Preventing anxiety and promoting social and emotional strength in early childhood: An investigation of aetiological risk factors

Anxiety disorders are among the most prevalent psychiatric disorders in children and adolescents, with ten to fifteen percent of young children experiencing internalising problems (Briggs-Gowan, Carter, Irwin, Wachtel, & Cicchetti, 2004; Egger & Angold, 2006). Researchers have indicated that clinically significant anxiety can exist in preschool aged children and can be sub-typed into patterns similar to that of older children. This early identification of anxiety has lead researchers to recommend that prevention efforts occur early in the life course (Beinvenu & Ginsburg, 2007), before the onset of disorder(s). Research remains scarce as to when the ultimate time to intervene would be, as anxiety research with young children is minimal. The studies presented in this thesis attempt to expand the current literature within in the area of early childhood anxiety. The first objective of this thesis was to extend the literature in the field of early childhood anxiety by examining the aetiology of anxiety and behavioural inhibition (BI) through the investigation of potential risk factors. This study (Study One) represents one of the first investigations within the research to examine risk factors for early childhood anxiety. Two hundred and thirty-six children aged four to six years participated in this study. Parents of the children completed self-report questionnaires at one time point. Results revealed that BI did not significantly predict anxiety, nor did any of the risk factors significantly predict BI. Significant predictors of anxiety included mother’s negative affect and mother’s parenting stress. Father’s parenting stress was found to play a mediating role between mother’s parenting stress and child anxiety. Overall, the findings highlight the importance of both parents (directly or through mediation) in the aetiology of early childhood anxiety. The findings of Study One provide important information regarding the aetiology of early childhood anxiety and provide important implications for the development of preventative intervention programs. Study Two sought to examine the efficacy of a preventative intervention program (Fun FRIENDS; Barrett, 2007a) for preschool aged children, delivered as a school- based, universal intervention. This was the first study conducted evaluating the Fun FRIENDS program and was one of only a few prevention trials cited within the literature examining early childhood anxiety. The study involved a cohort of 263 children enrolled in one of 16 preschool classes. Children were aged between four and six years. Schools were randomly allocated to either an intervention group (IG) or a waitlist control group (WLG). Parents of the children and teachers completed self-report questionnaires at preintervention, postintervention, and at 12-month follow-up (parents in the IG only). Parent report data revealed no significant differences between intervention conditions on anxiety at postintervention, although participants in the IG experienced larger reductions in anxiety than participants in the WLG. Children in both conditions decreased in BI symptoms at postintervention, except for boys in the IG. Significant increases in social-emotional strength were found for girls in both conditions, but not for boys. When examining the IG only over the long-term (pre, post, 12 month follow-up), nearly significant decreases in anxiety were found at postintervention and significant decreases were found again at 12-month follow-up. Improvements in BI were found at all time points for girls but not for boys and improvements on social-emotional strength were found from preintervention to 12-month follow-up, with girls scoring significantly higher than boys. For teacher report, children in the IG improved significantly more on BI compared to the WLG at postintervention indicating that the intervention program may have had a positive impact on these children in learning strategies to manage BI symptoms. However, at pr-intervention, scores on BI were significantly different between the IG and the WLG. Similar to parent report, girls in the IG experienced the largest decrease in BI symptoms at postintervention. On social-emotional strength, children in the IG improved significantly more than children in the WLG at postintervention with girls in the IG experiencing the largest improvement from pre to postintervention. Overall, these findings suggest that the intervention program had a positive impact on some children as evidenced by improvements in anxiety, BI, and social-emotional strength at postintervention and at 12-month follow-up. Parent report indicated that children in the WLG also improved on these measures, making it difficult to contribute positive changes solely to the program. However, teacher report did indicate that children in the IG improved significantly more than children in the WLG. The improvements gained at 12-month follow-up highlight the potential long-term impact of the program although, without a comparison group, it is unknown whether significant differences would exist between both conditions. Implications of these results are discussed along with limitations and directions for future research.