What, me worry? Adolescent generalized anxiety disorder symptoms and problemematic interactions in the family

Abstract

Research has shown that Generalized Anxiety Disorder is one of the most common anxiety disorders found in adolescents today. Its main symptoms are disproportionate fear and anxiety (worrying) about work-related or school-related events or activities and social relations. Adolescents suffering from GAD symptoms have difficulty keeping fear and worries in check. This causes mounting stress and impairs their functioning. GAD sufferers tend to worry about issues stemming from social relationships in their immediate surroundings. This dissertation examined the relationship between adolescent GAD symptoms and problematic interactions in the family. The studies used data from longitudinal samples taken from the CONAMORE and RADAR-old projects. In CONAMORE, 1,313 adolescents filled out questionnaires for five consecutive years. In RADAR-old, 327 adolescents and their parents filled out questionnaires for three consecutive years. Chapter 2 examined the Screen for Child Anxiety Related Emotional Disorders (SCARED) questionnaire and evaluated its psychometric characteristics when applied to a general adolescent population in the Netherlands. The SCARED is a self-assessment questionnaire designed to measure five symptom-dimensions of anxiety, i.e. Panic Disorder, Social Phobia, GAD, Separation Anxiety Disorder and School Anxiety. The research findings supported the five symptom-dimensions for the group of adolescents as a whole and for different age, gender and ethnic subgroups. These research findings confirmed the SCARED's suitability for measuring anxiety symptoms such as those associated with GAD in adolescents. Chapter 3 focused on a longitudinal study into the interaction between GAD symptoms in adolescents on the one hand and perceived parental control on the other. A reliable child effect model was established: adolescent GAD symptoms predicted adolescent perception of parental control one year later. Adolescents with GAD symptoms perceived their parents as increasingly controlling during their adolescence. Chapters 4 and 5 investigated the relationship between GAD symptoms and problematic interactions in family relationships. The study in Chapter 4 focused on the relationship between GAD symptoms and the use of exiting statements as a conflict resolution style in parent-child conflicts. Exiting statements are statements that express the adolescent’s wish to minimize or cut off contact with his or her parents. In late adolescence, when the parent-child relationship becomes less hierarchical and more equal, girls in particular tend to use the ineffective and destructive conflict resolution strategy of exiting statements in arguments with their parents. Chapter 5 zoomed in on a longitudinal study into the mutual effects of parental marital conflict, the adolescent’s perception of those conflicts and the adolescent’s GAD symptoms. These effects can be explained using a bi-directional effect model. In short, the studies in this dissertation confirm the hypothesis that GAD symptoms in adolescents contribute to problematic interactions in families. An overarching theme in these studies is the importance of adolescent perception in the relationship between these GAD symptoms and problematic interactions. The child effects established by these studies confirm recent theories about the development of GAD symptoms in adolescents.