FAMILY ACCOMMODATION IN PEDIATRIC ANXIETY DISORDERS

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Abstract

Background

Family accommodation has been studied in obsessive compulsive disorder using theFamilyAccommodationScale (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 theFamilyAccommodationScale—Anxiety (FASA) that includes modified questions from theFASto 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 theFASAfor 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 includedFASA, 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. TheFASAdisplayed 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 theFASApointed 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. TheFASAshows promise as a means of assessing family accommodation in childhood anxiety disorders.

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