Addressing how anxiety in the family can lead to increased anxiety in children

Review of “The interplay between expressed parental anxiety & infant behavioral inhibition predicts infant avoidance in a social referencing paradigm.”


In a recent study, Aktar, Majdandžić, de Vente, and Bögels (2013) examined how anxiety in infants may be predicted by anxious communication/behavior in parents. The authors of this study found that after controlling for parental psychopathology (mental disorders in parents), both mother’s and father’s actual expression of anxiety during a social task, predicted infants’ anxious behaviors. In other words, parents were unknowingly contributing to anxious behaviors in children and this was independent of their struggles with mental disorders. These important findings underscore the importance of working on communication skills in the family to aid in healthy development and also suggest a way that parents can help their children to reduce anxiety.


Why did they conduct this study?

The authors noted that past research has identified important genetic and environmental factors that contribute to the development of anxiety. With regards to environmental factors, the authors hypothesized that children may receive cues from parents that may lead to more anxiety through a process called social referencing. Aktar et al. (2013) describe social referencing as a process where infants pay intention to emotional reactions/behaviors of parents in order to figure out how to behave in new situations. The authors noted that anxious, parental communications/behaviors may then support the development of anxiety disorders, particularly in children who have a genetic susceptibility, such as children with an anxious temperament. However, few studies have looked at these processes in groups of parents with and without anxiety disorders, which makes it unclear whether or not it is the parent’s disorder that increases anxiety in children or their expressions. Therefore, the authors conducted this study to examine social referencing among infants with parents with and without anxiety disorders.

What were the goals of this study?

The main goals of the study were the following:

  • To examine the impact of mother’s and father’s expressed anxiety on infant’s fear or avoidance.
  • To examine the impact of parents’ anxiety disorder status (whether or not the mother or father had a diagnosed anxiety disorder) on infant’s fear or avoidance.
  • To examine the interaction between parent’s behaviors, or expressed anxiety, with infant’s temperament. The author’s predicted here that parental expressed anxiety would lead to more fear or avoidance primarily with infants who had temperaments characterized by being more inhibited or shy.

How did the authors examine the study goals?

The authors invited 122 couples and their infants to attend a study in the laboratory. Mothers and fathers came separately with their infant, when their infant was 12 months of age. The infants’ temperament was coded by trained researchers for shyness or inhibition and parents completed interviews to assess their anxiety disorder status. Next, infants and their parents engaged in two tasks. One task involved a stranger coming into the room, talking with the infant’s parent, and then picking up the infant, while the other task involved a remote-controlled toy dinosaur with flashing lights coming into the room. During both tasks, infants’ behaviors were coded for fear or avoidance, and parents’ behaviors were coded for expressions of anxiety.

What were the main findings from this study?

There were three main findings:

  • Parental expressed anxiety did not significantly predict infant’s fear, but it did predict infants’ avoidance in the new situations.
  • Parental anxiety disorder diagnosis also did not significantly significant predict infants’ fear or avoidance in the new situations.
  • Infants’ inhibited temperament did interact with parental expressed anxiety to predict avoidance in these situations. More specifically, infants with moderate to high inhibition levels were most affected by parents’ expressions of anxiety.

What are the implications of this study?

The results of this study suggest that parents with young children who are more prone to anxiety may unknowingly contribute to the development of the child’s anxiety through their subtle communications or behaviors in novel situations. For example, a parent may assume that their child will be scared of a toy dinosaur and react by making emotional noises, such as a gasp. This can then be read by the child as a communication that the situation is dangerous, although no real danger is present. These subtle communications happen all the time, particularly when parents are responsive to their child’s emotions, but they may lead to increased anxiety in children with more shy or anxious temperaments.

In sum, the authors believe that parental expressions of anxiety may be one environmental factor that contributes to the development of anxiety disorders in children with a higher risk of developing anxiety.

What does this all mean for me and my child with social anxiety disorder?

This particular study may not mean anything for you or your child. For example, you may not communicate anxiety in situations with your child or your child may not be very responsive to your communications. However, the results of this study do suggest that parents with anxious children may find it beneficial to check in with themselves and see how they may be communicating anxiety to their child.

What can I do if I want to learn more about how to improve my communications and behaviors to support my child’s development and aid my child in reducing his or her anxiety?

If you think your child is more prone to anxiety than the average child, it may be helpful to consult several well-reviewed books on parenting anxious children:

Parenting Your Anxious Child with Mindfulness and Acceptance: A Powerful New Approach to Overcoming Fear, Panic, and Worry Using Acceptance and Commitment Therapy

Freeing Your Child from Anxiety: Powerful, Practical Solutions to Overcome Your Child’s Fears, Worries, and Phobias

In addition, it could be beneficial to discuss this issue with your child’s or your own mental healthcare provider. Clinicians have a lot of ideas for learning new skills that aid you in improving your communication, which may benefit you and your child.

How can I learn more about this study?

If you would like to learn more about this study, please click the following link:


Aktar, E., Majdandžić, M., de Vente, W., & Bögels, S. M. (2013). The interplay between expressed parental anxiety and infant behavioural inhibition predicts infant avoidance in a social referencing paradigm. Journal of Child Psychology and Psychiatry, 54(2), 144-156. doi: 10.1111/j.1469-7610.2012.02601.x

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