Volume 24, Issue 2 (Summer 2018)                   IJPCP 2018, 24(2): 164-175 | Back to browse issues page

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Sohrabzadeh Fard A, Hakim Shooshtari M, Alibaba S. Comparison of Psychopathology and Personality Traits in Three Groups of Mothers of Children With Anxiety Disorders, Obsessive-Compulsive Disorder and Healthy Group. IJPCP. 2018; 24 (2) :164-175
URL: http://ijpcp.iums.ac.ir/article-1-2756-en.html
1- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran
2- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran , E-mail: mitra_hakim2000@yahoo.com
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Extended Abstract
1. Introduction

Anxiety disorders are a group of most common and disabling mental disorders in children and adolescents. More than 10% of this age category suffer from anxiety disorders during their development [1, 2]. Diagnostic and Statistical Manual of Mental Disorders–fifth edition (DSM-5) has separated Obsessive-Compulsive Disorder (OCD) from the category of anxiety disorders and considered it as a distinct category [5]. Genetic factors have significant importance in development and persistence of anxiety. Correlation between psychiatric disorders in parents and children has been a main research area in child psychopathology, but the direct impact of different mental disorders in mothers on their children is not clear and yet to be identified [13]. Theatrical models of anxiety disorders in children emphasized the mutual relationship between parent and child under stressful environment [15, 16]. This study aims to compare personality traits and psychopathology in three groups of mothers of children with Anxiety Disorders, Obsessive-Compulsive Disorder, and healthy group.
2. Method
This research was a cross-sectional descriptive study. Study population was mothers of children with Anxiety Disorders, Obsessive-Compulsive Disorder, and healthy group. Mothers were interviewed with Structured Clinical Interview for DSM Disorders (SCID-I) and completed NEO Five-Factor Inventory (NEO-FFI-60). Sample size of 93 mothers (35 in anxiety group, 27 in obsessive group and 31 in healthy group) were selected, using available sampling.
3. Results
According to Figure 1, 40% mothers of children with anxiety disorders were diagnosed with an anxiety disorder, 17.4% diagnosed with depression and 20% diagnosed with comorbid anxiety and depression. In mothers of children with Obsessive-Compulsive Disorder, 25.9% had diagnosis of anxiety, 14.8% obsession, 14.8% depression and 22.25% comorbid anxiety and depression. Finally, in mothers of children in normal healthy group, diagnosis rate of anxiety disorders and depression was 16.2% and 3.2%, respectively. 
Results of multivariate analysis of variance showed significant statistical difference in neuroticism, extraversion and openness to experience between three groups of mothers (Table 1). The value of Chi-Square and significance level of P<0.001 indicate that there is a prominent difference between three groups in psychopathology of mothers and mean scores of all the groups indicate that psychopathology of mothers of children with anxiety and obsession is more than healthy group significantly (Table 2).

4. Discussion 
Findings indicate that the mean scores of the healthy group in neuroticism trait were lesser than anxiety and obsession group and the mean scores of obsession group in extraversion and openness to experience traits was lesser than anxiety and healthy group. With regards to psychopathology of mothers, results indicate that there is no significant difference in anxiety and obsession group; however, psychopathology in these two groups was significantly greater than healthy group. Despite important role of genetic heritability in children anxiety, which explain a considerable amount (at least one third) of variance, effect mechanisms of that are yet to be identified properly [18, 28]. Explaining this findings, along with emphasis on the role of inheritance as a predisposing factor in development of anxiety and obsessive-compulsive disorders in children, potential role of parent psychopathology related mediator variables such as caregiver stress, family structure malfunction, parent’s emotional dysregulation towards the child, dysfunctional modeling and reinforcement of maladjusted strategies (e.g. avoidance) could be mentioned [31, 33]. Results of this study marked that considering parent’s psychopathology in prevention and treatment of anxiety and obsessive-compulsive disorders in children may be of great importance.
Ethical Considerations
Compliance with ethical guidelines

In this research all ethical considerations such as informed consent, preservation of anonymity and secrecy, voluntary participation in the interview and assessment were observed. The project was approved by research ethics committee of the Iran University of Medical Science.
Funding
This research was extracted from the research project with code 25440 that was financially supported by the Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran.
Conflict of interest
No conflict of interest is reported for any of the contributing authors. 
Acknowledgements 
In the end, we thank all the participants who helped us complete this study.

 
References
  1. Smith AM, Flannery-Schroeder EC, Gorman KS, Cook N. Parent cognitive-behavioral intervention for the treatment of childhood anxiety disorders: A pilot study. Be-haviour Research and Therapy. 2014; 61:156-61. [DOI:10.1016/j.brat.2014.08.010] [PMID]
  2. Lebowitz ER, Omer H, Hermes H, Scahill L. Parent training for childhood anxiety disorders: the SPACE program. Cognitive and Behavioral Practice. 2013; 21(4):456-69. [doi:10.1016/j.cbpra.2013.10.004]
  3. Sadock BJ, Sadock VA. Synopsis of psychiatry. Classification in Psychiatry and Psychiatry Rating Scales. Philadelphia: Lippincot, Williams and Wilkins; 2003
  4. Rueter MA, Scaramella L, Wallace LE, Conger RD. First onset of depressive or anxiety disorders predicted by the longitudinal course of internalizing symptoms and parent-adolescent disagreements. Archives of General Psychiatry. 1999; 56(8):726-32. [DOI:10.1001/archpsyc.56.8.726] [PMID]
  5. American Psychiatric Association. The Diagnostic and Statistical Manual of Mental Disorders: DSM 5. Virginia: American Psychiatric Association; 2013.
  6. Freeman JB, Choate-Summers ML, Moore PS, Garcia AM, Sapyta JJ, Leonard HL, et al. Cognitive behavioral treatment for young children with obsessive-compulsive disorder. Biological Psychiatry. 2007; 61(3):337-43. [DOI:10.1016/j.biopsych.2006.12.015] [PMID] [PMCID]
  7. Barrett P, Farrell L, Dadds M, Boulter N. Cognitive-behavioral family treatment of childhood obsessive-compulsive disorder: Long-term follow-up and predictors of outcome. Journal of the American Academy of Child & Adolescent Psychiatry. 2005; 44(10):1005-14. [DOI:10.1097/01.chi.0000172555.26349.94] [PMID]
  8. Barton R, Heyman I. Obsessive–compulsive disorder in children and adolescents. Paediatrics and Child Health. 2016; 26(12):527-33. [DOI:10.1016/j.paed.2016.08.011]
  9. Hill C, Waite P, Creswell C. Anxiety disorders in children and adolescents. Paediatrics and Child Health. 2016; 26(12):548-53. [DOI:10.1016/j.paed.2016.08.007]
  10. Rockhill C, Kodish I, DiBattisto C, Macias M, Varley C, Ryan S. Anxiety disorders in children and adolescents. Current Problems in Pediatric and Adolescent Health Care. 2010; 40(4):66-99. [DOI:10.1016/j.cppeds.2010.02.002] [PMID]
  11. Hudson JL, Rapee RM. Parent–child interactions and anxiety disorders: An observational study. Behaviour Research and Therapy. 2001; 39(12):1411-27. [DOI:10.1016/S0005-7967(00)00107-8]
  12. Van Der Bruggen CO, Stams GJ, Bögels SM. Research review: The relation between child and parent anxiety and parental control: A meta-analytic review. Journal of Child Psychology and Psychiatry. 2008; 49(12):1257-69. [DOI:10.1111/j.1469-7610.2008.01898.x] [PMID]
  13. Nordahl HM, Ingul JM, Nordvik H, Wells A. Does maternal psychopathology discriminate between children with DSM-IV generalised anxiety disorder or opposition-al defiant disorder? The predictive validity of maternal axis I and axis II psychopathology. European Child & Adolescent Psychiatry. 2007; 16(2):87-95. [DOI:10.1007/s00787-006-0578-8] [PMID]
  14. Berg-Nielsen TS, Vikan A, Dahl AA. Parenting related to child and parental psychopathology: A descriptive review of the literature. Clinical Child Psychology and Psychiatry. 2002; 7(4):529-52. [DOI:10.1177/1359104502007004006]
  15. Ginsburg GS, Siqueland L, Masia-Warner C, Hedtke KA. Anxiety disorders in children: Family matters. Cognitive and Behavioral Practice. 2005; 11(1):28-43. [DOI:10.1016/S1077-7229(04)80005-1]
  16. Cobham VE, Dadds MR, Spence SH. The role of parental anxiety in the treatment of childhood anxiety. Journal of Consulting and Clinical Psychology. 1998; 66(6):893. [DOI:10.1037/0022-006X.66.6.893] [PMID]
  17. Liakopoulou M, Korlou S, Sakellariou K, Kondyli V, Kapsimali E, Sarafidou J, et al. The psychopathology of parents of children and adolescents with obsessive-compulsive disorder. Psychopathology. 2010; 43(4):209-15. [DOI:10.1159/000313518] [PMID]
  18. McClure EB, Brennan PA, Hammen C, Le Brocque RM. Parental anxiety disorders, child anxiety disorders, and the perceived parent–child relationship in an Australi-an high-risk sample. Journal of Abnormal Child Psychology. 2001; 29(1):1-10. [DOI:10.1023/A:1005260311313] [PMID]
  19. Pervin LA, Cervone DJ. Personality, theory and research. New York: John Wiley and Sons; 2005.
  20. Huver RM, Otten R, de Vries H, Engels RC. Personality and parenting style in parents of adolescents. Journal of Adolescence. 2010; 33(3):395-402. [DOI:10.1016/j.adolescence.2009.07.012] [PMID]
  21. Vreeke LJ, Muris P. Relations between behavioral inhibition, big five personality factors, and anxiety disorder symptoms in non-clinical and clinically anxious chil-dren. Child Psychiatry & Human Development. 2012; 43(6):884-94. [DOI:10.1007/s10578-012-0302-5] [PMID] [PMCID]
  22. Möller EL, Nikolić M, Majdandžić M, Bögels SM. Associations between maternal and paternal parenting behaviors, anxiety and its precursors in early childhood: A meta-analysis. Clinical Psychology Review. 2016; 45:17-33. [DOI:10.1016/j.cpr.2016.03.002] [PMID]
  23. Najmi SB, Hassanzadeh A. [On the relationship between personality traits of parents and type of the behavioral disorders of children (Persian)]. Fundamentals of Mental Health. 2010; 12(46):522-33. [doi:10.22038/jfmh.2010.1092]
  24. Sharifi V, Asadi SM, Mohammadi MR, Amini H, Kaviani H, Semnani Y et al. [Reliability and capability of administration of Persian version of SCID for DSM-IV (Persian)]. Advances in Cognitive Sciences. 2004; 6(1-2):10-22.
  25. Waters AM, Zimmer-Gembeck MJ, Farrell LJ. The relationships of child and parent factors with children’s anxiety symptoms: Parental anxious rearing as a mediator. Journal of Anxiety Disorders. 2012; 26(7):737-45 [DOI:10.1016/j.janxdis.2012.06.002] [PMID]
  26. Kerns KA, Brumariu LE. Is insecure parent–child attachment a risk factor for the development of anxiety in childhood or adolescence?. Child Development Perspectives. 2014; 8(1):12-7. [DOI:10.1111/cdep.12054] [PMID] [PMCID]
  27. Joshanloo M, Daemi F, Bakhshi A, Nazemi S, Ghafari Z. [Construct validity of NEO-personality inventory-revised in Iran (Persian)]. Iranian Journal of Psychiatry and Clinical Psychology. 2010; 16(3):220-30.
  28. Waters AM, Zimmer-Gembeck MJ, Farrell LJ. The relationships of child and parent factors with children’s anxiety symptoms: Parental anxious rearing as a mediator. Journal of Anxiety Disorders. 2012; 26(7):737-45. [DOI:10.1016/j.janxdis.2012.06.002] [PMID]
  29. Goodman R, Ford T, Meltzer H. Mental health problems of children in the community: 18 month follow up. BMJ. 2002; 324(7352):1496-7. [DOI:10.1136/bmj.324.7352.1496] [PMID] [PMCID]
  30. Wood JJ, McLeod BD, Sigman M, Hwang WC, Chu BC. Parenting and childhood anxiety: Theory, empirical findings, and future directions. Journal of Child Psychology and Psychiatry. 2003; 44(1):134-51.
  31. Schleider JL, Ginsburg GS, Keeton CP, Weisz JR, Birmaher B, Kendall PC, et al. Parental psychopathology and treatment outcome for anxious youth: roles of family functioning and caregiver strain. Journal of Consulting and Clinical Psychology. 2015; 83(1):213. [DOI:10.1037/a0037935] [PMID] [PMCID]
  32. Pirnia B, Rasoulzadeh Tabatabaei SK, Pirkhaefi A, Soleimani A. [Comparison of the Effectiveness of Two Cognitive-Behavioral and Mother-Child Interactive Therapies on Anxiety of Children With Under-Methadone Treatment Mother (Persian)]. Iranian Journal of Psychiatry and Clinical Psychology. 2017; 23(2):136-47. [DOI:10.29252/nirp.ijpcp.23.2.136]
  33. Cobham VE, Filus A, Sanders MR. Working with parents to treat anxiety-disordered children: A proof of concept RCT evaluating Fear-less Triple P. Behaviour Research and Therapy. 2017; 95: 128-38. [DOI:10.1016/j.brat.2017.06.004] [PMID]
Type of Study: Original Research | Subject: General
Received: 2017/09/12 | Accepted: 2017/12/24 | Published: 2018/07/24

References
1. Smith AM, Flannery-Schroeder EC, Gorman KS, Cook N. Parent cognitive-behavioral intervention for the treatment of childhood anxiety disorders: A pilot study. Be-haviour Research and Therapy. 2014; 61:156-61. [DOI:10.1016/j.brat.2014.08.010] [PMID] [DOI:10.1016/j.brat.2014.08.010]
2. Lebowitz ER, Omer H, Hermes H, Scahill L. Parent training for childhood anxiety disorders: the SPACE program. Cognitive and Behavioral Practice. 2013; 21(4):456-69. [DOI:10.1016/j.cbpra.2013.10.004] [DOI:10.1016/j.cbpra.2013.10.004]
3. Sadock BJ, Sadock VA. Synopsis of psychiatry. Classification in Psychiatry and Psychiatry Rating Scales. Philadelphia: Lippincot, Williams and Wilkins; 2003
4. Rueter MA, Scaramella L, Wallace LE, Conger RD. First onset of depressive or anxiety disorders predicted by the longitudinal course of internalizing symptoms and parent-adolescent disagreements. Archives of General Psychiatry. 1999; 56(8):726-32. [DOI:10.1001/archpsyc.56.8.726] [PMID] [DOI:10.1001/archpsyc.56.8.726]
5. American Psychiatric Association. The Diagnostic and Statistical Manual of Mental Disorders: DSM 5. Virginia: American Psychiatric Association; 2013.
6. Freeman JB, Choate-Summers ML, Moore PS, Garcia AM, Sapyta JJ, Leonard HL, et al. Cognitive behavioral treatment for young children with obsessive-compulsive disorder. Biological Psychiatry. 2007; 61(3):337-43. [DOI:10.1016/j.biopsych.2006.12.015] [PMID] [PMCID] [DOI:10.1016/j.biopsych.2006.12.015]
7. Barrett P, Farrell L, Dadds M, Boulter N. Cognitive-behavioral family treatment of childhood obsessive-compulsive disorder: Long-term follow-up and predictors of outcome. Journal of the American Academy of Child & Adolescent Psychiatry. 2005; 44(10):1005-14. [DOI:10.1097/01.chi.0000172555.26349.94] [PMID] [DOI:10.1097/01.chi.0000172555.26349.94]
8. Barton R, Heyman I. Obsessive–compulsive disorder in children and adolescents. Paediatrics and Child Health. 2016; 26(12):527-33. [DOI:10.1016/j.paed.2016.08.011] [DOI:10.1016/j.paed.2016.08.011]
9. Hill C, Waite P, Creswell C. Anxiety disorders in children and adolescents. Paediatrics and Child Health. 2016; 26(12):548-53. [DOI:10.1016/j.paed.2016.08.007] [DOI:10.1016/j.paed.2016.08.007]
10. Rockhill C, Kodish I, DiBattisto C, Macias M, Varley C, Ryan S. Anxiety disorders in children and adolescents. Current Problems in Pediatric and Adolescent Health Care. 2010; 40(4):66-99. [DOI:10.1016/j.cppeds.2010.02.002] [PMID] [DOI:10.1016/j.cppeds.2010.02.002]
11. Hudson JL, Rapee RM. Parent–child interactions and anxiety disorders: An observational study. Behaviour Research and Therapy. 2001; 39(12):1411-27. [DOI:10.1016/S0005-7967(00)00107-8] [DOI:10.1016/S0005-7967(00)00107-8]
12. Van Der Bruggen CO, Stams GJ, Bögels SM. Research review: The relation between child and parent anxiety and parental control: A meta-analytic review. Journal of Child Psychology and Psychiatry. 2008; 49(12):1257-69. [DOI:10.1111/j.1469-7610.2008.01898.x] [PMID] [DOI:10.1111/j.1469-7610.2008.01898.x]
13. Nordahl HM, Ingul JM, Nordvik H, Wells A. Does maternal psychopathology discriminate between children with DSM-IV generalised anxiety disorder or opposition-al defiant disorder? The predictive validity of maternal axis I and axis II psychopathology. European Child & Adolescent Psychiatry. 2007; 16(2):87-95. [DOI:10.1007/s00787-006-0578-8] [PMID] [DOI:10.1007/s00787-006-0578-8]
14. Berg-Nielsen TS, Vikan A, Dahl AA. Parenting related to child and parental psychopathology: A descriptive review of the literature. Clinical Child Psychology and Psychiatry. 2002; 7(4):529-52. [DOI:10.1177/1359104502007004006] [DOI:10.1177/1359104502007004006]
15. Ginsburg GS, Siqueland L, Masia-Warner C, Hedtke KA. Anxiety disorders in children: Family matters. Cognitive and Behavioral Practice. 2005; 11(1):28-43. [DOI:10.1016/S1077-7229(04)80005-1] [DOI:10.1016/S1077-7229(04)80005-1]
16. Cobham VE, Dadds MR, Spence SH. The role of parental anxiety in the treatment of childhood anxiety. Journal of Consulting and Clinical Psychology. 1998; 66(6):893. [DOI:10.1037/0022-006X.66.6.893] [PMID] [DOI:10.1037/0022-006X.66.6.893]
17. Liakopoulou M, Korlou S, Sakellariou K, Kondyli V, Kapsimali E, Sarafidou J, et al. The psychopathology of parents of children and adolescents with obsessive-compulsive disorder. Psychopathology. 2010; 43(4):209-15. [DOI:10.1159/000313518] [PMID] [DOI:10.1159/000313518]
18. McClure EB, Brennan PA, Hammen C, Le Brocque RM. Parental anxiety disorders, child anxiety disorders, and the perceived parent–child relationship in an Australi-an high-risk sample. Journal of Abnormal Child Psychology. 2001; 29(1):1-10. [DOI:10.1023/A:1005260311313] [PMID] [DOI:10.1023/A:1005260311313]
19. Pervin LA, Cervone DJ. Personality, theory and research. New York: John Wiley and Sons; 2005.
20. Huver RM, Otten R, de Vries H, Engels RC. Personality and parenting style in parents of adolescents. Journal of Adolescence. 2010; 33(3):395-402. [DOI:10.1016/j.adolescence.2009.07.012] [PMID] [DOI:10.1016/j.adolescence.2009.07.012]
21. Vreeke LJ, Muris P. Relations between behavioral inhibition, big five personality factors, and anxiety disorder symptoms in non-clinical and clinically anxious chil-dren. Child Psychiatry & Human Development. 2012; 43(6):884-94. [DOI:10.1007/s10578-012-0302-5] [PMID] [PMCID] [DOI:10.1007/s10578-012-0302-5]
22. Möller EL, Nikolić M, Majdandžić M, Bögels SM. Associations between maternal and paternal parenting behaviors, anxiety and its precursors in early childhood: A meta-analysis. Clinical Psychology Review. 2016; 45:17-33. [DOI:10.1016/j.cpr.2016.03.002] [PMID] [DOI:10.1016/j.cpr.2016.03.002]
23. Najmi SB, Hassanzadeh A. [On the relationship between personality traits of parents and type of the behavioral disorders of children (Persian)]. Fundamentals of Mental Health. 2010; 12(46):522-33. [DOI:10.22038/jfmh.2010.1092]
24. Sharifi V, Asadi SM, Mohammadi MR, Amini H, Kaviani H, Semnani Y et al. [Reliability and capability of administration of Persian version of SCID for DSM-IV (Persian)]. Advances in Cognitive Sciences. 2004; 6(1-2):10-22.
25. Waters AM, Zimmer-Gembeck MJ, Farrell LJ. The relationships of child and parent factors with children's anxiety symptoms: Parental anxious rearing as a mediator. Journal of Anxiety Disorders. 2012; 26(7):737-45 [DOI:10.1016/j.janxdis.2012.06.002] [PMID] [DOI:10.1016/j.janxdis.2012.06.002]
26. Kerns KA, Brumariu LE. Is insecure parent–child attachment a risk factor for the development of anxiety in childhood or adolescence?. Child Development Perspectives. 2014; 8(1):12-7. [DOI:10.1111/cdep.12054] [PMID] [PMCID] [DOI:10.1111/cdep.12054]
27. Joshanloo M, Daemi F, Bakhshi A, Nazemi S, Ghafari Z. [Construct validity of NEO-personality inventory-revised in Iran (Persian)]. Iranian Journal of Psychiatry and Clinical Psychology. 2010; 16(3):220-30.
28. Waters AM, Zimmer-Gembeck MJ, Farrell LJ. The relationships of child and parent factors with children's anxiety symptoms: Parental anxious rearing as a mediator. Journal of Anxiety Disorders. 2012; 26(7):737-45. [DOI:10.1016/j.janxdis.2012.06.002] [PMID] [DOI:10.1016/j.janxdis.2012.06.002]
29. Goodman R, Ford T, Meltzer H. Mental health problems of children in the community: 18 month follow up. BMJ. 2002; 324(7352):1496-7. [DOI:10.1136/bmj.324.7352.1496] [PMID] [PMCID] [DOI:10.1136/bmj.324.7352.1496]
30. Wood JJ, McLeod BD, Sigman M, Hwang WC, Chu BC. Parenting and childhood anxiety: Theory, empirical findings, and future directions. Journal of Child Psychology and Psychiatry. 2003; 44(1):134-51. [DOI:10.1111/1469-7610.00106] [PMID]
31. Schleider JL, Ginsburg GS, Keeton CP, Weisz JR, Birmaher B, Kendall PC, et al. Parental psychopathology and treatment outcome for anxious youth: roles of family functioning and caregiver strain. Journal of Consulting and Clinical Psychology. 2015; 83(1):213. [DOI:10.1037/a0037935] [PMID] [PMCID] [DOI:10.1037/a0037935]
32. Pirnia B, Rasoulzadeh Tabatabaei SK, Pirkhaefi A, Soleimani A. [Comparison of the Effectiveness of Two Cognitive-Behavioral and Mother-Child Interactive Therapies on Anxiety of Children With Under-Methadone Treatment Mother (Persian)]. Iranian Journal of Psychiatry and Clinical Psychology. 2017; 23(2):136-47. [DOI:10.29252/nirp.ijpcp.23.2.136] [DOI:10.29252/nirp.ijpcp.23.2.136]
33. Cobham VE, Filus A, Sanders MR. Working with parents to treat anxiety-disordered children: A proof of concept RCT evaluating Fear-less Triple P. Behaviour Research and Therapy. 2017; 95: 128-38. [DOI:10.1016/j.brat.2017.06.004] [PMID] [DOI:10.1016/j.brat.2017.06.004]

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