Family functioning and quality of life among children with anxiety disorder and healthy controls. A cross-sectional study
Keywords:
Anxiety disorders, Child, Family, Quality of lifeAbstract
BACKGROUND: Studies have shown that children with anxiety disorders (ADs) present impaired family functioning and quality of life. We aimed to evaluate family functioning and quality of life among children with AD and healthy controls. DESIGN AND SETTING: Cross-sectional study (survey) at two centers in Turkey. METHODS: The study group comprised 42 children diagnosed with AD and 55 controls. The Screen for Child Anxiety-Related Emotional Disorders (SCARED) questionnaire was filled out by their parents to measure the severity of anxiety symptoms. Family functioning among the children was assessed using the Family Assessment Device (FAD) and Parental Attitude Research Instrument (PARI). The children’s quality of life was assessed through the Pediatric Quality of Life Inventory (PedsQL). RESULTS: The children’s average age was 10.00 ± 0.21 years in the AD group and 9.98 ± 1.53 years among the controls. There were higher scores on all FAD subscales in the AD group (2.15 ± 0.52; 2.29 ± 0.44; 2.44 ± 0.55; 2.10 ± 0.61; 2.56 ± 0.40; 2.32 ± 0.33; and 2.29 ± 0.47). On PARI subscales, there were significant differences favoring the AD group (p < 0.05), except for democratic attitude. All PedsQL subscales differed significantly between the groups, favoring the AD group. A statistically significant relationship was found between all PedsQL subscales and SCARED scores in the AD group. CONCLUSION: We found that both family functioning and quality of life among children with AD were negatively affected. However, further studies with larger sample sizes are required to reach stronger conclusions.
Downloads
References
Kessler RC, Berglund P, Demler O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arc Gen Psychiatry. 2005;62(6):593-602. PMID: 15939837; doi: 10.1001/archpsyc.62.6.593.
Grills AE, Ollendick TH. Peer victimization, global self-worth, and anxiety in middle school children. J Clin Child Adolesc Psychol. 2002;31(1):59-68. PMID: 11845651; doi: 10.1207/S15374424JCCP3101_08.
Ramsawh HJ, Weisberg RB, Dyck I, et al. Age of onset, clinical characteristics, and 15-year course of anxiety disorders in a prospective, longitudinal, observational study. J Affective Disord. 2011;132:260-4. PMID: 21295858; doi: 10.1016/j.jad.2011.01.006.
Wehry AM, Baesdo-Baum K, Hennely MM, et al. Assessment and treatment of anxiety disorders in children and adolescents. Curr Psychiatry Rep. 2015;17(7):52. PMID: 25980507; doi: 10.1007/s11920-015-0591-z.
Mendlowicz MV, Stein MB. Quality of life in individuals with anxiety disorders. Am J Psychiatry. 2000;157:669-82. PMID: 10784456; doi: 10.1176/appi.ajp.157.5.669.
Mogotsi M, Kaminer D, Stein DJ. Quality of life in the anxiety disorders. Harv Rev Psychiatry. 2000;8:273-82. PMID: 11133822.
Rapaport MH, Clary C, Fayyad R, et al. Quality-of-life impairment in depressive and anxiety disorders. Am J Psychiatry. 2005;162(6):1171-8.
Kang EH, Kim B, Choe AY, et al. Panic disorder and health-related quality of life: the predictive roles of anxiety sensitivity and trait anxiety. Psychiatry Res. 2015;30:225(1-2):157-63. PMID: 25466228; doi: 10.1016/j.psychres.2014.10.029.
Sawyer MG, Whaites L, Rey JM, et al. Health-related quality of life of children and adolescents with mental disorders. J Am Acad Child Adolesc Psychiatry. 2002;41(5):530-7. PMID: 12014785; doi: 10.1097/00004583-200205000-00010.
Bastiaansen D, Koot HM, Ferdinand RF, et al. Quality of life in children with psychiatric disorders: self, parent, and clinician report. J Am Acad Child Adolesc Psychiatry. 2004;43(2):221-30. PMID: 14726730; doi: 10.1097/00004583-200402000-00019.
Jonsson U, Alaie I, Löfgren Wilteus A, et al. Annual Research Review: Quality of life and childhood mental and behavioural disorders - a critical review of the research. J Child Psychol Psychiatry. 2017;58(4):439-69. PMID: 27709604; doi: 10.1111/jcpp.12645.
Martinsen KD, Neumer SP, Holen S, et al. Self-reported quality of life and self-esteem in sad and anxious school children. BMC Psychol. 2016;13:4(1):41. PMID: 27624487; doi: 10.1186/s40359-016-0153-0.
Rapee RM, Schniering CA, Hudson JL. Anxiety disorders during childhood and adolescence: origins and treatment. Annu Rev Clin Psychol. 2009;5:311-41. PMID: 19152496; doi: 10.1146/annurev.clinpsy.032408.153628.
Edwards SL, Rapee RM, Kennedy S. Prediction of anxiety symptoms in preschool-aged children: Examination of maternal and paternal perspectives. J Child Psychol Psychiatry. 2010;51(3):313-21. PMID: 19769584; doi: 10.1111/j.1469-7610.2009.02160.x.
Towe-Goodman NR, Franz L, Copeland W, et al. Perceived family impact of preschool anxiety disorders. J Am Acad Child Adolesc Psychiatry. 2014;53(4):437-46. PMID: 24655653; doi: 10.1016/j.jaac.2013.12.017.
Hettema JM, Neale MC, Kendler KS. A review and meta-analysis of the genetic epidemiology of anxiety disorders. Am J Psychiatry. 2001;158(10):1568-78. PMID: 11578982; doi: 10.1176/appi.ajp.158.10.1568.
Murray L, de Rosnay M, Pearson J, et al. Intergenerational transmission of social anxiety: The role of social referencing processes in infancy. Child Dev. 2008;79(4):1049-64. PMID: 18717906; doi: 10.1111/j.1467-8624.2008.01175.x.
Öndinger N. Investigation of anxiety levels in divorced and married mothers and their children. Archives of Neuropsychiatry. 2011;48(1):66-70. doi: 10.4274/npa.y5538.
Kaufman J, Birmaher B, Brent D, et al. Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997;36(7):980-8. PMID: 9204677; doi: 10.1097/00004583-199707000-00021.
Gökler B, Ünal F, Pehlivantürk B, et al. Reliability and validity of schedule for affective disorders and schizophrenia for school age children present and lifetime version - Turkish version (K-SADS-PL-T). Turk J Child Adolesc Ment Health. 2004;11(3):109-16. Available from: http://www.scopemed.org/?mno=33747 Accessed in 2018 (Apr 26).
Birmaher B, Khetarpal S, Brent D, et al. The screen for child anxiety related emotional disorders (SCARED): scale construction and psychometric characteristics. J Am Acad Child Adolesc Psychiatry. 1997;36(4):545-53. PMID: 9100430; doi: 10.1097/00004583-199704000-00018.
Çakmakçi FK. The reliability and validity study of the screen for child anxiety-related emotional disorders (SCARED) [thesis]. Kocaeli, Turkey: Kocaeli University, Faculty of Medicine; 2004.
Varni JW, Seid M, Rode CA. The PedsQL: measurement model for the Pediatric Quality of Life Inventory. Med Care. 1999;37(2):126-39. PMID: 10024117.
Memik NÇ, Agaoglu B, Coskun A, Karakaya I. The validity and reliability of pediatric quality of life inventory in 8-12 year old Turkish children. Turk J Child Adolesc Ment Health. 2008;15(2):87-98. Available from: http://www.scopemed.org/?mno=33006 Accessed in 2018 (Apr 26).
Schafer ES, Bell RQ. Development of a parental attitude research instrument. Child Dev. 1958;29(3):339-61. PMID: 13573503.
Küçük S. The validity of the Turkish form of the PARI subscales II, III, IV [thesis]. Istanbul (Turkish): Bogaziçi University, Faculty of Medicine; 1987.
Epstein NB, Baldwin LM, Bishop DS. The McMaster Family Assessment Device. J Marital Fam Ther. 1983;9(2):171-80. doi: 10.1111/j.1752-0606.1983.tb01497.x.
Bulut I. Handbook of Family Assessment Device (FAD) 1990; Ankara: Özgüzelis Press; 1990.
Wood JJ, McLeod BD, Sigman M, Hwang WC, Chu BC. Parenting and childhood anxiety: theory, empirical findings, and future directions. J Child Psychol Psychiatry. 2003;44(1):134-51. PMID: 12553416; doi: 10.1111/1469-7610.00106.
Rapee RM. Family factors in the development and management of anxiety disorders. Clin Child Family Psychol Rev. 2012;15(1):69-80. PMID: 22116624; doi: 10.1007/s10567-011-0106-3.
Yap MB, Pilkington PD, Ryan SM, Jorm AF. Parental factor associated with depression and anxiety n young people: a systematic review and meta-analysis. J Affect Disord. 2014;156:8-23. PMID: 24308895; doi: 10.1016/j.jad.2013.11.007.
Egger HL, Angold A. The preschool age psychiatric assessment (PAPA): A structured parent interview for diagnosing psychiatric disorders in preschool children. In: Del Carmen-Wiggins R, Carter A, editors. Handbook of infant, toddler, and preschool mental health assessment. New York Oxford University Press; 2004. p. 223-43.
Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care. 1992;30(6):473-83. PMID: 1593914.
Ravens-Sieberer U, Kidscreen Group Europe. The Kidscreen questionnaires: Quality of life questionnaires for children and adolescents. Germany: Pabst Science Publications Lengerich; 2009.
Weitkamp K, Daniels JK, Romer G, Wiegand-Grefe S. Health-related quality of life of children and adolescents with mental disorders. Health Qual Life Outcomes. 2013;11:129. PMID: 23902824; doi: 10.1186/1477-7525-11-129.
Ramsawh HJ, Chavira DA. Association of childhood anxiety disorders and quality of life in a primary care sample. J Dev Behav Pediatr. 2016;37(4):269-76. PMID: 27096571; doi: 10.1097/DBP.0000000000000296.
Çakin Memik N, Karakaya I, Yildiz Ö, et al. The effect of sertraline on the quality of life for children and adolescents with anxiety disorders. Noro Psikiyatr Ars. 2014;51(1):30-9. PMID: 28360592; doi: 10.4274/npa.y6565.
