Anxiety levels in clinically referred children and their parents: Examining the unique influence of self-reported attachment styles and interview-based reflective functioning in mothers and fathers




Although much is known about childhood anxiety disorders, the differential contributions by mothers and fathers to child anxiety is poorly understood. This study examined the relation between child anxiety and parental level of psychopathology, attachment style, and reflective functioning (RF).


Thirty-eight clinically anxious children aged 7–12 years (55.3% female) referred for treatment and their parents (37 mothers, 34 fathers) participated in the study.


Reflective functioning was coded based on Adult Attachment Interviews. Self-report questionnaires on attachment and psychopathology were administered.


Paternal psychopathology, attachment avoidance, and attachment anxiety as well as maternal attachment anxiety were associated with child anxiety. Mothers had higher RF abilities than fathers. Lower levels of RF in mothers and higher levels of attachment avoidance in fathers explained 42% of the variance in anxiety levels of the child.


Mothers and fathers may provide unique contributions to the development of child anxiety. The findings highlight the importance of considering fathers as well as mothers in research and treatment for childhood anxiety disorders.

Practitioner points

  • Anxiety in children may be related to attachment avoidance in fathers and low levels of reflective functioning in mothers.
  • Fathers as well as mothers should be involved in research and treatment of childhood anxiety disorders.
  • The study is exploratory and findings must be replicated before firm conclusions can be drawn.
  • Data were derived from families whose children suffer from clinical levels of anxiety, and they may not be representative of non-clinical samples.