Familial predictors of treatment outcome in childhood anxiety disorders

Objective: To determine whether family factors are predictive of outcome in children with anxiety disorders who are receiving cognitive-behavioral tre atment. Method: Participants were 61 children aged 8 to 12 years (mean = 10 .0, SD = 1.4) with Axis I anxiety disorders who had been referred to a larg e Toronto children's hospital. Parents and children completed measures asse ssing family functioning, parenting stress, parental frustration, and paren tal psychopathology before and after treatment. Outcome measures included c linician-rated functioning (Children's Global Assessment Scale) and self- a nd parent-rated anxiety (Revised Children's Manifest Anxiety Scale). Result s: Child ratings of family dysfunction and frustration predicted clink cian -rated improvement (total R-2 = 0.28, p < .001). Mother and father reports of family dysfunction, and maternal parenting stress, predicted mother-rate d child improvement (total R-2 = 0.18, p < .01). Father-rated somatization and child reports of family dysfunction and frustration predicted child-rat ed improvement (total R-2 = 0.25, p < .001). Several family factors improve d with treatment. Conclusion: Family dysfunction appears to be related to l ess favorable treatment outcome in children with anxiety disorders.