Are Moms and Dads Passing Anxiety on to Their Kids?



Children were more likely to be diagnosed with an anxiety disorder when a parent of the same sex, rather than one of the opposite sex, had the condition, a cross-sectional study from Canada found.

The lifetime likelihood of an anxiety disorder diagnosis in offspring was nearly three times higher when a parent of the same sex had anxiety (OR 2.85, 95% CI 1.52-5.34, P=0.001), but no significant association was observed when it was a parent of the opposite sex, reported Barbara Pavlova, PhD, of Dalhousie University in Halifax, Nova Scotia, and colleagues in JAMA Network Open.

The same-sex association appeared driven more by females than males:

  • Mother-daughter: OR 3.30 (95% CI 1.43-7.59)
  • Father-son: OR 2.18 (95% CI 0.89-5.33)

“The sex-specific pattern is particularly pronounced when looking at parents who reside with their children,” the researchers wrote. For example, kids living with a same-sex parent not affected by anxiety were 62% less likely to be diagnosed with the disorder (OR 0.38, 95% CI 0.22-0.67, P=0.001).

Pavlova’s group added that the findings suggest environmental factors, such as modeling and “vicarious learning,” likely have a role in the intergenerational transmission of anxiety.

“Future studies should establish whether treating parents’ anxiety may protect their children from developing an anxiety disorder,” the researchers concluded.

While the genetic contribution to anxiety is well documented, there is no clear genetic explanation for the same-sex transmission of anxiety disorders, Pavlova and co-authors noted. However, data do suggest that modeling of a parent’s fearful responses and “overprotective” parenting can play a role in children’s risk for anxiety, the team said, citing children-of-twins research that also implicated environmental factors as central to parent-child transmission of anxiety.

In the current study, the researchers found that the odds of a lifetime anxiety disorder diagnosis in offspring increased proportionately to the number of parents with anxiety disorders — specifically, anxiety occurred in about 24% of those whose parents were not affected, in 28% of children with one affected parent, and in 41% of those with both parents affected.

The cross-sectional family study involved 398 offspring (203 female, 195 male) and was designed to examine the relative contribution of genes and environment to anxiety disorders, which are known to run in families.

Children had an average age of 11 years, and 27% had received a diagnosis of at least one anxiety disorder, the most common of which were: generalized anxiety disorder in 7.8%, social anxiety disorder in 6.3%, separation anxiety disorder in 8.6%, specific phobia in 8%, obsessive compulsive disorder in 2.8%, and anxiety disorder not otherwise specified in 5%. Rates of anxiety disorders were similar in males and females (24% and 30%) and increased with age, from 14% in those younger than 9 years to almost 52% in those older than 15.

Parents in the study (221 mothers, 172 fathers) had an average age of 41, and 88% were white. A total of 46% of the mothers and 23% of the fathers had anxiety disorders, most of them comorbid with major mood disorders, the authors reported. Psychiatric diagnoses for the mothers and fathers included major depressive disorder (42% and 24%, respectively), bipolar disorder (20% and 10%), and schizophrenia (5.0% and 4.1%).

Children of parents with bipolar disorder were over three times more likely to have anxiety than children of parents with no major mood or psychotic disorder, whereas the presence or absence of parental depression was not associated with different rates of anxiety in children, the team found.

But when parental anxiety disorders and major mood disorders were assessed as independent variables, parental anxiety was significantly associated with increased rates of a lifetime diagnosis of anxiety in offspring, but parental mood disorders were not.

Limitations of the study, Pavlova and colleagues said, included the potential for reverse causality and the sample’s low average age, which precluded assessment of any link between parental psychiatric disorders and children’s mood disorders, which typically begin later in life.

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    Kate Kneisel is a freelance medical journalist based in Belleville, Ontario.

Disclosures

The study was supported by grants from the Canada Research Chairs Program, the Canadian Institutes of Health Research, the Brain Behavior Research Foundation, the Nova Scotia Health Research Foundation, and the Dalhousie Medical Research Foundation.

Pavlova and co-authors reported no conflicts of interest.

Primary Source

JAMA Network Open

Source Reference: Pavlova B, et al “Sex-specific transmission of anxiety disorders from parents to offspring” JAMA Netw Open 2022; DOI: 10.1001/jamanetworkopen.2022.20919.

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