Article
Behavior Problems in Children of Parents with Anxiety Disorders

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Abstract

The Child Behavior Checklist was obtained on 42 children whose parents were given DSM-III diagnoses of agoraphobia with panic attacks, panic disorder, generalized anxiety disorder, and a group of mixed phobics. Although preliminary, results suggest that avoidance in agoraphobia may be a key variable associated with child maladjustment. Some possible mechanisms of familial transmission are discussed, with emphasis placed on modeling, the family structure, and the severity of disorder.

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      In order to be included in the meta-analysis, a study was required to meet the following inclusion criteria: (1) rates of anxiety disorders in offspring needed to be reported, (2) studies had to include a control group of offspring of non-affected parent probands, (3) proband groups within a study could not include overlapping participants (e.g., parents with comorbid anxiety and depression could not be counted once in the anxious group and then again in the depression group), (4) proband groups within a high-risk study could not have significantly different accession rates for interviewing offspring (e.g., if a large percentage of children of control parents agreed to be interviewed while a significantly smaller percentage of children of anxious parents were interviewed, then the study was not retained due to concerns about selection bias), and (5) offspring groups had to be distinct from other first- or second-degree family members in the data analyses. Six high-risk studies were excluded because they did not meet the above criteria for inclusion (Berg, 1976 [did not meet criterion 1]; Mancini, van Ameringen, Szatmari, Fugere, & Boyle, 1996 [criterion 2]; Merikangas, Lieb, Wittchen, & Avenevoli, 2003 [criterion 5]; Mufson, Nomura, & Warner, 2002 [criterion 3]; Silverman, Cerny, Nelles, & Burke, 1988 [criterion 2]; Warner et al., 1995 [criterion 4]). A total of 13 studies and 16 papers (including three follow-up papers), met the criteria for inclusion in the meta-analysis.

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    The authors thank Andrew Eisen, Wayne Fleisig, and Chris Kearny for assisting in the interviewing of subjects, and Bruce Dudek for consulting with us on the data analytic procedures. Special thanks are due to Dr. David H. Barlow for his comments on an earlier draft of this manuscript and for providing us with the patient population necessary for successful completion of this study.

    This study was supported by a Faculty Development Grant awarded to Dr. Silverman from the Research Foundation of the State University of New York. Dr. Cerny was on sabbatical leave at the University at Albany, with partial support from a Faculty Development Grant from the Indiana State University Research Foundation.

    An elaboration of some of the issues raised in this article appears in Advances in Clinical Child Psychology, Vol. 11, B. B. Lahey & A. E. Kazdin, Plenum Press: New York, in press.

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