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. 2025 Oct;39(7):1003-1015.
doi: 10.1037/fam0001388. Epub 2025 Jul 24.

Transdiagnostic correlates of family accommodation in anxious youth

Whitney S Shepherd  1 , Erika S Trent  2 , Orri Smarason  3 , Hannah N Sansone  2 , Daphne M Ayton  4 , Amanda Palo  2 , Abigail E Candelari  2 , Wayne K Goodman  2 , Andrew G Guzick  5 , Eric A Storch  2
Affiliations

Transdiagnostic correlates of family accommodation in anxious youth

Whitney S Shepherd et al. J Fam Psychol. 2025 Oct.

Abstract

Anxiety disorders are common in children and cause significant impairment. Family accommodation (FA), which refers to behavioral changes that family members make to temporarily alleviate a child's anxiety, has been linked to child anxiety symptom severity. Although emotional vulnerabilities for anxiety such as emotion dysregulation, anxiety sensitivity, and distress intolerance have been associated with family accommodation, research concerning the relationship between these constructs among anxious youth is limited. We hypothesized that these variables would be uniquely and positively associated with family accommodation and would moderate the relationship between anxiety symptom severity and family accommodation. Treatment-seeking child-parent dyads (N = 90; Mage = 10.17 years, SD = 2.71) completed measures assessing child emotion dysregulation, child anxiety sensitivity, child distress tolerance, and family accommodation; clinicians assessed child anxiety symptom severity. When controlling for child age, gender, and anxiety symptom severity in both models, emotion dysregulation was significantly and uniquely associated with parent-rated family accommodation. Distress tolerance significantly moderated the association between anxiety symptom severity and family accommodation, such that this association was stronger when distress tolerance was lower. Interventions targeting children's distress tolerance skills may help reduce family accommodation among families of children with high levels of anxiety. Additionally, targeting family accommodation in interventions for anxious children with low distress tolerance may help decrease child anxiety rates. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

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Conflict of interest statement

Ms. Shepherd, Ms. Sansone, Mrs. Ayton, Dr. Smarason, Dr. Palo, Dr. Candelari, and Dr. Trent have no financial disclosures to report. Dr. Goodman receives royalties from NView LLC and OCDscales LLC for distribution of the YBOCS scales. Dr. Guzick receives research support from the NIH and Misophonia Research Fund. Dr. Storch reports receiving research funding to his institution from the Ream Foundation, International OCD Foundation, and NIH. He was formerly a consultant for Brainsway and Biohaven Pharmaceuticals in the past 24 months. He owns stock less than $5000 in NView/Proem for distribution related to the YBOCS scales. He receives book royalties from Elsevier, Wiley, Oxford, American Psychological Association, Guildford, Springer, Routledge, and Jessica Kingsley.

Figures

Figure 1:
Figure 1:
The moderating effect of distress tolerance (DTS) on the relationship between anxiety symptom severity (PARS) and family accommodation among tertile groups of the sample.
See this image and copyright information in PMC

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