From parents to sons: vertical and environmental transmission of anxiety
DOI:
https://doi.org/10.32385/rpmgf.v39i4.13661Keywords:
Anxiety, Genetics, EnvironmentAbstract
Introduction: Anxiety is a universal feeling without constituting a disease or even an abnormality. This can assume a pathological character when it functions inappropriately, conditioning maladaptive control, more precisely, an anxiety disorder. Increasingly, the genomic and environmental influences are recognized as important in its genesis and perpetuation. Therefore, for a more holistic understanding, of the presence of an anxiety disorder, it is fundamental to have the family context available through family assessment, a practice that is often forgotten in the routine of the family physician.
Case description: In this family assessment, anxiety configures a multigenerational disorder with different expressions. This type of transmission supports the genetic and environmental components of an anxiety disorder. Three elements of a family household with anxiety disorder were evaluated: mother and two children. The genesis of the matriarch's anxiety disorder was possibly favored by a genetic predisposition, guessed by her family history, as well as by the confliction’s environment, recurrent episodes of verbal and physical violence by her husband, perpetuated by various anxiogenic events. The transmission of the anxiety disorder to the next generation would have been provided by the common environment of family violence, combined with the expression of maternal anxiety through the non-verbal component, by the physical expression of anxiety, instructional by the alarmism for the different situations of danger that operate throughout the day and behavioral by avoiding new situations. Interestingly, although the genesis of the anxiety disorder and the initial symptoms of both children were common, individual predisposition and subsequent anxiogenic events shaped them differently, both in the manifestation of anxiety and in its management.
Comments: General and family medicine occupies a privileged position in the individual and family evaluation of this pathology. Like this family, it is considered that many Portuguese families have the same characteristics and that proper attention is still not given to this chain of transmission of psychopathology. The active search for family factors that increase the risk of anxiety disorders and valuing anxiety disorders as psychopathologies with great individual, family, and social impact is essential. Appropriate treatment of anxiety disorders in one generation can reduce their prevalence in future generations.
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References
Sadock BJ, Sadock VA, Ruiz P. Kaplan and Sadock’s comprehensive textbook of psychiatry. 10th ed. Wolters Kluwer; 2017. ISBN 9781451100471
Waszczuk MA, Zavos HM, Eley TC. Genetic and environmental influences on relationship between anxiety sensitivity and anxiety subscales in children. J Anxiety Disord. 2013;27(5):475-84.
Gross C, Hen R. Genetic and environmental factors interact to influence anxiety. Neurotox Res. 2004;6(6):493-501.
Harrison P, Cowen P, Burns T, Fazel M. Shorter Oxford textbook of psychiatry. 7th ed. Oxford: Oxford University Press; 2017. ISBN 9780191064616
Murray L, De Rosnay M, Pearson J, Bergeron C, Schofield E, Royal-Lawson M, et al. Intergenerational transmission of social anxiety: the role of social referencing processes in infancy. Child Dev. 2008;79(4):1049-64.
Feinman S, Roberts D, Hsieh KF, Sawyer D, Swanson D. A critical review of social referencing in infancy. In: Feinman S, editor. Social referencing and the social construction of reality in infancy. New York: Springer; 1992. p. 15-54. ISBN 9781489924629
Feinman S. Social referencing in infancy. Merrill Palmer Q. 1982;28(4):445-70.
Feinman S. Emotional expression, social referencing, and preparedness for learning: mother knows best, but sometimes I know better. In: Zivin G, editor. The development of expressive behaviour: biology-environment Interactions. New York: Academic Press; 1985. p. 291-318.
Aktar E, Majdandžić M, de Vente W, Bögels SM. The interplay between expressed parental anxiety and infant behavioural inhibition predicts infant avoidance in a social referencing paradigm. J Child Psychol Psychiatry. 2013;54(2):144-56.
De Rosnay M, Cooper PJ, Tsigaras N, Murray L. Transmission of social anxiety from mother to infant: an experimental study using a social referencing paradigm. Behav Res Ther. 2006;44(8):1165-75.
Ollendick TH, Vasey MW, King NJ. Operant conditioning influences in childhood anxiety. In: Vasey MW, Dadds MR, editors. The developmental psychopathology of anxiety. New York: Oxford University Press; 2001. p. 231-52. ISBN 9780195123630
Aktar E, Nikolić M, Bögels SM. Environmental transmission of generalized anxiety disorder from parents to children: worries, experiential avoidance, and intolerance of uncertainty. Dialogues Clin Neurosci. 2017;19(2):137-47.
Păsărelu CR, Dobrean A, Predescu E, Sipos R, Lupu V. Intergenerational transmission of worry a transdiagnostic factor in child internalizing symptomatology. Rom J Child Adolesc Psychiatry. 2015;3(1):5-11.
Van der Bruggen C, Stams GJ, Bögels SM. Research review: the relation between child and parent anxiety and parental control – a meta-analytic review. J Child Psychol Psychiatry. 2008;49(12):1257-69.
McLeod BD, Weisz JR, Wood JJ. Examining the association between parenting and childhood depression: a meta-analysis. Clin Psychol Rev. 2007;27(8):986-1003.
Möller EL, Nikolić M, Majdandžić M, Bögels SM. Associations between maternal and paternal parenting behaviors, anxiety and its precursors in early childhood: a meta-analysis. Clin Psychol Rev. 2016;45:17-33.
Gottschalk MG, Domschke K. Genetics of generalized anxiety disorder and related traits. Dialogues Clin Neurosci. 2017;19(2):159-68.
Goger P, Weersing VR. Family based treatment of anxiety disorders: a review of the literature (2010-2019). J Marital Fam Ther. 2022;48(1):107-28.
Vasey MW, Dadds MR. An introduction to the developmental psychopathology of anxiety. In: Vasey MW, Dadds MR, editors. The developmental psychopathology of anxiety. New York: Oxford University Press; 2001. p. 3-26. ISBN 9780195123630
Muris P. The pathogenesis of childhood anxiety disorders: considerations from a developmental psychopathology perspective. Int J Behav Dev. 2006;30(1):5-11.
Degnan KA, Almas AN, Fox NA. Temperament and the environment in the etiology of childhood anxiety. J Child Psychol Psychiatry. 2010;51(4):497-517.
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