Maternal Punitive Responses, Safety Behaviors, and Fear in Anxious Children

Safety behaviors attenuate the effects of exposure therapy. Less is known about how safety behaviors interact with parenting behaviors in relation to anxious children’s fear responses. We examined if child safety behaviors interact with maternal punitive responses to explain unique variance in children’s fear downregulation—defined as self-reported reduction of anxious arousal—during an anxiety-provoking task. Anxious children ages 8–12 (N = 105; 57.1% female; 61.9% racial minority) completed a diagnostic interview and structured speech task. Mothers reported how often they responded punitively to children’s negative emotions. Independent observers coded child safety behaviors used during the speech, and a fear downregulation score was computed per child by subtracting post-speech fear scores from pre-speech fear scores. The interaction between child safety behaviors and maternal punitive responses predicted unique variance in subjective fear downregulation, such that increased use of safety behaviors during the speech task was associated with more difficulties downregulating subjective fear only among children whose mothers reported moderate and high use of punitive responses. Maternal punitive responses to children’s negative emotions may promote child safety behavior use to avoid anxiety, resulting in greater difficulties downregulating fear. Our findings provide preliminary evidence for targeting child safety behaviors and parenting behaviors during child anxiety treatment.