Mood and Anxiety Disorders in Children and Youth: The Role of Parenting and Child Temperament and Implications for Early Identification and Prevention

In this chapter, we review theory and evidence pertaining to the complex associations between parenting, offspring temperament, and offspring risk for internalizing disorders, including major depression and anxiety disorders. Understanding these complex associations is important for multiple reasons. First, a large body of literature has confirmed that individual differences in children’s and youths’ temperament or pertsonality traits can elucidate which youth are potentially vulnerable to internalizing disorders. More recent research has also begun to clarify the complex pathways and interactions with environmental factors, such as parenting and life stress, through which temperament may confer risk for internalizing disorders. It is also well-established that internalizing disorders are frequently heterogeneous in terms of the nature and severity of symptom presentation. Children’s personality traits may be useful in understanding this heterogeneity as certain traits may be associated with a relatively more or less severe presentation or course of a disorder. Moreover, identifying parenting behaviors or styles that confer risk for the development of maladaptive temperament traits may lead to interventions to prevent the development of these maladaptive traits, and potentially mitigate the vulnerability to mood and anxiety disorders. There is additional evidence that personality traits may be useful in tailoring treatment approaches as well as predicting who will best respond best to different therapeutic approaches. Here, we review specific models pertaining to parenting, temperament, and internalizing disorders grounded in psychoanalytic, humanistic, and cognitive–behavioral perspectives as well as developmental, social, and personality psychologists’ theories related to parenting and temperamental development. Throughout this chapter, we adopt a dynamic-interactionist framework that considers the complex interactions between these factors, as opposed to models that view one factor as simply an outcome of another. We review evidence regarding the influence of parenting on the development of children’s temperamental traits, and evidence that children’s traits are not only linked to internalizing symptoms but these traits also predict increases in symptoms over time as well as the onset of diagnosable episodes of internalizing disorders. However, we also review a growing body of literature that suggests children’s temperament traits and symptoms influence the parenting they receive, thus creating a pernicious cycle. We then review a large body of research examining diathesis-stress models, or the possibility that individual differences in personality traits may exacerbate or buffer the effects of parenting on psychopathological outcomes. We also consider evidence that mood and anxiety disorders may have a “scarring” effect on children’s temperament traits. Additionally, we discuss evidence about “pathoplasty” models, which propose that temperament traits may contribute to the severity or pattern of symptomatology, course, and response to treatment. Next, we discuss implications for clinicians, parents, and educators in terms of the early identification and prevention of mood and anxiety disorders in youth based on the parenting they receive and the nature of their temperamental traits. We conclude with a case example elucidating these complex associations between personality traits, parenting, and the development of internalizing disorders.

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