Parental factors associated with childhood anxiety, depression, and internalizing problems: a systematic review and...

There is a burgeoning and varied literature examining the associations between parental factors and depression or anxiety disorders in children. However, there is hitherto no systematic review of this complex literature with a focus on the 5-11 years age range, when there is a steep increase in onset of these disorders. Furthermore, to facilitate the application of the evidence in prevention, a focus on modifiable factors is required.

Employing the PRISMA method, we conducted a systematic review of parental factors associated with anxiety, depression, and internalizing problems in children which parents can potentially modify.

We identified 141 articles altogether, with 53 examining anxiety, 50 examining depression, and 70 examining internalizing outcomes. Stouffer׳s method of combining p-values was used to determine whether associations between variables were reliable, and meta-analyses were conducted with a subset of eligible studies to estimate the mean effect sizes of associations between each parental factor and outcome.

Limitations include sacrificing micro-level detail for a macro-level synthesis of the literature, the lack of generalizability across cultures, and the inability to conduct a meta-analysis on all included studies.

Parental factors with a sound evidence base indicating increased risk for both depression and internalizing problems include more inter-parental conflict and aversiveness; and for internalizing outcomes additionally, they include less warmth and more abusive parenting and over-involvement. No sound evidence linking any parental factor with anxiety outcomes was found.