Anxiety Disorders: Murray L

Ramchandani PG, Stein A, O'Connor TG, Heron J, Murray L, Evans J. · Section of Child and Adolescent Psychiatry, University of Oxford, Warneford Hospital, Headington, Oxford, UK. · J Am Acad Child Adolesc Psychiatry. · Pubmed #18388761 links to  free full text

Abstract: OBJECTIVE: Postnatal depression in women is associated with adverse effects on both maternal health and children's development. It is unclear whether depression in men at this time poses comparable risks. The present study set out to assess the association between depression in men in the postnatal period and later psychiatric disorders in their children and to investigate predisposing factors for depression in men following childbirth. METHOD: A population-based cohort of 10,975 fathers and their children from the Avon Longitudinal Study of Parents and Children (ALSPAC) was recruited in the prenatal period and followed for 7 years. Paternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale and later child psychiatric disorder (DSM-IV) with the Development and Well-Being Assessment. RESULTS: Depression in fathers in the postnatal period was significantly associated with psychiatric disorder in their children 7 years later (adjusted OR 1.72, 95% CI 1.07-2.77), most notably oppositional defiant/conduct disorders (adjusted OR 1.94, 95% CI 1.04-3.61), after adjusting for maternal depression and paternal educational level. A history of severe depression and high prenatal symptom scores for depression and anxiety were the strongest predictors of paternal depression in the postnatal period. CONCLUSIONS: Depression in fathers in the postnatal period is associated with later psychiatric disorders in their children, independently of maternal postnatal depression. Further research into the risks associated with paternal psychopathology is required because this could represent an important opportunity for public health intervention.

Creswell C, Willetts L, Murray L, Singhal M, Cooper P. · School of Psychology, University of Reading, RG6 6AL, UK. · Clin Psychol Psychother. · Pubmed #19115426 No free full text.

Abstract: Anxiety disorders are common among parents of anxious children and have been found to impede child treatment outcomes, yet it is unclear whether it is parental anxiety that needs to be targeted in therapy or associated parental behaviours. Twenty-two children (6-12 years) with a current anxiety disorder and their mothers received cognitive-behavioural treatment (CBT) for child anxiety. In addition, of the 12 mothers who met criteria for a current anxiety disorder, 6 received CBT for their own disorder. Assessments were made of the mother-child interaction. The main findings were: (1) children did less well from treatment where their mothers had a current anxiety disorder; (2) treatment of maternal anxiety disorder did not improve child treatment outcome; and (3) maternal overinvolvement and expression of fear was associated with child treatment outcome. The results suggest that in the context of maternal anxiety disorder, child treatment outcome may be improved by specifically targeting parenting behaviours.

Murray L, de Rosnay M, Pearson J, Bergeron C, Schofield E, Royal-Lawson M, Cooper PJ. · Winnicott Research Unit, School of Psychology, University of Reading, 3 Earley Gate, Whiteknights, Reading, RG6 6AL, UK. · Child Dev. · Pubmed #18717906 No free full text.

Abstract: Responses to an unfamiliar adult were examined in infants of mothers with social phobia (N= 79) and infants of nonanxious comparison mothers (N= 77) at 10 and 14 months in a social referencing paradigm. On each occasion, a female stranger first interacted with the mother and then approached and interacted with the infant. Over time, infants of mothers with social phobia showed increasing avoidance of the stranger, particularly when they were behaviorally inhibited. In boys, maternal social phobia was associated with increasing fearful responses. Infant avoidance was predicted by expressed maternal anxiety and low levels of encouragement to interact with the stranger. The findings are discussed in relation to theories concerning the intergenerational transmission of social anxiety.

Murray L, Cooper P, Creswell C, Schofield E, Sack C. · Winnicott Research Unit, School of Psychology, University of Reading, UK. · J Child Psychol Psychiatry. · Pubmed #17244269 No free full text.

Abstract: BACKGROUND: Social phobia aggregates in families. The genetic contribution to intergenerational transmission is modest, and parenting is considered important. Research on the effects of social phobia on parenting has been subject to problems of small sample size, heterogeneity of samples and lack of specificity of observational frameworks. We addressed these problems in the current study. METHODS: We assessed mothers with social phobia (N = 84) and control mothers (N = 89) at 10 weeks in face-to-face interactions with their infants, and during a social challenge, namely, engaging with a stranger. We also assessed mothers with generalised anxiety disorder (GAD) (N = 50). We examined the contribution to infant social responsiveness of early infant characteristics (neonatal irritability), as well as maternal behaviour. RESULTS: Mothers with social phobia were no less sensitive to their infants during face-to-face interactions than control mothers, but when interacting with the stranger they appeared more anxious, engaged less with the stranger themselves, and were less encouraging of the infant's interaction with the stranger; infants of index mothers also showed reduced social responsiveness to the stranger. These differences did not apply to mothers with GAD and their infants. Regression analyses showed that the reduction in social responsiveness in infants of mothers with social phobia was predicted by neonatal irritability and the degree to which the mother encouraged the infant to interact with the stranger. CONCLUSIONS: Mothers with social phobia show specific parenting difficulties, and their infants show early signs of reduced social responsiveness that are related to both individual infant differences and a lack of maternal encouragement to engage in social interactions.

Coelho HF, Cooper PJ, Murray L. · Winnicott Research Unit, School of Psychology, University of Reading, 3 Earley Gate, Whiteknights, Reading, UK RG6 6AL. · J Affect Disord. · Pubmed #17113155 No free full text.

Abstract: BACKGROUND: High rates of co-morbidity between Generalized Social Phobia (GSP) and Generalized Anxiety Disorder (GAD) have been documented. The reason for this is unclear. Family studies are one means of clarifying the nature of co-morbidity between two disorders. METHODS: Six models of co-morbidity between GSP and GAD were investigated in a family aggregation study of 403 first-degree relatives of non-clinical probands: 37 with GSP, 22 with GAD, 15 with co-morbid GSP/GAD, and 41 controls with no history of GSP or GAD. Psychiatric data were collected for probands and relatives. Mixed methods (direct and family history interviews) were utilised. RESULTS: Primary contrasts (against controls) found an increased rate of pure GSP in the relatives of both GSP probands and co-morbid GSP/GAD probands, and found relatives of co-morbid GSP/GAD probands to have an increased rate of both pure GAD and co-morbid GSP/GAD. Secondary contrasts found (i) increased GSP in the relatives of GSP only probands compared to the relatives of GAD only probands; and (ii) increased GAD in the relatives of co-morbid GSP/GAD probands compared to the relatives of GSP only probands. LIMITATIONS: The study did not directly interview all relatives, although the reliability of family history data was assessed. The study was based on an all-female proband sample. The implications of both these limitations are discussed. CONCLUSIONS: The results were most consistent with a co-morbidity model indicating independent familial transmission of GSP and GAD. This has clinical implications for the treatment of patients with both disorders.

Halligan SL, Murray L, Martins C, Cooper PJ. · Winnicott Research Unit, School of Psychology, University of Reading, UK. · J Affect Disord. · Pubmed #16863660 No free full text.

Abstract: BACKGROUND: Maternal postnatal depression (PND) has been associated with adverse outcomes in young children, but an association with longer-term psychiatric disorder has not been demonstrated. We present the preliminary findings of a 13-year longitudinal study. METHODS: In the course of a prospective longitudinal study, we examined DSM-IV Axis I disorders in 13-year-old adolescents who had (n=53) or had not (n=41) been exposed to maternal PND. We also detailed the occurrence of depression in mothers throughout the 13-year follow-up period. RESULTS: Maternal PND was associated with higher rates of affective disorders in adolescent offspring. However, mothers who developed PND were also substantially more likely than those who did not to experience depression subsequently, a fact that contributed to the development of depressive disorder in offspring. Maternal PND was associated with increased risk for depression in adolescent offspring only if there had also been later episodes of maternal depression. In contrast, anxiety disorders in offspring were elevated in the maternal PND group regardless of the occurrence of subsequent maternal depression. LIMITATIONS: Due to the modest sample size and consequently limited power, findings must be regarded as preliminary. CONCLUSIONS: The particular association between early maternal depression and anxiety disorders in offspring was consistent with theories that emphasise the primacy of early environmental exposures. This position was not supported with respect to offspring depressive disorder, where overall duration of maternal depression was a significant factor. PND was associated with recurrent episodes of depression in the majority of cases, underlining the need for monitoring of this population beyond the postnatal period.

Coelho HF, Cooper PJ, Murray L. · Winnicott Research Unit, School of Psychology, University of Reading, 3 Earley Gate,Whiteknights, Reading RG6 6AL, UK. · Br J Psychiatry. · Pubmed #16507974 links to  free full text

Abstract: Previous studies have suggested that collecting psychiatric data on relatives in family studies by asking probands to provide information on them leads to a bias in estimates of morbidity risk, because probands'accounts are influenced by their own psychiatric histories. We investigated this in a UK sample and found that daughters'anxiety disorder histories did not influence their reports of anxiety disorder in mothers, but their history of mood disorder/alcohol dependence made them more sensitive in predicting mood disorder/alcohol dependence in mothers.

de Rosnay M, Cooper PJ, Tsigaras N, Murray L. · Winnicott Research Unit, School of Psychology, University of Reading, Earley Gate, Whiteknights Road, Reading RG6 6AL, UK. · Behav Res Ther. · Pubmed #16288978 No free full text.

Abstract: In this experiment we investigated the impact of indirect expressions of maternal social anxiety on infant interactions with a stranger. A social referencing paradigm was used in which infants first observed their mothers interacting with a stranger and then interacted with the stranger themselves. Mothers made no direct communicative gestures to the infant concerning the stranger throughout the procedure. There were two experimental conditions experienced by all mother-infant pairs (N = 24; 12 boys)-non-anxious and socially anxious-and there were two male strangers. Infants were between 12 and 14 months (M = 12.8, SD = .76). Order of condition and stranger presentation were counter-balanced. Before testing, mothers, none of whom were significantly socially anxious, were trained to behave in a non-anxious and a socially anxious manner on the basis of clinical and empirical descriptions of social phobia. The results showed that, compared to their responses following their mothers interacting normally with a stranger, following a socially anxious mother-stranger interaction, infants were significantly more fearful and avoidant with the stranger. Infant-stranger avoidance was further modified by infant temperament; high fear infants were more avoidant in the socially anxious condition than low-fear infants. We discuss these findings in light of the possible mechanisms underpinning infant affective and behavioral responsiveness.

Torgrud LJ, Walker JR, Murray L, Cox BJ, Chartier M, Kjernisted KD. · Department of Clinical Health Psychology, St Boniface General Hospital, Winnipeg, MB, Canada. · Cogn Behav Ther. · Pubmed #15279315 No free full text.

Abstract: Social phobia is a common anxiety disorder associated with significant impairment in social and occupational functioning. To date, few studies have examined the relationship between social phobia and perceived social support, a construct with important relationships to physical and mental health. The present study examined data from 2 widely used measures of perceived social support administered to 132 individuals with DSM-IV generalized social phobia. These data were compared with those obtained from a healthy control group and from several clinical and non-clinical samples reported in the literature. Persons with generalized social phobia scored significantly lower on both measures of social support compared with all other groups. It is suggested that deficits in perceived social support associated with generalized social phobia may play a role in the development of co-morbid problems and should be explicitly targeted by treatments for social phobia. Low correlations between perceived social support and social anxiety measures suggest that perceived support should be specifically evaluated in this population.