The Role of Family-Level Factors in Childhood Anxiety During the COVID-19 Pandemic
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childhood anxiety disorders
functional magnetic resonance imaging (fMRI)
parental assistance with child emotion regulation


The COVID-19 pandemic has caused pervasive disruptions to family life. In light of the established role of parent-child dynamics in the maintenance of pediatric anxiety, we conducted a multilevel, multimodal study to examine how family-level factors moderate anxious youths’ responses to the COVID-19 pandemic. Prior to the pandemic (“pre-pandemic”), children with anxiety disorders (n = 28; ages 6-12) completed an fMRI task probing parental modulation of amygdala reactivity to fearful faces. During the first peak of the COVID-19 pandemic (“mid-pandemic”), parents completed questionnaires about their family’s exposure to COVID-19-related stress, their child’s COVID-19-related fears and behaviors, and their own (parental) functioning. Pre-pandemic parental modulation of amygdala reactivity moderated the association between children’s exposure to COVID-19-related stress and their COVID-19-related fears and behaviors. Furthermore, greater mid-pandemic parental assistance with their child’s use of venting and with their child’s use of expressive suppression as emotion regulation strategies exacerbated the effects of COVID-19-related stress on children’s COVID-19-related fears and behaviors, respectively. These results provide preliminary insight into the ways in which distinct family-level factors may buffer or exacerbate the effects of COVID-19-related stress on youth with a history of anxiety disorders.
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Copyright (c) 2023 Elizabeth R. Kitt, Emily M. Cohodes, Sarah McCauley, Grace Hommel, Cristina Nardini, Sadie J. Zacharek, Alyssa Martino, Tess Anderson, Hannah Spencer, Paola Odriozola, Georgia F. Spurrier, Alexis Broussard, Carla E. Marin, Wendy K. Silverman, Eli R. Lebowitz, Dylan G. Gee