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Child / Adolescent - Anxiety

(PS3-D95) A Psychometric Evaluation of the Parenting Anxious Kids Rating Scale in a Clinical Sample

Friday, November 17, 2023
11:30 AM – 12:30 PM PST
Location: Regency Ballroom, Level 7
Caregiver factors, such as anxiogenic parenting, are thought to maintain child anxiety symptoms and to impact the efficacy of treatment. As such, it is critical to have measures that accurately assess these approaches. The Parenting Anxious Kids Rating Scale (PAKRS; Flessner et al., 2017) was developed to measure anxiogenic parenting behaviors. The PAKRS can be interpreted in terms of its total score or in terms of 5 subscales (Overinvolvement, Accommodation, Modeling, Conflict, and Warmth/Support).  The psychometric properties of the PAKRS have been examined in community and internet samples (Flessner et al., 2017), but not in clinical populations. The current study aims to explore the psychometric properties of the PAKRS within a sample of caregivers seeking treatment for their children with a primary fear-based disorder. A secondary aim was to explore sensitivity to treatment of the PAKRS over 15 sessions of cognitive-behavioral therapy (CBT). The sample consisted of 594 caregivers (M age = 47.1 years, SD = 5.67; 76.8% married; 89.1% White) who presented for treatment with their child (M age = 13.6 years, SD = 2.67) at a specialty outpatient clinic in a psychiatric hospital. At baseline and at session 15, caregivers completed the PAKRS and children completed the Multidimensional Anxiety Scale for Children, second edition (MASC-2). Caregivers reported a moderate amount of anxiogenic parenting behaviors (M = 128.14, SD = 19.05, range = 32-224). All subscale scores were in the moderate range, except for the Modeling subscale, which was in the low range. The total PAKRS score demonstrated acceptable reliability (α = .79). Four subscales demonstrated acceptable to good reliability (Overinvolvement α = .74; Accommodation α = .66; Modeling α = .80; and Conflict α = .86), while the Warmth/Support subscale had low reliability (α = .59). Overall, anxiogenic parenting behaviors showed significant low to moderate positive correlations with MASC-2 total and subscale scores (rs: .13-.32). MASC-2 Separation Anxiety was significantly associated with Overinvolvement (r = .24) and Modeling (r = .17, p = .01), though the strength of the relationships were low. Accommodation and Warmth/Support showed low- to moderate-strength relationships with MASC-2 total and subscale scores (rs = .15-.33). Conflict was not correlated with any of the MASC-2 scores. Paired-sample t-tests found significant reductions in Accommodation between baseline and session 15, t(79) = 4.72, p < 0.001. Overall, these findings suggest that the PAKRS is a reliable and valid measure of anxiogenic parenting behaviors for caregivers of anxious children. These results comport with Flessner and colleagues’ (2017) findings of low- to moderate-strength positive associations between child anxiety and anxiogenic parenting. Future studies in clinical samples should examine the link between pre-treatment PAKRS and CBT outcome, as well as to examine the impact of reductions in anxiogenic parenting on child anxiety treatment outcomes.