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. Author manuscript; available in PMC: 2022 Apr 1.
Published in final edited form as: Child Psychiatry Hum Dev. 2021 Apr;52(2):225–235. doi: 10.1007/s10578-020-01004-6

Do maternal parenting behaviors indirectly link toddler dysregulated fear and child anxiety symptoms?

Brianne Maag 1, Randi A Phelps 1, Elizabeth J Kiel 1
PMCID: PMC7666014  NIHMSID: NIHMS1594329  PMID: 32406038

Abstract

Dysregulated fear (DF), display of high-fear in low-threat contexts, has been shown to predict child anxiety development. Maternal protective, comforting, and intrusive behaviors have also been linked to child anxiety development and may be candidate mechanisms linking DF to anxiety. First, the relation between DF (age 2) and child separation anxiety (age 4) as indirectly linked by maternal protective, comforting, and intrusive behaviors was investigated. Second, the relation between DF and social anxiety (age 4) through parenting behaviors was investigated. Results suggested DF significantly predicted child separation anxiety through maternal intrusive behaviors, above and beyond protective and comforting behaviors. Neither protective nor comforting parenting behavior served as indirect effects between DF and separation anxiety. No parenting behaviors were found to indirectly link the relation between DF and social anxiety. Results suggest that multiple parenting behaviors are involved as environmental mechanisms by which DF predicts separation anxiety.

Keywords: Child anxiety, Parenting behaviors, Protective behaviors, Comforting behaviors, Intrusive behaviors

Among the most prevalent childhood disorders, anxiety has been shown to have a broad range of consequences. Anxiety-related disorders are pervasive and can negatively influence several areas of functioning, including social and academic concerns1,2. Social and separation anxiety, in particular, commonly lead to school refusal1 and disruptions in the home and family life, creating dysfunction within multiple domains3,4. The consequences associated with the development of anxiety in childhood make it necessary to investigate factors that may be early predictors of anxiety. The current study investigates dysregulated fear, an early temperamental risk factor for social anxiety, as a predictor of both separation and social anxiety, as separation anxiety has been shown to be a precursor to social anxiety5. However, the mechanisms by which temperament predicts later anxiety are not entirely accounted for by stability in intraindividual characteristics. Therefore, environmental factors may provide insight into how anxiety develops6,7,8,9. One mechanism through which temperament may predict anxiety longitudinally is the parenting environment. Children influence their parenting environments based on their temperaments10, and parenting behaviors are a major influence on children’s emotional development11,12. Therefore, parenting behaviors were tested as indirect effects to better understand the longitudinal link between dysregulated fear and anxiety outcomes. Identifying mechanisms of risk is critical to identifying prevention and intervention strategies for anxiety development.

Dysregulated Fear

Temperament comprises the early emerging, largely biologically based, individual differences in emotionality and personality that are both inherited and shaped by the environment13,14. Fearful temperament, a construct often studied as a predictor of anxiety15, is characterized by displays of high levels of fear, wariness, or reticent responses to novel situations16. Fearful temperament is a risk factor for the development of inhibited, hypervigilant behaviors that may then lead to social withdrawal13. Social withdrawal has been established to have at least moderate stability over time, such that one-third of children who displayed fearful temperament as infants showed similar behaviors during interactions with unfamiliar individuals in later childhood17,18. The propensity to withdraw from novel situations increases one’s risk for the development of anxiety disorders19,20. These inhibited behaviors have specifically been found to be linked to the development of both separation anxiety and social anxiety22. It has been theorized that early social withdrawal as indicated by inhibited temperament underlies the development of social anxiety5. Additionally, separation anxiety in early childhood is often a precursor to future social anxiety, as social anxiety typically becomes clinically relevant in adolescence23,24. Separation anxiety is specifically linked to inhibited temperament and lack of future social initiative in children24.

Although fearful temperament measures have shown a modestly strong prediction of anxiety-related problems, not all children who exhibit fearful temperament go on to develop anxiety problems13,17,21. In order to distinguish the children who will, dysregulated fear has been introduced as a stronger predictor of anxiety development due to its association with higher stress reactivity13,25. Dysregulated fear (hereafter, “DF”) is characterized by a fear level that is a mismatch for the context in which it is elicited (i.e., a high fear level in a low threat context that most children find engaging)13. Children who display high levels of DF are likely to perceive relatively safe situations as more threatening than children low in DF, indicating deficits in emotion regulation. That is, a child who displays a high level of DF, or high levels of fear in a low-threat context, may be more likely to develop anxiety problems26. Indeed, DF has been associated with higher anxiety scores concurrently13 and over time27. DF at age 2 predicts social anxiety symptoms, as well as observed wariness of unfamiliar adults and peers, in kindergarten-age children13. Avoidance and wariness of unfamiliar peers causes disruption in peer interactions that then promotes social maladjustment, creating consistent reinforcement that novel situations should be approached cautiously or avoided altogether27. However, it is still unclear precisely how children high in DF develop anxiety. There are likely environmental mechanisms through which DF predicts anxiety symptomatology.

Parenting Behaviors

Parenting behaviors play a role in contributing to emotional outcomes in children, broadly. Young children are still in the process of developing the capability of regulating emotions on their own, and parental behaviors serve as a regulatory model11,12,28. Additionally, watching parents behaviorally regulate emotions can help children learn appropriate responses to situations and serve as a form of joint-regulation12. Given this, parenting can have a large role in child emotional outcomes19.

One form of parent behaviors that have been linked to anxiety development is physical comfort. Comforting behaviors are thought to buffer again anxiety development in children, working to provide the child with a secure base in distressing contexts29,30. However, the use of high-intensity comforting behaviors (e.g., hugging, embracing) with children high in DF may reinforce fearful reactions and dependency on parents for regulation. Higher levels of maternal sensitivity and warmth have been linked to higher levels of child anxiety, possibly due to the reinforcing sense of safety associated with withdrawal from a distressing situation or stimulus30. This may lead to a reliance on the caregiver and the under-development of independent skills necessary to cope with stressors31. Over-comforting may result in a smaller range of situations in which children can regulate on their own and may lead to a diminished ability to cope with stressors. Comforting behavior is often studied in conjunction with protective parenting, a known risk for child anxiety32, so it is important to understand whether comforting behavior uniquely relates to anxiety outcomes.

Protective behaviors, such as shielding a child from a stimulus when the situation or child does not warrant it, have been shown to lead to positive adjustment outcomes when used at moderate levels33,34. When paired with encouragement of independence, appropriate levels of protective parenting behavior can assist in a child’s development of self-regulation skills and lead to lower levels of distress35. However, higher levels of protective behaviors can lead to higher levels of distress. Overprotective parenting behaviors could be inhibiting spontaneous regulation and the development of regulatory abilities36. Furthermore, maternal protective behaviors have been shown to provide an indirect link between fearful temperament and social withdrawal, particularly in situations where mothers were more accurately able to predict child behaviors32, as well as being a predictor of social withdrawal above and beyond DF and fearful temperament37. When a child is allowed to avoid a novel situation by means of parental protective behavior, the alleviation of distress negatively reinforces avoidances and reliance on the caregiver. This prevents, adaptive, independent emotion regulation from developing.

Intrusive parenting behavior, or forcing a child to perform a specific behavior or interact with novel stimuli, has also been shown to predict shyness and anxiety-spectrum outcomes19,29,38. Intrusive parenting behaviors, such as when a mother asserts her own desires on a situation over and above the desires of her child, have also been found to predict high anxiety symptoms in children who display high levels of fearful temperament15,39,40. Over-involved and controlling behaviors in mothers have been shown across studies to be positively related to children’s displays of shyness, inhibition, and anxious behaviors38. Often, intrusive behaviors can be unintentional or enacted with belief that pushing the child will have a positive effect29,38,41. Intruding on a child’s play could be interpreted as teaching the child, and forcing them to interact with their environment could be interpreted as encouraging autonomy. Despite the intention behind the actions, intrusive behaviors have been consistently tied to anxiety disorders38,41. However, these behaviors have not been studied in relation to DF and emerging anxiety symptoms.

The current study uniquely contributes to the developmental psychopathology and parenting literatures by examining the relation between toddler DF and both separation and social anxiety outcomes as indirectly linked by comforting, protective, and intrusive parenting behaviors. We investigated parenting behaviors simultaneously (i.e., in parallel) using a longitudinal design in order to understand these parenting behaviors as unique, as well as collective, mechanisms through which DF predicts separation and social anxiety. Therefore, the aim was to investigate the unique versus shared contributions of each indirect effect. We hypothesized that each parenting behavior would account for unique variance in anxiety outcomes.

Methods

Participants

One hundred and eighteen toddlers (69 male; Mage2 = 26.8 months) and their mothers were included in the current study based on participation in a multiphase, longitudinal study. The larger study used a rolling recruitment design to minimize consequences of attrition on sample size. One hundred and nine (92.4%) mothers identified as European American and 80% of children were living in households with both parents. Gross household income ranged from $15,000 or less to greater than $100,000 (8.5% of caregivers earned $15,000 or less, 11 % earned 16,000–20,000, 6.8% earned 21,000–30,000, 4.2% earned 31,000–40,000, 8.5% earned 41,000–50,000, 6.8% earned 51,000–60,000, 8.5% earned 61,000–70,000, 5.9% earned 71,000–80,000, 4.2% earned 81,000–90,000, 8.5% earned 91,000–100,000, and 13.6% earned 100,000 or more). Of dyads who participated in the age 2 visit, 67.3% returned for the age 4 visit, and 9.26% of participants included in analyses were recruited at age 3 or 4 through ongoing enrollment. Dyads were recruited from public birth announcements, from the local Women, Infants, and Children office, and at local events and offices (e.g., farmer’s markets, child care centers, pediatricians’ offices) in a Midwestern town of the United States.

Procedure

All procedures were approved by the university’s Institutional Review Board. Mother-child dyads participated in a laboratory visit at child age 2. Mothers were provided with a detailed explanation of all laboratory tasks (episodes) by the experimenter. Once consent was provided, the mother completed a questionnaire packet and joined her child in engaging in tasks designed to elicit a range of reactions to novel situations. Episodes were video and audio-recorded for later behavioral coding. Although the visit involved more episodes, only the “clown” and “puppet show” episodes were used for the current study. These episodes were modeled after the Toddler Version of the Laboratory Temperament Assessment Battery (Lab-TAB)42 and have been previously validated as low-threat for 2-year-old toddlers13.

Each mother was instructed to interact naturally with her child during each episode. During the clown episode, a female research assistant, dressed in a clown costume with a rainbow wig and red nose, introduced herself in a friendly manner to the dyad as “Floppy the Clown.” The child was invited to play three games with the clown: blowing bubbles (1 min), playing with 2 large beach balls (1 min), and playing with musical instruments (1 min). Approximately two-thirds of the way through the episode, the female research assistant removed the wig and nose in order to “debrief” the dyad. During the puppet show episode, the same female research assistant performed the puppet show from behind a small wooden stage with plush lion and elephant puppets. The puppets invited the child to play two games: catch (1 min) and fishing (1 min). The puppets offered the child a sticker at the end of the puppet show as a prize. Finally, the female research assistant revealed herself to the dyad as a debriefing period. After the visit, mothers were provided with a debriefing form. Mothers were compensated $50 and children were given a small, stuffed teddy bear for their time.

Dyads who participated at child age 2 as well as newly recruited dyads were invited to participate in another laboratory visit at child age 4 (Mage4 = 52.5 months). Consent and compensation followed the same procedure as during the age 2 visit. For this visit, mothers once again completed a questionnaire packet and accompanied their children through multiple tasks in the laboratory. Although the age 4 laboratory visit included a series of tasks, the current study focused only on maternal report of child anxiety symptoms.

Measures

Puppet show and clown episodes were video-recorded for later behavioral coding of toddler DF and parenting behaviors. Separate teams of coders scored toddlers and mothers, and different coders scored each of the two episodes. All behavioral coders received 15–20 hours of training from a master coder and were required to achieve a minimum inter-rater reliability (intraclass correlation coefficient [ICC]) of .80 before coding independently. In order to prevent coder drift, a master coder double-scored approximately 20% of the episodes and resolved discrepancies through consultation. Reliability for each coded measure (prior to resolution of discrepancies) is reported below.

Dysregulated fear.

DF was computed from scores capturing children’s displays of distress and shyness/inhibition during the clown and puppet show episodes. Although fear-eliciting episodes such as those used in the current study do elicit fear-based responses, toddlers have been found to express sadness more frequently than fear in fear-eliciting situations when looking at their mothers43, which is common behavior in these episodes. Therefore, our coding incorporated fear and distress more broadly to fully capture how fear may be expressed or represented during mother-child interactions. negative vocalization (e.g., crying, whimpering). Distress was scored on a scale of 1–5 for the consistent with previous research13. Distress was considered to occur when the child displayed negative facial affect (e.g., sadness, fear) and/or entire episode (1 = no distress shown to 5 = display of distress that lasts the whole episode, is very intense, or the episode is stopped because of the child’s distress). Shyness/inhibition was considered to have occurred when the child displayed behavior such as avoidance of or withdrawal from the stimulus. Shyness/inhibition was also scored on a 1–5 scale for the entire episode (1 = no shyness/inhibition shown to 5 = extremely shy, freezes, never leaves mother’s lap, avoidant or resistant of stimulus throughout the entire episode). Inter-rater reliability was adequate across codes and episodes (distress in puppet show: ICC = 1.00; shyness in puppet show: ICC = .82; distress in clown episode: ICC = .90; shyness in clown episode: ICC = .95). Distress and shyness in puppet show were positively correlated (r = .425, p < .001) and therefore were averaged together. Distress and shyness in clown were also positively correlated (r = .344, p < .001) and thus averaged. Episode composites were positively correlated (r = .338, p < .001) and therefore, averaged to create one composite score to yield the final variable of DF.

Parenting behaviors.

Parenting behaviors were also scored from the puppet show and clown episodes. Comforting behaviors were considered to occur when the mother attempted to show affection or soothe her child (e.g., touching, soothing, or hugging or kissing the child). Intrusive behaviors were considered to occur when the mother’s behaviors influenced the child’s behavior in a manner that was inconsistent with the child’s pre-existing behavior, or when the mother inserted her goals and agendas on the child without apparent regard for what the child was doing or feeling. Protective behaviors were considered to occur when mothers engaged in behaviors such as shielding the child from the stimulus or activity or moving the child away from the stimulus (e.g., picking them up and/or moving them backwards), either solicited or unsolicited by the child. All parenting behaviors were scored on a 0–3 scale (0 = none to 3 = extreme) each 10-second epoch of each episode. Scores were averaged across epochs within each episode.

Reliability estimates were calculated on an epoch-by-epoch level and were found to be adequate (comforting: ICC = .80; protection: ICC = .75; intrusiveness: ICC = .92). The correlations between maternal parenting behaviors in clown episode and puppet show were investigated to determine if a composite score of parenting behaviors across episodes would be appropriate. Maternal comforting behaviors scores in puppet show and clown were significantly correlated (r = .34, p = .001), therefore, the scores were averaged to create a composite score across episodes. However, for maternal intrusive parenting (r = .13, p = .193) and maternal protective parenting (r = .08, p = .418), scores were not correlated across episodes, so a composite score could not be justified. Given that both episodes theoretically have similar threat levels and behaviors in the clown episode demonstrated more variability, maternal protective and intrusive behaviors from the clown episode were used in analyses.

Child social and separation anxiety.

Mothers completed the Preschool Anxiety Scale (PAS) to report on observed symptoms of anxiety at child age 4 years44. The PAS demonstrates adequate internal consistency, cross-informant reliability, and test-retest reliability45. Mothers responded to items by indicating how often the child engaged in specific behaviors on a 5-point scale (0 = not true at all to 4 = very often true). The Social Anxiety subscale consists of 6 items (α = .82; e.g., “Is afraid of meeting or talking to unfamiliar people”). The Separation Anxiety subscale consists of 5 items (α = .63; e.g., “Becomes distressed about your leaving him/her at preschool/school or with a babysitter”). The Separation Anxiety subscale had a low alpha and should be considered a limitation of this study. For each scale, items were summed to yield the final variables, with higher values indicating higher levels of anxiety.

Results

Due to the longitudinal nature of the study, missing data were inevitable. For age 2 dysregulated fear, 12.7% of values were missing due to technological error and/or child refusal to participate. For age 2 parenting behaviors, 14.4% of data were missing for the same reasons, as well as the mother being off-camera for the entirety of the episode. For age 4 social and separation anxiety, 41.1% of participants were missing the entire PAS questionnaire due to attrition. One-hundred percent of item-level data were present for participants that completed the PAS. Little’s Missing Completely at Random statistic was nonsignificant ( χ2[10]= 3.71, p = .959) and suggested that the pattern of missingness did not significantly deviate from the missing completely at random pattern. All missing data were imputed using multiple imputation with 40 imputations and all variables in interest included in the algorithm. Multiple imputation is considered one of the best strategies for handling missing data46 because it increases the utility of the existing data, and is most accurate for longitudinal designs47.

Descriptive statistics were computed (see Table 1), and variables were examined for outliers, skew, and kurtosis as indicators of non-normality. Although protection and intrusiveness had higher skewness and kurtosis than desired (protection: skewness = 3.24, kurtosis = 10.62; intrusiveness: skewness = 3.42, kurtosis = 11.98), transforming the variables (e.g., square root, logarithm, inverse) did not bring skew below 3.00, so raw values were used. Therefore, raw values were used for all variables including maternal protective behaviors and intrusive behaviors. Bivariate correlations indicated that DF at age 2 was significantly correlated with maternal comforting, protective, and intrusive parenting behaviors as well as separation anxiety, but not social anxiety at age 4. Additionally, intrusive parenting behaviors were significantly correlated with separation anxiety, but not social anxiety at age 4 while comforting and protective behaviors did not significantly relate to anxiety outcomes (see Table 1).

Table 1.

Descriptive Statistics and Bivariate Correlations for Primary Study Variables

Variable Mean n 2 3 4 5 6
1. Toddler Dysregulated Fear 1.79 103 .52** .23* .29** .28** .20
2. Maternal Comforting Behavior 0.17 101 -- .48** .55** .27 .23
3. Maternal Protective Behavior 0.02 101 -- .45** .08 .07
4. Maternal Intrusive Behavior 0.06 101 -- .30* .08
5. Child Separation Anxiety 0.71 66 -- .37**
6. Child Social Anxiety 0.74 66 --
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Note.

*

p< .05,

***

p<.001

Demographic variables (i.e., income, maternal education, maternal race, child race, child biological sex) were investigated as possible covariates. No demographic variables were significantly correlated with primary variables of interest and, therefore, were not included as covariates.

Multiple regression was used to investigate each individual path. Contemporary approaches to testing indirect effects suggest against assuming normal distribution and rather determine the indirect effect through bootstrapping or the Monte Carlo Method for assessing mediation. Given that multiply imputed files cannot be used with macros requiring raw data (e.g., PROCESS48), we used the Monte Carlo Methods for Assessing Mediation which creates sampling distributions around regression coefficients and then samples values from those distributions to create a sample distribution to then determine the indirect effect49,50.

Assessing Indirect Effects

Separation anxiety.

The first set of analyses examined the relation between DF at child age 2 and child separation anxiety outcomes at age 4 through each maternal parenting behavior in a parallel model testing indirect effects. This model testing indirect effects incorporated the three maternal parenting behaviors and tested their indirect effects above and beyond each other. Multiple regression analyses were used to examine how the three parenting behaviors indirectly link the relation between DF at child age 2 and separation anxiety at child age 4 (see Table 2).

Table 2.

Regression analyses for separation anxiety model assessing indirect effects

Variable b SE β t
Paths A (IV=dysregulated fear)
DV: Maternal comforting behavior 0.18 0.03 0.49 5.99**
DV: Maternal protective behavior 0.02 0.01 0.23 2.57*
DV: Maternal intrusive behavior 0.10 0.03 0.29 3.26**
Path C (DV=separation anxiety)
Dysregulated fear 0.36 0.09 0.35 4.02**
Paths C’ and B (DV=separation anxiety)
Dysregulated fear (age 2) 0.26 0.10 0.25 2.57*
Maternal comforting behavior 0.40 0.29 1.42 1.36
Maternal protective behavior −2.15 1.09 −0.19 −1.96†
Maternal intrusive behavior 0.80 0.30 0.26 2.67*
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Note. Regression analyses examining relation between DF and separation anxiety outcomes as indirectly linked by parenting behaviors.

†

p < 0.10,

*

p< 0.05,

**

p< .001

The Monte Carlo Method for Assessing Mediation was used to examine the indirect effects. The total indirect effect between DF at age 2 and child separation anxiety at age 4 as indirectly linked by maternal comforting, protective, and intrusive parenting behaviors was not significant (ab = 0.10, SE = 0.06, 95% CI[−0.003, 0.25]). The indirect relation between DF at child age 2 and separation anxiety at child age 4 through comforting behaviors above and beyond protection and intrusiveness was not significant (ab = 0.07; SE = 0.06; 95% CI [−0.03, 0.18]). The indirect relation between DF at child age 2 and separation anxiety at child age 4 through protective parenting behaviors above and beyond comforting and intrusiveness was not significant (ab = −0.05; SE = 0.03; 95% CI [−0.12, 0.001]). Finally, the indirect relation between DF and separation anxiety through maternal intrusive behaviors above and beyond protective and comforting behaviors was significant (ab = 0.08; SE = 0.04; 95% CI [0.01, 0.17]; see Figure 1). Therefore, results suggest that maternal protective and intrusive parenting behaviors are unique mechanisms through which age 2 DF leads to separation anxiety at child age 4 while accounting for one another as well as maternal comforting behaviors.

Figure 1.

Figure 1.

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Maternal comforting behavior did not indirectly link the relation between toddler age 2 dysregulated fear and child age 4 separation anxiety above and beyond maternal protective behavior and maternal intrusive behavior (ab=0.07, SE = 0.06, 95% CI [−0.03, 0.18]). Maternal protective behavior did not indirectly link the relation between toddler age 2 dysregulated fear and child separation anxiety above and beyond maternal comforting behavior and maternal intrusive behavior (ab=−0.05, SE = 0.03, 95% CI [−0.12, 0.001]). Maternal intrusive behavior indirectly link the relation between toddler age 2 dysregulated fear and child age 4 separation anxiety above and beyond maternal comforting behavior and maternal protective behavior (ab=0.08, SE = 0.04, 95% CI [0.01, 0.17]).

*p < .05, **p < .01, ***p <.001

Social anxiety.

The second aim examined the relation between DF at child age 2 and child social anxiety outcomes at age 4 through each maternal parenting behavior in a parallel model assessing indirect effects. Multiple regression analyses were used to examine how the three parenting behaviors indirectly link the relation between DF at child age 2 and social anxiety at child age 4 (see Table 3).

Table 3.

Regression analyses for social anxiety model assessing indirect effects

Variable b SE β t
Paths A (IV=dysregulated fear)
DV: Maternal comforting behavior 0.18 0.03 0.49 5.99**
DV: Maternal protective behavior 0.02 0.01 0.23 2.57*
DV: Maternal intrusive behavior 0.10 0.03 0.29 3.26**
Path C (DV=separation anxiety)
Dysregulated fear 0.30 0.09 0.29 3.23**
Paths C’ and B (DV=separation anxiety)
Dysregulated fear (age 2) 0.27 0.11 0.26 2.47*
Maternal comforting behavior 0.18 0.31 0.06 0.57
Maternal protective behavior −0.18 1.18 −0.02 −0.16
Maternal intrusive behavior 0.04 0.32 0.01 0.12
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Note. Regression analyses examining relation between DF and social anxiety outcomes as indirectly linked by parenting behaviors.

*

p< 0.05,

**

p< .001

The Monte Carlo Method for Assessing Mediation was used to examine the indirect effects. The total indirect effect between DF at age 2 and child social anxiety at age 4 as indirectly linked by maternal comforting, protective, and intrusive parenting behaviors was not significant (ab = 0.03, SE = 0.06, 95% CI[−0.08, 0.14]). The indirect relation between DF at child age 2 and social anxiety at child age 4 through comforting behaviors above and beyond protection and intrusiveness was not significant (ab = 0.32; SE = 0.06; 95% CI [−0.08, 0.15]). The indirect relation between DF at child age 2 and social anxiety at child age 4 through protective parenting behaviors above and beyond comforting and intrusiveness was not significant (ab = −0.004; SE = 0.02; 95% CI [−0.06, 0.05]). Finally, the indirect relation between DF and social anxiety through maternal intrusive behaviors above and beyond protective and comforting behaviors was not significant (ab = 0.004; SE = 0.02; 95% CI [−0.06, 0.07]; see Figure 2).2Therefore, results suggest that these parenting behaviors do not indirectly link the relation between DF and age 4 social anxiety above and beyond each parenting behavior.

Figure 2.

Figure 2.

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Maternal comforting behavior did not indirectly link the relation between toddler age 2 dysregulated fear and child age 4 social anxiety above and beyond maternal protective behavior and maternal intrusive behavior (ab=0.32, SE = 0.06, 95% CI [−0.08, 0.15]). Maternal protective behavior did not indirectly link the relation between toddler age 2 dysregulated fear and child social anxiety above and beyond maternal comforting behavior and maternal intrusive behavior (ab=−0.004, SE = 0.02, 95% CI [−0.06, 0.05]). Maternal intrusive behavior did not indirectly link the relation between toddler age 2 dysregulated fear and child age 4 social anxiety above and beyond maternal comforting behavior and maternal protective behavior (ab=0.004, SE = 0.02, 95% CI [−0.06, 0.07]).

*p < .05, **p < .01, ***p <.001

Discussion

The current study sought to expand the extant literature by examining the relation between child DF and child social anxiety development through various maternal parenting behaviors. The results of the study provided initial support for the positive relation between DF and child separation anxiety development. The models investigating indirect effects indicated that maternal intrusive parenting behaviors indirectly linked the relation between toddler age 2 DF and child age 4 separation anxiety over and above maternal comforting and protective parenting behaviors. Results suggest that maternal intrusive parenting behavior is a mechanism through which DF predicts separation anxiety longitudinally.

Importantly, the current study is the first to examine the relation between DF and intrusive parenting. Maternal intrusive behaviors have been positively related to displays of fear in children who already show high levels of fearful temperament15,19. As noted, maternal intrusive behaviors accounted for unique variance above and beyond comforting and protective parenting behaviors in the relation between DF and separation anxiety, indicating that intrusive parenting may be a mechanism through which DF predicts separation anxiety. This mechanism may occur because intrusive behaviors further reinforce the child’s own fear levels. As intrusive behaviors are characterized by mothers acting against children’s own desires (e.g., pulling children towards the clown when they do not want to interact with it), they may reinforce the children’s feelings that they cannot trust their own instincts regarding their emotions, increasing their reliance on their caregivers51. Therefore, children may become more reliant on caregivers for instruction on how to react to fearful situations. Forcing children to interact with a stimulus of which they are already fearful may also increase their arousal to levels they cannot independently regulate. Therefore, when they are faced with separation from their caregiver, they are ill-equipped to deal with the independent regulation it requires. This dependency on their caregivers for regulation could lead to apprehension and anxiety when it comes to novel situations or separation from their caregivers, thus reinforcing a cycle of parenting behavior and behavioral regulation that increases risk for anxiety development.

Maternal comforting and protective behaviors did not indirectly link the relation between age 2 DF and age 4 social anxiety or separation anxiety above and beyond intrusive and protective behaviors. Although our hypotheses predicted that each parenting behavior would significantly predict social and separation anxiety, it is possible that comforting and protective behaviors are simply not mechanisms through which dysregulated fear predicts future separation or social anxiety symptoms. More specifically, comforting and protective behaviors may not accommodate the child’s fearful tendencies, but rather provide the child with appropriate levels of comforting and protection when the child desires it as the comforting behaviors measured were solicited by the child52. It is also possible that maternal comforting and protective behaviors are related to child anxiety development later in childhood and serve as an adaptive form of parent supported regulation in early toddlerhood. That is, comforting and protective parenting behaviors may more developmentally appropriate for toddlers who still need support in self-regulation, whereas these behaviors may interfere with developing autonomous self-regulation later in childhood.

Contrary to hypotheses, the study yielded nonsignificant findings in relation to social anxiety. It is possible that the developmental stage of the children from which data were collected from may preclude prediction of social anxiety. Social anxiety symptoms are not as relevant in 4-year old children due to typical patterns of cognitive development (i.e., skills required to evaluate oneself in relation to others and understand that evaluation may be negative have not yet developed). That is, we could expect to see an increase in social anxiety symptoms as the child ages and becomes more socially involved. Previous research suggests that separation anxiety may be a precursor to social anxiety, which suggests the lack of findings in relation to social anxiety may be developmentally appropriate23,24. Future studies should consider the developmental trajectory of separation and social anxiety and consider how early temperamental indicators may relate to social anxiety in middle childhood as indirectly linked by parenting behaviors.

Finally, we focused on separation and social anxiety for a number of reasons. There is a strong pattern in the literature that suggests temperament risk factors (behavioral inhibition and DF) increase risk for the development of social anxiety13. Separation anxiety is thought to be a precursor to social anxiety and may be a developmentally appropriate indicator of later social anxiety development5. It is possible, however that other forms of anxiety (e.g., worry and specific phobia) are also important to consider when investigating the impacts temperament may have on later psychopathology as indirectly linked by parenting behaviors. Future studies may consider investigating the relations between temperament, parenting, and other forms of anxiety (e.g., worry, specific phobia).

Strengths and Limitations

There are a number of strengths associated with the current study. We utilized a longitudinal design, which allowed for the investigation of the predictive relation. Models assessing indirect effects were investigated using data from mother-child dyads who participated in assessments over the course of two years. In order to avoid shared method variance with outcomes variables, including observational data from the same low-threat episodes for both measures of DF and parenting behaviors was a large strength of the study. We recruited typically developing children, meaning that mother-child dyads were not recruited on the basis of having a clinically diagnosed anxiety disorder nor were dyads recruited on the basis of being at heightened risk for the development of anxiety. This may be a strength as the use of subclinical population provides information for the prevention of the development of clinical levels of anxiety, but it may also be a limitation in that these finding are unable to generalized to a clinical population.

Although there were a number of strengths, the current study is not without its limitations. The current study was correlational in nature, meaning we cannot conclude that parenting behaviors are a causal mechanism of anxiety development. The current study had a higher amount of missing data at age 4 than might be expected. Results using imputation are consistent with results using raw data; however, it is still important to interpret these results with the knowledge of high attrition. Additionally, the sample of participants used in the current study was rather homogenous (i.e., middle class and White) and future studies should investigate such relations in more diverse populations in order to understand cultural influences on these types of parent-child dynamics. Furthermore, child anxiety scores were reliant on maternal report with the Separation Anxiety subscale of the PAS having a low alpha, and future work should include a more holistic measure of child anxiety (e.g., behavioral and report measures).

While the current study examined how each parenting behavior indirectly linked the relation between temperament and child anxiety outcomes separately, these parenting behaviors are not mutually exclusive. Research should investigate different profiles, or patterns, of parenting behaviors to determine if the extent to which mothers engage in a variety and varying degrees of behaviors, may impact anxiety development.

Summary

Temperamental characteristics (i.e., dysregulated fear (DF), or the display of high fear in low threat contexts), have been shown to predictive of child anxiety. Additionally, parenting behaviors (i.e., maternal protective, comforting, and intrusive behaviors) have also been linked to child anxiety development and though to reinforce displays of fear and decrease independent emotion regulation. The first aim of the current study investigated the relation between DF (age 2) and child separation anxiety (age 4) as indirectly linked by maternal protective, comforting, and intrusive behaviors. The second aim investigated the relation between DF and social anxiety at age 4 as indirectly linked by parenting behaviors. Results suggested that DF significantly and positively predicted child separation anxiety through maternal intrusive behaviors, above and beyond protective and comforting behaviors. Protective and comforting parenting behaviors were not found to serve as indirect effects between DF and separation anxiety above and beyond intrusive parenting behavior. Importantly, no parenting behaviors were found to indirectly link the relation between DF and social anxiety.

Overall, the current study expanded the extant literature on both DF as a predictor of anxiety (i.e., social and separation anxiety symptoms) and maternal parenting behaviors as indirect effects in anxiety outcomes. The current study more specifically suggested that maternal intrusive behaviors were shown to be the most predictive indirect link between DF and anxiety outcomes over and above comforting and protective behaviors. These results may have future implications for clinical practice such that parenting behaviors may be targeted in treatment for children who are at-risk for or are experiencing social or separation anxiety symptoms.

Funding:

The project from which these data were derived was supported, in part, by a grant from the National Institute of Child Health and Human Development (R15 HD076158) and funds from the Miami University College of Arts and Science, both to Elizabeth J. Kiel. We express our appreciation to the staff of the Behavior, Emotions, and Relationships Lab at Miami University for assistance with data collection, and to the families who participated in this project.

Footnotes

Publisher's Disclaimer: This Author Accepted Manuscript is a PDF file of an unedited peer-reviewed manuscript that has been accepted for publication but has not been copyedited or corrected. The official version of record that is published in the journal is kept up to date and so may therefore differ from this version.

Conflict of Interest: The authors declare no conflict of interests.

Ethical Approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent: Informed consent was obtained from all individual participants included in the study.

2

Results produced by raw data values remained consistent with results from our multiply imputed dataset. Maternal comforting behavior did not mediate the relation between toddler age 2 dysregulated fear and child age 4 separation anxiety above and beyond maternal protective behavior and maternal intrusive behavior (ab=0.04, SE = 0.13, 95% CI [−0.23, 0.26]). Maternal protective behavior did not mediate the relation between toddler age 2 dysregulated fear and child separation anxiety above and beyond maternal comforting behavior and maternal intrusive behavior (ab=−0.01, SE = 0.06, 95% CI [−0.22, 0.07]). Maternal intrusive behavior mediated the relation between toddler age 2 dysregulated fear and child age 4 separation anxiety above and beyond maternal comforting behavior and maternal protective behavior (ab=0.12, SE = 0.07, 95% CI [0.02, 0.29]). Maternal comforting behavior did not mediate the relation between toddler age 2 dysregulated fear and child age 4 social anxiety above and beyond maternal protective behavior and maternal intrusive behavior (ab=−0.09, SE = 0.13, 95% CI [−0.37, 0.16]). Maternal protective behavior did not mediate the relation between toddler age 2 dysregulated fear and child social anxiety above and beyond maternal comforting behavior and maternal intrusive behavior (ab=−0.009, SE = 0.06, 95% CI [−0.15, 0.06]). Maternal intrusive behavior did not mediate the relation between toddler age 2 dysregulated fear and child age 4 social anxiety above and beyond maternal comforting behavior and maternal protective behavior (ab=0.03, SE = 0.06, 95% CI [−0.05, 0.25]).

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