Perceived Barriers to Mental Health Treatment Moderates the Intergenerational Transmission of Anxiety Between Mothers and Children

• In Event: Poster Session 11
  In Poster Session: PS 11 Topic -Diversity, Equity & Social Justice

Abstract

Anxiety disorders are common in childhood and may be even more prevalent than depression and behavioral disorders (Creswell & Cartwright-Hatton, 2007). Research demonstrates a significant relationship between maternal mental health problems and children’s mental health, and this association is a public health concern among populations where economic adversity contributes to mental health problems (Letorneau, Dewey, Kaplan, & Ntanda, 2019). Individual- and family-level factors, including parenting behaviors, predict this association. Less understood are the ways that systemic barriers impact the intergenerational transmission of mental health problems. Mental health service delivery has been described as “fragmented and incomplete” where significant disparities exist for low-income and ethnoracial minority families (Bringewatt & Gershoff, 2010). Several types of barriers hinder low-income families in particular from obtaining services they need: practical, organizational, and perceptual barriers to treatment (Bornheimer, Acri, Gopalan, & McKay, 2018; Ofonedu, Belcher, Budhathoki, & Gross, 2017). In the current study, we consider the role of the mental health system, through parent report of barriers to treatment, alongside individual- and family-level factors, including family coping patterns, as moderators of the relationship between maternal and child mental health problems. Research participants (N=33) are part of a community sample of mostly African American (48.5%) and Latina (48.5%) mothers reporting low income (45% reported <$20,000 annually). Self-report measures completed by mothers measured perceived barriers to mental health treatment (BTPS; Kazdin, Holland, Crowley, and Breton, 1997), family coping (F-COPES; McCubbin, Olson, & Larsen, 1987), child (CBCL; Achenbach, 1999) and parent (BSI-18; Asner-Self, Schreiber, & Marotta, 2006) anxiety, and maternal adverse childhood experiences (ACEs; Felitti, 1998). A moderated regression (PROCESS macro, Hayes, 2013; F=4.60, p=.01, R2=.54) demonstrated a significant effect of maternal anxiety (effect =-.92, p=.02; CI [−1.72, −.13]) on children’s anxiety, controlling for income, maternal ACEs, perceived barriers to treatment (effect =-.09, p=.01; CI [−.14, −.02]). At high levels of perceived barriers to treatment, maternal anxiety was positively, significantly related to children’s anxiety (effect =.41, p=.00; CI [.22, .60]), but the relationship was non-significant at lower levels of perceived barriers to treatment (p>.05). These results were largely driven by two subscales: stressors that compete with treatment (example item: “I experience too much stress in my life to participate in treatment;”) and expected relationship with treating therapist (example item: “The therapist might question my ability to carry out treatment programs at home.”). Coping did not play a significant role in similar tests of moderation (p>.05). Neither maternal anxiety nor coping had significant direct effects on children’s anxiety without barriers to treatment in the model (p>.05). Findings are discussed within an equity framework.

Authors

• Christina DeAngelis, Wayne State University
  Presenting Author

• Brooke Wood, Wayne State University
  Non-Presenting Author

• LaKenya Johnson, Wayne State University
  Non-Presenting Author

• Tasnim Begum, Wayne State University
  Non-Presenting Author

• Hajr Muhammad, Wayne State University
  Non-Presenting Author

• Kamri Cunningham, Wayne State University
  Non-Presenting Author

• Kenicka Harper, Wayne State University
  Non-Presenting Author

• Erika London Bocknek, Wayne State University
  Non-Presenting Author