Background

Anxiety disorders are the most common childhood-onset psychiatric disorders and are extensively associated with child functional impairment. Data suggest that family accommodation plays a role in the association between anxiety severity and functional impairment in children, but more empirical evidence is needed.

Methods

Participants were 425 clinically anxious children (ages 6–17 years), and their mothers. We first examined associations between child anxiety symptom severity, family accommodation, and child functional impairment. Next, we investigated the hypothesized mediation pathway linking anxiety severity to child impairment through increased family accommodation using structural equation modeling. We tested two models: one using parent ratings of their child’s anxiety and the other using the child’s self-ratings. Finally, we estimated the effect sizes of the mediation pathway in both models.

Results

Family accommodation was significantly correlated with all the study variables. Child functional impairment was significantly correlated with parent-rated and self-rated child anxiety severity. Both structural equation models provided excellent fit for the data and supported the theoretical model by which family accommodation significantly explains part of the association between anxiety symptoms and functional impairment. The indirect effect sizes indicate that family accommodation accounts for between a fifth and a half of the impairment associated with symptom severity.

Conclusions

The data provide important empirical evidence that family accommodation mediates the association between child anxiety and functional impairment and accounts for up to 50 % of this association. These findings contribute to the growing understanding of the critical role of family accommodation and underscore the importance of assessing accommodation when evaluating and treating anxious children.

中文翻译：

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家庭住宿介导儿童焦虑对功能障碍的影响

背景

焦虑症是最常见的儿童期精神障碍，与儿童功能障碍广泛相关。数据表明，家庭适应在儿童焦虑严重程度和功能障碍之间的关联中发挥作用，但需要更多的经验证据。

方法

参与者是 425 名临床焦虑的儿童（6-17 岁）和他们的母亲。我们首先检查了儿童焦虑症状严重程度、家庭适应和儿童功能障碍之间的关联。接下来，我们使用结构方程模型研究了通过增加家庭适应将焦虑严重程度与儿童障碍联系起来的假设中介途径。我们测试了两种模型：一种使用家长对孩子焦虑的评分，另一种使用孩子的自我评分。最后，我们估计了两种模型中中介途径的影响大小。

结果

家庭住宿与所有研究变量显着相关。儿童功能障碍与父母评定和自评定的儿童焦虑严重程度显着相关。两种结构方程模型都为数据提供了极好的拟合，并支持了理论模型，通过该模型，家庭适应显着解释了焦虑症状和功能障碍之间的部分关联。间接影响大小表明，家庭调节占与症状严重程度相关的损害的五分之一到二分之一。

结论

数据提供了重要的经验证据，表明家庭调节调解儿童焦虑和功能障碍之间的关联，并占该关联的 50%。这些发现有助于加深对家庭适应的关键作用的理解，并强调在评估和治疗焦虑儿童时评估适应的重要性。