What about Me? Siblings of Children with an Anxiety Disorder

Sibling relationships are enduring and influential and can have a profound impact on children's development (Dunn, 2000). Positive sibling relationships are associated with better friendships, higher self-esteem, and lower levels of loneliness, depression, and delinquent behaviors (Yeh & Lempers, 2004). Although there has been research on siblings of children with chronic illnesses, there has been limited research on the impact of children's anxiety disorders on the functioning of siblings (Lindhout et al., 2003). This lack of research is surprising because anxiety disorders are the most common mental health problem in children and adolescents, with an estimated six-month prevalence rate of 10.5% to 16.5% (Verhulst, van der Ende, Ferdinand, & Kasius, 1997). In addition, anxiety disorders tend to run in families (Skre, Onstad, Edvardsen, Torgersen, & Kringlen, 1994), and first-degree relatives, such as siblings, of a patient with an anxiety disorder are at greater risk of developing an anxiety disorder compared with the general population (American Psychiatric Association, 1994). In addition to possible genetic risk factors, the family context may also be related to the development of anxiety disorders. For example, the quality of attachment to the caregiver is an important antecedent to a generalized psychological vulnerability to anxiety (Thompson, 1998). Parents of children with anxiety disorders may be overprotective, offer excessive reassurance, or engage in negative and adverse parent--child interactions, which may affect family functioning and sibling relationships (Eisen & Kearney, 1995). In addition, anxious children may perceive more differential treatment by parents than nonanxious children (Lindhout et al., 2003). The few studies of siblings of children with an anxiety disorder examined how the sibling relationship affects the anxious child or how the siblings interact (for example, Fox, Barrett, & Shortt, 2002; Hudson & Rapee, 2002). This limited research on sibling relationships in families with a child with an anxiety disorder has yielded inconsistent findings. Some research suggests that there may be no difference in perceived affection or hostility between siblings and children with an anxiety disorder (Lindhout et al., 2003). However, others have found that the interactions between siblings and children with an anxiety disorder were characterized by more conflict and control and less warmth as compared with a nonclinical control group and that the anxious children engaged in more controlling behaviors than the children in the control group (Fox et al.). Given the prevalence of anxiety disorders in children and the inconsistent findings in the research done to date, more research is needed on siblings of children with anxiety disorders. In this article, we describe an exploratory study aimed at examining the psychosocial functioning (that is, internalizing and externalizing behaviors) of children who have a sibling with an anxiety disorder. Because we found no descriptive research, the first purpose of this study was descriptive. We expected to find some of the sibling children suffering from an anxiety disorder because anxiety disorders tend to run in families (Skre et al., 1994). The second purpose of this study was to examine predictors of siblings' internalizing and externalizing behaviors. On the basis of the limited research available, gender, anxious child's diagnosis, length of treatment (used as a proxy for severity),interference in family functioning, and parental history of mental health diagnosis (Cobham, Dadds, & Spence, 1998) were examined. METHOD Sample and Procedure We used a one-time survey with a convenience sample. Data were collected on 65 siblings of anxious children. The anxious child's average age was 11.4 years (SD = 2.5); 36 (55%) were male and 29 (45%) were female. The average length of treatment was two years (SD = 2. …