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Approaching an answer to the complex question ‘how do childhood anxiety disorders develop?’ by merging attachment and social learning theory and their methodologies

Final Report Summary - ANXIETY IN CHILDHOOD (Approaching an answer to the complex question ‘how do childhood anxiety disorders develop?’ by merging attachment and social learning theory and their methodologies)

The anxiety in childhood project was a 27 months project with 15 months outgoing phase and 12 months ingoing. The outgoing host was Centre for Attachment Research, New School for Social Research, with Professor Howard Steele being the outgoing supervisor. The ingoing host was the Department of Psychology, University of Copenhagen, with the ingoing supervisor being Professor Axel Larsen.
During the scholars stay at the Centre for Attachment Research, New School for Social Science, the first project was carried out successfully. A total of 74 youth were eligible for participation in the study. A paper on the influence of attachment relations in childhood on the development of anxiety in youth was written and is currently under review in an international peer-reviewed journal. Furthermore, additionally 3 international peer-reviewed journal articles within the topic were accepted for publication. Besides strengthening of collaborations with the outgoing host’s institution, other collaborations were established and papers are currently being written up. A major spin-off of the scholars stay with the outgoing host was the commencement of developing a new observational assessment to evaluate parent-child interactions. It is based on social learning theory in relation to anxiety disorders and attachment theory. Pilot-work applying the observational method has been conducted, and refinements are currently taking place.
During the ingoing phase, two studies have been carried out. First, a 3 year follow-up of children who had partaken in therapy for their anxiety disorder was conducted. Preliminary findings on the effect of involving parents in the treatment of their child have been presented at an international conference. Second, a study of the influence of maternal cognitions and attachment relations on their behavior towards a child unknown to them was conducted. More than 160 mothers and their children participated in the study. Preliminary findings have been presented at an international conference. Furthermore, three journal articles within the topic have been accepted for publication during the ingoing period.
Of importance for the European community, knowledge within the field of childhood anxiety and attachment has been provided to the wider community. During the project period two conferences have been held, one was on childhood anxiety, with invited guest speakers from US, Norway and the UK. This conference also included presentations by researchers from numerous European countries. During the ingoing phase, the scholar has become the secretary in a newly established network on attachment for professionals, and organized a related conference “Nordic Attachment Network, conference” in Copenhagen in August 2014. The purpose of the network is to provide scholars and clinicians with opportunities to network and learn about gold standard methodology within the field. Additional workshops and other types of media appearances e.g. newspaper, radio and tv have been conducted on the topic of childhood anxiety disorders.
The development and maintenance of anxiety disorders involves a complex interplay among risk and protective factors in the child, parents and society. Different research traditions have focused on different factors in this complex equation. Attachment theory has provided insights into the impact of parent-child interactions on the child’s psychic development in longitudinal normal samples. Social learning theory and the associated treatment, cognitive behavior therapy, has focused on e.g. emotional and cognitive factors in clinically anxious children and their parents. Unfortunately knowledge regarding the connections among child, parent, family and societal factors is sparse and research has yet to explain who will develop anxiety and why. The purpose of the study was to take the field a step further, by merging theoretical perspectives and applying gold-standard methodologies, developed on both sides of the Atlantic, from both perspectives. The work addresses the interrelation between anxiety disorders, emotion regulation, attachment, cognitions and behaviors in two studies: (i) a high-risk New York longitudinal sample; and (ii) a Copenhagen sample of clinically anxious children and their parents.