Valérie La Buissonnière-Ariza1, Sophie C Schneider1, Davíð Højgaard2, Brian C Kay3, Bradley C Riemann3, Stephanie C Eken4, Peter Lake3, Joshua M Nadeau5, Eric A Storch6. 1. Department of Pediatrics, Rothman Center for Neuropsychiatry, University of South Florida, 880 6th Street South, Suite 460, Box 7523, St. Petersburg, FL 33701, USA. 2. Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Denmark. 3. Rogers Memorial Hospital, 34700 Valley Road, Oconomowoc, WI 53066, USA. 4. Rogers Behavioral Health - Nashville, 4230 Harding Road, Suite 707, Nashville, TN 37205, USA. 5. Rogers Behavioral Health - Tampa, 2002, North Lois Ave, Tampa Bay, Tampa, FL, 33607, USA. 6. Department of Pediatrics, Rothman Center for Neuropsychiatry, University of South Florida, 880 6th Street South, Suite 460, Box 7523, St. Petersburg, FL 33701, USA; Rogers Behavioral Health - Tampa, 2002, North Lois Ave, Tampa Bay, Tampa, FL, 33607, USA; Department of Psychology, University of South Florida, 4202 East Fowler Ave, PCD4118G, Tampa, FL 33620, USA; Department of Psychiatry and Behavioral Neurosciences, University of South Florida, 3515 E. Fletcher Ave., Tampa, FL 33613, USA; Department of Health Management and Policy, University of South Florida, 13201 Bruce B. Downs Blvd., MDC56, Tampa, FL 33612-3805, USA; Johns Hopkins All Children's Hospital, 501 6th Avenue South, St. Petersburg, FL 33701, USA. Electronic address: estorch@health.usf.edu.
Abstract
BACKGROUND: Family accommodation is associated with a range of clinical features including symptom severity, functional impairment, and treatment response. However, most previous studies in children and adolescents investigated family accommodation in samples of youth with obsessive-compulsive disorder (OCD) or anxiety disorders receiving non-intensive outpatient services. AIMS: In this study, we aimed to investigate family accommodation of anxiety symptoms in a sample of youth with clinical anxiety levels undergoing an intensive multimodal intervention for anxiety disorders or OCD. PROCEDURES: We first assessed the internal consistency of the Family Accommodation Scale - Anxiety (FASA). We next examined family accommodation presentation and correlates. RESULTS: The FASA showed high internal consistency for all subscales and total score, and good item and subscale correlations with the total score. All parents reported at least mild accommodation, and the mean levels of family accommodation were particularly high. Child age, anxiety severity, and comorbid depressive symptoms predicted baseline accommodation. However, the association between anxiety severity and family accommodation no longer remained significant after adding the other factors to the model. In addition, family accommodation partially mediated the relationship between anxiety severity and functional impairment. Finally, post-treatment changes in family accommodation predicted changes in symptom severity and functional impairment. CONCLUSIONS: These findings suggest the FASA is an appropriate tool to assess family accommodation in intensive treatment samples. Further, they underline the importance of addressing family accommodation in this population given the particularly high levels of accommodating behaviors and the evidence for adverse outcomes associated with this feature.
BACKGROUND: Family accommodation is associated with a range of clinical features including symptom severity, functional impairment, and treatment response. However, most previous studies in children and adolescents investigated family accommodation in samples of youth with obsessive-compulsive disorder (OCD) or anxiety disorders receiving non-intensive outpatient services. AIMS: In this study, we aimed to investigate family accommodation of anxiety symptoms in a sample of youth with clinical anxiety levels undergoing an intensive multimodal intervention for anxiety disorders or OCD. PROCEDURES: We first assessed the internal consistency of the Family Accommodation Scale - Anxiety (FASA). We next examined family accommodation presentation and correlates. RESULTS: The FASA showed high internal consistency for all subscales and total score, and good item and subscale correlations with the total score. All parents reported at least mild accommodation, and the mean levels of family accommodation were particularly high. Child age, anxiety severity, and comorbid depressive symptoms predicted baseline accommodation. However, the association between anxiety severity and family accommodation no longer remained significant after adding the other factors to the model. In addition, family accommodation partially mediated the relationship between anxiety severity and functional impairment. Finally, post-treatment changes in family accommodation predicted changes in symptom severity and functional impairment. CONCLUSIONS: These findings suggest the FASA is an appropriate tool to assess family accommodation in intensive treatment samples. Further, they underline the importance of addressing family accommodation in this population given the particularly high levels of accommodating behaviors and the evidence for adverse outcomes associated with this feature.
Authors: Elizabeth R Kitt; Krystal M Lewis; Jordan Galbraith; Rany Abend; Ashley R Smith; Eli R Lebowitz; Daniel S Pine; Dylan G Gee Journal: Behav Res Ther Date: 2022-05-13
Authors: Marina Iniesta-Sepúlveda; Tíscar Rodríguez-Jiménez; Eli R Lebowitz; Wayne K Goodman; Eric A Storch Journal: Child Psychiatry Hum Dev Date: 2021-02
Authors: Pedro Macul Ferreira de Barros; Natália Polga; Natalia Szejko; Eurípedes Constantino Miguel; James Frederick Leckman; Wendy K Silverman; Eli R Lebowitz Journal: J Anxiety Disord Date: 2020-09-28