Perceived Peer Victimization Predicts Anxiety Outcomes in a Prevention Program for Offspring of Anxious Parents

Abstract

Offspring of anxious parents are at heightened risk for developing anxiety disorders. Preventive interventions for these youths are promising but not universally effective, creating a need to identify outcome predictors. Peer experiences (e.g., peer victimization, social support) are associated with youth anxiety trajectories but have been relatively unexplored in this context. Thus, this study tested whether peer experiences predicted anxiety-related outcomes in families participating in a randomized controlled trial of a child anxiety prevention program for families with a clinically anxious parent. Parental anxiety severity was also examined as a moderator of relations between peer experiences and subsequent child anxiety. Participants were 121 families (child M age = 8.69, 55.90% girls). Hierarchical logistic and linear regressions were used to test whether baseline peer-related factors predicted increased anxiety symptom severity and anxiety disorder onset over 12 months. Youths reporting greater perceived peer victimization at baseline were more likely to develop an anxiety disorder and had more severe anxiety symptoms 12 months later. Lower social support from classmates also predicted increased anxiety severity, but this effect became nonsignificant after accounting for peer victimization. Further, parental anxiety severity moderated the peer victimization–child anxiety severity link: Higher child-reported peer victimization predicted increased anxiety in offspring of highly and moderately anxious but not low anxious parents. Children’s reports of peer victimization appear important for understanding which youth may not respond to preventive interventions in high-risk families—especially for children with more severely anxious parents. Implications for the focus of selective anxiety prevention programs are discussed.

FUNDING

This study was supported by a grant (R01 MH077312) awarded to Dr. Golda Ginsburg by the National Institute of Mental Health. ClinicalTrials.gov: NCT00847561.

Notes

¹ Given high rates of comorbidity between anxiety and depression, it is often useful to include depressive symptoms as a covariate in assessing anxiety-specific outcomes. However, no child participating in this study met diagnostic criteria for major depressive disorder (MDD) at any assessment point over the course of the study, based on the ADIS C/P. Further, children’s mean MDD CSR at baseline was .03 out of 8, and 97.8% of youths’ baseline MDD CSRs were 0. Based on the lack of MDD—or even subclinical MDD (e.g., CSR of 3)—in participating youths, depressive symptoms are extremely unlikely to have confounded results in this present study. Accordingly, we did not control for depression symptom severity (based on MDD CSRs) in analyses.

² Raw Total Anxiety CSR values at 12-month follow-up were available for 107 of the 121 youths whose 12-month follow-up data were collected. The original study was conducted within a survival analysis framework. Thus, the last observation carry-forward was used to estimate 12-month CSRs for youths diagnosed with an anxiety disorder throughout the study. Specifically, Total Anxiety CSR values were carried forward from either the postassessment or 6-month assessment, depending on the point at which children met criteria for an anxiety diagnosis. Results did not differ when using the last observation carry-forward–adjusted severity variable (n = 121) and unadjusted severity variable (n = 107) as outcomes.

Additional information

Funding

This study was supported by a grant (R01 MH077312) awarded to Dr. Golda Ginsburg by the National Institute of Mental Health. ClinicalTrials.gov: NCT00847561