The Lived Experience of Children of people with Generalized anxiety disorder: A qualitative Study

Document Type : Original Article

Author

Assistant Professor in Psychology, Department of Psychology and Educational Sciences, Faculty of Humanities, Khatam University, Tehran, Iran.

Abstract

Introduction: Generalized Anxiety Disorder is characterized by excessive anxiety and worry about various aspects of life or activities. The impact of anxious parents, particularly those with generalized anxiety disorder, can have devastating effects on their children. In this study, we examined the life experiences of children with parents who have generalized anxiety disorder.
Methods: This research employed qualitative and phenomenological approaches. Participants in this study were 15 children of individuals with generalized anxiety disorder who were purposefully selected using the snowball method from counseling centers in Tehran. The information gathered from the interviews was analyzed using the Colaizzi seven-step method.
Results: Four main themes were extracted from the interviews, including living conditions, the effects of parental anxiety on the individual's life, lack of assertiveness skills, and psychological effects on the individual. The living conditions encompassed four sub-themes: difficult life, stress, feelings of anger towards parents, and fatigue. The impact of parental anxiety on an individual's life can lead to a desire to migrate (as a means of escape), a constant need to be available for reassurance, a tendency to report to the parent, and a longing for love. Lack of assertiveness skills with three sub-themes included inability to say no, accepting overly tolerant responsibilities, and prioritizing the needs of others over one's own. The psychological effects of parental anxiety on individuals include five sub-themes: perfectionism, functional anxiety/social anxiety, driving phobia and other specific phobias, and low self-esteem.
Discussion and Conclusion: Parental anxiety disorders can have a significant impact on children. It is crucial to study them.

Keywords


  1. American Psychiatric Association, American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Arlington, VA. 2013.
    2. Eilert N, Enrique A, Wogan R, Mooney O, Timulak L, Richards D. The effectiveness of Internet‐delivered treatment for generalized anxiety disorder: An updated systematic review and meta‐analysis. Depression and Anxiety. 2021 Feb;38(2):196-219.
    3. Bandelow B, Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialogues in clinical neuroscience. 2015 Sep;17(3):327.
    4. Remes O, Brayne C, Van Der Linde R, Lafortune L. A systematic review of reviews on the prevalence of anxiety disorders in adult populations. Brain and behavior. 2016 Jul;6(7):e00497.
    5. Olatunji, B. O. Cisler, J. M. & Tolin, D. F. (2007). Quality of life in the anxiety disorders: A meta‐analytic review. Clinical Psychology Review, 27(5), 572–581. https://doi.org/10.1016/j.cpr.2007.01.015
    6. Saarni SI, Suvisaari J, Sintonen H, Pirkola S, Koskinen S, Aromaa A, Lönnqvist J. Impact of psychiatric disorders on health-related quality of life: general population survey. The British journal of psychiatry. 2007 Apr;190(4):326-32.
    7. Wittchen HU. Generalized anxiety disorder: prevalence, burden, and cost to society. Depression Anxiety. 2002;16:162–71. 8.
    8. Beesdo-Baum K. Phenomenology of generalized anxiety disorder. In: Simon NM, Hollander E, Rothbaum BO, Stein DJ, editors. Anxiety, trauma and OCD-related disorders. 3rd ed. Washington DC: American Psychiatric Association; 2020. p. 161–75. 9.
    9. Kessler RC, Berglund P, Demler O, Jin R, Walters EE. Lifetime prevalence and ageof-onset distributions’ of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry. 2005;62:593–602. 10.
    10. Grant BF, Hasin DS, Stinson FS, Dawson DA, June Ruan W, Goldstein RB, et al. Prevalence, correlates, co-morbidity, and comparative disability of DSM-IV generalized anxiety disorder in the USA: results from the National Epiderniologic Survey on Alcohol and Related Conditions. Psychol Med. 2005;35:1747–59
    11. Hirshfeld‐Becker DR, Micco JA, Simoes NA, Henin A. High risk studies and developmental antecedents of anxiety disorders. InAmerican Journal of Medical Genetics Part C: Seminars in Medical Genetics 2008 May 15 (Vol. 148, No. 2, pp. 99-117). Hoboken: Wiley Subscription Services, Inc. A Wiley Company.
  2. Quagliato LA, de Matos UM, Nardi AE. Lifetime psychopathology in the offspring of parents with anxiety disorders: A systematic review. Journal of Affective Disorders. 2022 Sep 26.
  3. Lawrence PJ, Murayama K, Creswell C. Systematic review and meta-analysis: anxiety and depressive disorders in offspring of parents with anxiety disorders. Journal of the American Academy of Child & Adolescent Psychiatry. 2019 Jan 1;58(1):46-60.
  4. Turner SM, Beidel DC, Costello A. Psychopathology in the offspring of anxiety disorders patients. Journal of consulting and clinical psychology. 1987 Apr;55(2):229.
  5. Koszycki D, Taljaard M, Bielajew C, Gow RM, Bradwejn J. Stress reactivity in healthy child offspring of parents with anxiety disorders. Psychiatry Research. 2019 Feb 1;272:756-64.
  6. Micco JA, Henin A, Mick E, Kim S, Hopkins CA, Biederman J, Hirshfeld-Becker DR. Anxiety and depressive disorders in offspring at high risk for anxiety: A meta-analysis. Journal of anxiety disorders. 2009 Dec 1;23(8):1158-64.
  7. Lawrence PJ, Murayama K, Creswell C. Systematic review and meta-analysis: anxiety and depressive disorders in offspring of parents with anxiety disorders. Journal of the American Academy of Child & Adolescent Psychiatry. 2019 Jan 1;58(1):46-60.
  8. McAdams TA, Neiderhiser JM, Rijsdijk FV, Narusyte J, Lichtenstein P, Eley TC. Accounting for genetic and environmental confounds in associations between parent and child characteristics: a systematic review of children-of-twins studies. Psychological bulletin. 2014 Jul;140(4):1138.
  9. Hirshfeld‐Becker DR, Micco JA, Simoes NA, Henin A. High risk studies and developmental antecedents of anxiety disorders. InAmerican Journal of Medical Genetics Part C: Seminars in Medical Genetics 2008 May 15 (Vol. 148, No. 2, pp. 99-117). Hoboken: Wiley Subscription Services, Inc. A Wiley Company.
  10. . Hettema JM, Neale MC, Kendler KS. A review and meta-analysis of the genetic epidemiology of anxiety disorders. American Journal of Psychiatry. 2001 Oct 1;158(10):1568-78.
  11. Thapar A, McGuffin P. Are anxiety symptoms in childhood heritable? Journal of Child Psychology and Psychiatry. 1995 Mar;36(3):439-47.
  12. . Hettema JM, Prescott CA, Myers JM, Neale MC, Kendler KS. The structure of genetic and environmental risk factors for anxiety disorders in men and women. Archives of general psychiatry. 2005 Feb 1;62(2):182-9.
  13. Scherrer JF, True WR, Xian H, Lyons MJ, Eisen SA, Goldberg J, Lin N, Tsuang MT. Evidence for genetic influences common and specific to symptoms of generalized anxiety and panic. Journal of affective disorders. 2000 Jan 1;57(1-3):25-35.
  14. . Noyes Jr R, Clarkson C, Crowe RR, Yates WR, McChesney CM. A family study of generalized anxiety disorder. The American journal of psychiatry. 1987 Aug 1;144(8):1019-24.
  15. Olsson A, Phelps EA. Social learning of fear. Nature neuroscience. 2007 Sep;10(9):1095-102.
  16. Aktar E, Nikolić M, Bögels SM. Environmental transmission of generalized anxiety disorder from parents to children: worries, experiential avoidance, and intolerance of uncertainty. Dialogues in clinical neuroscience. 2017 Jun;19(2):137.
  17. Andrews G, Hobbs MJ. The effect of the draft DSM-5 criteria for GAD on prevalence and severity. Australian & New Zealand Journal of Psychiatry. 2010 Sep;44(9):784-90.
  18. Hudson JL, Rapee RM. From Anxious Temperament to Disorder: An Etiological Model.
  19. Rachman S. The conditioning theory of fearacquisition: A critical examination. Behaviour research and therapy. 1977 Jan 1;15(5):375-87.
  20. Drake KL, Ginsburg GS. Family factors in the development, treatment, and prevention of childhood anxiety disorders. Clinical child and family psychology review. 2012 Jun;15(2):144-62.
  21. Askew C, Field AP. The vicarious learning pathway to fear 40 years on. Clinical psychology review. 2008 Oct 1;28(7):1249-65.
  22. Aktar E, Majdandžić M, de Vente W, Bögels SM. The interplay between expressed parental anxiety and infant behavioural inhibition predicts infant avoidance in a social referencing paradigm. Journal of Child Psychology and Psychiatry. 2013 Feb;54(2):144-56.
  23. . Morrow R, Rodriguez A, King N. Colaizzi’s descriptive phenomenological method.The psychologist. 2015;28(8):643-4.