FAMILY ACCOMMODATION IN PEDIATRIC ANXIETY DISORDERS: Research Article: Family Accommodation in Pediatric Anxiety
Open accessAbstract
BACKGROUND: Family accommodation has been studied in obsessive compulsive disorder using the Family Accommodation Scale (FAS) and predicts greater symptom severity, more impairment, and poorer treatment outcomes. However, family accommodation has yet to be systematically studied among families of children with other anxiety disorders. We developed the Family Accommodation Scale-Anxiety (FASA) that includes modified questions from the FAS to study accommodation across childhood anxiety disorders. The objectives of this study were to report on the first study of family accommodation across childhood anxiety disorders and to test the utility of the FASA for assessing the phenomenon. METHODS: Participants were parents (n = 75) of anxious children from two anxiety disorder specialty clinics (n = 50) and a general outpatient clinic (n = 25). Measures included FASA, structured diagnostic interviews, and measures of anxiety and depression. RESULTS: Accommodation was highly prevalent across all anxiety disorders and particularly associated with separation anxiety. Most parents reported participation in symptoms and modification of family routines as well as distress resulting from accommodation and undesirable consequences of not accommodating. The FASA displayed good internal consistency and convergent and divergent validity. Accommodation correlated significantly with anxious but not depressive symptoms, when controlling for the association between anxiety and depression. Factor analysis of the FASA pointed to a two-factor solution; one relating to modifications, the other to participation in symptoms. CONCLUSIONS: Accommodation is common across childhood anxiety disorders and associated with severity of anxiety symptoms. The FASA shows promise as a means of assessing family accommodation in childhood anxiety disorders.
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Several studies suggest that accommodation may be more prevalent among youth with a primary diagnosis of SAD.
“several studies suggest that accommodation may be more prevalent among youth with a primary diagnosis of SAD [64, 72, 73].”
From Intolerance of Uncertainty and Parental Accommodation: Promising Targets for Personalized Intervention for Youth Anxiety. (2020) · cites this paper as [72]
In Results > Prevalence of Family Accommodation (page unavailable), separation anxiety disorder was the only diagnosis significantly associated with the degree of accommodation in the specialty-clinic sample. The analysis tested whether each diagnosis was present, not whether SAD was the primary diagnosis, so the paper does not establish that qualifier. (LLM, conf=0.86)
Experimental — accuracy not yet measuredParental accommodation is associated with anxiety symptom severity in children and may need to be addressed in treatment.
“Research has shown that parental accommodation is associated with anxiety symptom severity in children and may need to be addressed in treatment (Lebowitz et al., 2013).”
From Intolerance of Uncertainty–Focused Treatment for Adolescents With Excessive Worry: A Pilot Feasibility Study (2020) · cites this paper as Lebowitz et al., 2013
Accommodation was originally examined in OCD, but researchers have increasingly recognized its importance in SAD and youth anxiety disorders more broadly.
“although originally examined in the context of obsessive compulsive disorder (OCD) [70, 71], researchers have increasingly recognized the importance of accommodation in the maintenance of separation anxiety disorder (SAD) [64, 72, 73] and youth anxiety disorders more broadly [63, 74]”
From Intolerance of Uncertainty and Parental Accommodation: Promising Targets for Personalized Intervention for Youth Anxiety. (2020) · cites this paper as [72]
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- Authors
- Lebowitz, E. R., Woolston, J., Bar-Haim, Y., Calvocoressi, L., Dauser, C., Warnick, E., Scahill, L., Chakir, A. R., Shechner, T., Hermes, H., Vitulano, L. A., King, R. A., & Leckman, J. F.
- Affiliations
- Yale University (US)
- Tel Aviv University School of Psychological Sciences; Tel Aviv Isreal
- Tel Aviv University (IL)
- National Institute of Mental Health (US)
- Corresponding author
- Lebowitz, Eli R.
- ORCID
- Venue
- Depression and Anxiety
- Publisher
- Hindawi Limited
- Published
- 2012-09-10
- Volume
- 30
- Issue
- 1
- Pages
- 47-54
- ISSN
- 1091-4269 (ISSN-L)
- PMC
- PMC3932435
- OpenAlex
- W1556194339
- Semantic Scholar
- e2e700226f4f03e241c9e2c4bc9d5764e1ad017a
- Cited by
- 385
- References
- 38
- Citations by year
- 2026: 42 · 2025: 33 · 2024: 31 · 2023: 32 · 2022: 38 · 2021: 41 · 2020: 41 · 2019: 18 · 2018: 18 · 2017: 24 · 2016: 18 · 2015: 22 · 2014: 16 · 2013: 8
- FWCI
- 16.68
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- 59th Annual Meeting
- Funders
- National Institutes of Health and the Tourette Syndrome Association
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Keywords
- family accommodation, childhood anxiety disorders, separation anxiety disorder, parental accommodation, symptom severity, anxiety and depression, scale development, family routines
- MeSH terms
- Adaptation, Psychological, Adolescent, Anxiety Disorders, Anxiety, Separation, Child, Factor Analysis, Statistical, Family, Family Health, Female, Humans, Male, Parents, Psychometrics, Surveys and Questionnaires, Severity of Illness Index, Social Behavior, Reproducibility of Results
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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