The intergenerational transmission of social anxiety:
Studying 2,5-year old toddlers and their parents, using a social
referencing paradigm
Masterscriptie Orthopedagogiek Pedagogische en Onderwijskundige Wetenschappen Universiteit van Amsterdam Studentnummer: 5882427 I.J. Meyssen Thesis supervisor: E. Aktar, Msc Second assessor: Dr. M. Majdandžić Amsterdam, 2013
Index Page number Abstract 3 Introduction 4 Method 9 Participants 9 Procedure 9 Instruments 9 Statistical analysis 11 Results 12 Discussion 13 Reference list 17 Appendix 21 Table 1 21 Table 2 22 Table 3 23 Table 4 24
Abstract
In this study the intergenerational transmission of social anxiety was examined in a social referencing (SR) situation. We were interested in the associations of
parental trait and state anxiety with toddlers’ trait and state anxiety in the SR
situation. Fathers and mothers with and without a social anxiety disorder participated with their 2,5-year old children. Parental anxiety disorder was measured via a
structured interview and toddler behavioural inhibition was measured via a
questionnaire. Parental expressions of anxiety and toddler fear and avoidance were observed in the SR situation. During the SR situation a stranger interacted first with the parent and then invited the child to read a book together. Mother and father visits were analyzed separately. Results revealed that while mothers and fathers with social anxiety disorder showed more anxiety in the SR situation in comparison to parents without social anxiety, neither maternal nor paternal social anxiety disorder predicted toddler behavioural inhibition. Furthermore, while maternal expressed and diagnosed anxiety did not predict toddler fear or avoidance, paternal diagnosed social anxiety predicted toddler fear and avoidance, such that children of fathers with (versus without) social anxiety disorder were significantly more fearful and marginally more avoidant. Finally, the interaction between parental expressed anxiety and toddler behavioural inhibition did not significantly predict toddler fear or avoidance.
Introduction
Social anxiety disorder (SAD) is one of the most prevalent anxiety disorders, with a lifetime prevalence of 7-13 % in Western countries (Furmark, 2002). In the DSM-IV-TR the SAD is described as a clear and persistent fear for one or more situations in which one must function or perform socially and is exposed to unfamiliar people or the possibility to be judged by others (American Psychiatric Association, 2007). The person involved is afraid that he/she may act in a humiliating,
embarrassing way. The long-term effects for children with SAD could be that they do not develop age-appropriate social skills, which causes them to have fewer friends, which in turn makes them feel lonely (Beidel, Turner, & Morris, 1999). Childhood social anxiety can also lead to academic dysfunction, school refusal and comorbid depression.
Behavioural inhibition (BI) is a temperamental characteristic that has been seen in 10 to 15% of children (Olledick & Benoit, 2012; Hirshfeld-Becker, Micco, Simoes, & Henin, 2008) and it seems to constitute a specific risk factor for the development of SAD (Hirshfeld-Becker et al., 2007; Muris et al., 2010). Children with BI (trait anxiety) persistently tend to act with restraint, withdrawal, and reticence when faced with unfamiliar people, objects and events and tend to avoid these
situations (Kagan, Reznick, Snidman, Gibbons, & Johnson, 1988). When put in such a situation they tend to seek the reassurance of their parents and rarely approach the unfamiliar people or objects. It has been found that when a child has a parent with an anxiety disorder (parental trait anxiety) he/she is more likely to be behaviourally inhibited (Rosenbaum et al., 1988) and that behaviourally inhibited children who have a parent with an anxiety disorder are the highest risk group for developing an anxiety disorder themselves (Rosenbaum et al. 1992). In addition, the degree of BI was found to predict the degree of fear/avoidance that infants showed in a novel situation (Aktar, Majdandzic, de Vente & Bögels, 2013), such that children with high levels of BI were more fearful in comparison to children with low levels of BI. Taken together, there seems to be a strong link between infant BI and parental SAD and an increased risk for inhibited children to also develop SAD themselves. Both genetic and
environmental factors seem to play a role in the development of childhood anxiety disorders (Fisak & Grills-Taquechel, 2007). It has been found that about one-third of the etiological variance associated with childhood anxiety disorders could be
genetic or a temperamental predisposition develops an anxiety disorder (Rapee & Spence, 2004), revealing the potential role of environmental factors.
Young children spend most of their time in the family environment were they model the behaviours they see from their parents (Parson, Adler & Kaczala, 1982); so parental behaviour may be assumed to particularly influence children at this period. Parenting behaviour and modelling of anxious behaviour (parental state anxiety) are among the most important environmental factors that have been suggested to play a role in the development of social anxiety (Rapee & Spence, 2004). Social learning theories of social anxiety suggest that when a child does not get any adequate instructions or modelling from their parents (parenting behaviour) this may increase their risk of developing social anxiety. A phenomenon that occurs in young children that could contribute tot the development of anxiety disorders via parental behaviour is called social referencing (Feinman, 1982). Social referencing (SR) concerns the way in which children form their own opinion about a certain situation by looking at the interpretation of that situation by someone else, in most cases their parents (Feinman & Lewis, 1983). Children start to look at their caregivers to regulate their behaviour when they are confronted with novel stimuli (Murray et al, 2008). So when a parent acts anxious towards a stranger the child may model this behaviour and become anxious towards the stranger as well (state anxiety). Two processes may be involved in SR: one indirect process and one direct process. The indirect process concerns the child’s learning by observation of their parents’ behaviour and affect (Feinman & Lewis, 1983) and modelling of these behaviours (Gerull & Rapee, 2002). The direct process concerns the way in which the parent talks to the child concerning the environment (Feinman & Lewis, 1983). It has been found that the SR process starts in infants from around 10 months old (Murray et al., 2008; Aktar et al., 2013).
The diathesis-stress model states that some individuals are more adversely affected by environmental factors due to a vulnerability in their temperament (Belsky & Pluess, 2009; Ingram & Luxton, 2005; Monroe & Simons, 1991), for example BI. According to this model some children may be more adversely affected by the anxiety of their parents due to their behaviourally inhibited temperament. The differential susceptibility hypothesis states that some individuals with a vulnerability are not only more adversely affected by negative environmental factors but also benefit more from positive environmental factors (Belsky, 1997; Belsky & Pluess, 2009). First, using a SR paradigm De Rosnay, Cooper, Tsigaras and Murray (2006) investigated the
influence of indirect maternal expressions of fear on socially anxious behaviour in children (between 12 and 14 months old). Mothers (N=24) were trained to act in a socially anxious way towards a stranger. Infant BI was measured via questionnaires and observations during the experiment. Mother-infant pairs were observed during two situations: the mother was instructed to interact with the stranger either like she normally would or in a socially anxious manner. They found that children were significantly more fearful towards the stranger when their mother acted in a socially anxious manner compared to when she acted in a normal way towards the stranger. In addition, they found that children with an inhibited/fearful temperament were
especially vulnerable to the effects of maternal social anxiety: such that behaviourally inhibited infants were significantly more avoidant in the socially anxious condition than non-behaviourally inhibited infants. Second, Murray and colleagues (2008) examined two groups of mothers with their child in a longitudinal design (at 10 and 14 months); a group of mothers with SAD (N=79) and a group of mothers without anxiety problems (N=77). Infant BI was also measured, via observational tasks. They found that children of mothers with SAD became more avoidant of strangers from 10 to 14 months. In addition, they found that mothers with SAD showed more anxiety during the experiment and were less encouraging, resulting in more infant avoidance. This led to the greatest increase in avoidance in inhibited children from socially anxious mothers and the least increase in inhibited children from comparison mothers. More recently Aktar, Majdandzic, de Vente and Bögels (2013) also found that infant avoidance during the SR situations was predicted by the interaction between
expressed parental anxiety and infant BI. In this study 122 couples participated with their child (12 months old). They used two SR situations; both expressed parental anxiety and infant fear and avoidance were observed during these tasks. The ADIS was used to determine the anxiety status of the parent and separate BI tasks were used to determine the child’s BI. They found that the association between expressed
parental anxiety and infant avoidance was not significant for infants with low BI and parents with low levels of expressed anxiety. However, this association was
significant for children with moderate to high levels of BI who also had a parent that showed moderate to high levels of parental anxiety. They concluded that this finding is inline with the differential susceptibility hypothesis (Belsky, 1997; Belsky & Pluess, 2009).
Most of the studies focusing on the development of anxiety have only taken maternal anxiety into account. Until recently, the role of fathers was neglected in terms of their influence on the development of anxiety in their children. Bögels and Phares (2008) suggest that fathers play a different role than mothers in the
development of their children. Mothers would be important for caring for their children whereas fathers would be more important for play (Paquette, 2004). Men seem to stimulate their children through physical play, which learns them to stand up for themselves and to not be anxious/nervous in novel situations. Furthermore, it has been suggested that fathers would be especially important for the development of autonomy and socialisation of their children. Bögels and Perotti (2011) see this difference from an evolutionary point of view. They argue that woman were traditionally more involved in caring for their children, which they call ‘internal protection’, and men were more involved in protecting their families from the outside world, ‘external protection’. As a result of this difference children would be more prone to look to their fathers for signals about the external world (e.g. social interactions). In addition, Bögels and Melick (2004) found that paternal, and not maternal autonomy-overprotection was related to child anxiety. Recently, Aktar and colleagues (2013) studied the difference between expressed paternal and maternal anxiety on infant (12 months old) avoidance via a SR paradigm. They did not find a difference between the associations of expressed paternal and maternal anxiety with infant avoidance, and concluded that there is no difference in the role that fathers and mothers play in the transmission of anxiety at 1-year.
Because most of the studies focussing on the development of SAD look at infants, not much is know about the processes involved in the development of SAD in older children. This is the reason why in this study, 2,5 year old children and their parents (both mothers and fathers) were observed during a SR situation. Parents were asked to behave like they would in normal life, so their response to the stranger was not experimentally manipulated. Expressed parental anxiety (parental state anxiety) and infant avoidance and fear (toddler state anxiety) were measured using
observations from this SR situation. To diagnose parental anxiety (parental trait anxiety), we used the Anxiety Disorder Interview Schedule (Ni Nardo, Brown & Barlow, 1994). To measure toddler BI (toddler trait anxiety) we used self-reports of mothers and fathers in the shortened version of the Early Childhood Behaviour Questionnaire (Putnam, Gartstein & Rothbart, 2006).
Because there seems to be a strong link between infant BI and parental SAD and given the increased risk that highly inhibited children seem to have for
developing SAD themselves, the first research question that was investigated in the present study is whether there is a difference in the BI levels of children with or without parents with SAD in the present sample. Considering previous evidence showing that there are genetic components associated with childhood anxiety (Eley, 2001) it is hypothesized that children of parents with SAD will show significantly higher levels of BI compared to children of parents without SAD. Second, we investigated whether children of parents who show high levels of expressed anxiety were more fearful and/or avoidant in the SR situation. Based on previous studies using a SR paradigm that have shown that mothers with SAD showed more anxiety during their experiment which resulted in more infant avoidance (Murray et al., 2008), it is expected that when parents act more anxious, children will model this behaviour towards the stranger and also become more fearful and avoidant.
Furthermore, we looked at the interaction between the levels of expressed parental anxiety and the levels of toddler BI on toddler fear and avoidance. Based on the diathesis-stress model (Belsky & Pluess, 2009; Ingram & Luxton, 2005; Monroe & Simons, 1991) and the differential susceptibility hypothesis (Belsky, 1997; Belsky & Pluess, 2009), we expected to find a significant interaction between parental
expressed anxiety and toddler BI. Third, because the role of paternal anxiety on children has not been studied in detail, only in infancy (Aktar et al., 2013) and not in toddlerhood, we explored the differences in the effect of paternal and maternal (expressed and diagnosed) anxiety on the degree of anxiety and avoidance of their children. Considering the evolutionary theory of Bögels and Perotti (2001) it is hypothesized that children will be more fearful/avoidant when their fathers are anxious compared to when their mothers are anxious. We expect to find an effect of paternal expressed anxiety, since this theory is talking about signals about the external world. Finally, we investigate whether parents with (versus without) SAD would express more anxiety during the SR situation.
Method
Participants
Participants were recruited via flyers, which were given out at midwife practices and baby shops in Amsterdam, Den Haag and Utrecht. Including criteria where that the parents were expecting their first child and had to speak fluent Dutch or English. The child had to have a birth weight of at least 2500 gram, an Apgar-score of 8 or higher and could not have any neurological defects. At the 2,5 year
measurements 117 families participated. In total, 116 mothers participated in the SR experiment of which 53 mothers were diagnosed with SAD and 114 fathers
participated in the experiment of which 42 were diagnosed with SAD. The study was approved by the ethics committee of the Department of Psychology and the
participants gave written consent prior to their participation.
Procedure
All the measurements took place at the Research Centre for Parent and Child from the University of Amsterdam and were a part of the longitudinal study called ‘The social development from baby to preschooler’. Central to this study is the development of social anxiety, shyness and confidence in children. At each measurement point, both parents came separately to the research centre with their child (so the child will be tested twice at each point in time, once with their mother and once with their father). The 2,5 year measurements were used for this study.
Instruments
Parental social anxiety status
To diagnose lifetime SAD in parents the Anxiety Disorder Interview Schedule (ADIS) was used (Ni Nardo, Brown & Barlow, 1994). This interview was completed in the prenatal measurements. The ADIS is a semi-structured interview, which uses the DSM-IV criteria to assess whether someone has an anxiety disorder. The ADIS was conducted at the prenatal measurements by three experienced interviewers with a master’s degree in Educational Sciences or Psychology. To ensure inter-observer reliability the interviewers were supervised by an experienced clinically registered psychologist. The inter-observer reliability ranged from 90% to 100% with a mean of 97.55% (SD=2.95).
Toddler BI
At the 2,5 year measurements both parents filed in the shortened version of the Early Childhood Behaviour Questionnaire (ECBQ) (Putnam, Gartstein & Rothbart, 2006). This questionnaire uses parental-reports to asses temperament in 1,5 to 3 year old children. The questionnaire consisted of 107 items, which were made up of 7-point Likert-style items in which 1 stood for ‘never’ and 7 for ‘always’. The scales used for this study were the fear scale (6 items) and the shyness scale (6 items). There is no information available about the psychometric characteristics of the shortened version of the ECBQ. However the normal version of the ECBQ is reliable, as well as the fear scale (α = .85 at 30 moths old) and the shyness scale (α = .85 at 30 months old) (Putnam, Gartstein & Rothbart, 2006).
Social Referencing task
Two social referencing (SR) tasks were performed during each measurement, first the ‘stranger SR task’ and second the ‘dinosaur SR task’. Only the stranger SR task was used for this study. The stranger SR task consisted of three stages. In the first stage the stranger came into the room and sat opposite of the parent and the child, who were sitting at a little table. The stranger then talked for two minutes with the parent about his/her experiences with raising their child. During this talk the stranger did not pay any attention to the child, the parent was instructed to act normally
towards his/her child. For coding, this stage was divided into two equal epochs of one minute each. In stage two the stranger told the parent she wanted to read a book with the child, and asked the parent to ask his/her child to sit next to her. This stage was also divided into two smaller epochs, the first epoch lasts 20 seconds and the last epoch ended when the child was next to the stranger. In the final stage the stranger read a book with the child whilst the parent remained seated at the table. This stage consisted of four epochs; each epoch started when the stranger starts telling a story and ends when she turns the page to read the following story. The last coding epoch started when the stranger closes the book and ends when the stranger had left the room.
The coding protocol that was used was derived from a 1-year protocol
developed by Murray and colleagues (2008) researching infant and parent behaviour. Several different measures were coded for both children and parents, important for
this study were: toddler fearfulness, toddler avoidance and expressions of parental anxiety. Two students were trained to code the toddler measures and two students were trained to code the parental measures. Each toddler-coder coded either mother or father from one family, same with the parent-coders; except for 20% of the files witch were coded by both students from each pair to measure inter-observer reliability. The intraclass correlations were satisfactory: .90 for parental anxiety, .89 for infant fear and .95 for infant avoidance.
Toddler stranger fearfulness was coded based on facial, bodily and vocal indications of fear, which for example could be manifested as wide eyes, a frozen body and crying. Toddler stranger fearfulness was scored on a 5-point scale in which a score of 1 was given for ‘no fearfulness’ and 5 for ‘very intense fearfulness’. The intensity of a given expression of fear was given more weight than the persistence of an expression. Toddler-stranger avoidance was also scored on a 5-point scale in which intensity was given more weight than persistence. Toddler-stranger avoidance could, for example be displayed as walking away from the stranger, looking away, turning the head away from the stranger or ignoring the stranger. Parental anxiety was coded based on facial, bodily and conversational manifestations of anxiety, for example frozen expressions, rapid blinking, motionless body or giving very short answers in the conversation. Parental anxiety was scored on a 5-point scale in which 1 stood for ‘no anxiety’ and 5 for ‘very intense anxiety’.
Statistical Analyses
SPSS version 20 was used for the statistical analysis. Observations from the mother and the father visits were analyzed separately for each research question. Research questions were investigated with between subjects anova’s and ancova’s. Parental SAD diagnosed with the ADIS was a categorical variable (0: no-diagnosis; 1: diagnosis). Toddler BI measured with the ECBQ was a continuous variable (ranging from 1: no behavioural inhibition, to 7: very behaviourally inhibited). Expressed parental anxiety (ranging from 1: no anxiety, to 5: very intense anxiety) and toddler fear and avoidance (ranging from 1: no fear or avoidance, to 5: very intense fear or avoidance) were all continuous variables, which were obtained by averaging the scores across the epochs of the SR observations.
Results
To investigate the difference in the BI levels of toddlers of parents with and without SAD a between subjects anova was used with the independent variable social anxiety diagnosis. The dependent variable was children’s BI measured with the ECBQ, averaged across parent reports. ECBQ scores were submitted to a 2 (mothers (0: no-diagnosis; 1: diagnosis)) by 2 (fathers (0: no-diagnosis; 1: diagnosis)) anova, which revealed a non-significant effect of maternal as well as paternal SAD on ECBQ scores. The model explains 2,3% of the variance in toddler BI (see table 1). Children of parents who both had SAD (M=4,14, SD=.68) showed similar BI levels to children of parents without SAD (M=4,11, SD=.43). These findings suggest that parental social anxiety status did not significantly predict the degree of BI in their children. However, the interaction between maternal social anxiety status and gender of the child (0: girl; 1:boy) was significant, implying a differential effect of maternal social anxiety diagnosis on girls versus boys. Posthoc tests revealed a significant difference among boys and girls of mothers without SAD, F(1,1)=4,94, p<.05, whereas this difference was not significant among toddlers of mothers with SAD, or among fathers. Girls of mothers without SAD (M=4,26, SD=.08) were significantly more behaviourally inhibited then boys of mothers without SAD (M=4,08, SD=.09). This effect was not found for mothers with SAD.
To investigate the impact of expressed parental anxiety and parental SAD on the levels of toddler fear and avoidance, between subjects ancova’s were used with the independent variables of parental anxiety disorder and gender of the child (0=girl, 1=boy). Expressed parental anxiety was entered as a covariate. We also added the ECBQ scores as a covariate and the interaction between ECBQ scores and expressed parental anxiety. The dependent variables were toddler fear and toddler avoidance. Mothers and fathers were analysed in separate ancova’s. Results are presented in Table 2 (mothers) and Table 3 (fathers). The analysis showed that neither maternal expressed anxiety nor diagnosed maternal social anxiety predicted toddler fear (R2=.05) or toddler avoidance (R2=.04). Expressed paternal anxiety did not significantly predict toddler fear (R2=.11) or toddler avoidance (R2=.06) either. However, the effect of SAD in fathers predicted toddler fear and toddler avoidance (marginally significant), such that children of fathers with SAD were more fearful (M=2,49, SD=.45) and avoidant (M=2,68, SD=.64) compared to children of fathers
without SAD (M=2,23, SD=.51 and M=2,45, SD=.75 respectively). Infant gender was not significant in any of the models. In other words, these findings suggest that expressed or diagnosed parental anxiety did not predict toddler fear or avoidance in the SR situation, except for the children of fathers with diagnosed SAD who where significantly more fearful and marginally more avoidant compared to children from fathers without SAD.
Furthermore we also looked at the interaction between maternal and paternal expressions of anxiety and the BI levels of their children. None of these significantly predicted toddler fear or avoidance. These findings suggest that children with high levels of BI who have parents that show high levels of anxiety during the SR situation are not significantly more fearful or avoidant in the SR situation compared to children with low levels of BI who have parents that show low level of anxiety.
Another between subjects anova was conducted to investigate the difference in the parental expressions of anxiety in the SR situation among parents with versus without SAD. Expressed parental anxiety was the dependent variable. To investigate the effect of maternal and paternal diagnostic status (independent variable) on the levels of expressed parental anxiety, two separate analyses were run with maternal and paternal expressions of anxiety analyzed in separate models. Results are presented in Table 4. The analyses revealed that mothers as well as fathers showed significantly more anxiety in the SR situation when they had SAD. The model for mothers explained 3,5% of the variance in expressed maternal anxiety and the model for fathers explained 5,1% of the variance in expressed paternal anxiety. The mean level of expressed anxiety of mothers (M=3,43, SD=.67) and fathers (M=3,48,
SD=.28) with SAD significantly differed from the mean level of expressed anxiety of mothers (M=3,31, SD=.30) and fathers (M=3.34, SD=.30) without SAD. This finding suggest that mothers and fathers with SAD showed significantly more anxiety in the SR situation in comparison to parents without SAD.
Discussion
In this study the intergenerational transmission of social anxiety was studied using 2,5-year old children and their parents. The associations of parental trait and state anxiety with toddlers’ trait and state anxiety were examined. First, the difference in the BI levels of children of parents with and without SAD was investigated. Based
on previous studies finding links between infant BI and parental SAD (Aktar, Majdandzic, de Vente & Bögels, 2013; Hirshfeld-Becker et al., 2007; Muris et al., 2010; Rosenbaum et al., 1988; Rosenbaum et al. 1992), we expected that children from parents with SAD would be more behaviourally inhibited compared to children from parents without SAD. Also, considering the genetic load associated with the development and maintenance of childhood anxiety (Eley, 2001), we expected to find a relation between parental SAD and toddler BI. In contrast with these hypotheses, this study did not find a significant relation between parental SAD and toddler BI. This suggests that there is no significant difference in the effect that parents with and without SAD had on the degree of BI in their children. It is difficult to explain why we did not find a relationship between parental SAD and infant BI. One reason could be because parental anxiety status was determined during the prenatal measurements only. So whether or not parents are still dealing with anxiety problems at this
measurement point is not known. However, if there would indeed be a genetic load associated with the development of childhood anxiety (Eley, 2001), the current anxiety status of parents would not be important for our findings because children would already have a genetic predisposition for developing SAD.
It was found that girls from mothers without SAD were significantly more behaviourally inhibited in comparison to boys from mothers without SAD. According to previous studies, females would be more susceptible for developing an anxiety disorder in comparison to males (Lewinsohn, Lewinsohn, Gotlib, Seeley, & Allen, 1998; McLean, C. P., Asnaani, I., Litz, B. T., & Hofmann, S. G., 2011; Yonkers & Gurguis, 1995). Furthermore, some studies have found that SAD prevalence rates would be higher for woman than for man (Kessler et al., 1994; Yonkers & Gurguis, 1995) In contrast, other studies found that SAD would be the only anxiety disorder that has equal prevalent rates for man and woman (Bögels & Perotti, 2011; McLean et al., 2011). So the difference that was found in this study between boys and girls from mothers without SAD could be an argument in favour for the standpoint that there are gender differences in the prevalence of SAD. It is possible that girls are more
susceptible for developing SAD in comparison to boys. However, if there were differences in the prevalence rates of SAD amongst boys and girls we would also expect to find gender differences for children of parents with SAD and fathers without SAD.
Second, the impact of expressed parental anxiety and diagnosed parental anxiety on the levels of fearfulness and avoidance in their children was examined. In contrast with the SR paradigm (Feinman & Lewis, 1983), we found that neither maternal nor paternal expressions of anxiety had a significant effect on toddler fear or avoidance in this study. This is also in contrast with a recent SR study examining 1-year old infants (Aktar et al., 2013) who found that expressed parental anxiety seemed to be a better predictor of infant avoidance compared to parental diagnosed social anxiety. A potential reason why a relation between expressed parental anxiety and toddler fear and avoidance was not found in the present study could be due to the fact that this research examined 2,5-year old children. It may be argued that there is a change in the mechanisms involved in the SR situation from infancy to toddlerhood years. At 2,5-years old, children are more experienced in interacting with strangers and are more confident in relying on their own interpretation of a certain situation (Degnan & Fox, 2007). So they do not have to look at their parents’ reaction towards a stranger to adjust their own reaction accordingly, making SR not as meaningful at 2,5-years anymore as it was at a younger age.
Next, it was found that paternal, and not maternal diagnosed social anxiety predicted toddler fear and avoidance in the SR situation. Children of fathers with SAD were more fearful in comparison to children of fathers without SAD, whereas this difference was only marginal for avoidance, and not significant for mothers. Based on the evolutionary theory of Bögels and Perotty (2011) we did expect to find that paternal anxiety would influence toddler fear and avoidance more than maternal anxiety. The fact that we found a significant effect of paternal diagnostic status could mean that there is indeed a genetic load associated with the development of SAD, especially for fathers. Because we have also found that parents with SAD express more anxiety during the SR situation, it could also be that children of fathers with SAD have already learned from previous SR experiences to be wary of strangers. So although they do not have to look at the expressions of their fathers anymore, they have already internalized their responses towards a stranger.
No evidence was found in favour of the differential susceptibility hypothesis: the interaction between parental expressed anxiety and toddler BI on toddler
fearfulness and avoidance was not significant for mothers or fathers. This is in contrast with previous studies (Aktar et al., 2013; Murray et al., 2008; de Rosnay et al., 2006). A difference with the current study is that this study examined 2,5-year old
children. As mentioned above the mechanisms involved in the transmission of anxiety at this age may be different to the transmission of anxiety at a younger age. Also these studies used systematic observations of BI whereas we used the ECBQ questionnaire to establish toddler BI. It may be that expressed parental anxiety in the SR situation (observation) does not predict toddler BI due to differences in measurement. However previous studies have found maternal reports on the temperament of their children to be of fairly good consistency (Coplan, Rubin, Fox, Calkins, & Stewart, 1994; Rosnay et al., 2004; Rothbart, 1981; Sanson, Pedlow, Cann, Prior, & Oberklaid, 1996). Sanson and colleagues (1996) suggest using multiple measures of temperament since maternal reports have the advantage of measuring behaviour seen over time and situations whereas observations would be more specific and objective.
Third, the difference in the parental expressions of anxiety in the SR situation among parents with versus without SAD was investigated. Previous studies have shown that mothers with SAD showed more anxiety in a SR situation in comparison to mothers without SAD (Murray et al., 2008). Also, Aktar and colleagues (2013) found that mothers as well as fathers with SAD showed more anxiety during their SR experiment with 1-year old children. In line with these previous findings, this study also found that mothers and fathers showed more anxiety during the SR situation when they had SAD, compared to parents who did not have SAD. This makes sense because parents are aware that they are being filmed by the cameras in the room and that there are people watching them from behind a one-way mirror during the experiment. It may be that this is a situation that is especially anxiety provoking for people with SAD. Whilst we did find that parents with SAD express more anxiety during the SR situation, we did not find a link with toddler fear and avoidance as was expected. As mentioned earlier, it is possible that the mechanisms involved in the transmission of anxiety are different at 2,5-years old compared to 1-years old.
A number of limitations should be taken into account. First, fathers and mothers were analyzed separately in this study, and the dependence stemming from repetition of the same task with mother and father has not been accounted for. Second, BI was studied using a questionnaire, for future research it would be recommended to use systematic observations of BI alongside parental reports of BI (Sanson et al., 1996). Third, we did not separately investigate the direct process of SR. It is possible that the way parents talk to their child about the situation influences the levels of fear and avoidance of their children (Mumme, Fernald & Herrera, 1996).
Also, because the influence of paternal anxiety on their children has only been studied with 1-year old infants (Aktar et al., 2013) and with 2,5-year old children in this study, this influence should be studied more longitudinally. At 1-year old no effect of paternal anxiety on infant fear and avoidance was found (Aktar et al., 2013). Whereas in this study, using 2,5-year old children, we did find an effect of paternal anxiety on toddler fear and avoidance. It would be interesting to see how this process develops in the coming years, as the children get older.
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Appendix
Table 1
The Effect of Diagnosed Parental Anxiety on Toddler BI
Source df Mean
square
F p
Corrected model 5 .39 1,74 .132
Intercept 1 1717,60 7643,55 .000
Maternal social anxiety status
1 .13 .57 .451
Paternal social anxiety status
1 .43 1,93 .168
Gender child 1 .01 .03 .875
Maternal social anxiety status * Gender child
1 .97 4,29 .041*
Paternal social anxiety status * Gender child
1 .18 .81 .369
Note. a. R Squared = .02 (Adjusted R Squared = -.005). * p<.05, two-tailed test.
Table 2
The Effect of Maternal Diagnosed and Expressed Anxiety on Toddler Fear and Avoidance
Toddler Fear Toddler Avoidance
Source df Mean square F p df Mean square F p Corrected Model 6 .24 .87 .517 6 .39 .74 .619 Intercept 1 .05 .17 .685 1 .52 1,00 .320 Maternal social anxiety status 1 .23 .83 .366 1 .27 .52 .473 Gender Child 1 .11 .41 .522 1 .03 .06 .802 Expressed maternal anxiety 1 .00 .01 .933 1 .18 .35 .557 Toddler BI 1 .00 .00 .980 1 .31 .59 .443 Expressed maternal anxiety * Toddler BI 1 .00 .01 .925 1 .33 .63 .431 Maternal social anxiety status * Gender child 1 .20 .71 .402 1 .07 .14 .711
Note. a. R Squared = .05 (Adjusted R Squared = -.007). b. R Squared = .04 (Adjusted R Squared = -.015).
Table 3
The Effect of Paternal Diagnosed and Expressed Anxiety on Toddler Fear and Avoidance
Toddler Fear Toddler Avoidance
Source df Mean square F p df Mean square F p Corrected Model 6 .46 2,02 .070 6 .5 .99 .438 Intercept 1 .34 1,47 .228 1 .05 .10 .749 Paternal social anxiety status 1 1,42 6,22 .014* 1 1,55 3,07 .083 Gender Child 1 .17 .76 .387 1 .10 .20 .659 Expressed paternal anxiety 1 .60 2,63 .108 1 .18 .36 .548 Toddler BI 1 .61 2,69 .104 1 .22 .45 .506 Expressed paternal anxiety * Toddler BI 1 .66 2,90 .092 1 .24 .48 .491 Paternal social anxiety status * Gender child 1 .12 .53 .467 1 .45 .89 .348
Note. a. R Squared = .11 (Adjusted R Squared = .054). b. R Squared = .06 (Adjusted R Squared = -,001). * p<.05, two-tailed test.
Table 4
The Effect of Diagnosed Maternal and Paternal Social Anxiety on Expressed Maternal and Paternal Anxiety
Mother Father Source df Mean square F p df Mean square F p Corrected model 1 .45 4,12 .045 1 .51 6,06 .015 Intercept 1 1309,13 12016,74 .000 1 1232,67 14550,52 .000 Parental social anxiety status 1 .50 4,12 .045* 1 .51 6,06 .015*
Note. a. R Squared = .04 (Adjusted R Squared = .026). b. R Squared = .05 (Adjusted R Squared = .043). * p<.05, two-tailed test.
