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. 2023 Sep;54(5):852-862.
doi: 10.1016/j.beth.2023.03.002. Epub 2023 Mar 30.

Parent Accommodation Contemporaneously Mediates the Association Between Youth Irritability and Youth Anxiety Treatment Outcome

Victoria M Cabrera  1 , Victor Buitron  1 , Guadalupe C Patriarca  1 , Yasmin Rey  1 , Eli R Lebowitz  2 , Wendy K Silverman  2 , Jeremy W Pettit  3
Affiliations

Parent Accommodation Contemporaneously Mediates the Association Between Youth Irritability and Youth Anxiety Treatment Outcome

Victoria M Cabrera et al. Behav Ther. 2023 Sep.

Abstract

Research documents that child and adolescent (youth) irritability and anxiety have high co-occurrence, and anxious-irritable presentations are associated with greater impairment than anxious nonirritable presentations. This study examines the association between irritability and youth anxiety treatment outcome and tests a conceptual model of the associations among youth irritability, parent accommodation, and youth anxiety severity following cognitive behavioral treatment (CBT). Participants were N = 128 clinic-referred youths ages 6 to 17 years (M = 9.76 years; 57% female) who met criteria for primary anxiety disorder diagnoses and completed a 12- to 14-week CBT anxiety protocol. Parent- and youth-report on youth irritability, parent accommodation of their child's anxiety, and youth anxiety severity were assessed pretreatment and posttreatment. Using parent-report, youth irritability at pretreatment was associated with high parent accommodation of youth anxiety and high youth anxiety severity at posttreatment. The association between irritability and youth anxiety outcome was mediated contemporaneously by parent accommodation at posttreatment. These findings show that parent accommodation of their anxious-irritable children's anxiety may account for high youth anxiety severity following treatment. Developing strategies to target irritability in anxious youth and/or reduce parent accommodation in the presence of youth irritability represent important directions for future research.

Keywords: CBT; accommodation; anxiety disorders; clinical child intervention; irritability; parenting.

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Figures

Figure 1
Figure 1. Conceptual Model of the Associations Between Youth Irritability, Parent Accommodation, and Youth Anxiety CBT outcome
Note: Youth age, youth anxiety severity at PRE, and parent accommodation at PRE were included as covariates when testing the model. They are excluded from the Figure to avoid clutter.
See this image and copyright information in PMC

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