Do Mothers Influence the Development of Social Phobia and Social Anxiety in their Children - Essay Example

Do Mothers Influence the Development of Social Phobia and Social Anxiety in their Children? Introduction Childhood fears and anxieties are a common thing in with children all over the world. As a child grows, at a certain stage in life, every child experiences some fear and anxiety. This is so because in most cases, childhood is all about potentially threatening things; new people, new schools, taking tests at home and in school, moving to new places and learning new things in life. One way or another, many children learn adequately ways of dealing with these fears in their life. However, some do not. These fears end up causing distress in their life and interfering with their normal day to day life. If such fears are not properly addressed in the early stages of the child’s life, he or she grows up feeling afraid of the real world and when faced by social challenges. Such challenges may not only affect their social life but also severely damage their mental health. For example, depression has been highly linked to social phobia and anxiety. With severe depression, a child’s education may be cut short if the child is then referred to a mental facility. Literature Review Anxiety disorders are very common psychological disorders among children. According to Angold and Costello (1995) the world’s statistics reveal that about 18 percent of adults and children experience various kinds of anxiety disorder. Therefore, anxiety disorders are quite common in the lives children (Cartright-Hatton et.al, 2006). According to the American Association (1994), anxiety disorders in children can be classified in a similar way to anxiety disorders in adults. Some psychologists view anxiety disorders in children as a downward extension of the adult cognitive disorder (Schniering, et.al, 2000). However, not all fears in human beings are problematic. Beidel et.al (1999) argue that fear is considered problematic and needs to be dealt with only in some situations. Such situations arise when fear, for example, is a sign of brain dysfunction; it is inappropriate to the period of mental development; it becomes persistent over a period of time, and when it is out of proportion to the dangers of their situation. A survey of British children revealed that children aged five to ten years are more likely to develop separation anxiety than children of the ages eleven years to sixteen years (Gren-Landell et.al, 2009). Older children had more likelihood of suffering from social phobia as well as generalized anxiety disorders. Common fears in childhood The fears and worries of human beings vary with age. In a survey done on children, it was found that seventy six percent of them had a fear of an object or situation, about sixty seven percent of them worried and around eighty percent experienced ‘scary dreams’ (Muris et.al, 2000). Most of these children feared animals, being kidnapped, imaginary creatures and other imaginary bad things, as well as the social threats in their lives. Scary dreams and fears were found to be common amongst children aged four to six years, and became more frequent between the ages of 7 to 9 years and less frequent between the ages of 10 to 12 years. According to Reynolds and Richmond (1978), fears in children are a common thing in most cultures of the world. Nevertheless, Ollendick et al (1996) observed a number of variations across different groups of children from Australia, America, Nigeria and China. In this context, the Nigerian children were more fearful when compared to other group. American, Australian and Chinese children did not differ from each other. Closer attention to the Nigerian and the Chinese groups revealed that they had higher safety and social-evaluative fears than the American and Australian children. This is as a result of cultural norms and values in the respective societies. The researcher suggested that this was because both Nigerian and the Chinese cultures put a lot of emphasis on cultural factors such as self-control, compliance to social rules and emotional restraint compared to the Australian and the American cultures. Social phobia and anxiety Social phobia is a condition that normally emerges in mid adolescence. It is significantly associated with both functional and psychological impairments in teens. They are treatable even though it may take years to disappear. Clinicians and psychologists use a variety of cognitive models as evidence of social phobic conditions. These cognitive models have been used, worldwide, to evaluate social phobia and anxiety not only in children but also in adults. Beck (1976) suggests that it is possible for clinicians to adequately evaluate the behaviors of a person with social phobia using these cognitive models. Beck (1976) described social phobia as a condition which makes an individual overestimate danger in crucial life situations and which undermines their ability mind to cope with such situations. Beck et.al (1985), stipulates that, in most cases, social phobia is influenced by the thoughts people hold as fact about themselves, as well as the standards they attach to their behaviors in different situations. In this way, social phobia is triggered by particular cognitions of individuals. There are three points of difference in the diagnosis of social phobic conditions in adults and children. First is the difference in how children react and express distress in various social situations when compared to adults. A good example of this would be that when children express their distress they cry, freeze or shrink from social encounters. Secondly, the children do not necessarily need to realize that their fear is excessive or unreasonable. Thirdly, their fear must prevail for more than six months to differentiate it from adjustment to new situations. Social phobia is on a continuum with social anxiety. According to Rapee (1995), social phobia lies at the top level end of the anxiety continuum. Therefore, high levels of social anxiety are highly linked with social phobia (Rapee and Spense (2004). In western society, the lifetime prevalence of social phobia has been estimated to be between 7 percent and 13 percent (Furmark, 2002; Fehm et.al, 2005, Kessler et.al, 2005, Ruscio et.al, 2008). Statistics have revealed that approximately 0.22 to 6 percent of children are affected by social phobia, while many children show high levels social anxiety or symptoms such as mild social fears, shyness and avoidance (Essau et.al, 1999; Ford et.al, 2003; Van Roy et.al, 2009, Sweeney and Rapee, 2005). Furmark (2002) suggests that the variation in the prevalence rates observed in different studies is attributable the methodological differences, as well as cultural differences prevailing in the different samples used in the different studies. Social phobia is a common occurrence for many children and emerges in early to mid teens (Last et.al, 19992; Rapee, 1995, Otto et.al, 2001). Changes as a result of cognitive development, and social developments at this stage of life are perceived responsible for the emergence of social phobia (Rapee and Spense, 2004). In early adolescence, things change. At this time, children have already developed the cognitive capacity and see themselves as perceived by others. Also, at this stage, they are able to make social comparisons (Cole et.al, 2001). During adolescence, the child’s social interactions with their peers increase in importance as they further enhance their independence from their parents (Ingersoll, 1989). Therefore, according to Rapee and Spence (2004), their increased need to interact with one another, and their capacity to evaluate their social actions, are significant factors contributing to their social phobia. Furmark (2002), further studied social phobia in adults compared to social phobia in children and observed that, in a community sample, adult females meet the criteria of being social phobic and anxious more than adult males. According to Gren-Landell et,al (2009), approximately 6.6 percent of girls, compared to a 1.8 percent of boys, met the criteria of social phobia in a Swedish community sample aged 12 to 14 years. But on the other hand, Last et.al (1992) found that in a sample of youths who had been referred to the mental health services, social phobia affected both girls and boys in equal proportions. Bearing in mind that, in western society, a boy is expected to play more social roles than a girl, there are more expectations that a boy will be confident and so they are more likely to be referred for treatment if they are not (Rapee and Sweeney, 2005). Childhood social phobia and anxiety mainly co-occur with several other anxiety disorders as well as depression (Strauss and Last, 1993). In a large longitudinal study, Beesdo et al. (2007) found that childhood social phobia and anxieties are were associated with depression in later life, independently of the sex and age of the individual. In short, the severity and persistence of childhood social phobia and anxiety are critical factors in the occurrence of depression at a later stage of life. Social phobia has had an impact on the social functioning and academic performance of children across the world. Beidel et.al (1999) characterized children with social phobia as lonely, isolated and living a restricted life. Studies around the world have observed a relationship between childhood social anxiety and peer problems. These problems included peer rejection, poor quality of friendship and peer neglect (La Greca and Stone, 1993; Vernberg, 1992; Ginsburg et.al, 1998). According to Verduin & Kendall (2008), children with social phobia are less liked by unfamiliar peers, compared with children who are independent. Interestingly, children suffering from other anxiety disorder are not characterized as less popular or liked than the control group. This suggests that social phobia is somehow a specific factor affecting peer group development (Verduin and Kendall, 2008; Bogels et.al, 2003). According to Spence et.al (1999), children with social phobia are likely to have a deficit in social skills. Although this has not constantly been demonstrated, children with social phobia have impaired social relations (Cartwright-Hatton et.al, 2003; Cart-wright-Hatton et.al, 2005). Further, Essau et.al (1999), approximately 60 percent of the adolescents with social phobia revealed impaired relations at school. Hence, most children with social phobia drop out of school since they are not able to create good social connections (Last et.al, 1991). Relationship between social phobia and anxiety in children and parents In the past, different researchers have linked parent’s anxiety to the development of social phobia and anxiety in their children. According to Turner et.al (1987), parental anxiety is one of the best predictors of childhood phobia and anxiety. Children with very anxious parent are three and a half times more likely to develop social phobia and anxiety conditions, as compared to children with less anxious parents (Turnel et.al, 1987). In this context, parents who are anxious are more likely to be over-involved and over-protective to their children since they do everything possible to limit the child’s distress. Their overprotection makes the child more vulnerable to social anxiety when the child then avoid threats in their life, increasing their bias to perceive dangers in life and further underestimate their cognitive ability to deal with such situations. Bandura (1978) proposed that parental anxiety can be passed down to the child through different social learning processes. According to Fyer et.al (1995), the adults with social phobia and anxiety conditions are more likely to have relatives with similar disorders. This is as a result of the fact that such individuals have a similar genetic predisposition (Stein et.al, 1998). Social phobia and anxiety conditions may therefore be passed down to the siblings. Lieb et.al (2000) and Amir et.al (1998), demonstrated that there was a significant interrelation between the parental and childhood symptoms of social phobia and anxiety. Cresswell et.al (2010), further explored the interrelation between the parent’s anxiety and that of the child and found out that there is a significant relation since, in real life, most parents who are anxious and view the world as such a threatening place expects their children to view the world with a similar perspective. Additionally, Lester et.al (2009) established that anxious parents view the world of their children in a similar way to that in which they view their own. Different scholars have undertaken different studies to investigate which of the family’s genes pass down the anxiety disorders to their children. The fact is, it is hard to establish the specific genes influencing the development of social phobia and anxiety (Eley, 1999). A study on the comorbidity of depression, panic disorder, social phobia and depression, suggested that the variance in social anxiety may be due to specific social anxiety genes (Mosing et.al, 2009). Rationale of the study There are various models that have been developed by different psychologists to help explain the process of development of social phobia and anxiety in adults and children. Many models have been tested with adults, but not all have been tested in children. This study will investigate some of these models to help explain how parents influence the development of social phobia and anxiety in their children. Rapee and Spence’s (2004) developmental model will be used to critically investigate the role played by parents in the development of their children’s social phobia. In particular, this study will analyze the behaviors of the parent and how such behaviors influence the cognitions of their children. Creswell et.al’s (2010) model will be used to analyze the various traits and anxiety symptoms in the parent and child, including their general anxiety. This will add further evidence in support of Quinn’s study, which used this model to analyze anxiety symptoms when testing for social phobias and anxiety in children. Research aims and objectives The main aim of the study will be to add more on the literature exploring maternal influence on the development process of social phobia and anxiety in children. The focus of the study will be based on the following objectives: i. To investigate whether mothers play a definite role in development of social fears and anxiety in children. ii. To critically evaluate the cognitive effects of social phobia and anxiety in children. iii. To investigate if the social anxiety symptoms of mothers contribute to social phobia and anxiety in their children. iv. To investigate whether maternal threat-interpretations are transmitted to their children. v. To examine whether there are similarities in the development process of social anxiety and in social phobia. Research Topic and hypothesis This study will be undertaken to ascertain how mothers influence the development of social phobia and anxiety in children as revealed in their cognitions and their social relations. In order to effectively guide the research process, the researcher has developed a number of hypotheses to be used in this study. Research hypothesis Hypothesis One: The mother’s threat-interpretations and distress in social situations will be a positively correlated with their child’s social threat-interpretations and distress. Hypothesis Two: The mother’s social anxiety and social phobia symptoms will be positively correlated with their child’s symptoms of social anxiety. Hypothesis Three: The mother’s expectations of the child’s social threat-interpretations and distress in various social situations will be positively correlated to the children’s social threat interpretations and distress. Hypothesis Four: The mother’s expectations of the child’s social threat-interpretations will strongly correlate with the child’s social anxiety and social phobia. Hypothesis Five: The child’s social phobia and anxiety will be positively correlated to their concern about the perception of them held by others. Research Methodology The study will involve children in their late childhood together with their mothers. This sample will be a non-clinical sample. The recruitment of this sample will not be focused on certain groups since it is believed that most of the factors under investigation such as the social cognitive biases and social anxieties in both the parents and children exist on a continuum (Harvey, 2004). This sample will make it possible for the researcher to adequately focus on children within a very narrow age range which is a difficult thing to do if a clinical sample is used. During the study, the researcher does not expect to cause any harm to the participants as a result of the questionnaires to be used. Therefore, there are no ethical concerns expected in this study. Also, the different participants will not be forced to participate in this study; participation will be voluntary. The study design The study will be a non-experimental correlation design. The participants will fill in questionnaires and assent forms at a certain point during the research process. The use of mother-child dyads will allow the researcher make between group comparisons between the symptoms, cognitions and expectations of the mother and the symptoms and cognitions of the child. This will be achieved through between-group analysis. Target Population The children to be targeted will be of ages 9 to 11 years. This age group has been selected as it is the point when a child begins to make social comparisons and has developed the cognitive capacity to see themselves as others perceive them (Cole et.al, 2001). Therefore, this is the most suitable age in childhood to ask children about their social anxieties and fears (Last et.al, 1992). Also, at this age, the parents are still influential to the child, since past this age, adolescents tend to be more influenced by their peers more than the parents (Coleman, 1980). During the recruitment of the non clinical sample, only mothers will be recruited since mothers are naturally more attached to a child than the fathers (Bogels & Phares, 2008). Mothers and fathers influence the cognitions and development of social phobia and anxiety in different ways (Cooper et.al, 2006; Bogels et.al, 2010). Fathers are more difficult to recruit in a research project. Therefore, the researcher will choose the best possible combination of mother-child dyads to help her adequately conduct her investigation. The recruitment procedure will also be well outlined by the researcher. The researcher will select a list of schools to involve in the study from the county council website. After acquiring the names of the best schools to involve in this study, she will send invitation letters to these schools to seek consent to recruit children and their mothers through the school. Not all children in the target population will be involved in the study. There will be criteria for inclusion and exclusion. Children with learning disabilities, reading difficulties, behavioral problems or with certain mental disorders will be excluded from the target population as well as the target sample. Data collection The study will incorporate the Strengths and Difficulties Questionnaires (Goodman, 1997). These questionnaires will be adequately downloaded by the researcher from the SDC website. A SDC questionnaire will be a screening questionnaire with twenty five items. It is normally designed for children of ages three to sixteen years. The researcher will have two types of SDC; children’s version and the mother’s version. These questionnaires are able to assess psychological difficulties in five broad areas; conduct problems, inattention, relationship or peer problems, emotional symptoms as well as the pro-social behavior (Goodman, 1997). Spence Children’s Anxiety Scale- Child version (SCAS-C; Spence, 1998) will further be used in the study. SCAS-C will have forty five items. SCAS-C is a self report and normally used to assess; panic, anxiety as a result of separation, generalized anxiety, social anxiety, physical injury fear as well as obsessions (Spence, 1998). Also, the Spence Children’s Anxiety Scale- Parent version (SCAS-P; Spence, 1998) will be used in the study. It will be completed by the mothers and will have 38 items. Both the SCAS-C and SCAS-P will be acquired by the researcher from the Spence Children’s Anxiety Scale website. Social Phobia and Anxiety Inventory for Children and Social Phobia and Anxiety Inventory (SPAI-C & SPAI; Beidel, Turner & Morris, 1995) will be further used by the researcher in the study. SPAI-C is a children’s self report and will consist of twenty six items. The researcher will employ it on children to assess; cognitive, behavioral and somatic aspects in relation to social situations of the children. To the mothers, it will be a forty five itemed questionnaire rated on a seven point scale testing for both social phobia and agoraphobia. The copies of the SPAI-C & SPAI will be acquired by the researcher from the Massachusetts’s General Hospital website. Ambiguous Situation Questionnaires (Creswell et.al, 2005; 2006) will further be employed in the study. This will help the researcher assess the social-threat interpretation of the children and their mothers. In this test, the researcher will read varied ambiguous situations to the participants and the participants will respond to them as the results are recorded. Each Ambiguous Situation Questionnaire will have 12 ambiguous situations with half of them referring to the physical threats and the other half to the social threats. The parent self-report will further use adult-appropriate scenarios. Copies of the Ambiguous Situation Questionnaires will be acquired by the researcher from the internet. Data Analysis During the study, both qualitative and quantitative data will be collected through the assent forms and questionnaires that will be administered by the researcher. The anonymised data collected by the researcher will be entered in the SPSS software such that the participants remain unidentifiable. During data analysis, the researcher will first screen the data collected for the missing data an anomalous results. The score distribution for each scale will be assessed through investigation of the plots of shape and through checking of the kurtosis and skewness values. Non-normal distribution of scores will be tested by use of the Shapiro-Wilk statistic. For the scales found to be non-normally distributed, the researcher will try to transform them to normal distributions. If the transformation is unsuccessful; the researcher will employ non-parametric analysis tools during the hypothesis testing. The descriptive data will further be computed and for each scale. The gender differences on the scales computed will further be analyzed by use of t-test when normally distributed and Whitney U test if the scale fails to meet the criteria for the normal distribution. For the reported anxiety symptoms levels that will be above the clinical cut off, Fisher’s Probability test will be applied in the analysis. One-tailed correlations will be used by the researcher to assess the association between the different variables in the different hypotheses. If the scales in the correlation analysis will be found to be normally distributed, Pearson r statistics will be employed. But if the scales in the correlation analysis will be non-normally distributed, Spearman’s rho statics will be used. Initial correlations between maternal expectations of child’s social –threat interpretation and social anxiety; and the correlations between the social anxiety and physical-threat will be calculated. Through a standardized score (z) as recommended by Meng et.al (1992), the researcher will check on the differences on the different coefficients. This is what will be used by the researcher to establish whether the social anxiety is more strongly related to either the physical-threat or the social-threat. Timetable Stages of Thesis Writing Process Number of days/weeks needed Start date End Date Literature surveys 3 weeks 7th April 30th April Data Collection 2 months 1st May 30th June Production 1 months 1st July 31st July Modeling 1 months 1st Aug 31st Aug Review 1 month 1st Sep 30th Sep Analysis 1 month 2 weeks 1st Oct 15th Nov Testing 3 weeks 15th Nov 5th Dec Reporting 2 weeks 6th Dec 20th Dec Chapter and thesis writing 2 months 21st Dec 14th Feb 2016 Thesis submission date 15th Feb 2016 References American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders(3rd ed.). Washington, DC: Author. Angold, A., & Costello, E. J. (1995). Developmental epidemiology. Epidemiologic Reviews, 17, 74. Amir, F., Foa, E. B., & Coles, M. E. (1998). Negative interpretation bias in social phobia. 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