The "over-anxious" parent

This study describes the sources of anxiety in parents who report being highly anxious at pediatric visits for minor problems, despite usual management and reassurance. During a one-year period, 44 parents (0.8% of all visits; 3% of all families) were identified as "over-anxious" in a private pediatric practice. The most common sign of anxiety in these parents was the lack of satisfaction, or lack of closure, at the end of the visit. Each parent had from one to three underlying sources of anxiety in addition to the presenting complaint. The underlying sources of concern were uncovered in a brief interview and they fell into six categories: hidden agenda (28%); vulnerable child (23%); inexperienced parents (23%); psychosocially stressed parents (14%); iatrogenic anxiety (7%); and the chronically anxious parent (4%). Reassurance alone did not relieve anxiety for these parents. However, their anxiety decreased when the physician recognized and treated their specific underlying concerns. Techniques are suggested for understanding and treating "over-anxious" parents in the practice setting.