Theoretical models of affectionate versus affectionless control in anxious families: a critical examination based on observations of parent-child interactions.

Psychosocial theories focused on the intrafamilial transmission of anxiety often concentrate on specific parenting behaviors that increase risk of anxiety disorders in children. Two such theories--affectionate versus affectionless control--both implicate parenting, although differently, in the pathogenesis of childhood anxiety. The present article reviews observational studies that focus on interactions between parents and children in anxious families in order to examine critically each of these two models. We divide these observational studies into two groups: those that seek to characterize the behavior of anxious parents (top-down studies) versus parents of anxious children (bottom-up studies). This approach reveals that there is a consistent relationship between controlling parental behavior in families with anxiety-disordered children as well as a consistent relationship between parental behavior low in warmth and families with anxiety-disordered parents. The present article discusses the implications of the pattern that unfolds from the observational studies of the last decade and provides suggestions for future research in the area.