3 - (IOP 5) Contextual Adversity and Childhood Anxiety: Identifying Parental and Affective Mechanisms

Introduction: Childhood anxiety disorders are prevalent and impairing, leading to deleterious consequences in adulthood if left untreated (Ginsburg, 2004; Merikangas et al., 2010). Despite advances in treatment, 30 – 40% of youth do not respond to gold-standard interventions such as cognitive behavioral therapy (CBT; James et al., 2013). Understanding the role of contextual factors in childhood anxiety may help to further personalize CBT treatments. Specifically, contextual adversity may affect parenting practices and children’s emotion regulation, in turn contributing to anxiety (Hurrell et al., 2015). However, research on these mechanisms is nascent and often relies on monomethod, single-informant data. This study examined the effects of contextual adversity on anxiety through unsupportive parental socialization of emotion (PSE; e.g., minimizing or punishing children’s display of negative emotions) and child emotion dysregulation. It was hypothesized that: 1) contextual adversity would be indirectly associated with emotion dysregulation through unsupportive PSE; and 2) unsupportive PSE would be indirectly associated with anxiety symptom severity through emotion dysregulation.

Method: Sixty-two clinically anxious children ages 8 – 12 years (M = 10.3 years, SD = 1.2; 40.3% female; 45.2% racial/ethnic minority) and their mothers (M age = 42.7 years, SD = 6.6; 48.4% racial/ethnic minority) completed questionnaires and three parent-child interaction tasks, during which children reported state anxiety and emotion dysregulation. Child-parent behaviors were also observationally coded (Schneider, 2004). Contextual adversity was calculated using theoretically informed variables, including traumas (M = 3.5), residential poverty rate (M = 8.4%), and single motherhood (19%), among others.

Results: Bivariate correlations suggested that contextual adversity was associated with greater mother-reported child emotion dysregulation (r = .28, p < .05). Contrary to expectations, contextual adversity was associated with lower behaviorally-coded unsupportive PSE (r = -.26, p < .05). Unsupportive PSE did not mediate the relationship between contextual adversity and emotion dysregulation, regardless of the method of assessment. However, emotion dysregulation mediated the relationship between unsupportive PSE and anxiety symptom severity assessed through child-report (mediation ratio PM = .23; abcs = .10, SE = .05, 95% CI [.02, .21]) and mother-report measures (PM = .84; abcs = .19, SE = .08, 95% CI [.03, .34]), but not state measures or behavioral coding.

Discussion: In this sample, contextual adversity was linked to emotion dysregulation as expected. However, contextual adversity was linked to unsupportive PSE in the opposite direction as expected, and showed no relationship with anxiety symptom severity. Unsupportive PSE contributed to emotion dysregulation, which in turn was associated with more severe anxiety. Our method of quantifying contextual adversity and the middle-range socioeconomic status of our sample may have influenced our findings. Future studies should explore the effects of specific facets of contextual adversity on parental practices in socioeconomically diverse populations.