Yale Child Study Center, New Haven, CT 06520, USA.
Depress Anxiety. 2013 Jan;30(1):47-54. doi: 10.1002/da.21998. Epub 2012 Sep 10.
Family accommodation has been studied in obsessive compulsive disorder using the Family Accommodation Scale (FAS) and predicts greater symptom severity, more impairment, and poorer treatment outcomes. However, family accommodation has yet to be systematically studied among families of children with other anxiety disorders. We developed the Family Accommodation Scale-Anxiety (FASA) that includes modified questions from the FAS to study accommodation across childhood anxiety disorders. The objectives of this study were to report on the first study of family accommodation across childhood anxiety disorders and to test the utility of the FASA for assessing the phenomenon.
Participants were parents (n = 75) of anxious children from two anxiety disorder specialty clinics (n = 50) and a general outpatient clinic (n = 25). Measures included FASA, structured diagnostic interviews, and measures of anxiety and depression.
Accommodation was highly prevalent across all anxiety disorders and particularly associated with separation anxiety. Most parents reported participation in symptoms and modification of family routines as well as distress resulting from accommodation and undesirable consequences of not accommodating. The FASA displayed good internal consistency and convergent and divergent validity. Accommodation correlated significantly with anxious but not depressive symptoms, when controlling for the association between anxiety and depression. Factor analysis of the FASA pointed to a two-factor solution; one relating to modifications, the other to participation in symptoms.
Accommodation is common across childhood anxiety disorders and associated with severity of anxiety symptoms. The FASA shows promise as a means of assessing family accommodation in childhood anxiety disorders.
家庭迁就在强迫症中已经通过家庭迁就量表（FAS）进行了研究，该量表预测了更严重的症状、更多的损伤和更差的治疗效果。然而，家庭迁就在儿童其他焦虑障碍的家庭中还没有得到系统的研究。我们开发了焦虑障碍儿童的家庭迁就量表（FASA），其中包括了来自 FAS 的修改后的问题，以研究儿童焦虑障碍中的迁就现象。本研究的目的是报告关于儿童焦虑障碍家庭迁就的第一项研究，并检验 FASA 评估这一现象的效用。
参与者是来自两家焦虑症专科诊所（n=50）和一家普通门诊诊所（n=25）的焦虑儿童的父母。测量工具包括 FASA、结构化诊断访谈以及焦虑和抑郁的测量工具。
迁就在所有焦虑障碍中都非常普遍，特别是与分离焦虑有关。大多数父母报告了参与症状和改变家庭常规，以及迁就带来的困扰和不迁就的不良后果。FASA 显示了良好的内部一致性和收敛和发散效度。在控制焦虑和抑郁之间的关联后，迁就与焦虑症状显著相关，但与抑郁症状无关。FASA 的因子分析指向了一个两因素解决方案；一个与修改有关，另一个与参与症状有关。
迁就在儿童焦虑障碍中很常见，与焦虑症状的严重程度有关。FASA 有望成为评估儿童焦虑障碍中家庭迁就的一种手段。
