Mental health among the population has reached new lows. The COVID-19 pandemic had a profound and prevailing toll on the mental well-being of children, well-documented by parents, pediatricians, and psychologists. Suicide has become a leading cause of death for children above the age of 10, and mental health issues were the reason behind a surge of children’s emergency room visits during the first portion of the pandemic.
Congruently, adult mental health has plummeted in recent years with rising rates of substance use disorders, overdoses, and mental health conditions. According to the latest statistics from Mental Health America, nearly 50 million American adults are currently experiencing a mental illness, and over half do not receive any treatment.
Neither of these populations struggles in a vacuum, yet the impact of caregivers’ mental health on that of their children can range from protective to debilitating. As recent research reports, declines in pediatric mental health are strongly associated with parent-driven factors, from maltreatment to parental mental illness.
Mental Health of Primary Caregivers
The latest data from the Centers for Disease Control and Prevention (CDC) reveals alarming findings about youth mental health and the many factors that threaten it. According to the agency, 55% of participants reported experiencing emotional abuse by an adult in the home, including being insulted, put down, or sworn at. Prior to the pandemic, the rates of psychological maltreatment ranged between 10% and 30%. Up to 11% of participating youth experienced physical abuse in the home, and 29% reported a parent or other adult in their home had lost a job.
According to a 2021 study, 7.2% of children have at least one caregiver with poor mental health, 2.8% have a male caregiver, and 5.1% have a female caregiver with poor mental health. Children with any male caregiver with poor mental health were more likely to have poor general health and have at least one diagnosed mental, behavioral, or developmental disorder when compared with children with all male caregivers who had good mental health.
The findings were similar in the comparison of children with any female caregiver with poor mental health to those with all female caregivers with good mental health.
Anxiety Transmission from Parents to Offspring
A new study published in JAMA Network Open aimed to further research in this area by studying the correlation between anxiety disorders in parents and their children as well as the relative contribution of genes and environment to the condition.
The cross-sectional study evaluated 398 offspring with an average age of 11 years and a diagnosis of at least one anxiety disorder in 27% of the cohort. The most common disorders were: separation anxiety disorder in 8.6%, specific phobia in 8%,
generalized anxiety disorder in 7.8%, social anxiety disorder in 6.3%, and obsessive-compulsive disorder in 2.8%. Prevalence of anxiety disorder increased with age from 14% in participants under nine years to nearly 52% in those above 15 years.
The parental cohort had an average age of 41 and was 88% white. A total of 46% of the mothers and 23% of the fathers had anxiety disorders, which were frequently comorbid with major mood disorders. Psychiatric diagnoses for mothers and fathers included major depressive disorder (42% mothers, 24% fathers), bipolar disorder (20% and 10%), and schizophrenia (5% and 4.1%).
Same-Sex Transmission of Anxiety
Led by Barbara Pavlova, PhD, the research team found that the likelihood of lifetime anxiety disorder diagnosis in children increased proportionately with the number of parents who had the same disorder. Anxiety occurred in 24% of offspring whose parents were unaffected, in 28% of those with one anxious parent, and in 41% of those with both parents affected.
The study also reported a same-sex association in transmission rates. Children were more likely to be diagnosed with an anxiety disorder when a parent of the same sex also had the condition. The lifetime likelihood of a diagnosis in offspring was nearly three times higher when a same-sex parent had anxiety, although no significant association was noted with parents of the opposite sex.
The same-sex association was more prominent in females than males, with a mother-daughter transmission odds ratio (OR) of 3.3 and father-son OR of 2.18. This pattern was even more pronounced in children who resided with their parents.
Pavlova et al. concluded that their findings implicate that environmental factors, including vicarious learning, play a role in the intergenerational transmission of anxiety disorders.
Limitations and Implications
The study’s authors note the potential for reverse causality and the sample’s low average age as limitations. Although the genetic link in anxiety disorders is well documented, there is no genetic explanation for the same-sex transmission exhibited which adds credibility to the study’s findings. Additional research is needed to establish whether the treatment of caregiver anxiety can have a protective effect on their offspring and to further elucidate the connection between parent and child mental health.
With mental health among adults at alarmingly low levels and the ongoing youth mental health crisis, the connection between parent and child well-being is gaining attention. Recent research points to a close association between parental mental health and that of their offspring, indicating a particularly strong correlation between anxiety disorders in same-sex parent-child pairs. Further study is necessary, though, in the immediate term, comprehensive psychological interventions and expanded access to mental health resources are critical.
Addressing this crisis requires the involvement of expertly trained clinicians and functional pediatric medicine specialists to effectively mitigate threatening factors and set children up for lifetime resilience. The Pediatric Brain and Resilience Summit aims to deliver the knowledge and tools needed to serve pediatric patients’ evolving needs best while helping them thrive. Join the nation’s top-tier pediatricians and leading minds in pediatric care at the inaugural event by registering here.