Parental styles and long-term outcome following treatment for anxiety disorders

Poor parenting has long been associated with the diagnosis of anxiety and mood disorders, but it is not clear whether perceived parenting can predict long-term outcome following treatment. The shortened Parental Bonding Instrument (PBI) was examined in respect to outcome, 3-14 years after initial treatment, in a group of patients having an original diagnosis of generalized anxiety, panic or post-traumatic stress disorder. All patients had been entered into one of six controlled clinical treatment trials between 1985 and 1999, which had compared cognitive behavioural therapy with other forms of treatment including psychotherapy, medication and placebo. Significantly lower levels of paternal care and higher levels of parental control were reported by patients still having a clinical diagnosis at long-term follow-up compared with those with no diagnosis. In addition, the parental style of 'affectionless control' (i.e. low care/high control) from either parent was over-represented in those with a diagnosis at long-term follow-up. However, only maternal control was significant for male patients, whilst only paternal care and control were significant for females. Findings on a subgroup of patients, who completed the PBI both pre-treatment and at long-term follow-up, suggest the results are not due to changes in clinical status affecting recall in the recovered patients. Copyright (C) 2004 John Wiley Sons, Ltd.