Child & adolescent anxiety and family accommodation : exploring the role of cognitive coping

Research demonstrates that family accommodation is positively correlated with the severity of childhood anxiety. This is partially due to important familial factors (e.g., attachment, parenting style, parental psychopathology) in the psychogenesis of childhood anxiety disorders. Additionally, the onset and maintenance of anxiety disorders is linked with how children and adolescents cognitively process information (e.g., interpretation and confirmation biases). Effective coping strategies, especially cognitive strategies, are a critical component to aid in the management of anxiety. Therefore, due to a need for effective parental modeling to acquire these strategies, it was hypothesized that higher levels of family accommodation reduce opportunities to acquire cognitive coping, which then results in more severe anxiety. Using data from a large anxiety treatment study evaluating the effectiveness of cognitive behavioral therapy with an added parent component, ninety-three participants who met study criteria—primary diagnosis of Generalized Anxiety Disorder, Social Anxiety Disorder, or Separation Anxiety Disorder—completed measures at baseline to assess levels of family accommodation, cognitive coping, and anxiety severity. After completing exploratory factor analyses and exploratory structural equation modeling to validate an experimental measure of cognitive coping, data was evaluated using structural equation modeling to assess the presence of the hypothesized mediation. Results indicated a replication of prior research supporting the relationship between family accommodation and anxiety severity. Results did not support the presence of the hypothesized mediation. Additional analyses were performed to assess potential reasons behind this finding. Data suggested that the mediator variable, cognitive coping, may have been poorly assessed via the experimental measure and, therefore, an inaccurate representation of the construct. This may have influenced the presented findings. Additionally, it is possible that cognitive coping does not explain the relationship between family accommodation and anxiety severity in youth.