woolgar , P Cooper , A Giannakakis , E Schofield , A Young , L Murray (2008 c). Processing of faces and emotional expressions in infants at risk of social phobia. Cognition and Emotion 22, 437458.

S Denham , D Zoller , E Couchard (1994). Socialisation of pre-schoolers emotion understanding. Developmental Psychology 30, 928936.

M de Rosnay , PJ Cooper , N Tsigaras , L Murray (2006). Transmission of social anxiety from mother to infant: an experimental study using a social referencing paradigm. Behavior Research and Therapy 44, 11651175.

PM DiBartolo , M Helt (2007). Theoretical models of affectionate versus affectionless control in anxious families: a critical examination based on observations of parent–child interactions. Clinical Child and Family Psychology 10, 253274.

JE Dumas , PJ LaFreniere (1993). Mother–child relationships as sources of support or stress: a comparison of competent, average, aggressive, and anxious dyads. Child Development 64, 17321754.

JE Dumas , WJ Serketich , PJ LaFreniere (1995). ‘Balance of power’: a transactional analysis of control in mother–child dyads involving socially competent, aggressive, and anxious children. Journal of Abnormal Psychology 104, 104113.

J Dunn , J Brown , L Beardsall (1991). Family talk about feeling states and children's later understanding of others' emotions. Developmental Psychology 27, 448455.

LJ Eaves , JL Silberg , JM Meyer , HH Maes , E Simonoff , A Pickles , M Rutter , MC Neale , CA Reynolds , MT Erikson , AC Heath , R Loeber , KR Truett , JK Hewitt (1997). Genetics and developmental psychopathology: 2. The main effects of genes and environment on behavioral problems in the Virginia Twin Study of Adolescent Behavioral Development. Journal of Child Psychology and Psychiatry 38, 965980.

MA Ehringer , SH Rhee , S Young , R Corley , JK Hewitt (2006). Genetic and environmental contributions to common psychopathologies of childhood and adolescence: a study of twins and their siblings. Journal of Abnormal Child Psychology 34, 117.

TC Eley , D Bolton , TG O'Connor , S Perrin , P Smith , R Plomin (2003). A twin study of anxiety-related behaviors in pre-school children. Journal of Child Psychology and Psychiatry 44, 945960.

TC Eley , J Stevenson (2000). Specific life events and chronic experiences differentially associated with depression and anxiety in young twins. Journal of Abnormal Child Psychology 28, 383394.

SA Feigon , ID Wladman , F Levy , AD Hay (2001). Genetic and environmental influences on separation anxiety disorder symptoms and their moderation by age and sex. Behavior Genetics 31, 403411.

AH Field , J Lawson (2003). Fear information and the development of fears during childhood: effects on implicit fear responses and behavioral avoidance. Behavior Research and Therapy 41, 12771293.

AP Field (2006). Is conditioning a useful framework for understanding the development and treatment of phobias? Clinical Psychology Review 26, 857875.

AP Field , SJ Hamilton , KA Knowles , EL Plews (2003). Fear information and social phobic beliefs in children: a prospective paradigm and preliminary results. Behavior Research and Therapy 41, 113123.

B Fisak , AE Grills-Taquechel (2007). Parental modeling, reinforcement, and information transfer: risk factors in the development of child anxiety? Clinical Child and Family Psychology 10, 213231.

R Fivush , A Vasudeva (2002). Remembering to relate: socioemotional correlates of mother–child reminiscing. Journal of Cognition and Development 3, 7390.

NA Fox , HA Henderson , PJ Marshall , KE Nichols , MM Ghera (2005). Behavioral inhibition: linking biology and behavior within a developmental framework. Annual Review of Psychology 56, 235262.

NA Fox , HA Henderson , KH Rubin , SD Calkins , LA Schmidt (2001). Continuity and discontinuity of behavioral inhibition and exuberance: psychophysiological and behavioral influences across the first four years of life. Child Development 72, 121.

W Furman , DF Rahe , WW Hartup (1979). Rehabilitation of socially withdrawn preschool children through mixed-age and same-age socialization. Child Development 50, 915922.

FC Gerull , RM Rapee (2002). Mother knows best: effects of maternal modelling on the acquisition of fear and avoidance behavior in toddlers. Behavior Research and Therapy 40, 279287.

IM Goodyer , C Wright , PME Altham (1988). Maternal adversity and recent stressful life events in anxious and depressed children. Journal of Child Psychology and Psychiatry 29, 651667.

AM Gregory , TC Eley (2007). Genetic influences on anxiety in children: what we've learned and where we're heading. Clinical Child and Family Psychology Review 10, 199212.

JA Hadwin , M Garner , G Perez-Olivas (2006). The development of information processing biases in childhood anxiety: a review and exploration of its origins in parenting. Clinical Psychology Review 26, 876894.

AR Hariri , VS Mattay , A Tessitore , B Kolochana , F Fera , D Goldman , MF Egan , DR Weinberger (2002). Serotonin transporter genetic variation and the response of the human amygdale. Science 297, 400403.

C Hayward , JD Killen , KC Kraemer , CB Taylor (1998). Linking self-reported childhood behavioral inhibition to adolescent social phobia. Journal of the American Academy of Child and Adolescent Psychiatry 37, 13081316.

JM Hettema , MC Neale , KS Kendler (2001). A review and meta-analysis of the genetic epidemiology of anxiety disorders. American Journal of Psychiatry 158, 15681578.

DR Hirshfeld , J Biederman , L Brody , SV Faraone , JF Rosenbaum (1997). Expressed emotion toward children with behavioral inhibition: associations with maternal anxiety disorder. Journal of the American Academy of Child and Adolescent Psychiatry 36, 910917.

JL Hudson , RM Rapee (2001). Parent–child interactions and anxiety disorders: an observational study. Behavior Research and Therapy 39, 14111427.

JL Hudson , RM Rapee (2002). Parent–child interactions in clinically anxious children and their siblings. Journal of Clinical Child and Adolescent Psychology 31, 548555.

J Kagan (1989). Temperamental contributions to social behavior. American Psychologist 44, 668674.

J Kagan , JS Reznick , N Snidman , J Gibbons , MO Johnson (1988). Childhood derivatives of inhibition lack of inhibition to the unfamiliar. Child Development 59, 15801589.

J Kaufman , BZ Yang , H Douglas-Palumberi , S Houshyar , D Lipschitz , JH Krystal , J Gelernter (2004). Social supports and the serotonin transporter gene moderate depression in maltreated children. Proceedings of the National Academy of Sciences USA 101, 1731617421.

KS Kendler , J Myers , CA Prescott (2000). Parenting and adult mood, anxiety and substance disorders in female twins: an epidemiological, multi-informant, retrospective study. Psychological Medicine 30, 281294.

KJ Kim , RD Conger , Jr. GH Elder , FO Lorenz (2003). Reciprocal influences between stressful life events and adolescent internalizing and externalizing problems. Child Development 74, 127143.

M Kindt , JS Bierman , JS Brosschot (1997). Cognitive bias in spider fear and control children: assessment of emotional interference by a card format and a single-trial format of the Stroop. Journal of Experimental Child Psychology 66, 163179.

NJ King , G Eleonora , TH Ollendick (1998). Etiology of childhood phobias: current status of Rachman's three pathways theory. Behavior Research and Therapy 36, 297309.

CG Last , M Hersen , AE Kazdin , H Orvaschel , S Perrin (1991). Anxiety disorders in children and their families. Archives of General Psychiatry 48, 928939.

J Lawson , R Banerjee , AP Field (2007). The effects of verbal information on children's fear beliefs about social situations. Behavior Research and Therapy 45, 2137.

LN Legrand , M McGue , WG Iacono (1999). A twin study of state and trait anxiety in childhood and adolescence. Journal of Child Psychology and Psychiatry 40, 953958.

C Mancini , M van Ameringen , P Szatmari , C Fugere , M Boyle (1996). A high risk pilot study of the children of adults with social phobia. Journal of the Academy of Child and Adolescent Psychiatry 35, 15111517.

M Martin , GV Jones (1995). Integral bias in the cognitive processing of emotionally linked pictures. British Journal of Psychology 86, 419435.

AC McFarlane (1987). Posttraumatic phenomena in a longitudinal study of children following a natural disaster. Journal of the American Academy of Child and Adolescent Psychiatry 26, 764769.

BD McLeod , JJ Wood , JR Weisz (2007). Examining the association between parenting and childhood anxiety: a meta-analysis. Clinical Psychology Review 27, 155172.

RG Menzies , JC Clarke (1995). The etiology of phobias: a nonassociative account. Clinical Psychology Review 15, 2348.

S Mineka , M Davidson , M Cook , R Kein (1984). Observational conditioning of snake fear in rhesus monkeys. Journal of Abnormal Psychology 93, 355372.

S Mineka , M Gunner , M Champoux (1986). Control and early emotional development: infant rhesus monkeys reared in controllable versus uncontrollable environments. Child Development 57, 12411256.

S Mineka , R Zinbarg (2006). A contemporary learning theory perspective on the etiology of anxiety disorders: it's not what you thought it was. American Psychologist 61, 1026.

PS Moore , SE Whaley , M Sigman (2004). Interactions between mothers and children: impacts of maternal and child anxiety. Journal of Abnormal Psychology 113, 471476.

MR Munafo , TG Clark , LR Moore , E Payne , R Wlaton , J Flint (2003). Genetic polymorphisms and personality in healthy adults: a systematic review and meta-analysis. Molecular Psychiatry 8, 471484.

P Muris , H Merckelbach , PJ Jong , TH Ollendick (2002). The etiology of specific fears and phobias in children: a critique of the non-associative account. Behavior Research and Therapy 40, 185195.

P Muris , P Steernmen , H Merckelbach , C Meesters (1996). The role of parental fearfulness and modeling in children's fear. Behavior Research and Therapy 34, 265268.

L Murray , PJ Cooper , C Creswell , E Schofield , C Sack (2007). The effects of maternal social phobia on mother–infant interactions and infant social responsiveness. Journal of Child Psychology and Psychiatry 48, 4552.

L Murray , M DeRosnay , J Pearson , C Bergeron , L Schofield , M Royal-Lawson , PJ Cooper (2008). Intergenerational transmission of maternal social anxiety: the role of the social referencing process. Child Development 79, 10491064.

K Nelson (1993). The psychological and social origins of autobiographic memory. Psychological Science 4, 18.

TH Ollendick (1979). Fear reduction techniques with children. In Progress in Behavior Modification (ed. M. Hersen , R. M. Eisler and P. M. Miller ), pp. 127168. Academic Press: New York.

TH Ollendick , NJ King (1991). Origins of childhood fears: an evaluation of Rachman's theory of fear acquisition. Behavior Research and Therapy 29, 117123.

NK Phillips , CL Hammen , PA Brennan , JM Najman , W Bor (2005). Early adversity and the prospective prediction of depressive and anxiety disorders in adolescents. Journal of Abnormal Child Psychology 33, 1324.

S Rachman (1990). The determinants and treatment of simple phobias. Advances in Behavior Research and Therapy 12, 130.

RM Rapee (2001). The development of generalized anxiety disorder. In The Developmental Psychopathology of Anxiety (ed. M. W. Vasey and M. R. Dadds ), pp. 481504. Oxford University Press: New York.

RM Rapee , SH Spence (2004). The etiology of social phobia: empirical evidence and an initial model. Clinical Psychology Review 24, 737767.

M Rickman , R Davidson (1994). Personality and behavior in parents of temperamentally inhibited or uninhibited children. Developmental Psychology 30, 346354.

JF Rosenbaum , J Biederman , M Gersten , DR Hirshfeld , SR Meminger , JB Herman , J Kagan , JS Reznick , N Snidman (1988). Behavioral inhibition in parents of children with panic disorder and agoraphobia: a controlled study. Archives of General Psychiatry 45, 463470.

JF Rosenbaum , J Biederman , DR Hirshfield , EA Bolduc , SV Faraone , J Kagan , N Snidman , JS Reznick (1991). Further evidence of an association between behavioral inhibition and anxiety disorders: results from a family study of children from a non-clinical sample. Journal of Psychiatric Research 25, 4965.

JF Rosenbaum , J Biederman , DR Hirshfeld-Becker , J Kagan , N Snidman , D Friedman , A Nineberg , DJ Gallery , SV Faraone (2000). A controlled study of behavioral inhibition in children of parents with panic disorder and depression. American Journal of Psychiatry 157, 20022010.

KH Rubin , KB Burgess , PD Hastings (2002). Stability and social-behavioral consequences of toddlers' inhibited temperament and parenting behaviors. Child Development 73, 483495.

LA Schmidt , NA Fox , KH Rubin , S Hu , DH Hamer (2002). Molecular genetics of shyness and aggression in preschoolers. Personality and Individual Differences 33, 227238.

C Schwartz , N Snidman , J Kagan (1999). Adolescent social anxiety as an outcome of inhibited temperament in childhood. Journal of the American Academy of Child and Adolescent Psychiatry 38, 10081015.

L Shanahan , W Copeland , EJ Costello , A Angold (2008). Specificity of putative psychosocial risk factors for psychiatric disorders in children and adolescents. Journal of Child Psychology and Psychiatry 49, 3442.

D Silove , V Manicavasagar , D O'Connell , A Morris-Yates (1995). Genetic factors in early separation anxiety: implications for the genesis of adult anxiety disorder. Acta Psychiatrica Scandanavica 92, 1724.

DE Stubbe , GE Zahner , MJ Goldstein , JF Leckman (1993). Diagnostic specificity of a brief measure of expressed emotion: a community study of children. Journal of Child Psychology and Psychiatry and Allied Disciplines 34, 139154.

C Suveg , J Zeman , E Flannery-Schroeder , M Cassano (2005). Emotion socialization in families of children with an anxiety disorder. Journal of Abnormal Child Psychology 33, 145155.

EMC Swearingen , LH Cohen (1985). Life events and psychological distress: a prospective study of young adolescents. Developmental Psychology 21, 10451054.

A Thapar , P McGuffin (1995). Are anxiety symptoms in childhood heritable? Journal of Child Psychology and Psychiatry 36, 439447.

SM Turner , DC Biedel , A Costello (1987). Psychopathology in the offspring of anxiety disordered patients. Journal of Consulting and Clinical Psychology 55, 229235.

SM Turner , DC Beidel , PL Wolff (1996). Is behavioral inhibition related to the anxiety disorders? Clinical Psychology Review 16, 157172.

V Warner , L Mufson , MM Weissman (1995). Offspring at low and high risk for depression and anxiety: mechanisms of psychiatric disorder. Journal of the Academy of Child and Adolescent Psychiatry 34, 786797.

SL Warren , RN Emde , LA Sroufe (2000). Internal representations: predicting anxiety from children's play narratives. Journal of the American Academy of Child and Adolescent Psychiatry 39, 100107.

SL Warren , SJ Simmens (2005). Predicting toddler anxiety/depressive symptoms: effects of caregiver sensitivity on temperamentally vulnerable children. Infant Mental Health Journal 26, 4055.

MM Weissman , JF Leckman , KR Merikangas , GD Gammon , BA Prusoff (1984). Depression and anxiety disorders in parents and children. Archives of General Psychiatry 41, 845852.

SE Whaley , A Pinto , M Sigman (1999). Characterizing interactions between anxious mothers and their children. Journal of Consulting and Clinical Psychology 67, 826836.

JJ Wood , BD McLeod , M Sigman , W Hwang , BC Chu (2003). Parenting and childhood anxiety: theory, empirical findings, and future directions. Journal of Child Psychology and Psychiatry 44, 134151.

JJ Wood , JC Piacentini , M Southam-Gerow , BC Chu , M Sigman (2006). Family cognitive behavioral therapy for child anxiety disorders. Journal of the American Academy of Child and Adolescent Psychiatry 45, 314321.

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