Family Accommodation and Preschool Dysregulated Fear Interact to Predict Child Anxiety

Family accommodation, or behaviors that parents enact to alleviate or prevent child anxiety, has been linked to child anxiety severity. Accommodation has also been implicated in the etiology and maintenance of child anxiety. Preschool children, who may show early anxiety symptoms, may be particularly impacted by accommodation when they show temperamental predisposition towards anxiety. Dysregulated fear, characterized by displays of fear and shyness in low-threat contexts, has emerged as a temperamental construct that highlights risk for anxiety. Typically studied in toddlerhood, dysregulated fear has not been operationalized in preschool children. The current study examined whether dysregulated fear, measured observationally at child age 4, moderated the longitudinal relation from family accommodation at age 4 to change in child anxiety from age 4 to age 5. The sample included 138 children (44.5% female, 83.9% White/European American, 3.6% Hispanic/Latino) and their mothers. Dysregulated fear was coded as shyness and withdrawal during stranger approach and compliments tasks deemed "low threat" in comparison to a speech task. Mothers reported family accommodation at child age 4 and child anxiety at child ages 4 and 5. Controlling for age 4 anxiety and maternal age, there was an interaction between family accommodation and dysregulated fear in predicting child anxiety. Family accommodation related to child anxiety across values of, but most strongly at high, dysregulated fear. These results expand evidence of environment-temperament interactions in predicting child anxiety to include dysregulated fear in the preschool developmental period, which is aligned with evidence-based child anxiety prevention programs.