Anxiety levels in clinically referred children and their parents: examining the unique influence of self-reported attachment styles and interview-based reflective functioning in mothers and fathers.
Abstract
Objective Although much is known about childhood anxiety disorders, the differential contributions by mothers and fathers to child anxiety is poorly understood. This study examined the relation between child anxiety and parental level of psychopathology, attachment style, and reflective functioning ( RF ). Design Thirty‐eight clinically anxious children aged 7–12 years (55.3% female) referred for treatment and their parents (37 mothers, 34 fathers) participated in the study. Method Reflective functioning was coded based on Adult Attachment Interviews. Self‐report questionnaires on attachment and psychopathology were administered. Results Paternal psychopathology, attachment avoidance, and attachment anxiety as well as maternal attachment anxiety were associated with child anxiety. Mothers had higher RF abilities than fathers. Lower levels of RF in mothers and higher levels of attachment avoidance in fathers explained 42% of the variance in anxiety levels of the child. Conclusion Mothers and fathers may provide unique contributions to the development of child anxiety. The findings highlight the importance of considering fathers as well as mothers in research and treatment for childhood anxiety disorders. Practitioner points Anxiety in children may be related to attachment avoidance in fathers and low levels of reflective functioning in mothers. Fathers as well as mothers should be involved in research and treatment of childhood anxiety disorders. The study is exploratory and findings must be replicated before firm conclusions can be drawn. Data were derived from families whose children suffer from clinical levels of anxiety, and they may not be representative of non‐clinical samples.
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Low maternal AAI-RF (and not low paternal AAI-RF) was a predictor of higher levels of anxiety in a sample of clinically anxious school-aged children referred for psychological treatment.
“Esbjørn et al. (2013) found that low maternal AAI-RF (and not low paternal AAI-RF) was a predictor of higher levels of anxiety in a sample of clinically anxious school-aged children referred for psychological treatment.”
From Mentalizing makes parenting work: a review about parental reflective functioning and clinical interventions to improve it (2017) · cites this paper as Esbjørn et al., 2013
Low maternal RF was found in mothers whose children suffered from anxiety disorders, impairment in emotion regulation, and externalizing behaviors.
“Low maternal RF was found in mothers whose children suffered from anxiety disorders (Esbjørn et al., 2013), impairment in emotion regulation (Heron-Delaney et al., 2016), and externalizing behaviors (Ensink et al., 2016a; Smaling et al., 2016b).”
From Mentalizing makes parenting work: a review about parental reflective functioning and clinical interventions to improve it (2017) · cites this paper as Esbjørn et al., 2013
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- Authors
- Esbjørn, B. H., Pedersen, S. H., Daniel, S. I. F., Hald, H. H., Holm, J. M., & Steele, H.
- Affiliations
- University of Copenhagen (DK)
- The New School (US)
- Corresponding author
- Esbjørn, Barbara H.
- Venue
- British Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 2013-07-02
- Volume
- 52
- Issue
- 4
- Pages
- 394-407
- ISSN
- 0144-6657 (ISSN-L)
- 2044-8260
- OpenAlex
- W2091190687
- Cited by
- 75
- References
- 42
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 6 · 2023: 10 · 2022: 9 · 2021: 10 · 2020: 8 · 2019: 4 · 2018: 3 · 2017: 6 · 2016: 5 · 2015: 4 · 2014: 1
- FWCI
- 3.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- British Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- childhood anxiety, parental attachment styles, reflective functioning, attachment avoidance, attachment anxiety, maternal psychopathology, paternal psychopathology, parents, Adult Attachment Interview, childhood anxiety disorders, parent-child relationship
- MeSH terms
- Adult, Anxiety, Anxiety Disorders, Child, Fathers, Female, Humans, Interview, Psychological, Male, Mothers, Object Attachment, Parent-Child Relations, Psychiatric Status Rating Scales, Surveys and Questionnaires, Severity of Illness Index, Thinking, Self Report
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