Parental factors associated with childhood anxiety, depression, and internalizing problems: A systematic review and meta-analysis

Background: 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. Methods: 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. Results: 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: 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. Conclusions: 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. (C) 2015 Elsevier By, All rights reserved.